ESTIMATING BENEFITS OF SCREENING FROM OBSERVATIONAL COHORT STUDIES

被引:13
作者
FLANDERS, WD
LONGINI, IM
机构
[1] Department of Epidemiology and Biostatistics, Emory University School of Medicine, Atlanta, Georgia, 30329, 1599 Clifton Rd, N.E.
关键词
D O I
10.1002/sim.4780090812
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Analysis and interpretation of observational studies of screening effectiveness is difficult because several biases threaten validity, including the structural healthy screenee bias, length bias, and effects of lead time. Although methods for the analysis of observational studies of screening effectiveness have been proposed, most have limitations such as incomplete control of length bias, or a heavy reliance on distributional assumptions. In this report we present a method for the analysis of observational cohort studies of screening effectiveness. Although developed independently and formulated specifically for estimating benefits of screening, our approach is implied by a more general approach developed previously by Robins. Our approach, in contrast to other available methods, avoids the healthy screenee bias, and length and lead time bias, and allows an empirical approach to analysis that need not depend highly on distributional assumptions. We illustrate application of the approach with analysis of published data from a study of breast cancer screening. Copyright © 1990 John Wiley & Sons, Ltd.
引用
收藏
页码:969 / 980
页数:12
相关论文
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