What are case-control studies?

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Case-control studies are observational and travel the reverse path of the cohort: they start from the outcome and look backwards for the exposure. They are the studies of odds measures.

30-second summary
  • The case-control study starts from the outcome and looks back.
  • The measure of association is the odds ratio — never say 'risk'.
  • Fast and inexpensive, but subject to recall bias.
Caseswith colorectal cancer
Controlswithout colorectal cancer
Look backquestionnaire, records
Exposurewhat was the fiber intake?

The case-control study looks backwards: from today’s outcome to yesterday’s exposure.

✓ Advantages: inexpensive, fast and ideal for rare or slowly-developing diseases — no follow-up needed.
✗ Disadvantage: it depends on patients’ memory of their exposures — the famous recall bias.
Here the measure of association is the odds ratio (OR) — the question CANNOT be about “risk”. Doubts between risk and odds? See the guide →

Frequently asked questions

How to choose good controls?

From the same source population as the cases, with the same chance of exposure — poor control selection is the biggest source of bias.

How many controls per case?

Up to about 4 controls per case increase statistical power; beyond that the gain is minimal.

Is it suitable for rare diseases?

It is the ideal design: it gathers existing cases without waiting years of follow-up.

✍️

Written by Francisco Tustumi, digestive system surgeon (FMUSP), associate editor of ABCD.


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ABCD – BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY is a periodic with a single annual volume in continuous publication, official organ of the Brazilian College of Digestive Surgery - CBCD. Technical manager: Dr. Francisco Tustumi | CRM: 157311 | RQE: 77151 - Cirurgia do Aparelho Digestivo

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