Opium use reporting error in case-control studies: neighborhood controls versus hospital visitor controls

Elham Mohebbi; Hamideh Rashidian; Ahmad Naghibzadeh Tahami; Ali Akbar Haghdoost; Afarin Rahimi-Movaghar; Monireh Sadat Seyyedsalehi; Abass Rezaianzadeh; Maryam Marzban; Abdolvahab Moradi; Mahin Gholipour; Maryam Hadji; Farin Kamangar; Kazem Zendehdel

doi:10.47176/mjiri.35.60

Opium use reporting error in case-control studies: neighborhood controls versus hospital visitor controls

Med J Islam Repub Iran. 2021 May 10:35:60. doi: 10.47176/mjiri.35.60. eCollection 2021.

Authors

Affiliations

¹ Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour Medical School, Kerman University of Medical Sciences, Kerman, Iran.
³ Modeling in Health Research Center, Institute for Future Studies in Health, Kerman Medical Science University, Kerman, Iran.
⁴ Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
⁵ Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁶ Clinical Research Development Center, "The Persian Gulf Martyrs", Bushehr University of Medical Science, Bushehr, Iran.
⁷ Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
⁸ Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
⁹ Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA.

Abstract

Background: There are relatively scant data to determine whether hospital visitors could serve as a proper source of controls in case-control studies of illicit drug use. The aim of this study was to evaluate using neighborhood versus hospital visitor controls in reporting opium use. Methods: We used data from 2 independent case-control studies of cancer in Iran. In the first study, controls were selected from neighborhoods of the patients. For the second one, controls were selected from among hospital visitors. In the latter study, hospital visitors were companions of the patients or others visiting the hospital for reasons other than disease treatment. We used stata (version 12; Stata Corp( for all analyses and with a significance level of 0.05. Results: Data from 616 of neighborhood controls and 414 of hospital visitor controls were analyzed. Opium point prevalence among men was significantly higher in hospital visitors than neighborhood controls (43.3% vs 32.2%; P = 0.047), while the prevalence of cigarette smoking was very similar in both control groups (46.3% vs 47.2%; P =.847). Using a logistic regression analysis, in an unadjusted analysis, neighborhood controls were less likely to report opium use in both genders, with (unadjusted OR = 0.77; 95% CI: 0.59,1). After adjusting for potential confounders, the differences of opium use between the 2 control groups became more pronounced (Adjusted OR = 0.26; 95% CI: 0.10, 0.69). Conclusion: Because of the similarity of reporting cigarette smoking among neighborhood controls but substantially lower reporting of opium use among them, we concluded that neighborhood controls underreport opium use-a sensitive question- and that using neighborhood control biases the findings in case-control studies. Hospital visitor controls may be more appropriate than neighborhood controls for case-control studies of illicit drugs.

Keywords: Case-Control Study; Cigarette Smoking; Epidemiologic Studies; Hospital Visitor Control; Opium; Substance-Related Disorders.