Negative control outcomes and the analysis of standardized mortality ratios

Details

• Personal Author:
  Cooper G ; Keil AP ; Richardson DB ; Tchetgen Tchetgen E
• Description:
  In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to noncomparability of the occupational cohort and reference population with respect to unmeasured risk factors for the outcome of interest. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for such bias. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR = 1.9; 95% confidence interval [CI] = 1.3, 2.7) but not among monthly-paid males (SMR = 1.0; 95% CI = 0.67, 1.3). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR = 2.2; 95% CI = 1.5, 3.2; and, aSMR = 2.0; 95% CI = 1.4, 2.8, respectively). The proposed adjusted SMR offers a complement to typical SMR analyses. [Description provided by NIOSH]
• Subjects:
  Air Movements Hazardous Substances Mining Occupational Health Particulate Matter Safety Smoke
• Keywords:
  Analytical-processes Bladder-cancer Bladder-disease Bladder-disorders Cancer Cancer-rates Mortality-data Mortality-rates Mortality-surveys Statistical-analysis
• ISSN:
  1044-3983
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Massachusetts ; North Carolina ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  26
• Issue:
  5
• NIOSHTIC Number:
  nn:20047449
• Citation:
  Epidemiology 2015 Sep; 26(5):727-732
• Contact Point Address:
  David B. Richardson, Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
• Email:
  david.richardson@unc.edu
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of North Carolina, Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20090901
• Source Full Name:
  Epidemiology
• End Date:
  20130831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8b9c0d85f7a531fecaddaa5a2a8b0272b8b6ed242051cee2517962ed52da18bb878e1a5e76770157feaa8e063ccf932e29c86a8c55b48ff02227da306677c8fd
• Download URL:
  https://stacks.cdc.gov/view/cdc/202509/cdc_202509_DS1.pdf
• File Type:
  [PDF - 346.87 KB ]