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Background: Case-control studies have been used extensively in determining the aetiology of rare diseases. However, case-control studies often suffer from participation bias in the control group, resulting in biased odds ratios that cause problems with interpretation. Participation bias can be hard to detect and is often ignored. Methods: Population data can be used in place of the possibly biased control group, to investigate whether participation bias may have affected the results in previous studies, or in place of controls in future studies. We demonstrate this approach by reanalysing and comparing the results of two case-control studies: Type 1 diabetes in Yorkshire children and stroke in Indian adults. Findings: Using population data to represent the control groups reduced the width of the confidence intervals given in the original studies and confirmed the findings for the two diabetes risk factors used; caesarean birth odds ratio OR = 2.12 1.53, 2.95 compared with 1.84 1.09, 3.10 and amniocentesis OR = 3.38 2.09, 5.47 compared with 3.85 1.34, 11.04. The three stroke risk factors investigated were found to have increased odds ratios when using population data; hypertension OR = 5.645 5.639, 5.650 compared with 3.807 2.114, 6.856, diabetes OR = 12.212 12.200, 12.224 compared with 3.473 1.757, 6.866 and smoking OR = 5.701 5.696, 5.707 compared with 2.242 1.255, 4.005. Interpretation: Participation bias can greatly affect the results of a study and cause some potential risk factors to be over-or underestimated. This approach allows previous studies to be investigated for participation bias and presents an alternative to a control group in future studies, while improving precision.

KEYWORDS

Case-Control, Diabetes, Participation Bias, Stroke, Selection Bias

Cite this paper

Keeble, C. , Barber, S. , Baxter, P. , Parslow, R. and Law, G. 2014 Reducing Participation Bias in Case-Control Studies: Type 1 Diabetes in Children and Stroke in Adults. Open Journal of Epidemiology, 4, 129-134. doi: 10.4236-ojepi.2014.43018.





Autor: Claire Keeble, Stuart Barber, Paul David Baxter, Roger Charles Parslow, Graham Richard Law

Fuente: http://www.scirp.org/



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