Levois M, Switzer P
Environmental Health Resources, Tiburon, California, USA.
J Clin Epidemiol. 1998 Jan;51(1):37-54. doi: 10.1016/s0895-4356(97)00224-2.
We review some of the literature on the effects of exposure misclassification on the statistical analysis of case-control studies. In particular, we focus on evidence for exposure misclassification which may be different for cases and controls in studies of environmental tobacco smoke (ETS). For example, such misclassification could induce relative risk estimates below unity for low exposure which appears to be the case in U.S. lung cancer and ETS studies. We describe procedures for systematically examining the sensitivity of dose-response statistics on exposure misclassification. The procedures demonstrate how p-values for the null hypothesis of no dose-response trend could be adjusted to account for exposure misclassification. The adjustment procedures were applied to an example based on a recently published large study of ETS and lung cancer in which a p-value for trend was reported as 0.03. In this example it is seen that modest differential exposure misclassification can induce substantial increases in the actual p-value, changing what appears to be statistically significant to decidedly nonsignificant.
我们回顾了一些关于暴露错误分类对病例对照研究统计分析影响的文献。特别地，我们关注环境烟草烟雾（ETS）研究中病例和对照的暴露错误分类证据，这种错误分类可能有所不同。例如，这种错误分类可能导致低暴露的相对风险估计值低于1，美国肺癌与ETS研究似乎就是这种情况。我们描述了系统检验剂量反应统计对暴露错误分类敏感性的程序。这些程序展示了如何调整无剂量反应趋势零假设的p值以考虑暴露错误分类。调整程序应用于一个基于最近发表的关于ETS与肺癌的大型研究的例子，该研究报告的趋势p值为0.03。在这个例子中可以看到，适度的差异暴露错误分类会使实际p值大幅增加，将看似具有统计学显著性的结果变为明显不显著。
