Association of attrition with mortality: findings from 11 waves over three decades of the Whitehall II study.
Association of attrition with mortality: findings from 11 waves over three decades of the Whitehall II study.
复制标题
DOI：
10.1136/jech-2019-213175
复制
发表时间：
2020-10
影响因子：
6.3
通讯作者：
Shipley MJ
中科院分区：
文献类型：
--
作者：
Akasaki M;Kivimäki M;Steptoe A;Nicholas O;Shipley MJ
随着研究的进展，参与者的流失，是纵向研究中一个相当大的挑战。本研究在多波纵向研究中考察了两种形式的消耗，“退出”（正式停止参与）和“无反应”（继续参与研究的参与者无反应）是否与死亡率有不同的关联，以及这些关联是否随时间而不同。参与者是10012名公务员，他们参加了白厅II队列研究的基线，在平均28年的随访中有11个数据波。我们进行了竞争风险分析来估计亚分布风险比和95%置信区间，并进行了似然比检验来检验两种形式的损耗之间的风险是否不同。然后，我们应用线性回归来检查任何随时间变化的危险趋势。数据收集的流失率在13%到34%之间。共有495人死于心血管疾病，1367人死于其他原因。因减员而死亡的研究参与者的心血管和非心血管死亡风险分别是应答者的1.55倍（95%可信区间1.26至1.89）和1.56倍（1.39至1.76）。停药和无反应的风险在心血管（p值= 0.28）或非心血管死亡率（p值= 0.38）方面没有差异。在11个波中，风险无线性趋势（心血管死亡率p值= 0.11，非心血管死亡率p值= 0.61）。在纵向研究中，损耗可能是导致选择偏差的一个问题。研究人员应该检查选择偏差的可能性，并考虑应用统计学方法来最小化这种偏差。
Attrition, the loss of participants as a study progresses, is a considerable challenge in longitudinal studies. This study examined whether two forms of attrition, “withdrawal” (formal discontinued participation) and “non-response” (non-response among participants continuing in the study) have different associations with mortality, and whether these associations differed across time in a multi-wave longitudinal study. Participants were 10 012 civil servants who participated at the baseline of the Whitehall II cohort study with 11 data waves over average follow-up of 28 years. We performed competing-risks analyses to estimate sub-distribution hazard ratios and 95% confidence intervals, and likelihood ratio tests to examine whether hazards differed between the two forms of attrition. We then applied linear regression to examine any trend of hazards against time. Attrition rate at data collections ranged between 13% and 34%. There were 495 deaths recorded from cardiovascular disease and 1367 deaths from other causes. Study participants lost due to attrition had 1.55 (95% confidence interval 1.26 to 1.89) and 1.56 (1.39 to 1.76) times higher hazard of cardiovascular and non-cardiovascular mortality than responders respectively. Hazards for withdrawal and non-response did not differ for either cardiovascular (p-value = 0.28) or non-cardiovascular mortality (p-value = 0.38). There was no linear trend in hazards over the 11 waves (cardiovascular mortality p-value = 0.11, non-cardiovascular mortality p-value = 0.61). Attrition can be a problem in longitudinal studies resulting in selection bias. Researchers should examine the possibility of selection bias and consider applying statistical approaches that minimise this bias.
登录
查看更多内容
影响因子：
1.9
作者：
Daniel RM;De Stavola BL;Cousens SN;Vansteelandt S
通讯作者：
Vansteelandt S
影响因子：
4
作者：
Gustavson, Kristin;Roysamb, Espen;Borren, Ingrid
通讯作者：
Borren, Ingrid
影响因子：
8.3
作者：
Damen, Nikki L.;Versteeg, Henneke;Boersma, Eric
通讯作者：
Boersma, Eric
影响因子：
7.2
作者：
Candido, Elisa;Kurdyak, Paul;Alter, David A.
通讯作者：
Alter, David A.
影响因子：
7.2
作者：
Goldberg, Marcel;Chastang, Jean Francois;Leclerc, Annette
通讯作者：
Leclerc, Annette