Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA.
Epidemiology. 2011 Mar;22(2):249-56. doi: 10.1097/EDE.0b013e3182093912.
The nested case-control design is frequently used to evaluate exposures and health outcomes within the confines of a cohort study. When incidence-density sampling is used to identify controls, the resulting data can be analyzed using conditional logistic regression (equivalent to stratified Cox proportional hazards regression). In these studies, exposure lagging is often used to account for disease latency. In light of recent criticism of incidence-density sampling, we used simulated occupational cohorts to evaluate age-based incidence-density sampling for lagged exposures in the presence of birth-cohort effects and associations among time-related variables. Effect estimates were unbiased when adjusted for birth cohort; however, unadjusted effect estimates were biased, particularly when age at hire and year of hire were correlated. When the analysis included an adjustment for birth cohort, the inclusion of lagged-out cases and controls (assigned a lagged exposure of zero) did not introduce bias.
巢式病例对照设计常用于在队列研究的范围内评估暴露和健康结果。当使用发病率密度抽样来识别对照时，可以使用条件逻辑回归（相当于分层 Cox 比例风险回归）来分析由此产生的数据。在这些研究中，常使用暴露滞后来解释疾病潜伏期。鉴于最近对发病率密度抽样的批评，我们使用模拟职业队列来评估存在出生队列效应和时间相关变量之间关联的滞后暴露的基于年龄的发病率密度抽样。在调整了出生队列后，效应估计值是无偏的；然而，未经调整的效应估计值存在偏差，尤其是在雇佣年龄和雇佣年份相关时。当分析包括对出生队列的调整时，排除滞后病例和对照（分配滞后暴露为零）不会引入偏差。
