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Observational analytic studies in multiple sclerosis: controlling bias through study design and conduct. The Australian Multicentre Study of Environment and Immune Function

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Lucas, RM and Pender, MP and Taylor, BV and Valery, P and Williams, D and Ponsonby, AL and McMichael, AJ and Van der Mei, IAF and Chapman, C and Coulthard, A and Dear, K and Dwyer, T and Kilpatrick, TJ (2007) Observational analytic studies in multiple sclerosis: controlling bias through study design and conduct. The Australian Multicentre Study of Environment and Immune Function. Multiple Sclerosis, 13 (7). pp. 827-839. ISSN 1352-4585

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Abstract

Rising multiple sclerosis incidence over the last 50 years and geographic patterns of occurrence suggest
an environmental role in the causation of this multifactorial disease. Design options for epidemiological
studies of environmental causes of multiple sclerosis are limited by the low incidence of
the disease, possible diagnostic delay and budgetary constraints. We describe scientific and methodological
issues considered in the development of the Australian Multicentre Study of Environment and
Immune Function (the Ausimmune Study), which seeks, in particular, to better understand the causes
of the well-known MS positive latitudinal gradient. A multicentre, case-control design down the
eastern seaboard of Australia allows the recruitment of sufficient cases for adequate study power and
provides data on environmental exposures that vary by latitude. Cases are persons with an incident
first demyelinating event (rather than prevalent multiple sclerosis), sourced from a population base
using a two tier notification system. Controls, matched on sex, age (within two years) and region of
residence, are recruited from the general population. Biases common in case-control studies, eg,
prevalence-incidence bias, admission-rate bias, non-respondent bias, observer bias and recall bias,
as well as confounding have been carefully considered in the study design and conduct of the
Ausimmune Study.

Item Type: Article
Keywords: bias; case-control; confounding; epidemiologic research design; multicentre; multiple sclerosis
Journal or Publication Title: Multiple Sclerosis
Publisher: SageScience Press (UK)
Page Range: pp. 827-839
ISSN: 1352-4585
Identification Number - DOI: 10.1177/1352458507077174
Date Deposited: 07 Apr 2008 14:08
Last Modified: 18 Nov 2014 03:33
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