Assessment of Selection Bias in Clinic-Based Populations of Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study
Assessment of Selection Bias in Clinic-Based Populations of Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study
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DOI：
10.1002/pbc.21829
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发表时间：
2009-03-01
影响因子：
3.2
通讯作者：
Robison, Leslie L.
中科院分区：
文献类型：
--
作者：
Ness, Kirsten K.;Leisenring, Wendy;Robison, Leslie L.
背景。目前尚不清楚从临床样本中得出的儿童癌症幸存者中晚期效应的患病率估计在多大程度上代表了如果招募整个儿童癌症幸存者人群并对其进行特定结果评估所得出的实际估计。过程。在一项针对儿童癌症幸存者的大型回顾性队列研究中，儿童癌症幸存者研究（CCSS），将报告在癌症中心或长期随访诊所就诊的参与者中慢性健康状况的患病率与整个队列中慢性疾病的患病率进行比较。结果。当比较10名在过去2年内没有接受过医疗护理的幸存者时，接受医疗跟踪治疗的幸存者患慢性疾病的可能性明显更高。如果在癌症中心或长期随访诊所就诊，报告慢性健康状况的相对风险为1.4 (95% CI: 1.3-1.5)，如果在普通医疗机构就诊，报告慢性健康状况的相对风险为1.2 （959% CI: 1.1-13）。仅从那些在癌症中心或长期随访诊所就诊的儿童癌症幸存者中得出的估计值高估了任何慢性病的患病率9.3% （95% CI: 7.0-11.6）。结论。将临床人群的慢性病患病率估计应用于儿童癌症幸存者的一般人群必须谨慎进行。生存研究必须保持高水平的科学严谨性，以确保结果；在文献报道中被解释在适当的上下文中。儿科血癌2009；52:37 79-386。(C) 2008 Wiley-Liss, Inc。
Background. It is not known to what extent prevalence estimates of late effects among childhood cancer survivors derived from clinic based samples represent file actual estimates that would he derived if the entire Population of childhood cancer survivors was recruited and evaluated for I particular Outcome. Procedure. In a large retrospective cohort study of childhood cancer survivors, the Childhood Cancer Survivor Study (CCSS), the prevalence of chronic health conditions among participants who reported being seen in a cancer center or long-term follow-up clinic was compared to the prevalence of chronic conditions in the entire cohort. Results. When compared 10 Survivors who had no medical care in the previous 2 years, Survivors accessing medical follow-Lip wore significantly more likely to have chronic health conditions. Relative risks of reporting a chronic health condition were 1.4 (95% CI: 1.3-1.5) if seen in a cancer center or long-term follow-up clinic and 1.2 (959% CI: 1.1-13) if seen in I general meclical care setting. Estimates derived from only those childhood cancer Survivors who were seen in a cancer center or long-term follow-up clinic overestimate the prevalence of any chronic disease by 9.3% (95% CI: 7.0-11.6). Conclusions. Applying chronic condition prevalence estimates from a clinical population to the general population of childhood cancer Survivors must be undertaken with caution. survivorship research must maintain a high level of scientific rigor to ensure that result,; reported in the literature are interpreted within the appropriate context. Pediatr Blood Cancer 2009;52:379-386. (C) 2008 Wiley-Liss, Inc.