Journal
BIOSTATISTICS
Volume 8, Issue 2, Pages 337-344Publisher
OXFORD UNIV PRESS
DOI: 10.1093/biostatistics/kxl013
Keywords
air pollution; case-crossover design; environmental epidemiology; log-linear model; overdispersion; Poisson regression; time series
Funding
- NIEHS NIH HHS [ES012054-03, P30 ES03819] Funding Source: Medline
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The case-crossover design was introduced in epidemiology 15 years ago as a method for studying the effects of a risk factor on a health event using only cases. The idea is to compare a case's exposure immediately prior to or during the case-defining event with that same person's exposure at otherwise similar reference times. An alternative approach to the analysis of daily exposure and case-only data is time series analysis. Here, log-linear regression models express the expected total number of events on each day as a function of the exposure level and potential confounding variables. In time series analyses of air pollution, smooth functions of time and weather are the main confounders. Time series and case-crossover methods are often viewed as competing methods. In this paper, we show that case-crossover using conditional logistic regression is a special case of time series analysis when there is a common exposure such as in air pollution studies. This equivalence provides computational convenience for case-crossover analyses and a better understanding of time series models. Time series log-linear regression accounts for overdispersion of the Poisson variance, while case-crossover analyses typically do not. This equivalence also permits model checking for case-crossover data using standard log-linear model diagnostics.
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