The British Journal of Psychiatry (2007) 190: 204-209. doi: 10.1192/bjp.bp.106.027250
© 2007 The Royal College of Psychiatrists
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REVIEW ARTICLES

Bias in psychiatric case–control studies

Literature survey

William Lee, MBChB, MRCPsych

Academic Department of Psychological Medicine

Jonathan Bindman, MSc, PhD, MRCPsych

Health Services Research

Tamsin Ford, MSc, PhD, MRCPsych

Child and Adolescent Psychiatry

Nick Glozier, MSc, PhD, MRCPsych and Paul Moran, MSc, MD, MRCPsych

Health Services Resarch

Robert Stewart, MSc, MD, MRCPsych

Section of Epidemiology

Matthew Hotopf, MSc, PhD, MRCPsych

Academic Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Correspondence: Professor Matthew Hotopf, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Rd, London SE5 9RJ, UK. Email:m.hotopf{at}iop.kcl.ac.uk

Declaration of interest None.

Background: Case–control studies are vulnerable to selection and information biases which may generate misleading findings.

Aims To assess the quality of methodological reporting of case–control studies published in general psychiatric journals.

Method All the case–control studies published over a 2-year period in the six general psychiatric journals with impact factors of more than 3 were assessed by a group of psychiatrists with training in epidemiology using a structured assessment devised for the purpose. The measured study quality was compared across type of exposure and journal.

Results The reporting of methods in the 408 identified papers was generally poor, with basic information about recruitment of participants often absent. Reduction of selection bias was described best in the `pencil and paper' studies and worst in the genetic studies. Neuroimaging studies reported the most safeguards against information bias. Measurement of exposure was reported least well in studies determining the exposure with a biological test.

Conclusions Poor reporting of recruitment strategies threatens the validity of reported results and reduces the generalisability of studies.


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