Document Detail


The nested case-control study in cardiology.
MedLine Citation:
PMID:  14564310     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The nested case-control study is an efficient epidemiological design whereby a case-control approach is employed within an established cohort. The large number of recent prospective studies and randomized trials conducted in cardiology provide cohorts within which the nested case-control approach is increasingly used. METHODS: This paper describes the design of the nested case-control study, and evaluates its role in cardiology by reviewing all such studies indexed in Medline from 1966 to 2000. The example of homocysteine is used to illustrate how discrepancies between results of nested case-control and case-control studies played an important role in the decisions and recommendations of national and international organizations. RESULTS: Seventy-seven nested case-control studies in cardiology were reviewed. The number of studies per year has been increasing since the first publication in 1987. The majority (96%) of studies evaluated potential risk factors for cardiovascular disease while the remainder evaluated drugs with cardiac adverse effects. In studies of homocysteine and coronary artery disease, nested case-control studies did not confirm the strong association suggested by early case-control studies that may have been influenced by bias (eg, selection, publication, or reverse causality). This led national and international organizations to advise against routine screening. CONCLUSIONS: The nested case-control study is increasingly used to study causal relationships in cardiology. The large cohorts of cardiac patients created by prospective studies, clinical trials, and administrative databases should be exploited using this methodology to assess potential cardiac risk factors and other causal relationships that cannot be studied in randomized trials.
Authors:
Vidal Essebag; Jacques Genest; Samy Suissa; Louise Pilote
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-17     Completed Date:  2003-11-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  581-90     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, McGill University Health Center, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cardiology*
Case-Control Studies*
Coronary Disease / blood,  etiology*
Homocysteine / blood*
Humans
Meta-Analysis as Topic
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 454-28-4/Homocysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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