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By Keogh R.H., Cox D.R.

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Sample text

Thus, the use of hospital controls relies on the assumption that the exposure is independent of the reasons for admission to hospital in the control group. 3 Bias due to retrospective exposure ascertainment The retrospective collection of exposure information is another, quite different, source of potential bias. 6 Bias in case-control studies October 7, 2013 25 collection differs systematically between cases and controls, that is, if the case or control status affects some aspect of the exposure measurement.

Bias can originate also from an interviewer who is obtaining exposure information if he or she is aware of the case or control status of the interviewee and this affects his or her recording of the exposure information; this is sometimes referred to as information bias. It can be avoided by blinding interviewers to the participants’ diagnoses when possible. • In some settings the collection of exposure information may involve biological measurements obtained retrospectively and it is possible that the outcome could affect the exposure measurement either via biological mechanisms, in the case of disease outcomes, or by changes in habits as a result of the outcome or changes leading up to the outcome.

Here, and throughout, by large-sample methods we mean procedures whose theory is based on the limiting behaviour as the amount of information increases indefinitely and which are then used to provide confidence intervals and other procedures with approximately the desired properties. The limiting operation considered in the mathematical theory of such procedures is just a technical device for obtaining approximations, whose adequacy has always in principle to be considered. In the applications considered in this book the approximate procedures are likely to be adequate provided that there are no very small frequencies having a substantial influence on the apparent conclusions.

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