Case-Control Confusion

doi:10.1016/j.ambp.2005.11.001

Ambulatory Pediatrics

Volume 6, Issue 2, 1 March 2006, Pages 96-99

https://doi.org/10.1016/j.ambp.2005.11.001 Get rights and content

Objective

Critical analysis of journal articles by using principles of evidence-based medicine is important for clinicians applying research results in their practice and is a valuable component of pediatric residency training. Appraisal of an article’s methodological rigor is often tailored to a particular type of study design, so that misclassification of study design can confuse the appraisal. The goal of this study was to determine how often pediatric research articles that are self-declared as case-control studies conform to a standard definition for this study design.

Methods

A Medline search identified articles published in two pediatric journals from January 1996 through August 2004 with the phrase “case-control study” in the title or abstract. Articles that were self-declared as case-control studies were analyzed to determine whether they satisfied a standard definition of a case-control study.

Results

Of the 91 purported case-control studies, only 68 (75%) met the standard definition for at least the most important analysis. The remaining 23 articles could be classified as cross-sectional studies (N = 16) or prospective cohort studies (N = 7).

Conclusions

Ambiguity in the definition of a case-control study can cause confusion in the critical appraisal of published clinical research.

Section snippets

Methods

We conducted a Medline search of articles published in Pediatrics or Archives of Pediatrics & Adolescent Medicine from January 1996 through August 2004 with the phrase “case-control study” in the title or abstract. Pediatrics is the official journal of the American Academy of Pediatrics and has a large circulation and high impact factor; Archives of Pediatrics & Adolescent Medicine is the oldest continuously published pediatric journal in the United States and includes a journal club feature

Results

The Medline search returned 99 articles: 69 in Pediatrics and 30 in the Archives of Pediatrics & Adolescent Medicine. In eight of these articles, the authors did not claim that their study was a case-control study, although the phrase “case-control” was used in another context in the title or abstract. These studies were excluded from further consideration. Of the remaining 91 articles, 68 studies (46 in Pediatrics and 22 in the Archives of Pediatrics & Adolescent Medicine) met the definition

Discussion

In this analysis of 91 self-defined case-control studies published in two pediatric journals over an 8-year period, 68 of the identified articles met our standard definition of a case-control study. The other 23 articles could be classified as cross-sectional studies or cohort studies, although each was literally a case-control study because it contained both cases and controls.

Confusion about the term case-control study is not unique to the pediatric literature. One recent study, for example,

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Cited by (11)

A systematic mixed-methods review of interventions, outcomes and experiences for midwives and student midwives in work-related psychological distress
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Citation Excerpt :
Some of these studies were described as either pilot or feasibility studies, yet only two (Wallbank, 2010; Foureur et al., 2013) were found to conform to the standardised definitions of either a pilot or a feasibility study (Arain et al., 2010; Abbott, 2014). As such, some studies were redefined as cohort studies (van et al., 2015; Warriner et al., 2016), where both a comparison and/or control group are not a necessary feature (Dekkers et al., 2012), as they each analysed either repeated outcome measures and/or observed a cohort of participants distinguished by some variable (Doll, 2004; Hellems et al., 2006; DiPietro, 2010). Two of the papers retrieved (McDonald et al., 2012, 2013) each fittingly reported themselves to be one part of a larger collective case study in which midwifery cohorts were included (Gerring, 2004).
within challenging work environments, midwives and student midwives can experience both organisational and occupational sources of work-related psychological distress. As the wellbeing of healthcare staff directly correlates with the quality of maternity care, this distress must be met with adequate support provision. As such, the identification and appraisal of interventions designed to support midwives and student midwives in work-related psychological distress will be important in the pursuit of excellence in maternity care.
to identify interventions designed to support midwives and/or student midwives in work-related psychological distress, and explore any outcomes and experiences associated with their use.
Data sources; study eligibility criteria, participants, and interventions This systematic mixed-methods review examined 6 articles which identified interventions designed to support midwives and/or student midwives in work-related psychological distress, and reports both the outcomes and experiences associated with their use. All relevant papers published internationally from the year 2000 to 2016, which evaluated and identified targeted interventions were included.
the reporting of this review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The quality of each study has been appraised using a scoring system designed for appraising mixed-methods research, and concomitantly appraising qualitative, quantitative and mixed-methods primary studies in mixed reviews. Bias has been assessed using an assessment of methodological rigor tool. Whilst taking a segregated systematic mixed-methods review approach, findings have been synthesised narratively.
this review identified mindfulness interventions, work-based resilience workshops partnered with a mentoring programme and the provision of clinical supervision, each reported to provide a variety of both personal and professional positive outcomes and experiences for midwives and/or student midwives. However, some midwives and/or student midwives reported less favourable experiences, and some were unable to participate in the interventions as provided for practical reasons.
eligible studies were few, were not of high quality and were limited to international findings within first world countries. Additionally, two of the papers included related to the same intervention. Due to a paucity of studies, this review could not perform sensitivity analyses, subgroup analyses, meta-analysis or meta-regression.
there is a lack of evidence based interventions available to support both midwives and student midwives in work-related psychological distress. Available studies reported positive outcomes and experiences for the majority of participants. However, future intervention studies will need to ensure that they are flexible enough for midwives and student midwives to engage with. Future intervention research has the opportunity to progress towards more rigorous studies, particularly ones which include midwives and student midwives as solitary population samples
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Letter from the EditorCase-Control Confusion

Objective

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Pediatric residents as learners and teachers of evidence-based medicine

Acad Med

The case-control studya practical review for the clinician

JAMA

Clinical Epidemiology and Biostatistics

Does group A β–hemolytic streptococcal infection increase risk for behavioral and neuropsychiatric symptoms in children?

Arch Pediatr Adolesc Med

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infectionsimplications for clinical practice

Arch Pediatr Adolesc Med

Clinical features of children with screening-identified evidence of celiac disease

Pediatrics

Letter from the Editor
Case-Control Confusion