van Wieren-de Wijer Diane B M A, Maitland-van der Zee Anke-Hilse, de Boer Anthonius, Kroon Abraham A, de Leeuw Peter W, Schiffers Paul, Janssen Rob G J H, Psaty Bruce M, van Duijn Cornelia M, Stricker Bruno H Ch, Klungel Olaf H
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), University of Utrecht, the Netherlands.
Pharmacoepidemiol Drug Saf. 2009 Aug;18(8):665-71. doi: 10.1002/pds.1764.
In epidemiological studies, non-response may introduce bias and limit generalizability. In genetic pharmacoepidemiological research, collection of DNA might be a major reason for non-response. We determined reasons for non-response and compared characteristics of non-responders and responders in a pharmacogenetic case-control study.
Myocardial infarction (MI) cases and controls, who were antihypertensive drug users, were recruited through community pharmacies that participate in the Pharmaco-Morbidity-Record-Linkage-System (PHARMO). The PHARMO database comprises drug dispensing histories of about 2 000 000 subjects from a representative sample of Dutch community pharmacies linked to the national registry of hospital discharges. Independent samples t-test and ANOVA-statistics were used to analyse the differences in continuous variables between responders and non-responders. chi2 statistics and logistic regression were used to compare categorical variables.
We approached 1871 cases and 14 102 controls of whom 794 MI cases (42.4%) and 4997 controls (35.4%) responded. We could not approach 2194 patients of whom 63.1% had died and 31.2% moved to another pharmacy. Main reasons for non-response were health problems or hospital stays (16.2%, OR 1.47; 95%CI: 1.00-2.16). Other reasons were old age or dementia (16.9%, OR 1.82; 95%CI: 1.24-2.65). Only a small percentage (1.1%, OR 1.43; 95%CI: 0.41-5.03) mentioned DNA sampling as a reason. About 30% of the non-responders did not give a reason. Women were statistically significantly (p < 0.0005) less willing to participate than men (38.8% versus 31.3%). An association with age was also found (mean age 64.6 versus 66.5 yrs) (p < 0.0005).
In a pharmacogenetic case-control study fear for genetic screening was not a major reported reason for non-response. Females were less willing to participate than males.
在流行病学研究中，无应答可能会引入偏差并限制研究结果的普遍性。在基因药物流行病学研究中，DNA采集可能是无应答的主要原因。我们在一项药物遗传学病例对照研究中确定了无应答的原因，并比较了无应答者和应答者的特征。
通过参与药物发病率记录链接系统（PHARMO）的社区药房招募心肌梗死（MI）病例和作为对照的高血压药物使用者。PHARMO数据库包含来自荷兰社区药房代表性样本中约200万受试者的药物配药历史记录，并与国家医院出院登记处相链接。使用独立样本t检验和方差分析统计方法分析应答者和无应答者之间连续变量的差异。使用卡方统计和逻辑回归比较分类变量。
我们联系了1871例病例和14102例对照，其中794例MI病例（42.4%）和4997例对照（35.4%）进行了应答。我们无法联系到2194名患者，其中63.1%已死亡，31.2%已转到另一家药房。无应答的主要原因是健康问题或住院（16.2%，比值比1.47；95%置信区间：1.00 - 2.16）。其他原因是年龄较大或患有痴呆症（16.9%，比值比1.82；95%置信区间：1.24 - 2.65）。只有一小部分（1.1%，比值比1.43；95%置信区间：0.41 - 5.03）提到DNA采样是一个原因。约30%的无应答者未给出原因。女性参与意愿在统计学上显著低于男性（38.8%对31.3%）（p < 0.0005）。还发现与年龄有关（平均年龄64.6岁对66.5岁）（p < 0.0005）。
在一项药物遗传学病例对照研究中，对基因筛查的担忧并非无应答的主要报告原因。女性比男性参与意愿更低。
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