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HLTH 240b (10)
Lecture 8

HLTH 240b Lecture 8: Case-Control Studies

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Yale University
Global Health Studies
HLTH 240b
Marney White

HLTH 240: Epidemiology and Public Health a. Case-control o Subjects selected with respect to presence (cases) or absence (controls) of disease, then inquiries are made about past exposure  Different from cohort study in that selection starts with cases and controls, whereas in cohort studies selection starts with exposure status o Compare diseased (cases) and non-diseased (controls) to find out level of exposure  Limited to OR o Exposure status traced backwards in time  Interview of medical record o Steps 1. Define cases and non-cases a. Establish strict diagnostic criteria with careful attention to case definition b. Classify into population of cases and population of controls 2. Select sample of cases from case population a. Sample must be representative of case population 3. Select sample of controls from control population a. Must be representative of control population b. Similar to cases except on outcome 4. Measure exposure in cases and controls 5. Compare/calculate OR a. For cases and controls: use same selection/sampling frame i. E.g., hospital records o Types  Retrospective  Use prevalent cases  Difficult to establish temporal sequence  Subject to recall bias  Prospective  Use incident cases  Can establish temporal sequence  Recall bias
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