The value of combining individual and small area sociodemographic data for assessing and handling selective participation in cohort studies: Evidence from the Swedish CardioPulmonary bioImage Study

PLoS One. 2022 Mar 8;17(3):e0265088. doi: 10.1371/journal.pone.0265088. eCollection 2022.

Abstract

Objectives: To study the value of combining individual- and neighborhood-level sociodemographic data to predict study participation and assess the effects of baseline selection on the distribution of metabolic risk factors and lifestyle factors in the Swedish CardioPulmonary bioImage Study (SCAPIS).

Methods: We linked sociodemographic register data to SCAPIS participants (n = 30,154, ages: 50-64 years) and a random sample of the study's target population (n = 59,909). We assessed the classification ability of participation models based on individual-level data, neighborhood-level data, and combinations of both. Standardized mean differences (SMD) were used to examine how reweighting the sample to match the population affected the averages of 32 cardiopulmonary risk factors at baseline. Absolute SMDs >0.10 were considered meaningful.

Results: Combining both individual-level and neighborhood-level data gave rise to a model with better classification ability (AUC: 71.3%) than models with only individual-level (AUC: 66.9%) or neighborhood-level data (AUC: 65.5%). We observed a greater change in the distribution of risk factors when we reweighted the participants using both individual and area data. The only meaningful change was related to the (self-reported) frequency of alcohol consumption, which appears to be higher in the SCAPIS sample than in the population. The remaining risk factors did not change meaningfully.

Conclusions: Both individual- and neighborhood-level characteristics are informative in assessing study selection effects. Future analyses of cardiopulmonary outcomes in the SCAPIS cohort can benefit from our study, though the average impact of selection on risk factor distributions at baseline appears small.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Drinking* / epidemiology
  • Cohort Studies
  • Humans
  • Middle Aged
  • Risk Factors
  • Self Report
  • Sweden / epidemiology

Grants and funding

The study presented in this paper was funded by research grants from Swedish Research Council for Health, Working life and Welfare (Forte, www.forte.se, grant no. 2017-00414; 2020-00962) and the Swedish Research Council (VR, www.vetenskapsradet.se, grant no. 2019-00198). SCAPIS also received external funding from Swedish Heart-Lung Foundation (www.hjart-lungfonden.se, grant no. not available), Knut and Alice Wallenberg Foundation (www.kaw.wallenberg.org, grant no. 2014-0047), Swedish Research Council (www.vetenskapsradet.se, grant no. 822-2013-2000) and VINNOVA (Sweden’s Innovation agency, www.vinnova.se, grant no. 2012-04476), and internal funding from University of Gothenburg and Sahlgrenska University Hospital, Karolinska Institutet and Stockholm county council, Linköping University and University Hospital, Lund University and Skåne University Hospital, Umeå University and University Hospital, Uppsala University and University Hospital (grant numbers not applicable for internal sources of funding). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.