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Examples of case control study - What is a case-control study? International Journal of Epidemiology Oxford Academic

Can utilize the baseline data on exposure and confounding collected before the onset of disease, which reduces the potential for recall bias and uncertainty regarding the temporal sequence between exposure and disease onset. Nonetheless, case control studies are relatively quick, inexpensive and easy. They do not require a long follow-up period as the disease has already developed, and are hence much cheaper. The true risk might therefore be expected to lie somewhere between estimates obtained with the two different designs. Examples from Real Life for non-Hodgkin lymphoma found a connection between the disease and inflammatory disorders like Sj grens, Celiac and rheumatoid arthritis. Slide 9 Case-Control Density Sampling in a Dynamic Primary Study Base Case-Control Density Sampling in a Dynamic Primary Study Base Use a disease registry to identify all new cases of disease during a defined time period and at the time each new case is reported sample controls from current residents.


Anything the researcher can do to minimize this type of bias will strengthen the study. When an exposure and an outcome are both strongly associated with a third variable. 7 used a case control design to investigate the severity of coronary artery disease by coronary angiography in age-matched and sex-matched patients with diabetes mellitus with atrial fibrillation versus sinus rhythm.


Case control studies aim to recruit, from a notional base population, a random sample of all persons with the disease under study cases and a random sample of persons without the disease controls. Material and Methods This retrospective study analyzed 169 patients who underwent isolated coronary artery bypass grafting CABG between January 2009 and December 2010.

pylori HP infection was associated with the development of gastric cancer, Parsonnet et al N Engl J Med. The association of premenopausal serum estradiol with breast cancer risk is less clear. The controls may be healthy or may have other diseases.


In this study, there was a strong and specific association between signs of asphyxia at birth and schizophrenia.

It is unlike cohort studies where study population is denominator adn incidence rate can be calculated for the disease as people are affected adn relative risk can be calculated.

A sampling frame of hospital patients is often used to select controls, however risk factors such as diet and smoking are commonly linked to many diseases. Gehlbach, Interpreting the Medical Literature, 1993 Case-control studies start with a disease, and work backward to find associations between exposures and the disease.

In a case-control study the prevalence of exposure to a potential risk factor s is compared between cases and controls. For example, a case-control study of glioma is likely to have difficulty contacting the cases quickly enough. Advantages Good for studying rare conditions or diseases Less time needed to conduct the study because the condition or disease has already occurred Lets you simultaneously look at multiple risk factors Useful as initial studies to establish an association Can answer questions that could not be answered through other study designs Disadvantages Retrospective studies have more problems with data quality because they rely on memory and people with a condition will be more motivated to recall risk factors also called recall bias.

The other basic type is a matched case-control study.

Though in certain circumstances OR is an approximation to RR, they are not the same index. Ideally they should be non-diseased people who come from the same source population as the cases, and, aside from their outcome status, they should be comparable to the cases in order to avoid selection bias. Cases and controls are then compared to assess whether there were any differences in their past exposure to putative risk factors.

Case-Control Study, you are studying the disease and see if you can associate risk factors to it. Lewallen S, Courtright P, Community Eye Health, 1998, volume 11, issue 28, pages 57-58.


, exposed non-exposed, but may be sampled proportional to their time at risk which is called density sampling.


Over-matching can make it difficult to find enough controls.


The study involved comparing a group of former lifeguards that had developed cancer on their cheeks and noses cases to a group of lifeguards without this type of cancer controls and assess their prior exposure to zinc oxide or absorbent sunscreen lotions. To evaluate the potential for reverse causality as an explanation for the observed association between serum testosterone and breast cancer risk, we repeated analyses restricted to cases whose blood was collected longer in time before diagnosis.


It is possible that using prevalent cases may not bias the findings but there is usually no way to determine that and the possible bias could go in either direction with respect to the study hypothesis. Models were fit by using natural hormone concentrations to test for trend.


Total and bioavailable estradiol concentrations did not differ between the groups. Lung cancer and other causes of death in relation to smoking. The researcher then inquire about possible exposure to risk factors in the past time exposure prior to disease development. most cancers, it can be a good proxy for the true relative risk Calculating Sample Size for Case Control Studies 1. Exposure information can come from records though, obvious disadvantage is that records can be inaccurate, incomplete and were not originially collected for the study purposes or can be via an interview or questionnaire this can introduce recall bias, where cases have more vested interest in recalling the exposures than controls, and sometimes rely on proxy respondents, e. This study design require fewer resources compared to cohort studies.

Association of maternal stilbestrol therapy with tumor appearance in young women. In an African study to evaluate the efficiency of BCG immunisation in preventing tuberculosis, history of inoculation was established by looking for a residual scar on the upper arm. NEJM 1971 284 15 878-81 Case-control studies are addressed by the following MFPH Part A past paper questions June 2001 Paper IA, Question 1 January 2003 Paper IA, Question 1 January 2004 Paper IA, Question 2 May 2005 Paper IA, Question 1 and 2 References Hennekens CH, Buring JE.


It had a substantial influence on clinical practice, yet it wasn t a randomized trial, a study that would have required huge numbers and many years of follow-up. Because a case-control study is typically retrospective, it is relatively quick to do. Various methods can be used to ascertain exposure status. Issues in the design of case-control studies Formulation of a clearly defined hypothesis As with all investigations the beginning of a case-control study should begin with the formulation of a clearly defined hypothesis. That is, if there is no true association between exposure and disease, the cases and controls should have the same distribution of exposure. However, they can be a very efficient way of identifying an association between an exposure and an outcome.

The specificity of reporting exposures by spouses was the same for both cases and controls, implying that if the industrial hygienist rated the occupation as not exposed to a certain chemical, both case and control spouse proxies were equally likely to rate it as nonexposed. A concern, usually minor, is that the remaining nondiseased persons from whom the controls are selected when it is decided to do the nested study, may not be fully representative of the original cohort due to death or losses to follow-up. Also, once a matching variable has been selected, it is not possible to analyse it as a risk factor. Possibly the most famous case control study using this method was a study into whether bicycle helmets reduce the chance of cyclists receiving bad head injuries in an accident. Matching on county serves to focus further the study base concept by regarding cases and controls in each of the six counties as subcohorts of the overall study. The case control study gave a jumping-off place, beginning with what is fondly and at the same time disparagingly termed fishing expeditions.


This is a particular problem associated with case-control studies and therefore needs to be carefully considered during the design and conduct of the study. 03 and to have occupations associated with affluence P 0. Controls selected from the general population for example, from general practice age-sex registers have the advantage that their exposures are likely to be representative of those at risk of becoming cases.


Another problem associated with case-control studies is selection bias because of the absence of patients who do not survive long enough to be enrolled in the study. In both cases the aim is to assess risk factors for certain outcome. The best way to ensure this is to sample controls from the same population that gave rise to the cases. Given the increasing heterogeneity characteristic of aging, bias can be a significant problem and care needs to be taken to well match cases and controls. Information published online, accessed August 2014. This type of reanalysis is useful in increasing the power to observe significant associations that are not evident in individual studies, particularly for uncommon exposures.

You select a group of children under five years, either all children of that age in the village, a random sample taken from the population register, or e.

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