Study Protocol, Sample Characteristics, and Loss to Follow-Up: The OPPERA Prospective Cohort Study
Study Protocol, Sample Characteristics, and Loss to Follow-Up: The OPPERA Prospective Cohort Study
复制标题
DOI：
10.1016/j.jpain.2013.06.006
复制
发表时间：
2013-12-01
期刊：
影响因子：
4
通讯作者：
Slade, Gary D.
中科院分区：
文献类型：
--
作者：
Bair, Eric;Brownstein, Naomi C.;Slade, Gary D.
在研究诸如颞下颌紊乱（TMD）等疼痛状况的发生率时，在前瞻性队列研究中需要反复监测。然而，监测方法通常有局限性，而且经过多年的随访，一些损失是不可避免的。首次发病TMD的OPPERA前瞻性队列研究使用季度调查问卷筛选症状，并对有症状的参与者进行检查，以明确确定TMD的发病率。在中位2.8年的观察期中，3263名受试者中有16%未完成随访问卷，其余受试者随访不完整，三分之一的症状发作未进行检查。虽然发现筛选方法和检查具有良好的信度和效度，但它们并不完善。随访损失根据一些假定的TMD危险因素而有所不同，尽管修正问题的多重归算表明偏差最小。第二种多重归因方法评估了与遗漏和可疑检查相关的偏倚，结果显示，用于量化风险因素影响的风险比中存在轻微低估和一些小偏差。虽然“底线”统计结论不受影响，但在评估OPPERA研究中调查的大量风险因素时，应考虑多重估算。(C) 2013年由美国疼痛学会出版
When studying incidence of pain conditions such as temporomandibular disorder (TMD), repeated monitoring is needed in prospective cohort studies. However, monitoring methods usually have limitations and, over a period of years, some loss to follow-up is inevitable. The OPPERA prospective cohort study of first-onset TMD screened for symptoms using quarterly questionnaires and examined symptomatic participants to definitively ascertain TMD incidence. During the median 2.8-year observation period, 16% of the 3,263 enrollees completed no follow-up questionnaires, others provided incomplete follow-up, and examinations were not conducted for one third of symptomatic episodes. Although screening methods and examinations were found to have excellent reliability and validity, they were not perfect. Loss to follow-up varied according to some putative TMD risk factors, although multiple imputation to correct the problem suggested that bias was minimal. A second method of multiple imputation that evaluated bias associated with omitted and dubious examinations revealed a slight underestimate of incidence and some small biases in hazard ratios used to quantify effects of risk factors. Although "bottom line" statistical conclusions were not affected, multiply-imputed estimates should be considered when evaluating the large number of risk factors under investigation in the OPPERA study. (C) 2013 by the American Pain Society