American Journal of Epidemiology Vol. 147, No. 12: 1123-1132
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Correction for Biases in a Population-based Study of Family History and Coronary Heart Disease
The Newcastle Family History Study I
1Discipline of Medicine, Faculty of Medicine and Health Sciences, The University of Newcastle Callaghan, Newcastle, New South Wales, Australia
2Cardiovascular Unit, John Hunter Hospital Newcastle, New South Wales, Australia
Reprint requests to Dr. Jonathan Silberberg, Department of Medicine, John Hunter Hospital, Locked Bag No.1, Hunter Region Mail Centre, NSW 2310, Australia.
In this paper, the authors report on the design of a population-based case-control study of family history as a risk factor for coronary heart disease (CHD). They studied the characteristics of subjects who completed a detailed family history questionnaire in 1992–1994 as well as the accuracy of recall of family history in order to quantify both selection and recall biases. Coronary disease cases were enrolled through the Newcastle MONICA Project (Monitoring Trends and Determinants in Cardiovascular Disease), which registered all suspected heart attacks and sudden cardiac deaths in the Lower Hunter region of New South Wales, Australia, between August 1984 and March 1994. Controls were selected at random from the New South Wales electoral roll. The response rate was 76% in cases and 62% in controls; the major factor associated with participation in the study was perceived family history of CHD, more so in the control series than in the case series. Accuracy was determined by comparing information obtained from the proband with that recorded on death certificates. In first-degree relatives, sensitivity of CHD recall was 85% (95% confidence interval (Cl) 74–92%) in cases and 95% (95% Cl 84–99%) in controls, while specificity was 59% (95% Cl 49–69%) and 74% (95% Cl 65–82%), respectively. The net bias in both selection and recall is toward the null and hence the comparisons provide a conservative estimate of risk of CHD associated with a positive family history. Am J Epidemiol 1998; 147:1123–32.
bias (epidemiology); case-control studies; coronary diseas1e; family characteristics
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