American Journal of Epidemiology Vol. 147, No. 5: 426-433
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Differential Misclassification and the Assessment of Gene-Environment Interactions in Case-Control Studies
1Department of Epidemiology, Harvard School of Public Health Boston, MA
2Applied Medical Sciences, School of Applied Science, University of Southern Maine Portland, ME
3Department of Biostatistics, Harvard School of Public Health Boston, MA
Reprint requests to Dr. Montserrat Garcia-Closas, Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPN/443, 6130 Executive Blvd., Bethesda, MD 208927374.
In case-control studies of interactions between genetic and environmental exposures, differential misclassification of the environmental exposure with respect to disease status can introduce spurious heterogeneity of the stratum-specific odds ratios. In this paper, the authors identify conditions under which differential misclassification does not introduce bias in the interaction parameter when no multiplicative interaction is present, and it biases the interaction parameter toward the null value when a multiplicative interaction is present. The conditions are that (i) conditional on potential confounders, the environmental exposure is independent of the genotype among the controls, and (ii) misclassification of the environmental exposure is nondifferential with respect to the genotype. These conditions can be tested from the misclassified data in the control group, since a test of the independence of the genotype and the misclassified environmental exposure among the controls is a test of the joint hypothesis that conditions (i) and (ii) are both true. Therefore, the authors propose a two-step test for interaction which first tests conditions (i) and (ii) and then goes on to test for interaction, provided the first step hypothesis is not rejected. A summary test procedure to test for gene-environment interactions in the presence of misclassification, based on both a conventional test for interaction and the two-step test, is recommended, and is illustrated with data from a case-control study of the role of diet as a modifier of the association between a metabolic polymorphism and lung cancer. Am J Epidemiol 1998; 147:42633.
case-control studies; epidemiologic methods; misclassification
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