Grimes David A, Schulz Kenneth F
Family Health International, PO Box 13950, Research Triangle Park, NC 27709, USA.
Lancet. 2005;365(9468):1429-33. doi: 10.1016/S0140-6736(05)66379-9.
Use of control (comparison) groups is a powerful research tool. In case-control studies, controls estimate the frequency of an exposure in the population under study. Controls can be taken from known or unknown study populations. A known group consists of a defined population observed over a period, such as passengers on a cruise ship. When the study group is known, a sample of the population can be used as controls. If no population roster exists, then techniques such as random-digit dialling can be used. Sometimes, however, the study group is unknown, for example, motor-vehicle crash victims brought to an emergency department, who may come from far away. In this situation, hospital controls, neighbourhood controls, and friend, associate, or relative controls can be used. In general, one well-selected control group is better than two or more. When the number of cases is small, the ratio of controls to cases can be raised to improve the ability to find important differences. Although no ideal control group exists, readers need to think carefully about how representative the controls are. Poor choice of controls can lead to both wrong results and possible medical harm.
使用对照组是一种强大的研究工具。在病例对照研究中,对照组用于估计所研究人群中暴露因素的频率。对照组可以取自已知或未知的研究人群。已知人群是指在一段时间内观察的特定人群,例如游轮上的乘客。当研究人群已知时,可以从该人群中抽取样本作为对照组。如果没有人群名册,则可以使用随机数字拨号等技术。然而,有时研究人群是未知的,例如被送往急诊科的机动车事故受害者,他们可能来自很远的地方。在这种情况下,可以使用医院对照组、社区对照组以及朋友、同事或亲属对照组。一般来说,精心挑选的一个对照组比两个或更多个对照组更好。当病例数量较少时,可以提高对照组与病例的比例,以增强发现重要差异的能力。虽然不存在理想的对照组,但读者需要仔细考虑对照组的代表性如何。对照组选择不当可能导致错误的结果,并可能造成医疗伤害。