3 Case-Control Methods

3.4 Spatial clustering or variation in risk?

Distinction between methods described in Sections 3.2 and 3.3.

In both cases,

  • Null hypothesis: cases occur independently AND with constant risk

  • Alternative hypothesis:

    1. 1.

      spatial clustering: stochastic dependence

    2. 2.

      spatial variation: non-constant risk

Distinction between stochastic dependence and non-constant risk is not sustainable empirically (and not always theoretically, without additional assumptions) (Bartlett, 1964).

A pragmatic strategy for problems of this kind, is to

  • try first to explain spatial variation in risk by adjusting for covariate effects before using stochastic models;

  • then use stochastic methods to analyse residual spatial effects

  • interpret small-scale residual effects as clustering, large-scale residual effects as variation in risk?

  • a scientific explanation always trumps a purely statistical one.