Quantifying the impact of selection bias caused by nonparticipation in a case-control study of mobile phone use.
OBJECTIVE
To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor.


METHODS
Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants.


RESULTS
Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios.


CONCLUSIONS
Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.
Vrijheid
Martine
M
International Agency for Research on Cancer, Lyon, France. mvrijheid@creal.cat
Richardson
Lesley
L
Armstrong
Bruce K
BK
Auvinen
Anssi
A
Berg
Gabriele
G
Carroll
Matthew
M
Chetrit
Angela
A
Deltour
Isabelle
I
Feychting
Maria
M
Giles
Graham G
GG
Hours
Martine
M
Iavarone
Ivano
I
Lagorio
Susanna
S
Lönn
Stefan
S
McBride
Mary
M
Parent
Marie-Elise
ME
Sadetzki
Siegal
S
Salminen
Tina
T
Sanchez
Marie
M
Schlehofer
Birgitte
B
Schüz
Joachim
J
Siemiatycki
Jack
J
Tynes
Tore
T
Woodward
Alistair
A
Yamaguchi
Naohito
N
Cardis
Elisabeth
E
D000328:Adult; D000367:Age Factors; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D040421:Cell Phone / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015983:Selection Bias; D012737:Sex Factors