Abstract
Objective
To test the feasibility and validity of the online case–control study design through
the empirical deployment of a prototype study of recent-onset systemic lupus erythematosus
(SLE).
Study Design and Setting
We conducted an Internet-based case–control study of SLE during 2003–2005. The source
population comprised Google users searching on medical key terms, solicited using
sponsored links. Cases fulfilled a self-administered algorithm for SLE diagnosed within
5 years. A subset underwent confirmation by medical record review. Controls were matched
to cases using a propensity score.
Results
Four hundred and two cases and 693 control applicants finished the questionnaires,
yielding 389 matched case–control pairs. Eighty-two percentage of the records documented
a clinical diagnosis of SLE, and 61% documented ≥4 American College of Rheumatology
criteria for SLE. Control applicants resembled Internet users, with the exceptions
of comprising more women (86% vs. 52%) and fewer minority individuals (e.g., 5% vs.
9% for African-Americans). There was a broad representation of clinical manifestations.
SLE was associated with miscarriage (odds ratio [OR]=3.0, 95% confidence interval [CI]=2.0–4.7), allergy to sulfonamides (OR=2.2, CI=1.5–3.2), hives (OR=1.9, CI=1.4–2.5), and shingles (OR=2.3, CI=1.4–3.7).
Conclusion
It is possible to perform case–control studies over the Internet using an internally
valid design, obtain reliable information from participants, and confirm established
associations.
Keywords
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Article info
Publication history
Published online: March 17, 2008
Accepted:
July 11,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
