伤害流行病学研究中仅基于病例的研究的因果推断
Causal Inference with Case-Only Studies in Injury Epidemiology Research.
作者信息
Rundle Andrew G, Bader Michael D M, Branas Charles C, Lovasi Gina S, Mooney Stephen J, Morrison Christopher N, Neckerman Kathryn M
机构信息
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA.
Department of Sociology, Johns Hopkins University, Baltimore, MD, USA.
出版信息
Curr Epidemiol Rep. 2022 Dec;9(4):223-232. doi: 10.1007/s40471-022-00306-8. Epub 2022 Sep 29.
PURPOSE OF REVIEW
We review the application and limitations of two implementations of the "case-only design" in injury epidemiology with example analyses of Fatality Analysis Reporting System data.
RECENT FINDINGS
The term "case-only design" covers a variety of epidemiologic designs; here, two implementations of the design are reviewed: (1) studies to uncover etiological heterogeneity and (2) studies to measure exposure effect modification. These two designs produce results that require different interpretations and rely upon different assumptions. The key assumption of case-only designs for exposure effect modification, the more commonly used of the two designs, does not commonly hold for injuries and so results from studies using this design cannot be interpreted. Case-only designs to identify etiological heterogeneity in injury risk are interpretable but only when the case-series is conceptualized as arising from an underlying cohort.
SUMMARY
The results of studies using case-only designs are commonly misinterpreted in the injury literature.
综述目的
我们通过对死亡分析报告系统数据的示例分析，回顾“病例对照设计”在伤害流行病学中的两种应用及局限性。
最新发现
“病例对照设计”这一术语涵盖多种流行病学设计；在此，对该设计的两种应用进行综述：（1）揭示病因异质性的研究；（2）测量暴露效应修正的研究。这两种设计产生的结果需要不同的解释，并依赖于不同的假设。两种设计中更常用的用于暴露效应修正的病例对照设计的关键假设，在伤害研究中通常不成立，因此使用该设计的研究结果无法进行解释。用于识别伤害风险中病因异质性的病例对照设计是可解释的，但前提是将病例系列概念化为源自潜在队列。
总结
伤害文献中常对使用病例对照设计的研究结果产生误解。
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