Empirical evaluation of complex epidemiologic study designs: workplace exposure and cancer.
OBJECTIVE
To test whether a frequently used cohort-nested case-control study design exaggerated exposure-response relationships because of unrecognized study design bias. Our aim was to evaluate empirically the performance of this complex study design.


METHODS
We applied the design from one such study to a closely related cohort using randomly selected probands as cases. Values for average exposures were assigned to probands equal to, greater than, and less than those assigned to controls (matches).


RESULTS
Under certain lag scenarios, the nested study design produced higher average exposure in probands compared with their matches, even when this was clearly not the case.


CONCLUSIONS
Empirical evaluation demonstrated that the study design produced a biased case-control lagged exposure difference under the null hypothesis and could not distinguish qualitatively between null and alternate hypotheses. Empirical evaluation provided a useful check on results generated from a complex study design. It gave useful insight into the behavior of the index study design that was not otherwise readily deducible.
Deubner
David C
DC
Brush Wellman, Inc, 14710 West Portage River South Road, Elmore, OH 43416, USA. david_deubner@brushwellman.com
Roth
H Daniel
HD
Levy
Paul S
PS
D000328:Adult; D000367:Age Factors; D001608:Beryllium / Q000633:toxicity*; D015982:Bias; D016022:Case-Control Studies; D015331:Cohort Studies; D036262:Empirical Research; D015340:Epidemiologic Research Design; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality*; D008875:Middle Aged; D016273:Occupational Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D011897:Random Allocation; D012494:Sampling Studies; D013223:Statistics as Topic; D013997:Time Factors
D001608:Beryllium