Reducing selection bias in case-control studies from rare disease registries

<p>Abstract</p> <p>Background</p> <p>In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective,...

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Main Authors: Mistry Pramod K, Weinreb Neal J, Hangartner Thomas N, Taylor John S, Cole J Alexander, Khan Aneal
Format: Article
Language:English
Published: BMC 2011-09-01
Series:Orphanet Journal of Rare Diseases
Online Access:http://www.ojrd.com/content/6/1/61
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author Mistry Pramod K
Weinreb Neal J
Hangartner Thomas N
Taylor John S
Cole J Alexander
Khan Aneal
author_facet Mistry Pramod K
Weinreb Neal J
Hangartner Thomas N
Taylor John S
Cole J Alexander
Khan Aneal
author_sort Mistry Pramod K
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses.</p> <p>The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example.</p> <p>Methods</p> <p>A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching.</p> <p>Results</p> <p>The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias.</p> <p>Conclusions</p> <p>We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.</p>
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spelling doaj.art-3be4ce5d3c8c4bb4ad9b4c704bf6a06d2022-12-22T03:17:59ZengBMCOrphanet Journal of Rare Diseases1750-11722011-09-01616110.1186/1750-1172-6-61Reducing selection bias in case-control studies from rare disease registriesMistry Pramod KWeinreb Neal JHangartner Thomas NTaylor John SCole J AlexanderKhan Aneal<p>Abstract</p> <p>Background</p> <p>In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses.</p> <p>The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example.</p> <p>Methods</p> <p>A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching.</p> <p>Results</p> <p>The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias.</p> <p>Conclusions</p> <p>We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.</p>http://www.ojrd.com/content/6/1/61
spellingShingle Mistry Pramod K
Weinreb Neal J
Hangartner Thomas N
Taylor John S
Cole J Alexander
Khan Aneal
Reducing selection bias in case-control studies from rare disease registries
Orphanet Journal of Rare Diseases
title Reducing selection bias in case-control studies from rare disease registries
title_full Reducing selection bias in case-control studies from rare disease registries
title_fullStr Reducing selection bias in case-control studies from rare disease registries
title_full_unstemmed Reducing selection bias in case-control studies from rare disease registries
title_short Reducing selection bias in case-control studies from rare disease registries
title_sort reducing selection bias in case control studies from rare disease registries
url http://www.ojrd.com/content/6/1/61
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AT hangartnerthomasn reducingselectionbiasincasecontrolstudiesfromrarediseaseregistries
AT taylorjohns reducingselectionbiasincasecontrolstudiesfromrarediseaseregistries
AT colejalexander reducingselectionbiasincasecontrolstudiesfromrarediseaseregistries
AT khananeal reducingselectionbiasincasecontrolstudiesfromrarediseaseregistries