Zenilman's anomaly reconsidered - Fallible reports, ceteris paribus, and other hypotheses
Zenilman's anomaly reconsidered - Fallible reports, ceteris paribus, and other hypotheses
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DOI：
10.1097/00007435-199710000-00005
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发表时间：
1997-10-01
影响因子：
3.1
通讯作者：
Miller, HG
中科院分区：
文献类型：
--
作者：
Turner, CF;Miller, HG
背景和目的：在1995年1月至2月的《性传播疾病》杂志上，Zenilman和他的同事报告说，性传播疾病(STDS)事件与自我报告的避孕套使用之间没有关联，这一异常发现引发了给编辑的一系列信件，其中一些相当激烈。本文重新考虑了Zenilman团队的结果，研究设计：进行了新的统计分析，以检验试图解释无效关联的两个假设：(1)偏离研究方案，(2)在不同报告的避孕套使用水平的研究人群中，感染事件性传播疾病的不同风险。结果：没有发现支持关于偏离研究方案和根据避孕套使用水平获得事件性传播疾病的差异风险的假设。事实上，对于报告有多个性伴侣的受访者，分析发现那些报告使用避孕套更一致的人的感染率增加，结论：对现有经验证据的重新分析不支持解释泽尼尔曼异常发现的两个最有希望的假设，报告使用避孕套的受访者在某种程度上始终与自我报告的不使用避孕套的人或不一致的使用者不同，这改变了他们感染性病的风险，从而掩盖了正确使用避孕套的保护作用，然而，正如泽尼尔曼和其他人所指出的那样，自我报告使用避孕套的错误仍然是导致这些异常结果的主要原因。当自我报告的行为数据是在包括强有力的教育活动或其他制定规范的干预措施的背景下收集时，这种错误可能会特别明显。
Background and Objectives: In the January-February, 1995 issue of Sexually Transmitted Diseases, Zenilman and colleagues reported a null association between incident sexually transmitted diseases (STDs) and self-reported condom use, That anomalous finding generated a flurry of letters to the editor, some of which were quite heated. This article reconsiders the Zenilman team's results,Study Design: New statistical analyses were conducted to test two hypotheses that sought to account for the null association: (1) deviation from study protocol, and (2) differential risks of acquiring an incident STD among segments of the study population that varied by reported level of condom use,Results: No support was found for hypotheses concerning deviation from study protocol and differential risk of acquiring an incident STD by level of condom use. Indeed, for respondents who reported multiple sexual partners, the analyses found increased rates of infection among those who reported more consistent condom use,Conclusions: Two of the most promising hypotheses for explaining Zenilman's anomalous findings are unsupported by reanalysis of the available empirical evidence, It is still possible that respondents who reported that they used condoms consistently differed from self-reported nonusers or inconsistent users in some way that altered their risk of acquiring an STD and thus obscured the protective effects of properly used condoms, Nonetheless, as Zenilman and others suggest, fallibility in self-reports of condom use remains the primary suspect as the cause of these anomalous results, Such fallibility may be particularly pronounced when self-reported behavioral data are collected in contexts that include strong educational campaigns or other norm-setting interventions.