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Can the validity of a cohort be improved by reweighting based on register data? Evidence from the Swedish MDC study

Nilsson, Anton LU ; Bonander, Carl ; Strömberg, Ulf LU and Björk, Jonas LU (2020) In BMC Public Health 20(1).
Abstract

Background: In any study with voluntary participation, self-selection risks leading to invalid conclusions. If the determinants of selection are observed, it is however possible to restore the parameters of interest by reweighting the sample to match the population, but this approach has seldom been applied in epidemiological research. Methods: We reweighted the Malmö Diet and Cancer (MDC) study based on population register data on background variables, including socio-demographics and hospital admissions for both participants and the background population. Following individuals from baseline in 1991–1996 and at most until 2016, we studied mortality (all-cause, cancer, and CVD), incidences (cancer and CVD), and associations between... (More)

Background: In any study with voluntary participation, self-selection risks leading to invalid conclusions. If the determinants of selection are observed, it is however possible to restore the parameters of interest by reweighting the sample to match the population, but this approach has seldom been applied in epidemiological research. Methods: We reweighted the Malmö Diet and Cancer (MDC) study based on population register data on background variables, including socio-demographics and hospital admissions for both participants and the background population. Following individuals from baseline in 1991–1996 and at most until 2016, we studied mortality (all-cause, cancer, and CVD), incidences (cancer and CVD), and associations between these outcomes and background variables. Results from the unweighted and reweighted participant sample were compared with those from the background population. Results: Mortality was substantially lower in participants than in the background population, but reweighting the sample helped only little to make the numbers similar to those in the background population. For incidences and associations, numbers were generally similar between participants and the background population already without reweighting, rendering reweighting unnecessary. Conclusion: Reweighting samples based on an extensive range of sociodemographic characteristics and previous hospitalizations does not necessarily yield results that are valid for the population as a whole. In the case of MDC, there appear to be important factors related to both mortality and selection into the study that are not observable in registry data, making it difficult to obtain accurate numbers on population mortality based on cohort participants. These issues seem less relevant for incidences and associations, however. Overall, our results suggest that representativeness must be judged on a case-by-case basis.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohorts, Incidence, Mortality, Representativeness, Reweighting, Validity
in
BMC Public Health
volume
20
issue
1
article number
1918
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85097681498
  • pmid:33334333
ISSN
1471-2458
DOI
10.1186/s12889-020-10004-z
project
Nya statistiska ansatser för att bedöma betydelsen av selektion och variation i befolkningsbaserade kohort- och screeningundersökningar
language
English
LU publication?
yes
id
d8bfecf7-e463-4877-bd98-f05f9c53cdb1
date added to LUP
2021-01-07 10:13:52
date last changed
2024-08-08 08:54:28
@article{d8bfecf7-e463-4877-bd98-f05f9c53cdb1,
  abstract     = {{<p>Background: In any study with voluntary participation, self-selection risks leading to invalid conclusions. If the determinants of selection are observed, it is however possible to restore the parameters of interest by reweighting the sample to match the population, but this approach has seldom been applied in epidemiological research. Methods: We reweighted the Malmö Diet and Cancer (MDC) study based on population register data on background variables, including socio-demographics and hospital admissions for both participants and the background population. Following individuals from baseline in 1991–1996 and at most until 2016, we studied mortality (all-cause, cancer, and CVD), incidences (cancer and CVD), and associations between these outcomes and background variables. Results from the unweighted and reweighted participant sample were compared with those from the background population. Results: Mortality was substantially lower in participants than in the background population, but reweighting the sample helped only little to make the numbers similar to those in the background population. For incidences and associations, numbers were generally similar between participants and the background population already without reweighting, rendering reweighting unnecessary. Conclusion: Reweighting samples based on an extensive range of sociodemographic characteristics and previous hospitalizations does not necessarily yield results that are valid for the population as a whole. In the case of MDC, there appear to be important factors related to both mortality and selection into the study that are not observable in registry data, making it difficult to obtain accurate numbers on population mortality based on cohort participants. These issues seem less relevant for incidences and associations, however. Overall, our results suggest that representativeness must be judged on a case-by-case basis.</p>}},
  author       = {{Nilsson, Anton and Bonander, Carl and Strömberg, Ulf and Björk, Jonas}},
  issn         = {{1471-2458}},
  keywords     = {{Cohorts; Incidence; Mortality; Representativeness; Reweighting; Validity}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Public Health}},
  title        = {{Can the validity of a cohort be improved by reweighting based on register data? Evidence from the Swedish MDC study}},
  url          = {{http://dx.doi.org/10.1186/s12889-020-10004-z}},
  doi          = {{10.1186/s12889-020-10004-z}},
  volume       = {{20}},
  year         = {{2020}},
}