Case-control studies: research in reverse
Case-control studies: research in reverse
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DOI：
10.1016/s0140-6736(02)07605-5
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发表时间：
2002-02-02
期刊：
影响因子：
168.9
通讯作者：
Grimes, DA
中科院分区：
文献类型：
--
作者：
Schulz, KF;Grimes, DA
流行病学家从病例对照研究设计中获益匪浅。与其他研究设计相比，病例对照研究可以用相对较少的时间、金钱和精力获得重要的科学发现。这条看似快速的研究成果之路吸引了许多新培训的流行病学家。事实上，研究者实施病例对照研究的频率比任何其他分析性流行病学研究都要高。不幸的是，病例对照设计也往往比其他比较研究更容易受到偏倚的影响。虽然容易做，但也更容易做错。五个主要概念指导进行病例对照研究的研究者或评估病例对照研究的读者。首先，研究者必须明确定义病例诊断标准和用于选择的任何合格标准。第二，对照组应来自与病例相同的人群，其选择应独立于感兴趣的风险敞口。第三，研究者应该让数据收集者对受试者的病例或对照状态保持盲态，或者如果不可能，至少让他们对研究的主要假设保持盲态。第四，数据收集者需要接受全面培训，以类似的方式从病例和对照组中引出暴露;他们应该使用记忆辅助工具来促进和平衡病例和对照组之间的回忆。最后，研究者应该在病例对照研究中解决混杂问题，无论是在设计阶段还是使用分析技术。对这些问题的细致关注增强了研究结果的有效性，并增强了读者对研究结果的信心。
Epidemiologists benefit greatly from having case-control study designs in their research armamentarium. Case-control studies can yield important scientific findings with relatively little time, money, and effort compared with other study designs. This seemingly quick road to research results entices many newly trained epidemiologists. Indeed, investigators implement case-control studies more frequently than any other analytical epidemiological study. Unfortunately, case-control designs also tend to be more susceptible to biases than other comparative studies. Although easier to do, they are also easier to do wrong. Five main notions guide investigators who do, or readers who assess, case-control studies. First, investigators must explicitly define the criteria for diagnosis of a case and any eligibility criteria used for selection. Second, controls should come from the same population as the cases, and their selection should be independent of the exposures of Interest. Third, investigators should blind the data gatherers to the case or control status of participants or, if impossible, at least blind them to the main hypothesis of the study. Fourth, data gatherers need to be thoroughly trained to elicit exposure in a similar manner from cases and controls; they should use memory aids to facilitate and balance recall between cases and controls. Finally, investigators should address confounding in case-control studies, either In the design stage or with analytical techniques. Devotion of meticulous attention to these points enhances the validity of the results and bolsters the reader's confidence in the findings.