PURPOSE: The case-crossover design was originally intended to study brief exposures with immediate and transient effects, and acute outcomes with abrupt onsets. We investigated whether case-crossover methods can be used to study prolonged exposures and insidious outcomes. METHODS: We conducted a case-crossover study of 8220 patients aged > or = 65 years enrolled in several health benefits programs in New Jersey during the period between 1991 and 1995. All had episodes of central nervous system (CNS) adverse events (e.g., delirium). Drug exposures were assessed during case time periods and control time periods lasting 1, 2, 3, or 4 months. Exposures included 3 active regimens with established deleterious CNS effects (corticosteroids, digoxin, and opiates) and 2 inactive regimens without such effects (multivitamins and statins). RESULTS: In conditional logistic regression models, significantly elevated risks were observed for all three active drugs, regardless of which time windows were used. The magnitude of these risks generally increased with longer time windows. No significantly increased risks were observed for the 2 inactive drugs, regardless of the window duration. CONCLUSIONS: These results suggest that with lengthened exposure assessment windows, case-crossover methods may be useful for studying exposures with prolonged effects and outcomes with insidious onsets.
PURPOSE: The case-crossover design was originally intended to study brief exposures with immediate and transient effects, and acute outcomes with abrupt onsets. We investigated whether case-crossover methods can be used to study prolonged exposures and insidious outcomes. METHODS: We conducted a case-crossover study of 8220 patients aged > or = 65 years enrolled in several health benefits programs in New Jersey during the period between 1991 and 1995. All had episodes of central nervous system (CNS) adverse events (e.g., delirium). Drug exposures were assessed during case time periods and control time periods lasting 1, 2, 3, or 4 months. Exposures included 3 active regimens with established deleterious CNS effects (corticosteroids, digoxin, and opiates) and 2 inactive regimens without such effects (multivitamins and statins). RESULTS: In conditional logistic regression models, significantly elevated risks were observed for all three active drugs, regardless of which time windows were used. The magnitude of these risks generally increased with longer time windows. No significantly increased risks were observed for the 2 inactive drugs, regardless of the window duration. CONCLUSIONS: These results suggest that with lengthened exposure assessment windows, case-crossover methods may be useful for studying exposures with prolonged effects and outcomes with insidious onsets.
Authors: Julie H Ishida; Charles E McCulloch; Michael A Steinman; Barbara A Grimes; Kirsten L Johansen Journal: Clin J Am Soc Nephrol Date: 2018-04-19 Impact factor: 8.237
Authors: David B Hanna; Nancy A Hessol; Elizabeth T Golub; Jennifer M Cocohoba; Mardge H Cohen; Alexandra M Levine; Tracey E Wilson; Mary Young; Kathryn Anastos; Robert C Kaplan Journal: J Acquir Immune Defic Syndr Date: 2014-04-15 Impact factor: 3.731
Authors: Imre Janszky; Ioannis Vardaxis; Bo Henry Lindqvist; Jens Wilhelm Horn; Ben Michael Brumpton; Linn Beate Strand; Inger Johanne Bakken; Ingvild Vatten Alsnes; Pål Richard Romundstad; Rickard Ljung; Kenneth Jay Mukamal; Abhijit Sen Journal: Sci Rep Date: 2021-11-04 Impact factor: 4.379
Authors: Toni M Rudisill; Motao Zhu; Danielle Davidov; D Leann Long; Usha Sambamoorthi; Marie Abate; Vincent Delagarza Journal: BMC Res Notes Date: 2016-03-15