Case–control studies in diabetes. Do they really use a case–control design?

Studies defined as case–control do not always use this design. We aimed to estimate the frequency of mislabelled case–control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling.

We searched Medline and Web of Science for articles with “diabetes” and “case control” in title and filtered for language (English/Romance) and period (January 2010–December 2014). Inclusion criteria were: (1) statement to use a case–control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. Outcome variable: case–control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. Statistics: proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis.

We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7–50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area.

A relevant subset of studies defined as case–control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause–effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.