Original article| Volume 43, ISSUE 1, P87-91, 1990

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Recall bias in epidemiologic studies

  • Steven S. Coughlin
    Reprint requests should be addressed to: Steven S. Coughlin, Ph.D., M.P.H., Division of Biostatistics and Epidemiology, Kober-Cogan Hall, Room 404, Georgetown University School of Medicine, Washington, DC 20007, U.S.A.
    Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, U.S.A.
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      The factors which contribute to bias due to differential recall between cases and controls in retrospective studies have been little studied. A review of the literature on recall accuracy suggests that the extent of inaccurate recall is related to characteristics of the exposure of interest and of the respondents, though a distinction must be drawn between recall which is biased and that which is simply inaccurate. Interviewing technique and the study protocol, including the design of questionnaires and the motivation of respondents, play a central role and are under the control of the investigator. The results of validation studies carried out to date suggest that the likelihood of recall bias may be greater when recall is poor in general.


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        • Lilienfeld A.M.
        • Lilienfeld D.
        Foundations of Epidemiology.
        2nd Edn. Oxford University Press, New York1980
        • Schlesselman J.J.
        Case-Control Studies. Design, Conduct, Analysis.
        Oxford University Press, New York1982
        • Sackett D.L.
        Bias in analytic research.
        J Chron Dis. 1979; 32: 51-63
        • Copeland K.T.
        • Checkoway H.
        • McMichael A.J.
        • Holdbrook R.H.
        Bias due to misclassification in the estimation of relative risk.
        Am J Epidemiol. 1977; 105: 488-495
        • Raphael K.
        Recall bias: A proposal for assessment and control.
        Int J Epidemiol. 1987; 16: 167-170
        • Barron B.A.
        Effects of misclassification on the estimation of relative risk.
        Biometrics. 1977; 33: 414-418
        • Baumgarten M.
        • Siemiatycki J.
        • Gibbs G.W.
        Validity of work histories obtained by interview for epidemiologic purposes.
        Am J Epidemiol. 1983; 118: 583-591
        • Stewart W.
        • Tonascia J.
        • Matanoski G.
        The validity of questionnaire-reported work history in live respondents.
        J Occup Med. 1987; 29: 795-800
        • Rohan T.E.
        • Potter J.D.
        Retrospective assessment of dietary intake.
        Am J Epidemiol. 1984; 120: 876-887
        • Van Leeuwen F.E.
        • De Vat H.C.W.
        • Hayes R.B.
        • et al.
        An assessment of the relative validity of retrospective interviewing for measuring dietary intake.
        Am J Epidemiol. 1983; 118: 752-758
        • Jensen O.M.
        • Wahrendorf J.
        • Rosenqvist A.
        • Geser A.
        The reliability of questionnaire-derived historical dietary information and temporal stability of food habits in individuals.
        Am J Epidemiol. 1984; 120: 281-290
        • Jain M.
        • Howe G.R.
        • Johnson K.C.
        • Miller A.B.
        Evaluation of a diet history questionnaire for epidemiologic studies.
        Am J Epidemiol. 1980; 111: 212-219
        • Vobecky J.S.
        • Vobecky J.
        • Froda S.
        The reliability of the maternal memory in a retrospective assessment of nutritional status.
        J Clin Epidemiol. 1988; 41: 261-265
        • Wilcox A.J.
        • Horney L.F.
        Accuracy of spontaneous abortion recall.
        Am J Epidemiol. 1984; 120: 727-733
        • Tilley B.C.
        • Barnes A.B.
        • Bergstralh E.
        • et al.
        A comparison of pregnancy history recall and medical records. Implications for retrospective studies.
        Am J Epidemiol. 1985; 121: 269-281
        • Bean J.A.
        • Leeper J.D.
        • Wallace R.B.
        • et al.
        Variations in the reporting of menstrual histories.
        Am J Epidemiol. 1979; 109: 181-185
        • Yerushalmy J.
        • Bierman J.M.
        • Kemp D.H.
        • et al.
        Longitudinal studies of pregnancy on the island of Kaui, Territory of Hawaii.
        Am J Obstet Gynecol. 1956; 71: 80-96
        • Glass R.
        • Johnson B.
        • Vessey M.
        Accuracy of recall of oral contraceptive use.
        Br J Prev Soc Med. 1974; 28: 273-275
        • Paganini-Hill A.
        • Ross R.K.
        Reliability of recall of drug usage and other health-related information.
        Am J Epidemiol. 1982; 116: 114-122
        • Stolley P.D.
        • Tonascia J.A.
        • Sartwell P.E.
        • et al.
        Agreement rates between oral contraceptive users and prescribers in relation to drug use history.
        Am J Epidemiol. 1978; 107: 226-235
        • Corwin R.G.
        • Krober M.
        • Roth H.P.
        Patients' accuracy in reporting their past medical history. A study of 90 patients with peptic ulcer.
        J Chron Dis. 1971; 23: 875-879
        • Parten M.
        Surveys, Polls, and Samples: Practical Procedures.
        Harper and Brothers, New York1950
        • Chappell M.N.
        Factors influencing recall of radio programs.
        Public Opinion Q. 1942; 6: 197-214
        • Warner K.E.
        Possible increaseas in the under-reporting of cigarette consumption.
        J Am Stat Assoc. 1978; 73: 314-316
        • Bauman K.E.
        • Koch G.G.
        Validity of self-reports and descriptive and analytical conclusions. The case of cigarette smoking by adolescents and their mothers.
        Am J Epidemiol. 1983; 118: 90-98
      1. 2nd edn. Handbook of Survey Research. Academic Press, New York1983
        • Parry H.H.
        • Crossley H.M.
        Validity of responses to survey questions.
        Public Opinion Q. 1950; 14: 61-80
        • Backstrom C.H.
        • Hursh-Ceaser G.
        Survey Research.
        2nd edn. John Wiley, New York1981
        • Haley N.J.
        • Axelrod C.M.
        • Tilton K.A.
        Validation of self-reported smoking behavior: biochemical analyses of continine and thiocyanate.
        Am J Public Health. 1983; 73: 1204-1207
        • Vasey C.J.
        • Saboojee Y.
        • Cole P.V.
        • Russell M.A.H.
        Blood carboxyhemoglobin, plasma thiocyanate and cigarette consumption: implications for epidemiological studies in smokers.
        Br Med J. 1982; 284: 1516-1518
        • Gillies P.A.
        • Wilcox B.
        • Coates C.
        • et al.
        Use of objective measurement in the validaton of self-reported smoking in children aged 10–11 years: saliva thiocyanate.
        J Epidemiol Commun Health. 1982; 36: 205-208
        • Coughlin S.S.
        A Case-Control Study of Dilated Cardiomyopathy.
        in: 3rd edn. Doctoral dissertation. The Johns Hopkins University, 1987
        • Preston-Martin S.
        • Bernstein L.
        • Maldonado A.A.
        • et al.
        A dental X-ray validation study.
        Am J Epidemiol. 1985; 121: 430-439
        • Graham S.
        • Levin M.L.
        • Lilienfeld A.M.
        • et al.
        Methodological problems and design of the tristate leukemia study.
        Ann NY Acad Sci. 1963; 107: 557-569
        • Sudman S.
        • Bradburn N.
        Response Effects in Surveys: A Review and Synthesis.
        Aldine, Chicago1974
        • Feinstein A.R.
        Clinical Epidemiology. The Architecture of Clinical Research.
        W.B. Saunders Co.,, Philadelphia1985
        • Klemetti A.
        • Saxen L.
        Prospective versus longitudinal approach in the search for environmental causes of malformation.
        Am J Public Health. 1967; 57: 2071-2075
        • Linet M.S.
        • Brookmeyer R.
        Use of cancer controls in case-control cancer studies.
        Am J Epidemiol. 1987; 125: 1-11
        • Mackenzie S.G.
        • Lippman A.
        An investigation of report bias in a case-control study of pregnancy outcome.
        Am J Epidemiol. 1989; 129: 65-75