Exposure measurement in cohort studies: the challenges of prospective data collection.

Cohort study designs have several advantages over case-control studies in terms of exposure measurement. If exposure measurement occurs before disease occurrence, cohort studies are much less prone to differential measurement error. Prospective data collection should also reduce measurement error due to poor recall of past exposures. The primary drawback of cohort studies is the large sample size leading to high data collection costs. Several approaches to reduce such costs have been discussed in this presentation, such as selection of lower cost measurement methods and fully measuring the exposure only on a subsample of the cohort (e.g., nested case-control design). However, other innovative approaches to reduce costs are needed. In addition, study reviewers should also consider that the higher costs are justified in relation to the several benefits of this study design, which include not only less measurement error, but also less susceptibility to selection bias and often the ability to study multiple disease outcomes. Improving the accuracy of exposure measurement is increasingly important for cohort studies as we move on to the study of exposures that are difficult to measure or to those with lower relative risks of disease. In such studies, attenuation of the relative risk by the effects of measurement error can lead to failure to detect an association between exposure and disease. The validity of exposure measurements could be improved by a better understanding of the biologically active agent and etiologically important time period of the exposure-disease relation, and by incorporating these into the measure. Long-term cohort studies which cover the etiologically relevant time period could improve the accuracy of measures of exposures by use of repeated biologic measures or repeated updates of self-reported exposures. Measurement error also can be reduced by judicious choice of a cohort to study and by careful attention to quality control procedures. Continued emphasis on the evaluation and improvement of the measurement properties of instruments used in epidemiologic studies will improve the validity of the results of cohort studies.

[1]  R. Kronmal,et al.  The Cardiovascular Health Study: design and rationale. , 1991, Annals of epidemiology.

[2]  W. Grove Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[3]  L H Moulton,et al.  Latency and time-dependent exposure in a case-control study. , 1991, Journal of clinical epidemiology.

[4]  JoAnn E. Manson,et al.  Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. , 1998, Controlled clinical trials.

[5]  I. Cohen,et al.  [Postmenopausal estrogen therapy and cardiovascular disease]. , 1991, Harefuah.

[6]  Re Waller,et al.  Principles of Exposure Measurement in Epidemiology , 1994 .

[7]  Daniel L. McGee,et al.  Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to biologic and lifestyle characteristics. , 1984, American journal of epidemiology.

[8]  A. Dyer,et al.  Statistical methods to assess and minimize the role of intra-individual variability in obscuring the relationship between dietary lipids and serum cholesterol. , 1978, Journal of chronic diseases.

[9]  P. Pietinen,et al.  European Prospective Investigation into Cancer and Nutrition: validity studies on dietary assessment methods. , 1997, International journal of epidemiology.

[10]  D. Dillman Mail and telephone surveys : the total design method , 1979 .

[11]  B J Flehinger,et al.  Declining serum cholesterol levels prior to diagnosis of colon cancer. A time-trend, case-control study. , 1990, JAMA.

[12]  Seymour Sudman,et al.  Asking Questions: A Practical Guide to Questionnaire Design.@@@The Design and Understanding of Survey Questions. , 1982 .

[13]  P. Strax,et al.  A prospective study of endogenous estrogens and breast cancer in postmenopausal women. , 1995, Journal of the National Cancer Institute.

[14]  D. Thomas,et al.  Exposure measurement error: influence on exposure-disease. Relationships and methods of correction. , 1993, Annual review of public health.

[15]  W. Willett,et al.  An overview of issues related to the correction of non-differential exposure measurement error in epidemiologic studies. , 1989, Statistics in medicine.

[16]  R E LaPorte,et al.  Assessment of physical activity in epidemiologic research: problems and prospects. , 1985, Public health reports.

[17]  R. Prentice Covariate measurement errors and parameter estimation in a failure time regression model , 1982 .

[18]  J E White,et al.  A two stage design for the study of the relationship between a rare exposure and a rare disease. , 1982, American journal of epidemiology.

[19]  A. B. Smith,et al.  Leukemia in benzene workers. , 1981, American journal of industrial medicine.

[20]  Hammond Ec,et al.  Smoking in relation to the death rates of one million men and women. , 1966 .

[21]  L S Freedman,et al.  The impact of dietary measurement error on planning sample size required in a cohort study. , 1990, American journal of epidemiology.

[22]  Jennifer L. Kelsey,et al.  Methods in Observational Epidemiology , 1986 .

[23]  B E Ainsworth,et al.  Accuracy of the College Alumnus Physical Activity Questionnaire. , 1993, Journal of clinical epidemiology.

[24]  P. Hannaford,et al.  Breast cancer and the pill--a further report from the Royal College of General Practitioners' oral contraception study. , 1988, British Journal of Cancer.

[25]  B G Armstrong,et al.  Analysis of case-control data with covariate measurement error: application to diet and colon cancer. , 1989, Statistics in medicine.

[26]  Michael C. Nevitt,et al.  Mortality Following Fractures in Older Women: The Study of Osteoporotic Fractures , 1996 .

[27]  T T Chen A review of methods for misclassified categorical data in epidemiology. , 1989, Statistics in medicine.

[28]  V. E. Archer,et al.  RADIATION AS THE CAUSE OF LUNG CANCER AMONG URANIUM MINERS. , 1965, The New England journal of medicine.

[29]  R. Paffenbarger,et al.  Physical activity as an index of heart attack risk in college alumni. , 1978, American journal of epidemiology.

[30]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[31]  J. Fleiss The design and analysis of clinical experiments , 1987 .

[32]  T R Holford,et al.  Study design for epidemiologic studies with measurement error , 1995, Statistical methods in medical research.

[33]  J. Wagoner,et al.  LEUKÆMIA IN BENZENE WORKERS , 1977, The Lancet.

[34]  D. Jacobs,et al.  Change and secular trends in physical activity patterns in young adults: a seven-year longitudinal follow-up in the Coronary Artery Risk Development in Young Adults Study (CARDIA). , 1996, American journal of epidemiology.

[35]  Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the nurses' health study. , 1991 .

[36]  K. Rothman Induction and latent periods. , 1981, American journal of epidemiology.

[37]  S. Cummings,et al.  Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group. , 1996, JAMA.

[38]  E. Riboli,et al.  Nutrition and cancer: background and rationale of the European Prospective Investigation into Cancer and Nutrition (EPIC). , 1992, Annals of oncology : official journal of the European Society for Medical Oncology.

[39]  Graham V. Vimpani,et al.  Environmental exposure to lead and children's intelligence at the age of seven years. The Port Pirie Cohort Study. , 1992, The New England journal of medicine.

[40]  N. Mantel Synthetic retrospective studies and related topics. , 1973, Biometrics.

[41]  Seymour Sudman,et al.  Measurement errors in surveys , 1993 .

[42]  J. Phair,et al.  The Multicenter AIDS Cohort Study: rationale, organization, and selected characteristics of the participants. , 1987, American journal of epidemiology.

[43]  Lung-fei Lee,et al.  Estimation of Linear and Nonlinear Errors-in-Variables Models Using Validation Data , 1995 .

[44]  W. Willett,et al.  Validation of a semi-quantitative food frequency questionnaire: comparison with a 1-year diet record. , 1987, Journal of the American Dietetic Association.

[45]  S B Hulley,et al.  CARDIA: study design, recruitment, and some characteristics of the examined subjects. , 1988, Journal of clinical epidemiology.

[46]  P. Savage,et al.  Comparison of two methods of assessing physical activity in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. , 1991, American journal of epidemiology.

[47]  S Wacholder,et al.  Selecting an efficient design for assessing exposure-disease relationships in an assembled cohort. , 1991, Biometrics.

[48]  David Kriebel,et al.  Research Methods in Occupational Epidemiology , 1989 .

[49]  R. Kulka,et al.  Personal versus telephone surveys for collecting household health data at the local level. , 1983, American journal of public health.

[50]  S Wacholder,et al.  Practical considerations in choosing between the case-cohort and nested case-control designs. , 1991, Epidemiology.

[51]  E White,et al.  Effects of biomarker measurement error on epidemiological studies. , 1997, IARC scientific publications.

[52]  Alice S. Whittemore,et al.  Approximations for Regression with Covariate Measurement Error , 1988 .

[53]  Edward G. Carmines,et al.  Reliability and Validity Assessment , 1979 .

[54]  C. Gross,et al.  A comparison of response rate, data quality, and cost in the collection of data on sexual history and personal behaviors. Mail survey approaches and in-person interview. , 1989, American journal of epidemiology.

[55]  T. Dawber,et al.  The Framingham Study: The Epidemiology of Atherosclerotic Disease , 1980 .

[56]  J. Manson,et al.  The Nurses' Health Study: 20-year contribution to the understanding of health among women. , 1997, Journal of women's health.

[57]  S. Self,et al.  Ovarian tumors in a cohort of infertile women. , 1994, The New England journal of medicine.

[58]  A. Bostom,et al.  Postmenopausal estrogen therapy and cardiovascular disease. , 1992, The New England journal of medicine.

[59]  Graham Dunn,et al.  Review papers : Design and analysis of reliability studies , 1992 .

[60]  B Rosner,et al.  Correction of logistic regression relative risk estimates and confidence intervals for systematic within-person measurement error. , 2006, Statistics in medicine.

[61]  P. Baghurst,et al.  Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study , 1996, BMJ.

[62]  T. Sellers,et al.  Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer. , 1992 .

[63]  J. Chmiel,et al.  The Multicenter AIDS Cohort Study: retention after 9 1/2 years. , 1995, American journal of epidemiology.

[64]  Norman E. Breslow,et al.  Logistic regression for two-stage case-control data , 1988 .

[65]  A. Folsom,et al.  Accuracy and reliability of self-measurement of body girths. , 1988, American journal of epidemiology.

[66]  S. Cummings,et al.  BONE MINERAL DENSITY AND RISK OF BREAST CANCER IN OLDER WOMEN : THE STUDY OF OSTEOPOROTIC FRACTURES , 1997 .

[67]  R J Marshall,et al.  Validation study methods for estimating exposure proportions and odds ratios with misclassified data. , 1990, Journal of clinical epidemiology.

[68]  J. Robins,et al.  Analysis of case-control data derived in part from proxy respondents. , 1988, American journal of epidemiology.

[69]  R. D'Agostino,et al.  Sex and time trends in cardiovascular disease incidence and mortality: the Framingham Heart Study, 1950-1989. , 1996, American journal of epidemiology.

[70]  B. Rodda,et al.  Clinical trials: Design, conduct, and analysis , 1987 .

[71]  B. Lind,et al.  Quality assurance and quality control in longitudinal studies. , 1998, Epidemiologic reviews.

[72]  P. Strax,et al.  Reliability of measurements of total, protein-bound, and unbound estradiol in serum. , 1994, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[73]  Donna Spiegelman Cost-efficient study designs for relative risk modeling with covariate measurement error , 1994 .

[74]  W. Strawbridge,et al.  Natural history of leisure-time physical activity and its correlates: associations with mortality from all causes and cardiovascular disease over 28 years. , 1996, American journal of epidemiology.

[75]  R. L. Prentice,et al.  A case-cohort design for epidemiologic cohort studies and disease prevention trials , 1986 .

[76]  D. English,et al.  A review of the effects of random measurement error on relative risk estimates in epidemiological studies. , 1989, International journal of epidemiology.

[77]  B Langholz,et al.  Nested case-control and case-cohort methods of sampling from a cohort: a critical comparison. , 1990, American journal of epidemiology.

[78]  M. Pepe,et al.  The effect of exposure variance and exposure measurement error on study sample size: implications for the design of epidemiologic studies. , 1994, Journal of clinical epidemiology.

[79]  N. Pearce,et al.  Latency analysis in occupational epidemiology. , 1990, Archives of environmental health.

[80]  N. Breslow,et al.  Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. , 1987, IARC scientific publications.

[81]  D C Thomas,et al.  Models for exposure-time-response relationships with applications to cancer epidemiology. , 1988, Annual Review of Public Health.

[82]  J. Samet,et al.  Classification of residential exposure to nitrogen dioxide , 1992 .

[83]  W. Willett,et al.  Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. , 1986, American journal of epidemiology.

[84]  G R Howe,et al.  Use of computerized record linkage in cohort studies. , 1998, Epidemiologic reviews.

[85]  E. Rimm,et al.  The assessment of alcohol consumption by a simple self-administered questionnaire. , 1991, American journal of epidemiology.

[86]  T D Koepsell,et al.  Proxy respondents in epidemiologic research. , 1990, Epidemiologic reviews.

[87]  J. Hunt,et al.  Retaining and tracking cohort study members. , 1998, Epidemiologic reviews.

[88]  W F Stewart,et al.  Exposure measurement in case-control studies: reported methods and recommendations. , 1996, Epidemiologic reviews.

[89]  R. L. Prentice,et al.  Retrospective studies and failure time models , 1978 .

[90]  R. Prentice Design issues in cohort studies , 1995, Statistical methods in medical research.