Outcome-wide Epidemiology.
Outcome-wide Epidemiology.
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DOI：
10.1097/ede.0000000000000641
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发表时间：
2017-05
期刊：
影响因子：
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通讯作者：
VanderWeele TJ
中科院分区：
文献类型：
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作者：
VanderWeele TJ
作者建议，流行病学研究应更多地评估一次暴露与同时发生的多种结果之间的关系。这种“结果范围流行病学”对于可能对某些结果有益但对其他结果有害的暴露尤其重要。结果范围流行病学也可能有助于确定公共卫生建议的优先次序。从方法上讲，开展全结果流行病学通常比最近提出的全暴露流行病学研究更直接，后者同时评估单一结果与许多暴露之间的关系。由于无法同时进行混淆控制，而且暴露可能会影响和调解其他暴露的影响，这种暴露范围的研究可能会受到许多偏差的影响。当考虑单个暴露时，这些问题在结果范围方法中大大简化。此外，在形成公共卫生建议方面，结果范围方法通常比接触范围方法更有用。
The author proposes that epidemiologic studies should more often assess the associations of a single exposure with multiple outcomes simultaneously. Such “outcome-wide epidemiology” will be especially important for exposures that may be beneficial for some outcomes but harmful for others. Outcome-wide epidemiology may also be helpful in prioritizing public health recommendations. Methodologically, the conduct of outcome-wide epidemiology will generally be more straightforward than recent proposals for exposure-wide epidemiologic studies, in which the associations between a single outcome and many exposures are assessed simultaneously. Such exposure-wide studies are likely to be subject to numerous biases because of the inability to make simultaneous confounding control and because exposures are likely to affect, and mediate the effects of, other exposures. These problems simplify considerably in an outcome-wide approach when a single exposure is being considered. Moreover, outcome-wide approaches will generally be more useful than exposure-wide approaches in shaping public health recommendations.