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Biostatistics Advance Access published online on June 9, 2009
Biostatistics, doi:10.1093/biostatistics/kxp015
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Estimation and inference for case–control studies with multiple non–gold standard exposure assessments: with an occupational health application

Haitao Chu*

Department of Biostatistics and Lineberger Comprehensive Cancer Center, The University of North Carolina, Chapel Hill, NC 27599, USA hchu{at}bios.unc.edu

Stephen R. Cole

Department of Epidemiology, The University of North Carolina, Chapel Hill, NC 27599, USA

Ying Wei

Department of Biostatistics, Columbia University, New York, NY 10032, USA

Joseph G. Ibrahim

Department of Biostatistics and Lineberger Comprehensive Cancer Center, The University of North Carolina, Chapel Hill, NC 27599, USA

* To whom correspondence should be addressed.

In occupational case–control studies, work-related exposure assessments are often fallible measures of the true underlying exposure. In lieu of a gold standard, often more than 2 imperfect measurements (e.g. triads) are used to assess exposure. While methods exist to assess the diagnostic accuracy in the absence of a gold standard, these methods are infrequently used to correct for measurement error in exposure–disease associations in occupational case–control studies. Here, we present a likelihood-based approach that (a) provides evidence regarding whether the misclassification of tests is differential or nondifferential; (b) provides evidence whether the misclassification of tests is independent or dependent conditional on latent exposure status, and (c) estimates the measurement error–corrected exposure–disease association. These approaches use information from all imperfect assessments simultaneously in a unified manner, which in turn can provide a more accurate estimate of exposure–disease association than that based on individual assessments. The performance of this method is investigated through simulation studies and applied to the National Occupational Hazard Survey, a case–control study assessing the association between asbestos exposure and mesothelioma.

Keywords: Case–control study; Gold standard; Missing data; Occupational exposure assessment

Received January 11, 2008; revised September 30, 2008; revised March 20, 2009; accepted for publication May 6, 2009.


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