Interpreting Epidemiologic Evidence: Strategies for Study Design & Analysis

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Oxford University Press, Jun 5, 2003 - Medical - 336 pages
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Evaluating the strength or persuasiveness of epidemiologic evidence is inherently challenging, both for those new to the field and for experienced researchers. There are a myriad of potential biases to consider, but little guidance about how to asses the likely impact on study results. This book offers a strategy for assessing epidemiologic research findings, explicitly describing the goals and products of epidemiologic research in order to better evaluate it successes and limitations. The focus throughout is on practical tools for making optimal use of available data to assess whether hypothesized biases are operative and to anticipate concerns at the point of study design in order to ensure that needed information is generated. Specific tools for assessing the presence and impact of selection bias in both cohort and case-control studies, bias from non-response, confounding, exposure measurement error, disease measurement error, and random error are identified and evaluated. The potential value of each approach as well as its limitations are discussed, using examples from the published literature. Such information should help those who generate and interpret epidemiologic research to apply methodological principles more effectively to substantive issues, leading to a more accurate appraisal of the current evidence and greater clarity about research needs.
 

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Contents

1 Introduction
1
2 The Nature of Epidemiologic Evidence
7
3 Strategy for Drawing Inferences from Epidemiologic Evidence
29
4 Selection Bias in Cohort Studies
51
5 Selection Bias in CaseControl Studies
81
6 Bias Due to Loss of Study Participants
115
7 Confounding
137
8 Measurement and Classification of Exposure
163
9 Measurement and Classification of Disease
205
10 Random Error
243
11 Integration of Evidence Across Studies
261
12 Characterization of Conclusions
285
Index
305
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