Optimising the case-crossover design for use in shared exposure settings.

Last updated on 4-1-2021 by Toon Braeye

Public Access


Peer reviewed scientific article



With a case-crossover design, a case’s exposure during a risk period is compared to the case’s exposures at referent periods. The selection of referents for this self-controlled design is determined by the referent selection strategy (RSS). Previous research mainly focused on systematic bias associated with the RSS. We additionally focused on how RSS determines the number of referents per risk, sensitivity to overdispersion and time-varying confounding.We illustrated the consequences of different RSS using a simulation study informed by data on meteorological variables and Legionnaires’ dis…

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