Case-control studies on venous thromboembolism: bias due to design? A methodological study on venous thromboembolism and steroid hormone use
Case-control studies on venous thromboembolism: bias due to design? A methodological study on venous thromboembolism and steroid hormone use
复制标题
DOI：
10.1016/s0010-7824(01)00309-2
复制
发表时间：
2002-03-01
期刊：
影响因子：
2.9
通讯作者：
Thiel, C
中科院分区：
文献类型：
--
作者：
Heinemann, LAJ;Lewis, MA;Thiel, C
这项研究解决了静脉血栓栓塞症(VTE)流行病学研究的方法学问题，以显示设计决策如何影响结果。在VTE风险和口服避孕药(OC)使用的病例对照研究中，研究了对住院和“特发性”VTE病例的限制对VTE的影响以及由此产生的偏差潜力。从1994年到1999年，对德国21个中心1068例VTE疑似病例的诊断过程和OC暴露进行了跟踪调查，并与人群和医院对照进行了评估。在606例确诊病例中，385例(65.5%)住院，168例(27.7%)为“特发性”。比较使用OCS和不使用OCS的患者，所有病例和对照组的VTE风险的优势比(OR)分别为3.38和5.44。在住院病例和对照组中，“特发性”VTE的OR分别为3.72和9.1。第三代OCS与第二代OCS的风险比在医院基础上增加，但在人口基础上没有增加。结论是，限制住院事件和排除某些病例高估了OCS的VTE风险。在VTE和类固醇激素使用的病例对照研究中，需要就方法学标准和定义达成循证共识。(C)2002 Elsevier Science Inc.保留所有权利。
This study addressed methodological issues of epidemiologic studies on venous thromboembolism (VTE) to show how design decisions can affect the results. It examines the influence of a restricting to hospitalized and to "idiopathic" cases of VTE in case-control studies on VTE risk and oral contraceptive (OC) use and thereby the bias potential. The diagnostic processes and OC exposures of 1068 suspected cases of VTE were followed in 21 German centers from 1994 to 1999 and evaluated compared to population and hospital controls.Of 606 confirmed cases, 385 (65.5%) were hospitalized, 168 (27.7%) were "idiopathic." Comparing users versus nonusers of OCs, the odds ratio (OR) for VTE risk for all cases and controls was 3.38 and 5.44 for "idiopathic" VTE. For hospital cases and controls, the OR was 3.72 and 9.1 for "idiopathic" VTE. The risk ratio for third- vs. second-generation OCs was increased in the hospital base but not in the population base.It was concluded that restriction to hospitalized events and exclusions of certain cases overestimate the VTE risk of OCs. An evidence-based consensus on methodological standards and definitions in case-control studies on VTE and steroid hormone use is required. (C) 2002 Elsevier Science Inc. All rights reserved.