Cited by 2,327Statistical Methods in EpidemiologyAdvanced Causal Inference TechniquesHealth, Environment, Cognitive Aging

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The Case-Crossover Design: A Method for Studying Transient Effects on the Risk of Acute Events

Maclure, Malcolm·1991·American Journal of Epidemiology

DOI 10.1093/oxfordjournals.aje.a115853

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Abstract

A case-control design involving only cases may be used when brief exposure causes a transient change in risk of a rare acute-onset disease. The design resembles a retrospective nonrandomized crossover study but differs in having only a sample of the base population-time. The average incidence rate ratio for a hypothesized effect period following the exposure is estimable using the Mantel-Haenszel estimator. The duration of the effect period is assumed to be that which maximizes the rate ratio estimate. Self-matching of cases eliminates the threat of control-selection bias and increases efficiency. Pilot data from a study of myocardial infarction onset illustrate the control of within-individual confounding due to temporal association of exposures.

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Authors: Maclure, M.
Affiliations: Harvard University (US)
Corresponding author: Maclure, Malcolm
ORCID: Maclure, Malcolm
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 1991-01-15
Volume: 133
Issue: 2
Pages: 144-153
ISSN: 0002-9262 (ISSN-L)
1476-6256
DOI: 10.1093/oxfordjournals.aje.a115853
OpenAlex: W2136527705
Cited by: 2,327
References: 12
Citations by year: 2026: 76 · 2025: 75 · 2024: 124 · 2023: 93 · 2022: 139 · 2021: 121 · 2020: 113 · 2019: 118 · 2018: 113 · 2017: 100 · 2016: 112 · 2015: 115 · 2014: 118 · 2013: 113 · 2012: 94
FWCI: 9.57
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (HL41016, R01HL041016)
Topics: Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
Keywords: case-crossover design, incidence rate ratio, Mantel-Haenszel estimator, control selection bias, myocardial infarction, exposure duration
MeSH terms: Humans, Research Design, Retrospective Studies, Risk Factors, Time Factors, Bias, Confounding Factors, Epidemiologic, Case-Control Studies

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The Case-Crossover Design: A Method for Studying Transient Effects on the Risk of Acute Events

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