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Bidirectional case-crossover designs for exposures with time trends

W Navidi1

  • 1Department of Mathematical and Computer Sciences, Colorado School of Mines, Golden 80401, USA. wnavidi@mines.edu

Biometrics
|June 18, 1998
PubMed
Summary

The bidirectional case-crossover design improves upon traditional methods by comparing exposures before and after an event. This approach enhances risk estimation accuracy, especially for environmental exposures, by mitigating confounding from time trends.

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Area of Science:

  • Epidemiology
  • Biostatistics

Background:

  • The case-crossover design is a valuable epidemiological tool for studying transient exposures.
  • Unidirectional control sampling in this design can introduce confounding due to time trends in exposure.

Purpose of the Study:

  • To introduce and evaluate a bidirectional case-crossover design.
  • To address confounding by time trends in case-crossover studies.

Main Methods:

  • The bidirectional case-crossover design compares exposures at failure times with exposures both before and after failure.
  • Simulation analyses were used to assess the performance of the bidirectional design.
  • The method was extended to accommodate multiple failure times.

Main Results:

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  • Bidirectional case-crossover design estimates are resistant to confounding by time trends.
  • The proposed method effectively handles environmental exposure data.
  • The design is adaptable for studies with multiple failure events.

    • Conclusions:

    • The bidirectional case-crossover design offers a robust alternative to traditional methods, particularly for environmental exposures.
    • This design enhances the reliability of risk estimates by accounting for temporal exposure patterns.