Document Detail

Observational studies of cause-effect relationships: an analysis of methodologic problems as illustrated by the conflicting data for the role of oral contraceptives in the etiology of rheumatoid arthritis.
MedLine Citation:
PMID:  3760110     Owner:  NLM     Status:  MEDLINE    
We review the structure of the two most common observational study designs, cohort and case-control studies, and outline guidelines to help clinicians evaluate the validity of studies that employ these designs. To demonstrate the use of these guidelines we apply them to the important issue of whether oral contraceptive usage may reduce the risk of developing rheumatoid arthritis. A recent case-control study has contradicted provocative evidence from two previous studies suggesting the existence of such a protective effect. Our analysis leads to the conclusion that the case-control study suggesting no association of oral contraceptives with the subsequent development of rheumatoid arthritis provides the best estimate of the effect of oral contraceptives currently available, and furthermore, the analysis permits recommendations to be made for the design of future investigations on this topic.
J M Esdaile; R I Horwitz
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of chronic diseases     Volume:  39     ISSN:  0021-9681     ISO Abbreviation:  J Chronic Dis     Publication Date:  1986  
Date Detail:
Created Date:  1986-11-21     Completed Date:  1986-11-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985123R     Medline TA:  J Chronic Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  841-52     Citation Subset:  IM    
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MeSH Terms
Arthritis, Rheumatoid / diagnosis,  etiology*,  prevention & control
Contraceptives, Oral / administration & dosage*,  adverse effects
Diagnostic Errors
Research Design*
Reg. No./Substance:
0/Contraceptives, Oral

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