Kim Ryung S, Kaplan Robert C
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, 10461, U.S.A.
Stat Med. 2014 Oct 30;33(24):4215-26. doi: 10.1002/sim.6231. Epub 2014 Jun 12.
One of the main perceived advantages of using a case-cohort design compared with a nested case-control design in an epidemiologic study is the ability to evaluate with the same subcohort outcomes other than the primary outcome of interest. In this paper, we show that valid inferences about secondary outcomes can also be achieved in nested case-control studies by using the inclusion probability weighting method in combination with an approximate jackknife standard error that can be computed using existing software. Simulation studies demonstrate that when the sample size is sufficient, this approach yields valid type 1 error and coverage rates for the analysis of secondary outcomes in nested case-control designs. Interestingly, the statistical power of the nested case-control design was comparable with that of the case-cohort design when the primary and secondary outcomes were positively correlated. The proposed method is illustrated with the data from a cohort in Cardiovascular Health Study to study the association of C-reactive protein levels and the incidence of congestive heart failure.
在流行病学研究中，与巢式病例对照设计相比，使用病例队列设计的一个主要优势在于能够用同一个亚队列评估除主要关注结局之外的其他结局。在本文中，我们表明，通过使用包含概率加权法并结合一种可使用现有软件计算的近似刀切法标准误，在巢式病例对照研究中也能够对次要结局进行有效的推断。模拟研究表明，当样本量足够时，这种方法在巢式病例对照设计中对次要结局的分析能够产生有效的一类错误率和覆盖率。有趣的是，当主要结局和次要结局呈正相关时，巢式病例对照设计的统计效能与病例队列设计相当。本文以心血管健康研究队列的数据为例，阐述了所提出的方法，以研究C反应蛋白水平与充血性心力衰竭发病率之间的关联。
