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KMID : 1011320200120010008
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Journal of Pharmacoepidemiology and Risk Management
2020 Volume.12 No. 1 p.8 ~ p.14
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Concept and Application of Case-Crossover Study and Case-Case-Time-Control Study in Pharmacoepidemiologic Study
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Kim Seon-Ji
Park Byung-Joo
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Abstract
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The importance of observational studies for evaluating drug safety in the field of pharmacoepidemiology is increasing
rapidly. However observational studies are susceptible to selection bias and confounding. Many researchers have tried to
develop ways to solve these problems. Case-crossover study (CCO study), a case-only design, was developed to overcome the methodological limitations of the case-control study, which was developed by Maclure in 1991 to identify the
relationship between transient exposure and acute outcome. However, if level of exposure has time trend over calendar
time, the application of CCO study is inadequate because it could overestimate or underestimate risk estimates. Casecase-time-control study (CCTC study) is the most recently developed method among the case-only study designs, which can control bias due to temporal trends in exposure. This article introduces concept and method of CCO study and
CCTC study, and compare the results of two study designs evaluating the relationship between antidepressants and the
risk of gastrointestinal bleeding. Understanding the concept and method of CCO study and CCTC study should be needed
for conducting more valid phamacoepidemiologic research.
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KEYWORD
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Case-crossover study, Case-case-time-control study, Bias, Pharmacoepidemiologic research
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