Department of Critical Care Medicine, Peter Lougheed Centre, Calgary.
Clin Epidemiol. 2012;4:99-110. doi: 10.2147/CLEP.S30816. Epub 2012 Apr 27.
Case-control studies are a common and efficient means of studying rare diseases or illnesses with long latency periods. Matching of cases and controls is frequently employed to control the effects of known potential confounding variables. The analysis of matched data requires specific statistical methods.
The objective of this study was to determine the proportion of published, peer-reviewed matched case-control studies that used statistical methods appropriate for matched data. Using a comprehensive set of search criteria we identified 37 matched case-control studies for detailed analysis.
Among these 37 articles, only 16 studies were analyzed with proper statistical techniques (43%). Studies that were properly analyzed were more likely to have included case patients with cancer and cardiovascular disease compared to those that did not use proper statistics (10/16 or 63%, versus 5/21 or 24%, P = 0.02). They were also more likely to have matched multiple controls for each case (14/16 or 88%, versus 13/21 or 62%, P = 0.08). In addition, studies with properly analyzed data were more likely to have been published in a journal with an impact factor listed in the top 100 according to the Journal Citation Reports index (12/16 or 69%, versus 1/21 or 5%, P ≤ 0.0001).
The findings of this study raise concern that the majority of matched case-control studies report results that are derived from improper statistical analyses. This may lead to errors in estimating the relationship between a disease and exposure, as well as the incorrect adaptation of emerging medical literature.
病例对照研究是一种研究罕见疾病或潜伏期长的疾病的常见且有效的方法。病例和对照的匹配常用于控制已知潜在混杂变量的影响。匹配数据的分析需要特定的统计方法。
本研究的目的是确定已发表的、经过同行评审的匹配病例对照研究中，使用适合匹配数据的统计方法的比例。我们使用一套全面的搜索标准，确定了 37 项用于详细分析的匹配病例对照研究。
在这 37 篇文章中，只有 16 项研究使用了适当的统计技术进行分析（43%）。经过适当分析的研究更有可能纳入患有癌症和心血管疾病的病例患者，而不是那些没有使用适当统计学方法的研究（10/16 或 63%，而 5/21 或 24%，P = 0.02）。它们也更有可能为每个病例匹配多个对照（14/16 或 88%，而 13/21 或 62%，P = 0.08）。此外，经过适当数据分析的研究更有可能发表在期刊影响因子（JIF）排名前 100 位的期刊上（12/16 或 69%，而 1/21 或 5%，P ≤ 0.0001）。
本研究的结果令人担忧，即大多数匹配病例对照研究报告的结果来自于不适当的统计分析。这可能导致对疾病与暴露之间关系的估计错误，以及对新兴医学文献的不正确应用。
