A mathematic analysis of the "epidemiologic necropsy".
There has been much debate regarding the validity and implications of the "epidemiologic necropsy." Two opposing mathematic analyses have previously appeared--one by Flanders and O'Brien and one by Feinstein and colleagues. Because these analyses omitted discussion of certain key parameters and assumptions, I provide a more detailed analysis. I show that under the assumptions used by earlier authors, the observed ("registry") disease rates will equal the true disease rates, even if there is differential disease detection and large pool of undetected cases. Under realistic violations of assumptions, both the observed rates and the necropsy estimates will be biased. In any case, the data offered thus far are insufficient to accurately assess the impact of undetected disease on epidemiologic studies.
Greenland
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Department of Epidemiology, UCLA School of Public Health 90024-1772.
D015982:Bias; D004812:Epidemiologic Methods; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality