Improving the efficiency of nested case-control studies of interaction by selecting controls using counter matching on exposure
Improving the efficiency of nested case-control studies of interaction by selecting controls using counter matching on exposure
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DOI：
10.1093/ije/dyh097
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发表时间：
2004-06-01
影响因子：
7.7
通讯作者：
Nakachi, K
中科院分区：
文献类型：
--
作者：
Cologne, JB;Sharp, GB;Nakachi, K
背景：在整个队列中测量的暴露于危险因素的影响的研究可以通过嵌套的病例对照亚组来加强，以调查未对所有队列成员进行实际评估的其他因素的混淆或影响修改。我们比较了三种控制选择策略——暴露匹配、暴露反匹配和随机抽样——以确定在暴露是已知的、连续变量和高剂量罕见的情况下，哪种策略最有效。方法：在一项原子弹辐射暴露和血清雌二醇水平对乳腺癌的联合影响的计划病例对照研究中，我们使用四种对照病例比（1:1,2:1,4:1和8:1）来估计检测相互作用的能力。辐射剂量是在整个队列中测量的，但由于既不知道血清雌二醇水平也不知道相互作用的真实程度，我们模拟了雌二醇的值和假设的雌二醇-辐射相互作用的水平。结果与随机抽样相比，与两个或多个对照进行匹配或反匹配时，检测相互作用的能力同样更高。由于反匹配通常至少与随机抽样一样有效，而暴露匹配可能导致效率的损失，并排除暴露风险的估计，我们建议在多个危险因素联合效应的巢式病例对照研究中选择对照时，如果之前在整个队列中测量过一个，则使用反匹配。
Background Studies of the effect of exposure to a risk factor measured in an entire cohort may be augmented by nested case-control subsets to investigate confounding or effect modification by additional factors not practically assessed on all cohort members. We compared three control-selection strategies-matching on exposure, counter matching on exposure, and random sampling-to determine which was most efficient in a situation where exposure is a known, continuous variable and high doses are rare.Methods We estimated the power to detect interaction using four control-to-case ratios (1:1, 2:1, 4:1, and 8:1) in a planned case-control study of the joint effect of atomic bomb radiation exposure and serum oestradiol levels on breast cancer. Radiation dose is measured in the entire cohort, but because neither serum oestradiol level nor the true degree of interaction was known, we simulated values of oestradiol and hypothetical levels of oestradiol-radiation interaction.Results Compared with random sampling, power to detect interaction was similarly higher with either matching or counter matching with two or more controls.Conclusions Because counter matching is generally at least as efficient as random sampling, whereas matching on exposure can result in loss of efficiency and precludes estimation of exposure risk, we recommend counter matching for selecting controls in nested case-control studies of the joint effects of multiple risk factors when one is previously measured in the full cohort.