病例对照研究中对照的选择.pptVIP

病例对照研究中对照的选择 Selection of controls in a case-control or case-base study Robert E. Fontaine, MD, MSc Bao-Ping Zhu, MD, MS US Expert Advisors to Chinese FETP 选择对照的原则 Rules of control selection ? 病例和对照来自于同一人群或人群组 Cases and controls come from the same base (population or population subset) ? 病例和对照间除了要研究的暴露因素外其他越相似越好 Selection designed to increase similarity with cases for all characteristics except the exposures under investigation ? 如果对照发生了疾病，那么也会变成病例的一部分 If controls had developed illness, they would have been detected as a case 在工厂、学校、小村庄中选择对照 Selection of controls: factories, schools, institutions, small villages ? 常常有各群 组 的名 单 Lists are available by groups ? 用 单纯 随机、系 统 抽 样 或其他方法来抽 样 Random, systematic or other probability selection from lists. ? 若各群 组 罹患率不同， 应 使病例和 对 照中各 组 人 数平衡 If attack rates differ by group then balance cases to controls by group. 某工厂疾病在各群组中的分布情况。如何选 择对照？ A disease in a factory. How do you choose controls? Group Cases People A 6 35 B 12 80 C 10 55 D 13 90 E 14 95 F 18 125 G 9 50 H 10 65 Group Cases People A 0 35 B 28 80 C 0 55 D 3 90 E 24 95 F 34 125 G 2 50 H 1 65 某工厂疾病在各群组中的分布情况。如何选 择对照？ A disease in a factory. How do you choose controls? 在“开放”人群中选择对照 Control selection in an “open” population ? 没有有用的名单 No useful list 例： o 大单位或工厂 Large institutions or factories o 城镇 Towns o 城市 Cities o 县 Counties o 省 Provinces, o 国家 Countries 根据入选标准，从范围较小的人群中选择 We select from a more limited population defined by eligibility criteria ? 将人群根据以下特征进行定义 Population + collection of persons defined by: o 时间 Time o 地点 Place o 人群 Person ? 用入选标准，从这一假定人群中选择对照 Use eligibility criteria to select from this hypothetical population 病例和对照应该用同样的入选标准 Eligibility criteria should be applied equally to cases and controls. 例：在一个 1,110,000 人的城市中有 150 个病例。 需要随机选择对照 You have 150 cases in a city of 1,110,000 you select controls at random ? 如何选择对照？ How do you select controls? ? 要考虑哪些问题？ What must you think about? ? 假定我们随机选择了 150 名对照 Lets take a random selection of 150 但