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Design considerations for case series models with exposure onset measurement error.

ABSTRACT: The case series model allows for estimation of the relative incidence of events, such as cardiovascular events, within a pre-specified time window after an exposure, such as an infection. The method requires only cases (individuals with events) and controls for all fixed/time-invariant confounders. The measurement error case series model extends the original case series model to handle imperfect data, where the timing of an infection (exposure) is not known precisely. In this work, we propose a method for power/sample size determination for the measurement error case series model. Extensive simulation studies are used to assess the accuracy of the proposed sample size formulas. We also examine the magnitude of the relative loss of power due to exposure onset measurement error, compared with the ideal situation where the time of exposure is measured precisely. To facilitate the design of case series studies, we provide publicly available web-based tools for determining power/sample size for both the measurement error case series model as well as the standard case series model.

SUBMITTER: Mohammed SM

PROVIDER: S-EPMC4075338 | biostudies-literature | 2013 Feb

REPOSITORIES: biostudies-literature

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Design considerations for case series models with exposure onset measurement error.

Mohammed Sandra M SM Dalrymple Lorien S LS Sentürk Damla D Nguyen Danh V DV

Statistics in medicine 20120822 5

The case series model allows for estimation of the relative incidence of events, such as cardiovascular events, within a pre-specified time window after an exposure, such as an infection. The method requires only cases (individuals with events) and controls for all fixed/time-invariant confounders. The measurement error case series model extends the original case series model to handle imperfect data, where the timing of an infection (exposure) is not known precisely. In this work, we propose a ...[more]

PMID: 22911898

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Project description:BackgroundTwo distinctly different types of measurement error are Berkson and classical. Impacts of measurement error in epidemiologic studies of ambient air pollution are expected to depend on error type. We characterize measurement error due to instrument imprecision and spatial variability as multiplicative (i.e. additive on the log scale) and model it over a range of error types to assess impacts on risk ratio estimates both on a per measurement unit basis and on a per interquartile range (IQR) basis in a time-series study in Atlanta.MethodsDaily measures of twelve ambient air pollutants were analyzed: NO2, NOx, O3, SO2, CO, PM10 mass, PM2.5 mass, and PM2.5 components sulfate, nitrate, ammonium, elemental carbon and organic carbon. Semivariogram analysis was applied to assess spatial variability. Error due to this spatial variability was added to a reference pollutant time-series on the log scale using Monte Carlo simulations. Each of these time-series was exponentiated and introduced to a Poisson generalized linear model of cardiovascular disease emergency department visits.ResultsMeasurement error resulted in reduced statistical significance for the risk ratio estimates for all amounts (corresponding to different pollutants) and types of error. When modelled as classical-type error, risk ratios were attenuated, particularly for primary air pollutants, with average attenuation in risk ratios on a per unit of measurement basis ranging from 18% to 92% and on an IQR basis ranging from 18% to 86%. When modelled as Berkson-type error, risk ratios per unit of measurement were biased away from the null hypothesis by 2% to 31%, whereas risk ratios per IQR were attenuated (i.e. biased toward the null) by 5% to 34%. For CO modelled error amount, a range of error types were simulated and effects on risk ratio bias and significance were observed.ConclusionsFor multiplicative error, both the amount and type of measurement error impact health effect estimates in air pollution epidemiology. By modelling instrument imprecision and spatial variability as different error types, we estimate direction and magnitude of the effects of error over a range of error types.

Project description:Using multipollutant models to understand combined health effects of exposure to multiple pollutants is becoming more common. However, complex relationships between pollutants and differing degrees of exposure error across pollutants can make health effect estimates from multipollutant models difficult to interpret.We aimed to quantify relationships between multiple pollutants and their associated exposure errors across metrics of exposure and to use empirical values to evaluate potential attenuation of coefficients in epidemiologic models.We used three daily exposure metrics (central-site measurements, air quality model estimates, and population exposure model estimates) for 193 ZIP codes in the Atlanta, Georgia, metropolitan area from 1999 through 2002 for PM2.5 and its components (EC and SO4), as well as O3, CO, and NOx, to construct three types of exposure error: ?spatial (comparing air quality model estimates to central-site measurements), ?population (comparing population exposure model estimates to air quality model estimates), and ?total (comparing population exposure model estimates to central-site measurements). We compared exposure metrics and exposure errors within and across pollutants and derived attenuation factors (ratio of observed to true coefficient for pollutant of interest) for single- and bipollutant model coefficients.Pollutant concentrations and their exposure errors were moderately to highly correlated (typically, > 0.5), especially for CO, NOx, and EC (i.e., "local" pollutants); correlations differed across exposure metrics and types of exposure error. Spatial variability was evident, with variance of exposure error for local pollutants ranging from 0.25 to 0.83 for ?spatial and ?total. The attenuation of model coefficients in single- and bipollutant epidemiologic models relative to the true value differed across types of exposure error, pollutants, and space.Under a classical exposure-error framework, attenuation may be substantial for local pollutants as a result of ?spatial and ?total with true coefficients reduced by a factor typically < 0.6 (results varied for ?population and regional pollutants).

Project description:BackgroundIn epidemiological studies, it is often not possible to measure accurately exposures of participants even if their response variable can be measured without error. When there are several groups of subjects, occupational epidemiologists employ group-based strategy (GBS) for exposure assessment to reduce bias due to measurement errors: individuals of a group/job within study sample are assigned commonly to the sample mean of exposure measurements from their group in evaluating the effect of exposure on the response. Therefore, exposure is estimated on an ecological level while health outcomes are ascertained for each subject. Such study design leads to negligible bias in risk estimates when group means are estimated from 'large' samples. However, in many cases, only a small number of observations are available to estimate the group means, and this causes bias in the observed exposure-disease association. Also, the analysis in a semi-ecological design may involve exposure data with the majority missing and the rest observed with measurement errors and complete response data collected with ascertainment.MethodsIn workplaces groups/jobs are naturally ordered and this could be incorporated in estimation procedure by constrained estimation methods together with the expectation and maximization (EM) algorithms for regression models having measurement error and missing values. Four methods were compared by a simulation study: naive complete-case analysis, GBS, the constrained GBS (CGBS), and the constrained expectation and maximization (CEM). We illustrated the methods in the analysis of decline in lung function due to exposures to carbon black.ResultsNaive and GBS approaches were shown to be inadequate when the number of exposure measurements is too small to accurately estimate group means. The CEM method appears to be best among them when within each exposure group at least a 'moderate' number of individuals have their exposures observed with error. However, compared with CEM, CGBS is easier to implement and has more desirable bias-reducing properties in the presence of substantial proportions of missing exposure data.ConclusionThe CGBS approach could be useful for estimating exposure-disease association in semi-ecological studies when the true group means are ordered and the number of measured exposures in each group is small. These findings have important implication for cost-effective design of semi-ecological studies because they enable investigators to more reliably estimate exposure-disease associations with smaller exposure measurement campaign than with the analytical methods that were historically employed.

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Design considerations for case series models with exposure onset measurement error.

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Design considerations for case series models with exposure onset measurement error.

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