A CASE-CONTROL STUDY OF PROSTHETIC IMPLANTS AND SELECTED CHRONIC DISEASES IN MEDICARE CLAIMS DATA

PURPOSE: In an exploratory case-control study of a private insurance-c laims database, Greenland and Finkle (Ann Epidemiol. 1996;6:530-540) o bserved associations of certain prosthetic nonbreast implants with cer tain connective-tissue and neurologic conditions. We wished to test th ese associations using the same design with new data. METHODS: We exam ined these associations in a case-control analysis of Medicare claims data. To control for possible confounding effects of surgery, our anal ysis examined nonimplant surgeries of severity similar to implant surg eries. RESULTS: We again found associations of silicone and metal impl ants with connective-tissue and neurologic conditions, but we also fou nd similar associations of carpel-tunnel surgery with those conditions . CONCLUSIONS: Possible explanations for these findings include confou nding by presurgical conditions. Therefore, we recommend further studi es be done in which such conditions can be measured and controlled. (C ) 1998 Elsevier Science Inc.