疾病分类错误对暴露-疾病关联的影响。
Effects of disease misclassification on exposure-disease association.
机构信息
Department of Biostatistics, Columbia University, New York, NY, USA.
出版信息
Am J Public Health. 2013 May;103(5):e67-73. doi: 10.2105/AJPH.2012.300995. Epub 2013 Mar 14.
OBJECTIVES
We explore how misclassification in disease status can distort the exposure-disease association in a study with dichotomous disease and exposure status.
METHODS
We define the difference in population odds ratios between populations with and without disease misclassification as population-level bias and derive the bias as a function of sensitivity and specificity for observed disease status. The magnitude and direction of bias can be elucidated through analytic derivations, as illustrated with numerical examples.
RESULTS
Patterns of bias exist not only for nondifferential misclassification but also for some differential misclassification scenarios. We have provided conditions defined in terms of sensitivity and specificity that correspond to each pattern of bias.
CONCLUSIONS
Caution is needed in interpreting results when misclassification is present. Our findings can be used to assess the effects of disease misclassification in a population when sensitivity and specificity are known or can be estimated.
目的
我们探讨了在二分类疾病和暴露状态的研究中，疾病状态的错误分类如何扭曲暴露-疾病关联。
方法
我们将具有和不具有疾病错误分类的人群之间的人群比值差异定义为人群水平偏差，并将偏差推导为观察到的疾病状态的灵敏度和特异性的函数。通过分析推导，可以阐明偏差的幅度和方向，如图所示。
结果
不仅存在非差异错误分类，而且存在某些差异错误分类情况的偏差模式。我们已经提供了根据灵敏度和特异性定义的条件，这些条件对应于每种偏差模式。
结论
当存在错误分类时，在解释结果时需要谨慎。当灵敏度和特异性已知或可以估计时，我们的发现可用于评估人群中疾病错误分类的影响。
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