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Researchers investigated whether antipsychotic drugs were associated with venous thromboembolism. A population based nested case-control study design was used. Data were taken from the UK QResearch primary care database consisting of 7267673 patients. Cases were adult patients with a first ever record of venous thromboembolism between 1 January 1996 and 1 July 2007. For each case, up to four controls were identified, matched by age, calendar time, sex, and practice. Exposure to antipsychotic drugs was assessed on the basis of prescriptions on, or during the 24 months before, the index date. 1
There were 25532 eligible cases (15975 with deep vein thrombosis and 9557 with pulmonary embolism) and 89491 matched controls. The primary outcome was the odds ratios for venous thromboembolism associated with antipsychotic drugs adjusted for comorbidity and concomitant drug exposure. When adjusted using logistic regression to control for potential confounding, prescription of antipsychotic drugs in the previous 24 months was significantly associated with an increased occurrence of venous thromboembolism compared with non-use (odds ratio 1.32, 95% confidence interval 1.23 to 1.42). The researchers concluded that prescription of antipsychotic drugs was associated with venous thromboembolism in a large primary care population.
Which of the following statements, if any, are true?
a) The nested case-control study is a retrospective design
b) The study design minimised selection bias compared with a case-control study
c) Recall bias was minimised compared with a case-control study
d) Causality could be inferred from the association between prescription of antipsychotic drugs and venous thromboembolism
Answers
Statements a, b, and c are true, whereas d is false.
The aim of the study was to investigate whether prescription of antipsychotic drugs was associated with venous thromboembolism. A nested case-control study design was used. The study design was an observational one that incorporated the concept of the traditional case-control study within an established cohort. This design overcomes some of the disadvantages associated with case-control studies, 2 while incorporating some of the advantages of cohort studies. 3 4
Data for the study above were extracted from the UK QResearch primary care...