Accounting for Outcome Misclassification in Estimates of the Effect of Occupational Asbestos Exposure on Lung Cancer Death
Accounting for Outcome Misclassification in Estimates of the Effect of Occupational Asbestos Exposure on Lung Cancer Death
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DOI：
10.1093/aje/kwt309
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发表时间：
2014-03-01
影响因子：
5
通讯作者：
Richardson, David B.
中科院分区：
文献类型：
--
作者：
Edwards, Jessie K.;Cole, Stephen R.;Richardson, David B.
在石棉对健康影响的研究中，肺癌死亡可能会被错误分类。我们采用修正的最大似然法，在南卡罗来纳州查尔斯顿的一项纺织工人队列研究中，探讨了结果错误分类对肺癌死亡率比的影响，该队列研究的时间为1940年至2001年。率比的标准协变量调整估计值为1.94（95%置信区间：1.55，2.44），当我们假设结局分类的特异性为0.98时，修改的最大似然法产生了类似的结果。假设敏感性为0.80，特异性为0.95，估计的率比进一步偏离零值，精确度较低（率比= 2.17; 95%置信区间：1.59，2.98）。在目前的情况下，石棉对肺癌死亡影响的标准估计数与考虑到有限错误分类的估计数相似。然而，需要使用修改的最大似然法进行敏感性分析，以验证标准估计的稳健性，这种方法将在错误分类较多的情况下提供无偏估计。
In studies of the health effects of asbestos, lung cancer death is subject to misclassification. We used modified maximum likelihood to explore the effects of outcome misclassification on the rate ratio of lung cancer death per 100 fiber-years per milliliter of cumulative asbestos exposure in a cohort study of textile workers in Charleston, South Carolina, followed from 1940 to 2001. The standard covariate-adjusted estimate of the rate ratio was 1.94 (95% confidence interval: 1.55, 2.44), and modified maximum likelihood produced similar results when we assumed that the specificity of outcome classification was 0.98. With sensitivity assumed to be 0.80 and specificity assumed to be 0.95, estimated rate ratios were further from the null and less precise (rate ratio = 2.17; 95% confidence interval: 1.59, 2.98). In the present context, standard estimates for the effect of asbestos on lung cancer death were similar to estimates accounting for the limited misclassification. However, sensitivity analysis using modified maximum likelihood was needed to verify the robustness of standard estimates, and this approach will provide unbiased estimates in settings with more misclassification.