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Statistics Seminar Series
Thursday, Jan. 31, 2013, 4:00 PM
Cullimore, Room 611
New Jersey Institute of Technology
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Case Definition and Design
Sensitivity in Case Control Studies
Dylan
Small
Department of Statistics, Whaston School
University of Pennsylvania
Abstract
A case-control study compares
cases of some disease or disorder to some group of controls (non-cases),
looking backwards in time to contrast the frequency of treatment among cases
and controls. Cases are typically matched to controls on measured
pretreatment covariates. However, in an observational study, there may be
unmeasured pretreatment covariates that affect both treatment and
outcomes. A sensitivity analysis asks: What magnitude of bias from
unmeasured covariates would need to be present to materially alter the
conclusions of a naïve analysis that presumes adjustments for measured
covariates suffice to remove all bias?
The first step in designing a case-control study is to
define a case of disease and a control. For example, the disease may have
different severities and one needs to choose how severe a person’s disease
needs to be for the person to be a case. We examine the effects of this
design decision on the sensitivity of conclusions to unmeasured biases.
We develop an adaptive procedure for choosing the case definition based on the
data to make the study as insensitive to unmeasured biases as possible
asymptotically. This is joint work with Jing Cheng, Betz Halloran and
Paul Rosenbaum.