Recall and Survivor Bias: Impact on SES-CVD Associations

描述（由申请人提供）：本修订申请于2004年1月107日首次提交（R 01 HL 81627 - 01 A1），旨在研究不利的早期社会经济地位（SES）对成年期慢性疾病发展的影响，是流行病学研究的当前关注领域。早期生活SES往往是在中年使用父亲的职业进行评估，但很少有人做这些代理方法的准确性进行评估。此外，早期生活SES有时在队列开始后才确定，这可能会导致有偏见的发现，因为SES较低的人失访和死亡率往往更高。我们将在生命历程SES，社会背景和心血管疾病（LC-SES）研究的背景下解决这些问题，该研究收集了基线后约15年的中年和老年参与者队列幸存者的早期生活SES。该研究的第一个目的是从大约2800名死者的历史记录（出生和死亡证明，社会保障记录和个人人口普查记录）中获取早期生活SES数据，其中许多人在参与LC-SES研究之前就去世了。第二个目的是评估从历史记录中获得的早期生活SES与参与LC-SES研究后死亡的死者子集中回顾性回忆的早期生活SES的可比性。然后将这些数据用于敏感性分析，以评估召回错误的影响（如果有）。第三项研究的目的是比较解决缺失的早期生活SES数据的方法（完整的病例分析，多重插补分析和历史记录分析）。方法学比较将用于评估生存偏倚在整个生命过程中SES与成年中后期CVD相关健康状况之间的相关性研究中的影响。总之，拟议的研究旨在提供验证数据回顾性获得的早期生活SES和提供估计的潜在规模的回忆错误和生存偏倚，这两个将是宝贵的贡献，在生命历程研究的一个不足的领域。

DESCRIPTION (provided by applicant): This revised application, first submitted on 107/01/04 (R01 HL81627-01A1), which proposes to investigate the contribution of adverse early life socioeconomic status (SES) to the development of chronic diseases in adulthood, is a current area of interest in epidemiologic research. Early life SES is often assessed at midlife using father's occupation but little has been done to evaluate the accuracy of these proxy approaches. Further, early life SES is sometimes ascertained after a cohort's inception, which creates the potential for biased findings since loss to follow-up and mortality tend to be greater among those with lower SES. We will address these issues in the context of the Life Course SES, Social Context, and Cardiovascular Disease (LC-SES) Study, which collected early life SES from survivors of a cohort of middle-aged and older participants about 15 years after baseline. The first aim of the study is to acquire early life SES data from historical records (birth and death certificates, social security records and individual census records) for approximately 2800 decedents, many of whom died prior to participating in the LC-SES Study. The second aim is to assess the comparability of early life SES obtained from historical records to retrospectively recalled early life SES in the subset of decedents who died after participating in the LC-SES Study. This data will be then used in sensitivity analyses to assess the impact, if any, of recall error. The third study aim is to compare methods for addressing missing early life SES data (complete case analysis, multiple imputation analysis, and historical record analysis). The comparison of methodologies will be used to assess the impact of survivorship bias in studies of the association between SES across the life course on CVD-related health conditions in mid to later adulthood. In summary, the proposed study seeks to provide validation data on retrospectively obtained early life SES and to provide estimates of the potential magnitude of recall error and survivorship bias; both would be valuable contributions to an understudied area in life course research.