健康参与者效应:基于人群的乳腺癌病例控制研究的见解和结果
Kevin Maldonado-Cañón1,2, Annika Möhl2, Nadia Obi2,3
1Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, 111321, Bogotá, Colombia.
American journal of epidemiology
|June 25, 2024
概括
病例对照研究中的健康参与者偏见是一个问题,但这项乳腺癌研究在病例和对照中发现了类似的死亡效应. 这表明,尽管参与率低,但偏见可能是最小的.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 在病例控制研究中的低参与率可能导致健康参与者偏见.
- 这种偏见源于病例和对照之间的不同反应率,可能会扭曲研究结果.
- 评估这种偏差的大小是具有挑战性的.
研究的目的:
- 为了调查健康参与者偏见在一个大型基于人口的乳腺癌病例对照研究的影响.
- 为了评估与一般人群相比,病例和对照之间的死亡率差异.
- 根据观察到的参与率,确定是否需要偏差调整.
主要方法:
- 一项基于人口的乳腺癌病例控制研究,参与率为43.4%的对照和64.1%的病例.
- 2020年对2002-2005年期间招募的3813例病例和7335例对照进行的死亡随访.
- 对总死亡率和特定死亡原因的标准化死亡率 (SMR) 的估计.
主要成果:
- 招募时的平均年龄为63.1岁.
- 与参考人群相比,对照人群的总死亡率 (SMR=0.66) 降低了34%.
- 对于非乳腺癌死亡原因的SMR在病例 (0.70) 和对照 (0.64) 中是相似的.
- 在这两组中,高等教育与较低的SMR有关.
结论:
- 尽管参与者不同,但在乳腺癌病例和对照组中观察到类似的健康参与者效应.
- 这表明健康参与者偏见可能是最小的,不太可能显著扭曲这项特定研究的结果.
- 当基本的人口风险因子分布未知时,调整偏差的选择有限,这强调了评估其存在的重要性.
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