课件：匹配病例对照研究的分析Analysis of matched case control stud.ppt

* * * Etude cas- témoins correspondant à la cohorte Rétrospective dans sa logique Sac de cas contre sac de témoins Sens de la lecture f1 et f2 Adieu risque * * * * * * * * * * * * * * 匹配变量The matched set variable 是一个另加的变量 Extra variable 每个病例-对照的识别号 Identifier for each case-control 在频数匹配中是“层” Stratum (Frequency matching) 在集合匹配中是“集合” Set (Case control sets) 在配对匹配是“对子” Pair (Case control pairs) 在每一“层/集合/对子”内中，所有病例和对照的这个变量值都是相同的 All cases and controls belonging to the same stratum/ set/ pair share the same value for the matched set variable 在不同的“层/集合/对子”，这个变量值不同 Each stratum/ set/ pair have a unique value 2个集合的1:3集合匹配数据库变量结构Database structure for 2 sets of one case and three controls ID Set Status Age Sex SES 1 1 1 12 1 3 2 1 2 13 1 3 3 1 2 11 1 3 4 1 2 10 1 3 5 2 1 42 2 2 6 2 2 44 2 2 7 2 2 40 2 2 8 2 2 41 2 2 4个对子的配对匹配数据库变量结构Database structure for 4 pairs of one case and one control ID Pair Status Age Sex SES 1 1 1 12 1 3 2 1 2 13 1 3 3 2 1 22 2 7 4 2 2 22 2 7 5 3 1 42 2 2 6 3 2 44 2 2 7 4 1 54 2 1 8 4 2 55 2 1 匹配：优点Matching: Advantages 易于沟通 Is easy to communicate 对很强地混杂有用处 Is useful for strong confounding factors 能增加小型研究的效率 Can increase the power of small studies 能较容易地选择对照 Can ease control recruitment 如果只有一个研究因素，则有用处 Is useful if only one factor is studied 匹配后，仍可以识别效应修饰因子 Allows looking for effect modification with matching criteria 匹配：不方便的方面Matching: Inconvenience 必须使作者清楚 Must be understood by the author 在不存在混杂情况下导致不利 Is deleterious in the absence of confounding 可降低研究效率 Can decrease power 造成对照选择的复杂 Can complicate control recruitment 存在多个危险因素时，作用有限 Is limiting if more than one factor 不再能对匹配因素进行关联性分析 Does not allow examining the association with the matching criteria 匹配变量与暴露有关，但与疾病无关时（匹配过度）Matching with a variable associated with exposure, but not with illness (Overmatching) 减少了变异度 Reduces variability 增加了一致地对子 Increases the number of concordant pairs 造成有害的结果 Has deleterious consequences: 如果匹配分析：降低了研究效率 If matched analysis: reduction of p