The nested case-control study in cardiology
The nested case-control study in cardiology
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DOI：
10.1016/s0002-8703(03)00512-x
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发表时间：
2003-10-01
影响因子：
4.8
通讯作者：
Pilote, L
中科院分区：
文献类型：
--
作者：
Essebag, V;Genest, J;Pilote, L
背景巢式病例对照研究是一种有效的流行病学设计，即在一个已建立的队列中采用病例对照方法。大量最近的前瞻性研究和随机试验进行心脏病学提供队列内巢式病例对照方法越来越多地used.Methods本文介绍了巢式病例对照研究的设计，并评估其在心脏病学的作用，通过审查所有这些研究索引Medline从1966年至2000年。以同型半胱氨酸为例说明巢式病例对照研究结果之间的差异，并说明巢式病例对照研究在国家和国际组织的决策和建议中发挥了重要作用。自1987年首次出版以来，每年的研究报告数量一直在增加。大多数（96%）研究评估了心血管疾病的潜在风险因素，而其余研究评估了具有心脏不良反应的药物。在同型半胱氨酸和冠状动脉疾病的研究中，巢式病例对照研究并没有证实早期病例对照研究所提出的强相关性，这些研究可能受到偏倚（例如，选择、发表或反向因果关系）的影响。这导致国家和国际组织反对常规screen.Conclusions巢式病例对照研究越来越多地用于心脏病学因果关系的研究。前瞻性研究、临床试验和管理数据库所创建的大量心脏病患者队列应使用该方法来评估潜在的心脏病风险因素和其他无法在随机试验中研究的因果关系。
Background The nested case-control study is an efficient epidemiological design whereby a case-control approach is employed within an established cohort. The large number of recent prospective studies and randomized trials conducted in cardiology provide cohorts within which the nested case-control approach is increasingly used.Methods This paper describes the design of the nested case-control study, and evaluates its role in cardiology by reviewing all such studies indexed in Medline from 1966 to 2000. The example of homocysteine is used to illustrate bow discrepancies between results of nested case-control and case-control studies played an important role in the decisions and recommendations of national and international organizations.Results Seventy-seven nested case-control studies in cardiology were reviewed. The number of studies per year has been increasing since the first publication in 1987. The majority (96%) of studies evaluated potential risk factors for cardiovascular disease while the remainder evaluated drugs with cardiac adverse effects. In studies of homocysteine and coronary artery disease, nested case-control studies did not confirm the strong association suggested by early case-control studies that may have been influenced by bias (eg, selection, publication, or reverse causality). This led national and international organizations to advise against routine screening.Conclusions The nested case-control study is increasingly used to study causal relationships in cardiology. The large cohorts of cardiac patients created by prospective studies, clinical trials, and administrative databases should be exploited using this methodology to assess potential cardiac risk factors and other causal relationships that cannot be studied in randomized trials.