Attrition and bias in the MRC cognitive function and ageing study: an epidemiological investigation.
Attrition and bias in the MRC cognitive function and ageing study: an epidemiological investigation.
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DOI：
10.1186/1471-2458-4-12
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发表时间：
2004-04-27
影响因子：
4.5
通讯作者：
MRC CFAS
中科院分区：
文献类型：
--
作者：
Matthews FE;Chatfield M;Freeman C;McCracken C;Brayne C;MRC CFAS
纵向研究中的任何假设都可能受到磨损和不良反应率的影响。MRC认知功能和衰老研究（MRC CFAS）是一项基于人口的纵向研究，在英格兰和威尔士的五个中心采用相同的方法，每个中心招募大约2500人。本文旨在识别两年随访访谈中潜在的偏见。最初无反应：在第二波访谈（1993-1996）期间，将未参加基线访谈的人与参加基线访谈的人的死亡率进行比较。纵向损耗：使用逻辑回归分析来检查参加两年纵波的个体与未参加的个体之间的基线差异。最初无反应：在调整年龄后，在抽样后但在基线访谈之前搬离的个体在两年内死亡的可能性是受访者的1.8倍（95%置信区间（CI） 1.3-2.4）。拒绝者的死亡率略高，但与应答者相似（优势比1.2,95%CI 1.1-1.4）。纵向损耗：由于死亡而退学的预测因素是年龄较大、男性、日常生活活动受损、自我感觉健康状况不佳、认知能力差和吸烟。同样，拒绝接受教育的人更有可能认知能力较差，但接受全日制教育的年限较短，而且更经常住在自己家里，但独居的可能性较小。农村中心的拒绝率较高。搬离或无法联系的人更可能是单身、吸烟、精神错乱或抑郁，如果在基线时住在看守控制的住所，则不太可能搬离。上述因素的纵向估计可能有偏差，特别是认知能力和从自己的家到住宅的移动估计。然而，这些差异也可能影响其他调查，特别是对健康和精神疾病的发病率和纵向影响的估计，这里显示的与消耗相关的因素是这些疾病的风险因素。所有的纵向研究都应该调查损耗，这可能有助于设计方面和具体假设的分析。
Any hypothesis in longitudinal studies may be affected by attrition and poor response rates. The MRC Cognitive Function and Ageing study (MRC CFAS) is a population based longitudinal study in five centres with identical methodology in England and Wales each recruiting approximately 2,500 individuals. This paper aims to identify potential biases in the two-year follow-up interviews. Initial non-response: Those not in the baseline interviews were compared in terms of mortality to those who were in the baseline interviews at the time of the second wave interviews (1993–1996). Longitudinal attrition: Logistic regression analysis was used to examine baseline differences between individuals who took part in the two-year longitudinal wave compared with those who did not. Initial non-response: Individuals who moved away after sampling but before baseline interview were 1.8 times more likely to die by two years (95% Confidence interval(CI) 1.3–2.4) compared to respondents, after adjusting for age. The refusers had a slightly higher, but similar mortality pattern to responders (Odds ratio 1.2, 95%CI 1.1–1.4). Longitudinal attrition: Predictors for drop out due to death were being older, male, having impaired activities of daily living, poor self-perceived health, poor cognitive ability and smoking. Similarly individuals who refused were more likely to have poor cognitive ability, but had less years of full-time education and were more often living in their own home though less likely to be living alone. There was a higher refusal rate in the rural centres. Individuals who moved away or were uncontactable were more likely to be single, smokers, demented or depressed and were less likely to have moved if in warden-controlled accommodation at baseline. Longitudinal estimation of factors mentioned above could be biased, particularly cognitive ability and estimates of movements from own home to residential homes. However, these differences could also affect other investigations, particularly the estimates of incidence and longitudinal effects of health and psychiatric diseases, where the factors shown here to be associated with attrition are risk factors for the diseases. All longitudinal studies should investigate attrition and this may help with aspects of design and with the analysis of specific hypotheses.
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