Gains in Statistical Power From Using a Dietary Biomarker in Combination With Self-reported Intake to Strengthen the Analysis of a Diet-Disease Association: An Example From CAREDS
Open Access
- 17 August 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Epidemiology
- Vol. 172 (7), 836-842
- https://doi.org/10.1093/aje/kwq194
Abstract
A major problem in detecting diet-disease associations in nutritional cohort studies is measurement error in self-reported intakes, which causes loss of statistical power. The authors propose using biomarkers correlated with dietary intake to strengthen analyses of diet-disease hypotheses and to increase statistical power. They consider combining self-reported intakes and biomarker levels using principal components or a sum of ranks and relating the combined measure to disease in conventional regression analyses. They illustrate their method in a study of the inverse association of dietary lutein plus zeaxanthin with nuclear cataracts, using serum lutein plus zeaxanthin as the biomarker, with data from the Carotenoids in Age-Related Eye Disease Study (United States, 2001–2004). This example demonstrates that the combined measure provides higher statistical significance than the dietary measure or the serum measure alone, and it potentially provides sample savings of 8%–53% over analysis with dietary intake alone and of 6%–48% over analysis with serum level alone, depending on the definition of the outcome variable and the choice of confounders entered into the regression model. The authors conclude that combining appropriate biomarkers with dietary data in a cohort can strengthen the investigation of diet-disease associations by increasing the statistical power to detect them.Keywords
This publication has 10 references indexed in Scilit:
- Can we use biomarkers in combination with self-reports to strengthen the analysis of nutritional epidemiologic studies?Epidemiologic Perspectives & Innovations, 2010
- Associations Between Age-Related Nuclear Cataract and Lutein and Zeaxanthin in the Diet and Serum in the Carotenoids in the Age-Related Eye Disease Study (CAREDS), an Ancillary Study of the Women's Health InitiativeAmerican Journal of Ophthalmology, 2008
- Correlated measurement error--implications for nutritional epidemiologyInternational Journal of Epidemiology, 2004
- The women's health initiative observational study: baseline characteristics of participants and reliability of baseline measuresAnnals of Epidemiology, 2003
- Measurement Characteristics of the Women’s Health Initiative Food Frequency QuestionnaireAnnals of Epidemiology, 1999
- Design of the Women’s Health Initiative Clinical Trial and Observational StudyControlled Clinical Trials, 1998
- Incident Cataract SurgeryOphthalmology, 1997
- Destruction of tocopherols, carotenoids, and retinol in human plasma by cigarette smokeThe American Journal of Clinical Nutrition, 1996
- The problem of profound mismeasurement and the power of epidemiological studies of diet and cancerNutrition and Cancer, 1988
- The use of polytomous dual response data to increase power in case-control studies: An application to the association between dietary fat and breast cancerJournal of Chronic Diseases, 1985