Original Article| Volume 61, ISSUE 7, P671-678, July 2008

Feasibility and validity were demonstrated of an online case–control study using the prototype of recent-onset systemic lupus erythematosus



      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.


      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).


      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.


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