Participation bias assessment in a community-based study of myocardial infarction, 2002-2005

Yariv Gerber, Steven J. Jacobsen, Jill M. Killian, Susan A. Weston, Veronique Lee Roger

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE: To compare the characteristics and survival of participants and nonparticipants in a community-based study of myocardial infarction (MI). PATIENTS AND METHODS: Residents of Olmsted County, MN, who presented with elevated cardiac troponin T levels from September 1, 2002, through December 31, 2005, were prospectively enrolled and classified with standardized criteria for MI. With specific Institutional Review Board approval, the medical records of patients with MI who did not provide consent but who had given general research authorization were reviewed, as was done for their consenting peers. RESULTS: During the study period, 2277 individuals with elevated cardiac troponin T levels were approached, of whom 1863 (82%) consented to participate. Among the 414 nonparticipants, 375 (91%) had general research authorization. Of the 558 with general research authorization who met the criteria for incident (ie, first-ever) MI, 67 (12%) refused to participate. These participants tended to be older (mean ± SD age, 71±14 vs 67±15 years; P=.04), were more likely to be of races other than white (9% vs 2%; P=.01), and had more comorbidities, including peripheral vascular disease (P=.02), chronic pulmonary disease (P=.06), heart failure (P=.07), and Impaired creatinine clearance (P=.02). No significant differences were detected in cardiovascular risk factors or MI characteristics. During a median foilow-up of 517 days, nonparticipants experienced increased mortality rates compared with participants (hazard ratio, 1.97; 95% confidence interval, 1.21-3.20), which was largely attributable to their older age and excess comorbidities (adjusted hazard ratio, 1.43; 95% confidence interval, 0.86-2.35). CONCLUSION: in this community-based study of MI, nonparticipants experienced worse survival rates than participants largely because of differences in demographic and clinical characteristics. These differences should be kept in mind when interpreting study results, particularly if participation is low.

Original languageEnglish (US)
Pages (from-to)933-938
Number of pages6
JournalMayo Clinic Proceedings
Volume82
Issue number8
DOIs
StatePublished - 2007

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Myocardial Infarction
Troponin T
Comorbidity
Research
Confidence Intervals
Peripheral Vascular Diseases
Research Ethics Committees
Lung Diseases
Medical Records
Creatinine
Chronic Disease
Survival Rate
Heart Failure
Demography
Survival
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Participation bias assessment in a community-based study of myocardial infarction, 2002-2005. / Gerber, Yariv; Jacobsen, Steven J.; Killian, Jill M.; Weston, Susan A.; Roger, Veronique Lee.

In: Mayo Clinic Proceedings, Vol. 82, No. 8, 2007, p. 933-938.

Research output: Contribution to journalArticle

Gerber, Yariv ; Jacobsen, Steven J. ; Killian, Jill M. ; Weston, Susan A. ; Roger, Veronique Lee. / Participation bias assessment in a community-based study of myocardial infarction, 2002-2005. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 8. pp. 933-938.
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abstract = "OBJECTIVE: To compare the characteristics and survival of participants and nonparticipants in a community-based study of myocardial infarction (MI). PATIENTS AND METHODS: Residents of Olmsted County, MN, who presented with elevated cardiac troponin T levels from September 1, 2002, through December 31, 2005, were prospectively enrolled and classified with standardized criteria for MI. With specific Institutional Review Board approval, the medical records of patients with MI who did not provide consent but who had given general research authorization were reviewed, as was done for their consenting peers. RESULTS: During the study period, 2277 individuals with elevated cardiac troponin T levels were approached, of whom 1863 (82{\%}) consented to participate. Among the 414 nonparticipants, 375 (91{\%}) had general research authorization. Of the 558 with general research authorization who met the criteria for incident (ie, first-ever) MI, 67 (12{\%}) refused to participate. These participants tended to be older (mean ± SD age, 71±14 vs 67±15 years; P=.04), were more likely to be of races other than white (9{\%} vs 2{\%}; P=.01), and had more comorbidities, including peripheral vascular disease (P=.02), chronic pulmonary disease (P=.06), heart failure (P=.07), and Impaired creatinine clearance (P=.02). No significant differences were detected in cardiovascular risk factors or MI characteristics. During a median foilow-up of 517 days, nonparticipants experienced increased mortality rates compared with participants (hazard ratio, 1.97; 95{\%} confidence interval, 1.21-3.20), which was largely attributable to their older age and excess comorbidities (adjusted hazard ratio, 1.43; 95{\%} confidence interval, 0.86-2.35). CONCLUSION: in this community-based study of MI, nonparticipants experienced worse survival rates than participants largely because of differences in demographic and clinical characteristics. These differences should be kept in mind when interpreting study results, particularly if participation is low.",
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N2 - OBJECTIVE: To compare the characteristics and survival of participants and nonparticipants in a community-based study of myocardial infarction (MI). PATIENTS AND METHODS: Residents of Olmsted County, MN, who presented with elevated cardiac troponin T levels from September 1, 2002, through December 31, 2005, were prospectively enrolled and classified with standardized criteria for MI. With specific Institutional Review Board approval, the medical records of patients with MI who did not provide consent but who had given general research authorization were reviewed, as was done for their consenting peers. RESULTS: During the study period, 2277 individuals with elevated cardiac troponin T levels were approached, of whom 1863 (82%) consented to participate. Among the 414 nonparticipants, 375 (91%) had general research authorization. Of the 558 with general research authorization who met the criteria for incident (ie, first-ever) MI, 67 (12%) refused to participate. These participants tended to be older (mean ± SD age, 71±14 vs 67±15 years; P=.04), were more likely to be of races other than white (9% vs 2%; P=.01), and had more comorbidities, including peripheral vascular disease (P=.02), chronic pulmonary disease (P=.06), heart failure (P=.07), and Impaired creatinine clearance (P=.02). No significant differences were detected in cardiovascular risk factors or MI characteristics. During a median foilow-up of 517 days, nonparticipants experienced increased mortality rates compared with participants (hazard ratio, 1.97; 95% confidence interval, 1.21-3.20), which was largely attributable to their older age and excess comorbidities (adjusted hazard ratio, 1.43; 95% confidence interval, 0.86-2.35). CONCLUSION: in this community-based study of MI, nonparticipants experienced worse survival rates than participants largely because of differences in demographic and clinical characteristics. These differences should be kept in mind when interpreting study results, particularly if participation is low.

AB - OBJECTIVE: To compare the characteristics and survival of participants and nonparticipants in a community-based study of myocardial infarction (MI). PATIENTS AND METHODS: Residents of Olmsted County, MN, who presented with elevated cardiac troponin T levels from September 1, 2002, through December 31, 2005, were prospectively enrolled and classified with standardized criteria for MI. With specific Institutional Review Board approval, the medical records of patients with MI who did not provide consent but who had given general research authorization were reviewed, as was done for their consenting peers. RESULTS: During the study period, 2277 individuals with elevated cardiac troponin T levels were approached, of whom 1863 (82%) consented to participate. Among the 414 nonparticipants, 375 (91%) had general research authorization. Of the 558 with general research authorization who met the criteria for incident (ie, first-ever) MI, 67 (12%) refused to participate. These participants tended to be older (mean ± SD age, 71±14 vs 67±15 years; P=.04), were more likely to be of races other than white (9% vs 2%; P=.01), and had more comorbidities, including peripheral vascular disease (P=.02), chronic pulmonary disease (P=.06), heart failure (P=.07), and Impaired creatinine clearance (P=.02). No significant differences were detected in cardiovascular risk factors or MI characteristics. During a median foilow-up of 517 days, nonparticipants experienced increased mortality rates compared with participants (hazard ratio, 1.97; 95% confidence interval, 1.21-3.20), which was largely attributable to their older age and excess comorbidities (adjusted hazard ratio, 1.43; 95% confidence interval, 0.86-2.35). CONCLUSION: in this community-based study of MI, nonparticipants experienced worse survival rates than participants largely because of differences in demographic and clinical characteristics. These differences should be kept in mind when interpreting study results, particularly if participation is low.

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