Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
BMC Med Res Methodol. 2023 Jul 4;23(1):157. doi: 10.1186/s12874-023-01978-6.
This study was conducted to evaluate the effect of alcohol consumption on breast cancer, adjusting for alcohol consumption misclassification bias and confounders.
This was a case-control study of 932 women with breast cancer and 1000 healthy control. Using probabilistic bias analysis method, the association between alcohol consumption and breast cancer was adjusted for the misclassification bias of alcohol consumption as well as a minimally sufficient set of adjustment of confounders derived from a causal directed acyclic graph. Population attributable fraction was estimated using the Miettinen's Formula.
Based on the conventional logistic regression model, the odds ratio estimate between alcohol consumption and breast cancer was 1.05 (95% CI: 0.57, 1.91). However, the adjusted estimates of odds ratio based on the probabilistic bias analysis ranged from 1.82 to 2.29 for non-differential and from 1.93 to 5.67 for differential misclassification. Population attributable fraction ranged from 1.51 to 2.57% using non-differential bias analysis and 1.54-3.56% based on differential bias analysis.
A marked measurement error was in self-reported alcohol consumption so after correcting misclassification bias, no evidence against independence between alcohol consumption and breast cancer changed to a substantial positive association.
本研究旨在评估饮酒与乳腺癌之间的关系，同时调整饮酒的错误分类偏倚和混杂因素。
本研究采用病例对照设计，共纳入 932 例乳腺癌患者和 1000 例健康对照。使用概率性偏倚分析方法，在最小充分调整混杂因素的基础上，调整饮酒错误分类的偏倚，对饮酒与乳腺癌的相关性进行了校正。使用 Miettinen 公式估计人群归因分数。
基于传统的逻辑回归模型，饮酒与乳腺癌之间的比值比估计值为 1.05（95%置信区间：0.57，1.91）。然而，基于概率性偏倚分析的校正比值比估计值在非差异分类下为 1.82 至 2.29，在差异分类下为 1.93 至 5.67。非差异偏倚分析的人群归因分数范围为 1.51%至 2.57%，基于差异偏倚分析的人群归因分数范围为 1.54%至 3.56%。
自我报告的饮酒量存在明显的测量误差，因此在纠正错误分类偏倚后，没有证据表明饮酒与乳腺癌之间的独立性发生改变，而是显示出显著的正相关关系。
