Case ascertainment in stroke studies: the risk of selection bias

Acta Neurol Scand. 2003 Feb;107(2):145-9. doi: 10.1034/j.1600-0404.2003.02120.x.

Abstract

Objectives: The purpose was to compare the completeness of case ascertainment in two stroke registers, one local population-based, the other a national quality register (Riks-Stroke), and to examine if patient characteristics could be affected by selection bias.

Material and methods: By the way of linking and matching computer files, the completeness of case ascertainment was evaluated.

Results: In the local stroke incidence study 377 patients were included. Of them, 63% were reported to the hospital-based national quality register. The case-fatality was lower in the national register. A larger proportion of the patients in the national register appeared to have been treated in a stroke unit and undergone rehabilitation, and computerized tomography seemed to have been performed in a larger proportion.

Conclusions: Because of selection bias, outcome data get skewed when case ascertainment does not embrace all stroke cases. A community-based stroke register is the golden standard when measuring stroke incidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Hospital Departments / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Outcome Assessment, Health Care / methods*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patient Selection
  • Registries / standards*
  • Registries / statistics & numerical data*
  • Reproducibility of Results
  • Residence Characteristics / statistics & numerical data
  • Selection Bias
  • Stroke / diagnosis*
  • Stroke / epidemiology*
  • Stroke Rehabilitation
  • Sweden / epidemiology
  • Tomography, X-Ray Computed / statistics & numerical data