title: On the equivalence of case-crossover and time series methods in environmental epidemiology.
abstract: The case-crossover design was introduced in epidemiology 15 years ago as a method for studying the effects of a risk factor on a health event using only cases. The idea is to compare a case's exposure immediately prior to or during the case-defining event with that same person's exposure at otherwise similar "reference" times. An alternative approach to the analysis of daily exposure and case-only data is time series analysis. Here, log-linear regression models express the expected total number of events on each day as a function of the exposure level and potential confounding variables. In time series analyses of air pollution, smooth functions of time and weather are the main confounders. Time series and case-crossover methods are often viewed as competing methods. In this paper, we show that case-crossover using conditional logistic regression is a special case of time series analysis when there is a common exposure such as in air pollution studies. This equivalence provides computational convenience for case-crossover analyses and a better understanding of time series models. Time series log-linear regression accounts for overdispersion of the Poisson variance, while case-crossover analyses typically do not. This equivalence also permits model checking for case-crossover data using standard log-linear model diagnostics.
authors.affiliation: Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA. ylu@jhsph.edu
authors.forename: Yun
authors.initials: Y
authors.lastname: Lu
authors.forename: Scott L
authors.initials: SL
authors.lastname: Zeger
mesh_terms: D000397:Air Pollution; D018592:Cross-Over Studies; D004781:Environmental Exposure; D004812:Epidemiologic Methods; D006801:Humans; D016015:Logistic Models