Glossary of Epidemiology: 6) Disease Outcomes
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- Common reasons why a surrogate endpoint may fail
- 1)D variable not relevant (whiteness of teeth and lung cancer).
2)D variable relevant but extreme value may confer poor health.
3)Procedures to change D have other adverse (worse) effects.
- Issues associated with measuring D
- Correct measurement procedures.
How well executed.
- Diagnostic criteria
- Involve expert.
Have definitive case definition
- Disease onset timeing
- Index date: time of onset - should be explicitly outlined
- Identifying Death
- 1)State vital records
2)National vital records
3)National death index
- Issues for using death
- 1)Quality of code of death on death certificate.
2)Determine time of disease onset
3)Relevance to study question
- Identify Diseases leading to medical care
- 1)Provider records
- Key issues of medical care and disease
- 1)Access to records
3)Exposure influece decision to diagnose/treat
4)Appropriate severity level
- Misclssification of D can
- Incorrectly classify non-cases of D (False pos - Poor PPV or Specificity).
Fail to detect true D (Sensitivity).
- Nondifferential misclassification
- false positive can bias towards null
- Differential Misclassification
- False negative: Bias AWAY from the null
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