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American Journal of Epidemiology Vol. 126, No. 6: 1198-1209
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

EXTERNAL COMPARISONS WITH THE CASE-COHORT DESIGN

SHOLOM WACHOLDER1 2, and JEAN-FRANÇOIS BOIVIN1

1Department of Epidemio1o and Biostatistics, McGill University Montréal, Québec, Canada

Send reprint requests to Dr. Sholom Wacholder at this address.

The case-cohort design can be an economic alternative to the standard cohort design. Prentice (Blometrlka 1986;73:1–11) showed how the case-cohort design can be used to obtain relative risk estimates for comparisons within the cohort being studied. In this paper, the authors consider ways In which the case-cohort design can be used for comparing risk in exposure groups within the cohort to the risk in an external population. The problem reduces to estimating the number of expected cases at each exposure level in the total cohort, when exposure status is available only for members of a subcohort, i.e., a random sample of the total cohort. The authors describe theoretical and empirical properties of several variations of the design and analysis of case-cohort studies. Empirical properties were examined by replicating the selection of the subcohort in a study of second cancer risk after chemotherapy for a first cancer. Use of a case-cohort design In that study would have saved five-sixths of the cost of gathering covarlate information at the price of only an 11% loss in efficiency relative to a full cohort study.

biometry; epidemiologic methods; follow-up studies; research design; statistics

2Current address: National Cancer Institute, Biostatistics Branch, Landow Building, Room 3C18, Bethesda, MD 20892


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