Nested exposure case-control sampling: a sampling scheme to analyze rare time-dependent exposures

Lifetime Data Anal. 2020 Jan;26(1):21-44. doi: 10.1007/s10985-018-9453-4. Epub 2018 Nov 13.

Abstract

For large cohort studies with rare outcomes, the nested case-control design only requires data collection of small subsets of the individuals at risk. These are typically randomly sampled at the observed event times and a weighted, stratified analysis takes over the role of the full cohort analysis. Motivated by observational studies on the impact of hospital-acquired infection on hospital stay outcome, we are interested in situations, where not necessarily the outcome is rare, but time-dependent exposure such as the occurrence of an adverse event or disease progression is. Using the counting process formulation of general nested case-control designs, we propose three sampling schemes where not all commonly observed outcomes need to be included in the analysis. Rather, inclusion probabilities may be time-dependent and may even depend on the past sampling and exposure history. A bootstrap analysis of a full cohort data set from hospital epidemiology allows us to investigate the practical utility of the proposed sampling schemes in comparison to a full cohort analysis and a too simple application of the nested case-control design, if the outcome is not rare.

Keywords: Cost-effective sampling; Cox proportional hazards model; Hospital-acquired pneumonia; Matched case-control study; Time-dependent covariate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Binomial Distribution
  • Case-Control Studies*
  • Cohort Studies*
  • Computer Simulation
  • Cross Infection
  • Environmental Exposure
  • Epidemiologic Methods*
  • Humans
  • Time Factors