Connor R J, Prorok P C, Weed D L
Biometry Branch, National Cancer Institute, Bethesda, MD 20892.
J Clin Epidemiol. 1991;44(11):1215-21. doi: 10.1016/0895-4356(91)90154-2.
Case-control studies have been used in recent years to evaluate the efficacy of cancer screening. However, relatively little work has been done to examine the methodology itself for this purpose. In this paper, it is demonstrated that because of self-selection bias the case-control study can yield a biased estimate of screening efficacy. Further, it is shown how this bias can be assessed using data from a randomized trial. Using data from the HIP breast cancer screening study, the magnitude of the self-selection bias is estimated and is seen to be substantial.
近年来，病例对照研究已被用于评估癌症筛查的效果。然而，针对这一目的对该方法本身进行检验的工作相对较少。本文表明，由于自我选择偏倚，病例对照研究可能会得出有偏差的筛查效果估计值。此外，还展示了如何使用随机试验的数据来评估这种偏倚。利用来自HIP乳腺癌筛查研究的数据，估计了自我选择偏倚的大小，发现其相当可观。
