Temporal bias in case-control design: preventing reliable predictions of the future

Nat Commun. 2021 Feb 17;12(1):1107. doi: 10.1038/s41467-021-21390-2.

Abstract

One of the primary tools that researchers use to predict risk is the case-control study. We identify a flaw, temporal bias, that is specific to and uniquely associated with these studies that occurs when the study period is not representative of the data that clinicians have during the diagnostic process. Temporal bias acts to undermine the validity of predictions by over-emphasizing features close to the outcome of interest. We examine the impact of temporal bias across the medical literature, and highlight examples of exaggerated effect sizes, false-negative predictions, and replication failure. Given the ubiquity and practical advantages of case-control studies, we discuss strategies for estimating the influence of and preventing temporal bias where it exists.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bias
  • Biomedical Research / methods
  • Biomedical Research / standards*
  • Biomedical Research / trends
  • Case-Control Studies
  • Clinical Trials as Topic / methods
  • Clinical Trials as Topic / standards*
  • Forecasting
  • Humans
  • Patient Selection*
  • Reproducibility of Results
  • Research Design / standards*