Predicting Future Excess Events in Risk Assessment
Predicting Future Excess Events in Risk Assessment
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DOI：
10.1111/j.1539-6924.2009.01197.x
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发表时间：
2009-06-01
期刊：
影响因子：
3.8
通讯作者：
Ross, N. Phillip
中科院分区：
文献类型：
--
作者：
Furukawa, Kyoji;Cologne, John B.;Ross, N. Phillip
研究人群中的风险特征依赖于与研究中暴露的因果关系相关的疾病或死亡病例。这类病例的数量，即所谓的“超额”病例，不仅是风险因素在研究人群中的影响的一个指标，而且也是评估风险方面的统计能力的一个重要决定因素，例如年龄-时间趋势和易感亚组。在确定研究人群有多大和/或跟踪研究人群多长时间以积累足够的过剩病例时，必须预测未来的风险。在这项研究中，我们描述了一种预测预期超额病例数量的方法，并评估了这些预测中的不确定性，重点讨论了具有可能影响修正的超额风险模型。为此，我们通过扩展贝叶斯APC模型进行比率预测，以包括暴露相关的额外风险，并可能根据暴露时的年龄和达到的年龄进行修改。该方法以对日本原子弹幸存者的跟踪研究为例，这是确定辐射暴露的长期健康影响和评估辐射防护风险的主要依据之一。通过使用在为交叉验证保留的测试数据上获得的预测性能测量所选择的模型，我们预测了A炸弹幸存者队列中因辐射暴露和与癌症和非癌症疾病死亡相关的终身风险测量(暴露诱导死亡的风险(REID)和预期寿命损失(LLE))而产生的额外计数。
Risk characterization in a study population relies on cases of disease or death that are causally related to the exposure under study. The number of such cases, so-called "excess" cases, is not just an indicator of the impact of the risk factor in the study population, but also an important determinant of statistical power for assessing aspects of risk such as age-time trends and susceptible subgroups. In determining how large a population to study and/or how long to follow a study population to accumulate sufficient excess cases, it is necessary to predict future risk. In this study, focusing on models involving excess risk with possible effect modification, we describe a method for predicting the expected magnitude of numbers of excess cases and assess the uncertainty in those predictions. We do this by extending Bayesian APC models for rate projection to include exposure-related excess risk with possible effect modification by, e.g., age at exposure and attained age. The method is illustrated using the follow-up study of Japanese Atomic-Bomb Survivors, one of the primary bases for determining long-term health effects of radiation exposure and assessment of risk for radiation protection purposes. Using models selected by a predictive-performance measure obtained on test data reserved for cross-validation, we project excess counts due to radiation exposure and lifetime risk measures (risk of exposure-induced deaths (REID) and loss of life expectancy (LLE)) associated with cancer and noncancer disease deaths in the A-Bomb survivor cohort.