Case control studies are a type of observational study used in medical research to investigate the

potential causes of a disease or condition. They are often used to compare individuals with a specific
disease (cases) to individuals without the disease (controls) to determine potential risk factors.

These studies are an important tool in understanding the underlying causes of diseases and can help
inform prevention and treatment strategies. They are particularly useful for rare diseases or
conditions where it may be difficult to conduct a randomized controlled trial.

At HelpWriting.net, we understand the importance of accurate and well-designed case control

studies. Our team of experienced researchers and writers can assist you in all aspects of your study,
from study design to data analysis and report writing.

Our services include:

Study design and methodology

Data collection and management
Data analysis using advanced statistical methods
Interpretation of results
Report writing and presentation of findings

We have a team of experts with diverse backgrounds in medicine, public health, and statistics,
ensuring that we can provide high-quality and comprehensive support for your case control study.

Don't let the complexities of case control studies hold you back from conducting important research.
Let HelpWriting.net be your partner in producing reliable and valuable results. Contact us today to
learn more and to place your order.

Order now on HelpWriting.net

5. "any particular group of prevalent individuals at risk for the disease in the source population
during the study period (i.e. the study base) that correctly reflects the ratio of exposed to unexposed
person-time in this population over this period can be used for this purpose." 6. "To the extent that Ye
/Yo (the exposure odds among the controls) is an unbiased estimate of Te/To, controls may be
viewed as reflecting the person-time by exposure status," (p.231) For all open access content, the
Creative Commons licensing terms apply. – Test for the presence of RA antigen 8. Case Control
Studies Cohort Studies Proceeds from effect to cause Proceeds from cause to effect Starts with the
disease Starts with people exposed to the risk factor or suspected cause Tests whether the suspected
cause occurs more frequently in those with disease than those without disease Tests whether disease
occurs more frequently in those exposed than in those not exposed Usually the 1st approach to the
testing of hypothesis, but also useful for exploratory studies Reserved for the testing of precisely
formulated hypothesis Involves fewer study subjects Involves larger number of subjects Yields
results relatively quickly Long follow-up, delayed results Suitable for study of rare diseases
Inappropriate when disease or exposure under investigation is rare Generally, yields only estimate of
relative risk (Odds ratio) Yields incidence rates, relative risk, attributable risk Cannot yield
information about disease other than that under study Can give information about more than one
disease outcome Relatively inexpensive Expensive Question 1: You are participating in a race. You
overtake the second person. Question: What position are you in? Here are the results from our
incidence rate calculations earlier in the lecture. If you are seeing this in color, the 7 cases (4 plus 3)
are shown in red, since we will use them to estimate the exposure odds in the cases. 40. Matching:
Problems – Overmatching: Matching on variables other than those that are risk factors for the
disease under study, either in a planned manner or inadvertently. Example: In a study on OCP use
as a risk factor for cancer, if we use “best friend controls”, it is most likely that the controls would
also be OCP users. In effect we would have matched for the very factor we want to study.
Example: If we use neighbourhood controls in a study on nutrition and tuberculosis, we would be
inadvertently matching for socioeconomic status and thus nutrition. Ury, H.K. 1975. Efficiency of
case-control studies with multiple controls per case: continuous or dichotomous data. Biometrics, 31,
643–649. (Cited on p. 82.) Possible Sources of Bias and Error (cont.) • Cases may search for a cause
for their disease and thereby be more likely to report an exposure than controls (recall bias) • The
investigator may be unable to determine with certainty whether the suspected agent caused the
disease or whether the occurrence of the disease caused the person to be exposed to the agent
Liddell, F.D.K., McDonald, J.C., Thomas, D.C., and Cunliffe, S.V. 1977. Methods of cohort
analysis: appraisal by application to asbestos mining. Journal of the Royal Statistical Society A, 140,
469–491. (Cited on pp. 164, 186 and 187.) Scheike, T.H. and Juul, A. 2004. Maximum likelihood
estimation for Cox's regression model under nested case-control sampling. Biostatistics, 5, 193–206.
(Cited on p. 190.) Table 1. Advantages and disadvantages of case-control studies. 53. 10/7/2008
Case-control studies 53 Compare incidence rates in exposed and unexposed 0 0.005 0.01 0.015 0.02
Exposed Unexposed An Image/Link below is provided (as is) to download presentation Case-
Control Studies - Slide 24 Note that this formulation does not involve any assumptions about
disease rarity. It requires that the likelihood of being sampled from the source “population” of
person-time varies as a proportion of the person-time potentially “contributed” by each individual.
For example: A potential control subject who was absent from the geographic area of interest during
most of the accrual period should have less chance of being selected than a potential subject who
was present throughout. As with the cumulative incidence design, validity hinges on the assumption
that f (the sampling fraction) does not vary with exposure status. Dr. Snow’s map Evidence-based
Chiropractic 38. 6/23/2002 Case-control studies 38 Incidence rate (“incidence density”) 7 IR =
–––––– = 0.0119 cases / person-wk 589.5 average over 3 weeks Number of new cases IR =
––––––––––––––––––– Population time Cohort and Case-Control Studies. September 2013
Alexander M. Walker MD, DrPH With Sonia Hernández-Díaz MD, DrPH. Cohort Study. If you have
People Observed for a health event For some amount of elapsed time in every one You have a cohort
study. Graphical Representation. Randomized Trial. 3. Case Control Study design Exposure Present
Diseased Exposure absent Compare Trace back Select Exposure Present Non-diseased Exposure
absent Case control study proceed from effect to the cause Borgan, Ø. and Langholz, B. 1993.
Nonparametric estimation of relative mortality from nested case-control studies. Biometrics, 49,
593–602. (Cited on p. 189.) Lin, D.Y. and Ying, Z. 1993. Cox regression with incomplete covariate
measurements. Journal of the American Statistical Association, 88, 1341–1349. (Cited on p. 210.)
Guolo, A. and Brazzale, A.R. 2008. A simulation-based comparison of techniques to correct for
measurement error in matched case-control studies. Statistics in Medicine, 27, 3755–3775. (Cited on
p. 239.) It follows from the above that a pool of potential controls must be defined. This pool must
mirror the study base of the cases. Over-the-counter analgesics and risk of ovarian cancer. I am
taking epidemiology class this winter, and your paper really saved me. Case-Control Studies
Principles of Epidemiology Lecture 10 Dona Schneider, PhD, MPH, FACE McCullagh, P. 1980.
Regression models for ordinal data (with discussion). Journal of the Royal Statistical Society B, 42,
109–142. (Cited on p. 131.) Here is the population at risk at the beginning of the period, once again –
200 people, with the top three rows exposed and the bottom five rows unexposed. 117. 10/7/2008
Case-control studies 117 Odds ratio Exposed odds in cases OR = ––––––––––––––––––––––––
Exposure odds in population 1.33 = ––––– = 2.29 0.58 (slightly larger than CIR) 12. Bias: Any
systematic error in the design, conduct, or analysis of a study that results in mistaken estimates of the
effect of the exposure on disease. Confounding: When a measure of the effect of an exposure on
risk is distorted because of the association of exposure with other factors that influence the outcome.
It creates data where it is not possible to separate the contribution that any single causal factor has
made an effect.
Greenhalgh, Trisha. How to Read a Paper: the Basics of Evidence-Based Medicine, John Wiley &
Sons, Incorporated, 2014. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/deakin
/detail.action?docID=1642418. Liu, M., Lu, W., and Tseng, C.-H. 2010. Cox regression in nested
case-control studies with auxiliary covariates. Biometrics, 66, 374–381. (Cited on p. 190.) Cornfield,
J., Haenszel, W., Hammond, E.C., Lilienfeld, A.M., Shimkin, M.B., and Wynder, E.L. 1959.
Smoking and lung cancer: recent evidence and a discussion of some questions. Journal of the
National Cancer Institute, 22, 173–203. Reprinted in International Journal of Epidemiology 38
(2009), 1175-1191. (Cited on pp. 61 and 251.) Here are the results from our incidence rate
calculations earlier in the lecture. If you are seeing this in color, the 7 cases (4 plus 3) are shown in
red, since we will use them to estimate the exposure odds in the cases. = 1 – indicates no
association Epidemiology. Factors That Influence Epidemics Transmission and The Role of Nurses in
the Identification of an Epidemic. Factors That May Influence Epidemics. Host susceptibility – How
susceptible is individual to coming down with infectious disease? Immunization Genetic background
Guangzhou October 9, 2010. Clinical Study Design. Henrik Ekberg, MD, PhD Malmö, Sweden
Associate Editor: American Journal of Transplantation 2003- Editorial Board Member:
Transplantation 2004 - Transplant International 2004 - Clinical Transplantation 2008 - Odds Ratio
(OR) • A ratio that measures the odds of exposure for cases compared to controls • Odds of exposure
= number exposed number unexposed • OR Numerator: Odds of exposure for cases • OR
Denominator: Odds of exposure for controls Whittemore, A.S. 1982. Statistical methods for
estimating attributable risk from retrospective data. Statistics in Medicine, 1, 229–243. (Cited on p.
110.) [3] Marouf, Nadya, Wenji Cai, Khalid N. Said, Hanin Daas, Hanan Diab, Venkateswara Rao
Chinta, Ali Ait Hssain, Belinda Nicolau, Mariano Sanz, and Faleh Tamimi. “Association between
periodontitis and severity of COVID‐19 infection: A case–control study.” Journal of clinical
periodontology 48, no. 4 (2021): 483-491. EXAMPLES OF PROBLEMS • Doll’s 1951 study of
smoking and lung cancer. The problem was that the control population (lung diseases other than
cancer) was biased in relation to the exposure. • McMahon’s 1981 study of coffee and pancreatic
cancer. Problem was that some of the controls may have been biased in relation to the exposure,
because gastro-intestinal diseases were excluded from the control series, and these diseases might
have people who reduced coffee intake on medical advice or because of symptoms. 103. 10/7/2008
Case-control studies 103 Exposure odds in cases = Exposed cases / Unexposed cases = 4 / 3 = 1.33
(same as for incidence density ratio) 21. Scope of case control study design It is quick and
inexpensive as compared to other analytic study designs It is particularly suitable for evaluation of
diseases with long latent periods It is optimum design for rare diseases Chen, T. 2001. RE:
Methods of adjustment for estimating the attributable risk in case-control studies; a review. Statistics
in Medicine, 20, 979–982. (Cited on p. 110.) Figure 1. Case-control study design. Prentice, R.L.
1986a. A case-cohort design for epidemiologic cohort studies and disease prevention trials.
Biometrika, 73, 1–11. (Cited on pp. 209 and 210.) STUDY DESIGN CASE-CONTROL. Daniel E.
Ford, MD, MPH Vice Dean of Clinical Investigation Johns Hopkins School of Medicine Introduction
to Clinical Research July 15, 2010. STUDY DESIGNS AND CORRESPONDING QUESTIONS.
Ecologic • What explains differences between groups? Case-Control Studies - Slide 15 Doll and Hill,
1950 Assume that the source population was as follows: 900 smokers & 1000 non smokers -
followed 5 years Then the 2x2 table would be: Smokers Non-Smokers Total Cancer + 41 19 60
Cancer - 859 981 1,840 Total 900 1,000 2,000
________________________________________________ Risk of cancer in smokers: 41/900 =
0.046 Risk of cancer in non smokers: 19/1000 = 0.019 Risk ratio: 0.046/0.019 = 2.4 Odds of
smoking in women with cancer: 41/19 = 2.2 Odds of smoking in women without cancer: 859/981 =
0.88 Odds ratio = 2.5 few of your posts. A number of them are 9. 10/7/2008 Case-control studies 9
Question 3 – what is the total? Take 1000 and add 40 to it. Now add another 1000. Now add 30.
Add another 1000. Now add 20. Now add another 1000. Now add 10. Case-control studies.
Overview of different types of studies Review of general procedures Sampling of controls
implications for measures of association implications for bias Logistic regression modeling. Learning
Objectives. Epidemiology 242: Cancer Epidemiology. Zuo-Feng Zhang, MD, PhD Fall Quarter,
2009. Overall Objectives of the Course. Rice, K. and Holmans, P. 2003. Allowing for genotyping
error in analysis of unmatched case-control studies. Annals of Human Genetics, 67, 165–174. (Cited
on p. 237.) 88. 10/7/2008 Case-control studies 88 Population at risk – baseline

Advantages and disadvantages of case control studies • Advantages : • Inexpensive, requires only a
few subjects gives quick results • Well suited for outcome which is rare • Helps in examining
multiple etiologic factors- once we have the case of the disease, we can take history of all the factors
that we feel may be risk factors • No attrition problem, because case control study do not require
follow up of individuals into the future. • No risk to the subject 5. Analyze data: compare the
exposure frequencies in those with and without disease. Measure of association = Odds ratio
(exposure odds ratio) Samuelsen, S.O. 1997. A pseudolikelihood approach to analysis of nested case-
control studies. Biometrika, 84, 379–394. (Cited on p. 188.) Now, for our main course, let’s
investigate the case-control study design.
Now, can we estimate the incidence density ratio using our case-control data, in which the “density
controls” serve to provide an estimate of exposure odds in population-time? So the 3-week CIR
estimated from the ratio of exposure odds in cases to exposures odds in controls is 1.33/0.6 = 2.22,
identical to what we found by taking the ratio of cumulative incidences. Of course, in real life we
would expect some difference, due to sampling variability. 12. 10/7/2008 Case-control studies 12
Question 4 Mary's father has five daughters: 1. Nana, 2. Nene, 3. Nini, 4. Nono. Question: What is
the name of the fifth daughter? An Image/Link below is provided (as is) to download presentation
Case-control study of screening for prostatic cancer by digital rectal examinations. Download
presentation by click this link. While downloading, if for some reason you are not able to download
a presentation, the publisher may have deleted the file from their server. Today i spent 300 $ for
platinium roulette system , i hope 71. 10/7/2008 Case-control studies 71 Ratio of exposed to
unexposed population-time = “exposure odds” Exposed cases / Unexposed cases IRR =
–––––––––––––––––––––––––––––––– Exp Person-time / Unexp Person-time “Exposure odds” in
cases = ––––––––––––––––––––––––––– “Exposure odds” in population Epidemiology. Steven
Shoptaw, Ph.D. October 7, 2004. Important Concepts in Drug Abuse and Dependence. Prevalence:
The total number or percentage of cases of a disease in a population at a given time Download
Policy: Content on the Website is provided to you AS IS for your information and personal use and
may not be sold / licensed / shared on other websites without getting consent from its author.
Whittemore, A.S. and Halpern, J. 1997. Multi-stage sampling in genetic epidemiology. Statistics in
Medicine, 16, 153–167. (Cited on pp. 156 and 158.) The antecedents of psychoses: a case-control
study of selected risk factors. 99. 10/7/2008 Case-control studies 99 Ratio of incidence proportions,
a.k.a. cumulative incidence ratio CI1 Exposed cases / Exp PAR CIR = –––– =
–––––––––––––––––––––––––– CI0 Unexposed cases / Unexp PAR COMPARABILITY VS.
REPRESENTATIVENESS Usually, study cases are not a random sample of all cases in the
population, and therefore controls must be selected so as to mirror the same biases that entered into
the selection of cases 78. 1/29/2007 Case-control studies 78

OO
O O O O O Can we estimate exposure odds in the population by taking a sample? Consider first the
exposed group. There were 75 exposed people at risk at the beginning of the follow-up period. 74 of
them were at risk for the entire first week. If we think of the one case that occurred during week 1 as
having been at risk for half of the week, then there were a total of 74.5 person-weeks of population-
time during week 1. Similarly, if the two people who developed the disease during week 2 can each
be regarded as having been at risk for a half-week, then there were 73 person-weeks at risk in week
2: 72 people (75-1-2) who were at risk for the entire 2nd week plus 2 people at risk for half of the
2nd week. Week 3 began with 72 people at risk, but one of them developed the disease, so instead of
72 person-weeks of follow-up there were only 71.5 in week 3. Adding up the person-time gives us a
total of 219 person-weeks, for an ID of 0.018 / week or 18 per 1,000 person-weeks. Whittemore,
A.S. 1995. Logistic regression of family data from case-control studies. Biometrika, 82, 57–67.
(Cited on p. 158.) As such, controls should also be selected carefully. It is possible to match controls
to the cases selected on the basis of various factors (e.g. age, sex) to ensure these do not confound
the study results. It may even increase statistical power and study precision by choosing up to three
or four controls per case (2). 113. 10/7/2008 Case-control studies 113 Exposure odds in population at
risk (after cases occur) = Exposed noncases / Unexp. noncases = 71 / 122 = 0.58 (slightly different
from ratio of person-time and ratio of population at risk) And in week 3, the fourth case has
occurred. that i will make my first money online Possible Sources of Bias and Error • Information on
the potential risk factor (exposure) may not be available either from records or the study subjects’
memories • Information on potentially important confounding variables may not be available either
from records or the study subjects’ memories 41. Definition: Any systematic error in the design,
conduct, or analysis of a study that results in mistaken estimates of the effect of the exposure on
disease. Types of bias in case control studies: Selection bias Information bias Confounding
bias This blog summarizes the concepts of Expertise-based randomized controlled trials with a focus
on the advantages and challenges associated with this type of study. An Image/Link below is
provided (as is) to download presentation • Cannot directly measure incidence rates (risk) or
relative risk (In certain circumstances, can use the odds ratio to estimate the relative risk) 61. 2/28
/2006 Case-control studies 61 Odds odds = probability / (1 – probability) odds = risk / (1 – risk)
(most commonly) Risk 0.010 0.050 0.100 0.20 0.80 Odds 0.010 0.053 0.111 0.25 4.00
Epidemiologists benefit greatly from having case-control study designs in their research
armamentarium. Case-control studies can yield important scientific findings with relatively little
time, money, and effort compared with other study designs. This seemingly quick road to research
results entices many newly trained epidemiologists. Indeed, investigators implement case-control
studies more frequently than any other analytical epidemiological study. Unfortunately, case-control
designs also tend to be more susceptible to biases than other comparative studies. Although easier to
do, they are also easier to do wrong. Five main notions guide investigators who do, or readers who
assess, case-control studies. First, investigators must explicitly define the criteria for diagnosis of a
case and any eligibility criteria used for selection. Second, controls should come from the same
population as the cases, and their selection should be independent of the exposures of interest. Third,
investigators should blind the data gatherers to the case or control status of participants or, if
impossible, at least blind them to the main hypothesis of the study. Fourth, data gatherers need to be
thoroughly trained to elicit exposure in a similar manner from cases and controls; they should use
memory aids to facilitate and balance recall between cases and controls. Finally, investigators should
address confounding in case-control studies, either in the design stage or with analytical techniques.
Devotion of meticulous attention to these points enhances the validity of the results and bolsters the
reader's confidence in the findings.
really thanks for wonderful information because i doing my bachelor degree research by survival
model Patients aware of certain risk factors may focus on those and ignore other exposures.
Bradford Hill, A. 1965. The environment and disease: association or causation?Proceedings of the
Royal Society of Medicine, 58, 295–300. (Cited on p. 61.) Freedman, L.S., Midthune, D., Carroll,
R.J., and Kipnis, V. 2008. A comparison of regression calibration, moment reconstruction and
imputation for adjusting for covariate measurement error in regression. Statistics in Medicine, 27,
5195–5216. (Cited on p. 238.) Selecting Controls (cont.) • Controls estimate the exposure rate to be
expected in cases if there were no association between exposure and disease 89. 10/7/2008 Case-
control studies 89 Entire population, week 3

O O O O O O O Rubin, D.B. 1987. Multiple

Imputation for Nonresponse in Surveys. New York: Wiley. (Cited on p. 189.) Farewell, V.T. 1979.
Some results on the estimation of logistic models based on retrospective data. Biometrika, 66, 27–32.
(Cited on pp. 30 and 108.) Amedauwa, Ya’-teh habeen, Bienvenidos, Ni-hau, Bagunara, Karibu,
Aloha 104. 10/7/2008 Case-control studies 104 Population at risk (before cases occur)

Design and Analysis of Clinical Study 7. Analysis of Case-control Study. Dr. Tuan V. Nguyen
Garvan Institute of Medical Research Sydney, Australia. Overview. Risk Odds ratio (OR) Standard
erros of OR 95% confidence interval of OR Interpretation. Results of a CC study. Population.
Austin, H., Perkins, L.L., and Martin, D.O. 1997. Estimating a relative risk across sparse case-
control and follow-up studies: a method for meta-analysis. Statistics in Medicine, 16, 1005–1015.
(Cited on p. 251.) In respiratory research design, various epidemiological studies can be conducted to
understand the patterns, causes, and impact of respiratory diseases in populations. Here are some
common types of epidemiological studies in respiratory research: 1.Cross-Sectional Studies 2.Case-
Control Studies 3.Cohort Studies 4.Longitudinal Studies 5.Intervention Studies (Clinical Trials) Visit
us @ https://pubrica.com/academy/systematic-review/different-epidemiological-studies-in-
respiratory-research/ Case-Control Studies - Slide 43 Example: The total incidence (It) of
cardiovascular death in the Saskatchewan cohort was 30 deaths/47,842 person-years = 0.00063 per
person-year. Then Io = 0.00063 = 0.00035 ___________________________ [4.3 x (956/4080)] +
(3124/4080) and Ie = 0.00036 x 4.3 = 0.0015 RD = 0.0015 - 0.00035 = 0.00115 Paneth, N., Susser,
E., and Susser, M. 2002a. Origins and early development of the case-control study: part 1, early
evolution. Sozial- und Praventivmedizin, 47, 282–288. (Cited on p. 30.) Prevalence (cont.) • For
example, a study of community with a population of 30,000 which found 1,000 persons with
migraine headaches • The prevalence is 1,000/30,000 = 0.33 or 3,333 per 100,000 persons • It doesn’t
matter that 200 of the cases were newly diagnosed and 800 already had migraine headaches when
the study began Evidence-based Chiropractic Both the relative risk and odds ratio are interpreted as
follows: © 2024 SlideServe. All rights reserved Case-control studies. Overview of different types of
studies Review of general procedures Sampling of controls implications for measures of association
implications for bias Logistic regression modeling. Learning Objectives. Chatterjee, N. and Carroll,
R.J. 2005. Semiparametric maximum likelihood estimation exploiting gene-environment
independence in case-control studies. Biometrika, 92, 399–418. (Cited on pp. 158 and 159.) Liu, M.,
Lu, W., and Tseng, C.-H. 2010. Cox regression in nested case-control studies with auxiliary
covariates. Biometrics, 66, 374–381. (Cited on p. 190.) The foregoing has largely been a review of
the concepts introduced during the lecture on incidence and prevalence. However, a key interest of
epidemiology is in identifying determinants of disease. To find which factors are related to the
occurrence of disease we generally compare the incidence of disease across different groups in the
population. So, for example, if we have a group of people who are exposed to some factor, then we
will want to estimate the incidence in that group. Here we have an exposed group of 75 people, in
the top three rows of our population at risk. In this first week of follow-up, one new case has
occurred. Cologne, J.B., Sharp, G.B., Neriishi, K., Verkasalo, P.K., Land, C.E., and Nakachi, K.
2004. Improving the efficiency of nested case-control studies of interaction by selection of controls
using counter-matching on exposure. International Journal of Epidemiology, 33, 485–492. (Cited on
p. 188.) Langholz, B. and Goldstein, L. 2001. Conditional logistic analysis of case-control studies
with complex sampling. Biostatistics, 2, 63–84. (Cited on pp. 158 and 188.) 7. 10/7/2008 Case-
control studies 7 Question 2 – answer Answer: If you answered that you are second to last, then you
are wrong again. Tell me, how can you overtake the LAST person?! …? You're not very good at this
are you? CASE-CONTROL STUDIES. Nigel Paneth. EVOLUTION OF THE CASE-CONTROL
STUDY. 1. CASE What is a case? Consolidating several different signs and symptoms into
"caseness" was a key development in medicine. Anderson, J.A. 1972. Separate sample logistic
discrimination. Biometrika, 59, 19–35. (Cited on pp. 30 and 108.) Thompson, W.D., Kelsey, J.L.,
and Walter, S.D. 1982. Cost and efficiency in the choice of matched and unmatched case-control
designs. American Journal of Epidemiology, 116, 840–851. (Cited on p. 82.) 83. 10/7/2008 Case-
control studies 83 Estimating the population odds with the odds in the control group Exposed cases
/ Unexposed cases IDR = ––––––––––––––––––––––––––––––– Exposed controls / Unexposed
controls We call this the “exposure odds ratio” (OR). 22. 10/7/2008 Case-control studies 22
Attributable risk Attributable risk can be presented as: 1. an “absolute” number, e.g., “80,000, or 20
per 100 cases/year of stroke are attributable to smoking” 2. a “relative” number, e.g., “20% of stroke
cases are attributable to smoking”. (analogy: a wage increase in a part-time job: $ increase, %
increase in wage, % increase in income)
On to question 3: The third question is very tricky math! Note: This must be done in your head only.
Do NOT use paper and pencil or a calculator. Try it. – Begin with a cohort of 10,000 individuals
without rheumatoid arthritis Borenstein, M., Hedges, L.V., Higgins, J.P.T., and Rothstein, H.R. 2010.
A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis
Methods, 1, 97–111. (Cited on p. 251.) Cross-sectional study design At one point in time Exposure
levels Health status Evidence-based Chiropractic Nested case control study. 分析流行病學方法
的詳細分類. Cohort study. 過去. 現在. 未來. Case control study. 過去. 現在. 未來. Nested
case control study. 過去. 現在. 未來. Disease risk in exposed. Risk exposure. Disease risk in
nonexposed. Risk nonexposure. Relative Risk ( FOR COHORT). Definition: Select 6 - Special
sampling designs Nested Case-Control Study • Case-control studies within a cohort study • In ARIC
(Atherosclerosis Risk in Communities) study, a cohort of 16 thousand men, all men provided serum
samples at the outset which were saved. • The cohort is observed for CHD. • After 5 years we have
246 cases of CHD. • We randomly choose 500 participants to be controls. • We only measure
Chlamydia antibody in the stored sera from these 246 + 500 subjects. • We compare the cases
(CHD) to the controls (no CHD) with regard to the presence of exposure (Chlamydia) which
preceded the outcome Case-Control Studies - Slide 33 With respect to the relationship between
theophylline use and sudden cardiac death, the authors found the following: Theophylline in last 3
months Yes No | Total Cardiac Death Yes 17 13 | 30 No 956 3124 | 4080 Note that numbers in table
refer to person-days (not to persons) OR (crude) = ad = 17 x 3124 = 4.3 (2.1 - 8.8) __ ________ bc
13 x 956 IRR (crude) = 4.3 (2.1 - 8.8) © 2024 SlideServe. All rights reserved Neyman, J. and Scott,
E.L. 1948. Consistent estimates based on partially consistent observations. Econometrica, 16, 1–32.
(Cited on p. 82.) 6. Purpose: To produce a valid estimate of a hypothesised cause-effect
relationship between suspected risk factor and disease. Case Control Study Cohort Study Starts with
diseased (cases) & not diseased (controls) Starts with not diseased but exposed & not exposed
Determine if 2 groups differ in exposure to specific factor or factors Followed up to determine
difference in rates at which disease develops in relation to exposure Called as case control study due
to the way Called so because of the use of a “cohort” in which study group is assembled (a group of
people who share a common characteristic or experience) (FOR ACCESSIBILITY: A case control
study is likely to show that most, but not all exposed people end up with the health issue, and some
unexposed people may also develop the health issue) 71. 10/7/2008 Case-control studies 71 Ratio of
exposed to unexposed population-time = “exposure odds” Exposed cases / Unexposed cases IRR =
–––––––––––––––––––––––––––––––– Exp Person-time / Unexp Person-time “Exposure odds” in
cases = ––––––––––––––––––––––––––– “Exposure odds” in population Race-start characteristics
and risk of catastrophic musculoskeletal injury in thoroughbred racehorses. Paneth, N., Susser, E.,
and Susser, M. 2002a. Origins and early development of the case-control study: part 1, early
evolution. Sozial- und Praventivmedizin, 47, 282–288. (Cited on p. 30.) Breslow, N.E. and Powers,
W. 1978. Are there two logistic regressions for retrospective studies?Biometrics, 34, 100–105. (Cited
on p. 108.) Thompson, S.G. and Sharp, S.J. 1999. Explaining heterogeneity in meta-analysis: a
comparison of methods. Statistics in Medicine, 18, 2693–2708. (Cited on p. 251.) The father of
epidemiology (cont.) • He surveyed the houses near a certain public water pump and discovered that
nearly all persons who died had consumed water from that pump • He presented his data to the local
authorities who immediately had the pump handle removed • The outbreak quickly subsided as a
result Evidence-based Chiropractic 52. Odds ratio: Using the four-fold table – Diseased/ Cases
Exposed a Not diseased/ Controls b Not exposed c d Odds that case was exposed Odds ratio =
Odds that control was exposed = (a/c)/ (b/d) = ad / bc Robins, J.M., Gail, M.H. and Lubin, J.H.
1986. More on ‘Biased selection of controls for case-control analyses of cohort studies’. Biometrics,
42, 293–299. (Cited on pp. 187 and 188.) 78. 1/29/2007 Case-control studies 78

OO
O O O O O Can we estimate exposure odds in the population by taking a sample? Since we are
using the same cases as for the IDR, the exposure odds in cases are identical to before, 4/3 = 1.33.
5. Analyze data: compare the exposure frequencies in those with and without disease. Measure of
association = Odds ratio (exposure odds ratio) CASE-CONTROL STUDIES. Nigel Paneth.
EVOLUTION OF THE CASE-CONTROL STUDY. 1. CASE What is a case? Consolidating several
different signs and symptoms into "caseness" was a key development in medicine. The StarNet Case
Control Study. Investigating the Effects of Genes and Environment on Smoking Behavior.
Overview of Research Study. Phase 1: Designing the StarNet Case Control Study Case-Control
Studies • Identify cases in a source population • Select at random non-cases from the same source
population • Compare exposure histories in cases & controls Cases Exposure histories Population
Odds Ratio Sample non-cases Exposure histories Note: case-control samples do not permit the
calculatino of incidence or prevalence! Higgins, J.P. and Thompson, S.G. 2002. Quantifying
heterogeneity in a meta-analysis. Statistics in Medicine, 21, 1539–1558. (Cited on p. 251.) In its
simplest form, we can say that case control study is comparing a case series to a matched control
series. Download Policy: Content on the Website is provided to you AS IS for your information and
personal use and may not be sold / licensed / shared on other websites without getting consent from
its author.
Thanks to the fudging, the OR estimate here, 1.33 / 0.58 = 2.29, is identical to that obtained by using
the exposure odds for all noncases. Again, it is slightly larger than the CIR. Case-Control Studies for
Outbreak Investigations. Goals. Describe the basic steps of conducting a case-control study Discuss
how to select cases and controls Discuss how to conduct basic data analysis (odds, odds ratios, and
matched analysis) White, I.R., Royston, P., and Wood, A.M. 2011. Multiple imputation using
chained equations: issues and guidance for practice. Statistics in Medicine, 30, 377–399. (Cited on p.
189.) The antecedents of psychoses: a case-control study of selected risk factors. FEATURES OF
CASE-CONTROL STUDIES 1. DIRECTIONALITY: Outcome to exposure 2. TIMING:
Retrospective for exposure, but case-ascertainment can be either retrospective or concurrent. 3.
SAMPLING: Almost always on outcome, with matching of controls to cases Neuhauser, M. and
Becher, H. 1997. Improved odds ratio estimation by post-hoc stratification of case-control data.
Statistics in Medicine, 16, 993–1004. (Cited on p. 109.) Graphical Representation Randomized Trial
Cohort Study People People Person-Time Person-Time Select 3 - Matched case-control studies Gene-
Environment Case-Control Studies. Raymond J. Carroll Department of Statistics Faculties of
Nutrition and Toxicology Texas A&M University http://stat.tamu.edu/~carroll. TexPoint fonts used in
EMF. Read the TexPoint manual before you delete this box.: A A A A A A A A A A. Outline. Case –
Control Study • Grouping studied: "cases" vs. "Control" group(s). • Measurements analyzed: past
"exposures.“ • Case-selection usually clinic- or hospital-based. • Controls may also be clinic- or
hospital-based, or population-sampled. • Controls may be unmatched, group-matched, or
individually matched. Greenland, S. 1982. The effect of misclassification in matched-pair case-
control studies. American Journal of Epidemiology, 116, 402–406. (Cited on p. 237.) Case-Control
Studies - Slide 1 Objectives Students will be able to: 1. Define the term “case-control study” 2.
Explain the relationship between case-control and cohort studies 3. Understand the difference
between cumulative incidence and incidence density designs Epidemiology . A branch of science
that investigates the frequency and distribution of diseases in a defined population in an attempt to
determine their causes, to discover ways to alleviate them, and to prevent their reoccurrences .
Features of epidemiologic studies . In its simplest form, we can say that case control study is
comparing a case series to a matched control series. – People who were exposed are no more or
less likely to have the outcome when compared to persons who were not exposed As expected, the
CIR can be expressed as a ratio of exposure odds in cases to exposure odds in the population at risk.
24. Selection of CASES: 3. Diagnostic criteria for case studies Example: In a study on breast
cancer – we can include all cases OR we can include only premenopausal women with lobular
cancer. If we take the later group as cases; we can elicit the etiology better. Subjects in case-
control studies • Controls should be as similar to cases as is possible • Cases and controls are
normally matched so that they are as alike as possible • Regarding variables such as age, gender,
weight, occupation, etc. • Except for the presence of the disease under investigation Evidence-based
Chiropractic Risk Sets Each case is compared to all the people who were at risk to become cases at
the time the case occurred. This collection of persons at risk is called the “Risk Set.” Persons over
Time Risk Set 30. 10/7/2008 Case-control studies 30

O Week 1 O Zota, A.R., Aschengrau, A., Rudel,

R.A., and Brody, J.G. 2010. Self-reported chemicals exposure, beliefs about disease causation, and
risk of breast cancer in the Cape Cod Breast Cancer and Environment Study: a case-control study.
Environmental Health, 9, doi:10.1186/1476-069X-9-40. (Cited on p. 213.) Case control studies aim
to identify if there is an association between a potential risk factor and a particular disease or
outcome. These studies are used frequently to identify the:- Take Home Lessons: Cohort Sampling •
All case-control studies can be seen as being samples drawn from specifiable cohorts. • Different
modes of cohort analysis give rise to corresponding case-control designs. • Closed cohort, fixed
folow-up Sample noncases • Variable follow-up time, time-varying exposure, stable baseline
incidence Sample person-time • Variable baseline incidence Sample risk sets • Case-control
analysis are directly tied to the corresponding cohort analysis, with further allowance for sampling •
“Case-control” studies that do not use cohort sampling are valid only to the extent that the
procedures used approximate cohort sampling. An Image/Link below is provided (as is) to download
presentation CASE-CONTROL STUDY DISADVANTAGES: • Memory errors, selection errors • It
doesn’t allow a direct calculation of incidence • Data validation is difficult to determine • Thay can’t
be used for rare exposures • They study only one effect 116. 10/7/2008 Case-control studies 116
Exposure odds in “cumulative” controls = Exposed noncases / Unexp. noncases = 5 / 9 (about) =
0.58 (Note: 5/9=0.555, but a larger “sample” would produce 0.58) Issues in case-control studies.
Internal Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Kwang
Hyuck Lee [email protected]. Issues in case-control studies. Eliseo Guallar , MD, DrPH
[email protected] Juhee Cho, M.A., Ph.D. [email protected]. Self, S.G. and Prentice, R.L. 1988.
Asymptotic distribution theory and efficiency results for case-cohort studies. Annals ofStatistics, 16,
64–81. (Cited on p. 210.) 15. Probability that an event will happen Odds= Probability that the even
will not happen Probability that an event will happen Odds= 1 - (Probability that the event will
happen) 73. 10/7/2008 Case-control studies 73 From before: Exposed: 4 4 IR = –––––––––––––– =
–––– = 0.018 / wk 74.5 + 73 + 71.5 219 Unexposed: 3 3 IR = –––––––––––––––––– = ––––– =
0.008 / wk 124.5 + 123.5 + 122.5 370.5