CORRELATED NONDIFFERENTIAL MISCLASSIFICATIONS OF DISEASE AND EXPOSURE - APPLICATION TO A CROSS-SECTIONAL STUDY OF THE RELATION BETWEEN HANDEDNESS AND IMMUNE DISORDERS
CORRELATED NONDIFFERENTIAL MISCLASSIFICATIONS OF DISEASE AND EXPOSURE - APPLICATION TO A CROSS-SECTIONAL STUDY OF THE RELATION BETWEEN HANDEDNESS AND IMMUNE DISORDERS
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DOI：
10.1093/ije/21.3.537
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发表时间：
1992-06-01
影响因子：
7.7
通讯作者：
LELLOUCH, J
中科院分区：
文献类型：
--
作者：
CHAVANCE, M;DELLATOLAS, G;LELLOUCH, J
在横断面研究中，暴露和健康状况的错误分类可能是相关的。例如，有些受试者可能倾向于高估暴露和疾病。如果一个错误分类的敏感性和特异性不依赖于受试者对其他变量的真实状态，则该错误分类被认为是无差别的。 两个二分变量的非微分误分类可能是相关的，如果其中一个变量被误分类的概率取决于第二个变量的分类错误的存在。模型估计的偏差引起的相关的非差分误分类的优势比，其真实值是统一的。对于大多数常见情况，当绝大多数受试者健康且未暴露时，多报的影响比少报的影响更大。它似乎是相对容易找到一个虚假的，但显着的，真实的的数据进行了分析，表明相关的非微分误分类的潜在后果是不纯粹的理论。在1676名来自普通人群的样本中，我们观察到左移与健康状况的各个方面之间存在显着关系：报告湿疹史、过去有严重健康问题的经历、目前有严重健康问题的经历、最近一个月使用止痛药或治疗循环系统问题或消化系统问题的药物，在过去一年内接受物理治疗师咨询或住院治疗。这些结果，与以前报道的许多类似的结果一样，高度暗示了信息偏差。他们不太容易解释的生物学假设，如Geschwind的理论，大脑偏侧化，比相关的错误分类，导致过度使用左手和存在的一些健康问题的健康右撇子。本报告中使用的模型支持这一假设。
In cross-sectional studies, misclassifications of exposure and of health status may be related. For instance some subjects may tend to overreport both exposure and disease. A misclassification is said to be nondifferential if the sensitivity and the specificity which characterize it do not depend on the true status of the subjects for the other variables. Nondifferential misclassifications of two dichotomic variables may be correlated if the probability of being misclassified for one of them depends on the presence of an error of classification for the second one. Models are presented to estimate the bias induced by correlated nondifferential misclassifications on an odds ratio whose true value is unity. For most usual situations, when the great majority of the subjects are healthy and nonexposed, the influence of overreporting is shown to be larger than that of underreporting. It appears to be relatively easy to find a spurious, but significant, relationship.Real data are analysed to show that the potential consequences of correlated nondifferential misclassifications are not purely theoretical. In a sample of 1676 subjects from the general population we observed significant relations between left-hand shift and various aspects of health status: reporting a history of eczema, experience of a serious health problem in the past, experience of a serious health problem presently, use during the last month of analgesics or of drugs for circulatory problems, or digestion, consultation with a physiotherapist or hospitalization during the last year. These results, as with many similar ones previously reported, are highly suggestive of an information bias. They are less easily explained by biological hypotheses, e.g. Geschwind's theory of cerebral lateralization, than by correlated misclassifications resulting from overreporting of both the use of the left hand and the existence of some health problems by healthy right-handers. The modelling used in this report supports this hypothesis.