Quantifying the Impact of Selection Bias Caused by Nonparticipation in a Case-Control Study of Mobile Phone Use

Martine Vrijheid*, Lesley Richardson, Bruce K. Armstrong, Anssi Auvinen, Gabriele Berg, Matthew Carroll, Angela Chetrit, Isabelle Deltour, Maria Feychting, Graham g. Giles, Martine Hours, Ivano Iavarone, Susanna Lagorio, Stefan Lönn, Mary Mcbride, Marie Elise Parent, Siegal Sadetzki, Tina Salminen, Marie Sanchez, Birgitte SchlehoferJoachim Schüz, Jack Siemiatycki, Tore Tynes, Alistair Woodward, Naohito Yamaguchi, Elisabeth Cardis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. Methods: Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. Results: Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. Conclusions: Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.

Original languageEnglish
Pages (from-to)33-41.e1
JournalAnnals of Epidemiology
Issue number1
StatePublished - Jan 2009


  • Brain Neoplasms
  • Case-Control Studies
  • Cellular Phones
  • Epidemiological Methods
  • Refusal to Participate
  • Selection Bias


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