Leventhal J M
Pediatrics. 1981 Nov;68(5):684-90.
To determine whether the findings of case-control studies of risk factors for child abuse may have been biased because of inattention to scientific principles of research design, 22-case-control studies were reviewed investigating either of two risk factors: (1) prematurity or low birth weight of the abused child or (2) young maternal age of the mother of the abused child. Each study was examined to determine compliance with seven methodologic standards that would minimize bias or distortion of the results. No study satisfied all seven standards. Two standards, choice of a specific control group and adjustment for differences in clinical and demographic susceptibility factors, most often affected the results. Studies complying with both of these standards indicated that prematurity or low birth weight is not a risk factor for abuse and that young maternal age at the birth of the abused child is likely to be a risk factor. Few studies complied with the standard concerned with avoidance of detection bias; this failure may have a major effect on the direction bias; this failure may have a major effect on the direction of the results of certain studies. Previous case-control studies of child abuse have important methodologic flaws that can affect the validity of the results. The standards presented should be helpful in planning methodologically rigorous studies.
为了确定虐待儿童风险因素的病例对照研究结果是否因未关注研究设计的科学原则而存在偏差，我们对22项病例对照研究进行了回顾，这些研究调查了以下两个风险因素中的任何一个：（1）受虐儿童早产或低出生体重；（2）受虐儿童母亲的低龄生育。对每项研究进行检查，以确定其是否符合七个方法学标准，这些标准将最大限度地减少结果的偏差或扭曲。没有一项研究符合所有七个标准。两个标准，即特定对照组的选择和对临床及人口易感性因素差异的调整，最常影响结果。符合这两个标准的研究表明，早产或低出生体重不是虐待的风险因素，而受虐儿童出生时母亲低龄生育可能是一个风险因素。很少有研究符合避免检测偏差的标准；这种不足可能对某些研究结果的方向产生重大影响。先前关于虐待儿童的病例对照研究存在重要的方法学缺陷，可能会影响结果的有效性。所提出的标准应有助于规划方法严谨的研究。
