Bouyer J, Dardenne J, Hémon D
INSERM U292, Hôpital de Bicêtre, LE Kremlin Bicêtre, France.
Scand J Work Environ Health. 1995 Aug;21(4):265-71. doi: 10.5271/sjweh.36.
Individual assessment of exposure by experts and the use of a job-exposure matrix are the two main methods of evaluating past occupational exposures in community-based case-referent studies. The objective of this study was to compare the performance of the estimations of the odds ratio in the two methods. This paper focuses on job-exposure matrices whose entries consist of proportions of persons exposed.
Simulations were used to compare the variances of the estimations of the odds ratios obtained with the two methods and to study the consequences with respect to bias and the precision of the odds ratios estimated for misclassifications of exposure produced by either the experts or the matrix.
When there was no misclassification, the results showed that the precision obtained with the job-exposure matrix was about three times less than that achieved by experts in a large range of practical situations. However, when potential errors of exposure assessment were taken into account, the simulations suggested that the test of the hypothesis OR = 1 against the alternative OR not equal to 1 when exposure was assessed with an unbiased job-exposure matrix had a statistical power close to that obtained when exposure was assessed by an expert with high sensibility and specificity.
The evaluation of exposure with an unbiased job-exposure matrix in studies of the association between exposure and disease had a statistical power close to that expected in practice with a good expert in the large range of practical situations which were investigated.
由专家进行个体暴露评估和使用工作暴露矩阵是在基于社区的病例对照研究中评估过去职业暴露的两种主要方法。本研究的目的是比较这两种方法中比值比估计的性能。本文重点关注条目由暴露人群比例组成的工作暴露矩阵。
采用模拟方法比较两种方法获得的比值比估计值的方差,并研究专家或矩阵导致的暴露错误分类对比值比估计偏差和精度的影响。
在无错误分类的情况下,结果表明,在大范围的实际情况中,使用工作暴露矩阵获得的精度比专家评估的精度低约三倍。然而,当考虑到暴露评估的潜在误差时,模拟结果表明,使用无偏工作暴露矩阵评估暴露时,针对备择假设OR≠1检验原假设OR = 1,其统计效能接近于由具有高灵敏度和特异性的专家评估暴露时所获得的统计效能。
在暴露与疾病关联研究中,使用无偏工作暴露矩阵评估暴露,在大范围的实际情况中,其统计效能接近于实际中由优秀专家评估时所预期的统计效能。