Dogmatists Cannot Learn.
Dogmatists Cannot Learn.
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教条主义者无法学习。
DOI：
10.1097/ede.0000000000000587
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Edwards,JessK
中科院分区：
文献类型：
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作者：
Cole,StephenR;Chu,Haitao;Brookhart,MAlan;Edwards,JessK
在本研究中，我们进一步评估了基于使用洛伦兹曲线的风险预测模型进行靶向筛查的可行性。洛伦兹曲线是计量经济学中广泛使用的一种图形工具，用于描述社会财富的分配，被认为对于展示疾病风险的“集中度”很有价值。 7 在评估疾病风险预测背景下的筛查计划时，该工具可能特别相关。我们根据 1995 年至 1997 年瑞典全国人口病例对照研究的数据开发了一个风险预测模型。 2, 5 参与者包括来自瑞典所有相关医院科室的 189 名经组织学证实的食管腺癌病例，以及从瑞典人群中随机选择的 820 名年龄和性别频率匹配的对照受试者。有关风险因素的详细信息是通过面对面访谈收集的。这项研究得到了瑞典所有六个区域伦理审查委员会的批准，并获得了每位参与者的书面和口头知情同意。简而言之，我们对从逻辑回归模型获得的所有对照（代表风险人群）的估计风险进行了排名。对于每个风险水平，使用具有该风险水平或以下风险水平的控制和估计风险的累积比例来绘制曲线。方法细节可以在 Mauguen 和 Begg 的报告中找到。 7 构建的洛伦兹曲线如图所示。基于一个简单的模型，仅包括反流症状或使用抗反流药物、体重指数和吸烟的信息，所有食管腺癌病例中的 37% 将发生在风险最高的 10% 人群中，并且根据风险可从前 5% 人群中识别出所有病例中的 22%。在考虑年龄和性别后，估计的风险会更加集中。例如，风险集中度应
In this study, we further assessed the feasibility of targeted screening based on a risk prediction model using the Lorenz Curve. the Lorenz Curve is a graphical tool widely used in econometrics to characterizing the distribution of wealth in the society, which has been suggested to be valuable in demonstrating the “concentration” of disease risks. 7 this tool may be particularly relevant when evaluating screening programs in the context of disease risk prediction. We have developed a risk prediction model based on data from a nationwide population-based case–control study in sweden in 1995–1997. 2, 5 Participants included 189 histologically confirmed incident cases of esophageal adenocarcinoma from all relevant hospital departments in sweden, and 820 control subjects frequency-matched for age and sex and randomly selected from the swedish population. Detailed information on risk factors was collected via face-to-face interviews. this study was approved by all six regional ethical review boards in sweden, and both written and oral informed consent was obtained from each participant. In brief, we ranked the estimated risks for all controls (representing the population at risk) obtained from the logistic regression model. For each of the risk levels, the cumulative proportions of controls and estimated risks having this level of risk or below were used to draw the curve. Methodological details can be found in the report by Mauguen and Begg. 7 the constructed Lorenz Curve is shown in Figure. Based on a simple model, which only included information on reflux symptoms or use of antireflux medication, body mass index, and tobacco smoking, 37% of all esophageal adenocarcinoma cases would occur in the 10% of the population with the highest risks, and 22% of all cases would be identifiable from the top 5% of the population based on risk. the estimated risks would be even more concentrated after also considering age and sex. For example, the risk concentration should