© 1992 Oxford University Press
research-article |
Correlated Nondifferential Misclassifications of Disease and Exposure: Application to a Cross-Sectional Study of the Relation between Handedness and Immune Disorders
INSERM U 169, 16 avenue Paul Vaillant-Couturier, F-94807 villejuif, France
In cross-sectional studies, misclassifications of exposure and of health status may be related. For instance some subjects may tend to overreport both exposure and disease. A misclassification is said to be nondifferential if the sensitivity and the specificity which characterize it do not depend on the true status of the subjects for the other variables. Nondifferential misclassifications of two dichotomic variables may be correlated if the probability of being misclassified for one of them depends on the presence of an error of classification for the second one. Models are presented to estimate the bias induced by correlated nondifferential misclassifications on an odds ratio whose true value is unity. For most usual situations, when the great majority of the subjects are healthy and nonexposed, the influence of overreporting is shown to be larger than that of underreporting. It appears to be relatively easy to find a spurious, but significant, relationship.
Real data are analysed to show that the potential consequences of correlated nondifferential misclassifications are not purely theoretical. In a sample of 1676 subjects from the general population we observed significant relations between left-hand shift and various aspects of health Status: reporting a history of eczema, experience of a serious health problem in the past, experience of a serious health problem presently, use during the last month of analgesics or of drugs for circulatory problems, or digestion, consultation with a physiotherapist or hospitalization during the last year. These results, as with many similar ones previously reported, are highly suggestive of an information bias. They are less easily explained by biological hypotheses, e.g. Geschwind's theory of cerebral lateralization, than by correlated misclassifications resulting from overreporting of both the use of the left hand and the existence of some health problems by healthy right-handers. The modelling used in this report supports this hypothesis.
Received 1 January 1992
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M Jurek, S. Greenland, and G. Maldonado Brief Report: How far from non-differential does exposure or disease misclassification have to be to bias measures of association away from the null? Int. J. Epidemiol., April 1, 2008; 37(2): 382 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Thoresen A Note on Correlated Errors in Exposure and Outcome in Logistic Regression Am. J. Epidemiol., August 15, 2007; 166(4): 465 - 471. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Pearce, H. Checkoway, and D. Kriebel Bias in occupational epidemiology studies Occup. Environ. Med., August 1, 2007; 64(8): 562 - 568. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Greenland and P. Gustafson Accounting for Independent Nondifferential Misclassification Does Not Increase Certainty that an Observed Association Is in the Correct Direction Am. J. Epidemiol., July 1, 2006; 164(1): 63 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P Fox, T. L Lash, and S. Greenland A method to automate probabilistic sensitivity analyses of misclassified binary variables Int. J. Epidemiol., December 1, 2005; 34(6): 1370 - 1376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M Jurek, S. Greenland, G. Maldonado, and T. R Church Proper interpretation of non-differential misclassification effects: expectations vs observations Int. J. Epidemiol., June 1, 2005; 34(3): 680 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S W Duffy, J Warwick, A R W Williams, H Keshavarz, F Kaffashian, T E Rohan, F Nili, and A Sadeghi-Hassanabadi A simple model for potential use with a misclassified binary outcome in epidemiology J. Epidemiol. Community Health, August 1, 2004; 58(8): 712 - 717. [Abstract] [Full Text] [PDF]
|
|