Case-Control Designs in the Study of Common Diseases: Updates on the Demise of the Rare Disease Assumption and the Choice of Sampling Scheme for Controls
Abstract
Rodrigues L (Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK) and Kirkwood BR. Case-control designs in the study of common diseases: updates on the demise of the rare disease assumption and the choice of sampling scheme for controls. International Journal of Epidemiology 1990, 19: 205–213. In recent years the use of case-control designs has been extended to the study of common diseases. It has been shown that the rare disease assumption is not necessary, and that by a suitable choice of sampling scheme for controls, it is possible to obtain direct estimates of relative risk and relative rate, instead of relying on the odds ratio as an indirect estimate. The majority of papers addressing these issues are theoretical, and the arguments have been couched in mathematical terms. As such they are not readily accessible to many practising epidemiologists. This paper summarizes the discussion in a simplified manner. It describes the three different measures of relative incidence, namely the relative risk, the relative rate and the odds ratio, together with their corresponding case-control designs. The discussion is extended to show that the choice of the appropriate measure of relative incidence depends on the mode of action of the risk factor, as well as on characteristics of disease. We propose a classification scheme comprising five different categories of situation, and make recommendations regarding study designs for each.
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Depending on sampling strategy for cases and controls and nature of population studied, the odds ratio obtained in a case-control study is interpreted as the risk ratio, rate ratio or (prevalence) odds ratio.
“Depending on the sampling strategy for cases and controls and the nature of the population studied, the odds ratio obtained in a case-control study is interpreted as the risk ratio, rate ratio or (prevalence) odds ratio [ 16 , 17 ].”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [16]
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- Authors
- RODRIGUES, L., & KIRKWOOD, B. R.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1990
- Volume
- 19
- Issue
- 1
- Pages
- 205-213
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2162529136
- Cited by
- 207
- References
- 0
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 1 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 7 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 8 · 2014: 17 · 2013: 10 · 2012: 7
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- case-control study, relative risk, relative rates, odds ratio, common diseases, study design recommendations
- MeSH terms
- Humans, Risk, Cohort Studies, Causality, Incidence, Odds Ratio, Case-Control Studies
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