Siemiatycki J, Dewar R, Richardson L
Epidemiology and Preventive Medicine Research Centre, Institute Armand-Frappier, Laval-des-Rapides, Québec, Canada.
Am J Epidemiol. 1989 Dec;130(6):1236-46. doi: 10.1093/oxfordjournals.aje.a115452.
The ascertainment of information on past occupational exposure of study subjects is perhaps the main problem in case-control studies of occupational risk factors. Several methods have been proposed and used but little is known of their relative merits. The present study, undertaken in the context of a large ongoing case-control study of occupational cancer in Montreal, was designed to compare the costs of and statistical power to be derived from five plausible methods of data collection: 1) job titles abstracted from routine records, 2) job titles abstracted from routine records and processed through a job exposure matrix to derive exposure data, 3) job titles obtained by interview, 4) job titles obtained by interview and processed through a job exposure matrix to derive exposure data, and 5) job descriptions obtained by interview and processed by a team of experts to derive exposure data. Statistical power of the five methods was derived for 160 hypothetical risk factors, partly on the basis of empirical data from the data set and partly on the basis of some theoretical constructs. The design based on interview and expert evaluation was used as a reference, and the degree of misclassification of other methods was estimated in relation to this reference. For fixed sample size the interview and expert evaluation design was estimated to be much more costly than the others, but it provides much greater statistical power for detecting risks. Under the conditions of this investigation, this design was the most cost-effective. However, it is not clear to what extent this finding is generalizable.
在职业危险因素的病例对照研究中,确定研究对象过去职业暴露的信息或许是主要问题。人们已经提出并使用了多种方法,但对它们各自的优缺点却知之甚少。本研究是在蒙特利尔一项正在进行的大型职业性癌症病例对照研究的背景下开展的,旨在比较五种看似可行的数据收集方法的成本及统计效能:1)从常规记录中提取的职位名称;2)从常规记录中提取并通过工作暴露矩阵处理以得出暴露数据的职位名称;3)通过访谈获得的职位名称;4)通过访谈获得并通过工作暴露矩阵处理以得出暴露数据的职位名称;5)通过访谈获得并由一组专家处理以得出暴露数据的工作描述。五种方法的统计效能是针对160个假设的危险因素得出的,部分基于数据集中的实证数据,部分基于一些理论构建。将基于访谈和专家评估的设计作为参照,估计其他方法相对于该参照的错误分类程度。对于固定样本量,基于访谈和专家评估的设计估计成本比其他方法高得多,但它在检测风险方面具有更强的统计效能。在本次调查的条件下,这种设计是最具成本效益的。然而,这一发现的普遍适用性尚不清楚。