| Titre : | Effect of inter-reader variability on outcomes in studies using carotid intima media thickness quantified by carotid ultrasonography. (2010) |
| Auteurs : | DELANEY (Joseph-Ac) : USA. College of Pharmacy. University of Florida. Gainesville. FL. ; Carl GRUNFELD ; HAIYING CHEN (.) : USA. Wake Forest University School of Medicine. Winston Salem. NC. ; Richard KRONMAL ; Mary LOU BIGGS ; POLAK (Joseph) : USA. Tufts Medical Center. Boston. MA. ; Rebecca SCHERZER ; SIDNEY (Stephen) : USA. Division of Research. Kaiser Permanente. Oakland. CA. ; Collaborative Health Studies Coordinating Center. Department of Biostatistics. University of Washington. Seattle. WA. USA ; Medical Service. Department of Veterans Affairs Medical Center. San Francisco. CA. USA |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 25, n° 6, 2010) |
| Pagination : | 385-392 |
| Langues: | Anglais |
| Mots-clés : | Echographie ; Pronostic ; Evolution ; Homme ; Epidémiologie ; Appareil cardiovasculaire ; Artère ; Vaisseau ; Biais |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xDm8kG. Diffusion soumise à autorisation]. Systematic differences between readers or equipment in imaging studies are not uncommon ; failure to account for such differences when using Carotid Ultrasonography may introduce bias into associations between carotid intima media thickness (cIMT) and outcomes. We demonstrate the impact of this source of systematic measurement error (SME) using data on 5,521 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) and 661 participants from the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM). Participants were between 37 and 78 years old. Two outcomes were considered : (1) the effect of HIV infection on cIMT (between study) and (2) the association of cIMT with cardiovascular events (within study). All estimates were adjusted for demographics (age, gender, and ethnicity) and for traditional cardiovascular disease risk factors (smoking, blood pressure, diabetes and cholesterol). When comparing the FRAM and MESA cohorts to estimate the association of HIV infection on common cIMT, accounting for machine and reader variability (between study variability) reduced the difference associated with HIV infection from+0.080 mm (95% Confidence Interval (CI) : 0.065-0.095) to+0.037 mm (95% CI : 0.003 to 0.072) while internal cIMT declined from+0.254 mm (95% CI : 0.205-0.303) to+0.192 mm (95% CI : 0.076-0.308). Attenuation of the association between cIMT and cardiovascular endpoints occurred when within study reader variability was not accounted for. The effect of SME due to use of multiple readers or machines is most important when comparisons are made between two different study populations. Within-cohort measurement error dilutes the association with events. |
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