Study Design: Nested Case-Control Motivation

Adolescent Cohort

N = 10,000
0m
8m
16m
24m

Analysis Model:

Conditional Logit

Key Information / Log

Step 1: Cohort & Timeline

We start with a cohort of 10,000 healthy adolescents and will follow them for 24 months.

Step 2: Case Identified @ 8 Months

An individual is hospitalized (Case 1). We stop time at this exact point.

Step 3: Risk-Set Sampling (1:4)

From everyone *still* healthy at 8 months (the "Risk Set"), we randomly select 4 matched controls.

Step 4: Process Repeats...

This sampling process repeats *each time* a new case (Case 2 @ 14m, Case 3 @ 19m...) occurs.

Step 5: Fast Forward to 24 Months

The process continues until all **300 target cases** are identified, matched with 1,200 controls. (N = 8,500)

Step 6: Why Conditional Logit?

This 1:N matching design breaks the assumption of independence. We **must** use an analysis that respects these matched sets. **Conditional Logistic Regression** is the standard method to analyze this specific data structure.

Resulting Data Structure (for Analysis)

Matched Set Case ID Control IDs Time
1 P-0752 P-1432, P-0012, P-8345, P-3321 8m
2 P-4512 P-2311, P-5543, P-0122, P-9876 14m
... ... ... ...
300 P-2319 P-5409, P-1120, P-7768, P-0034 24m

Sensitivity Analysis: SAP Threat Dashboard

1. Core Threat Simulation

3 Core Bias Threats for SAP design:

  • Clustering: (Scenario 3) Students in the same school are not independent. Ignoring this causes false positives.
  • Data Quality:
    • (Scenario 2) Misclassification: Self-report is unreliable.
    • (Scenario 4) Informative LTFU: Heavy users are more likely to drop out.

2. Simulation Parameters

Sensitivity: 0.95
Specificity: 0.95

Note: Parameters are locked based on the selected scenario.

Simulation Results

Statistical Power
?%
95% Confidence Interval
OR=1.0
0.0 2.0 3.5

Threat Visualization