Pan Jin-Ren, He Han-Qing, Yan Rui, Fu Jian
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2013 Aug;34(8):836-9.
Safety on vaccine issues has been under greater concern. Epidemiologically, classical study designs on investigating the association between a rare adverse event and vaccine inoculation usually confronted with lower feasibility in practice. Self-controlled case series (SCCS) method was derived from cohort studies. The key advantage of this method is that it only uses data related to cases and trying to find relative incidence of events in the 'at risk' periods relative to the 'controlled' periods. A further benefit of this method is that all the fixed confounders are controlled implicitly, by self-control, thus provides high statistic powers. With these advantages, SCCS is suitable for the causality assessment on rare but severe adverse events caused by immunization, which has been widely used,abroad. However,the methodology of SCCS is still being developed,and the areas in use have been expanded to the studies related to the safety and effectiveness of drugs, efficacy of vaccines as well as risk factors of disease.
疫苗问题的安全性一直备受更多关注。从流行病学角度来看,用于调查罕见不良事件与疫苗接种之间关联的经典研究设计在实际操作中通常可行性较低。自我对照病例系列(SCCS)方法源自队列研究。该方法的关键优势在于它仅使用与病例相关的数据,并试图找出“风险”期相对于“对照”期事件的相对发生率。此方法的另一个优点是,所有固定混杂因素通过自我对照被隐含地控制,从而提供了较高的统计效力。凭借这些优势,SCCS适用于对免疫接种引起的罕见但严重不良事件进行因果关系评估,该方法在国外已被广泛使用。然而,SCCS的方法仍在不断发展,其应用领域已扩展到与药物安全性和有效性、疫苗效力以及疾病风险因素相关的研究。