THE USE OF ATTRIBUTABLE FRACTION IN THE DESIGN AND INTERPRETATION OF EPIDEMIOLOGIC STUDIES
THE USE OF ATTRIBUTABLE FRACTION IN THE DESIGN AND INTERPRETATION OF EPIDEMIOLOGIC STUDIES
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DOI：
10.1016/0895-4356(89)90009-7
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发表时间：
1989-01-01
影响因子：
7.2
通讯作者：
JAMES, LM
中科院分区：
文献类型：
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作者：
ADAMS, MJ;KHOURY, MJ;JAMES, LM
由于许多疾病的病因异质性以及疾病发展过程中各因果因素之间的相互作用，任何一次接触某种疾病的相对风险可能很低，特别是在常见接触的情况下。然而，在流行病学研究的设计中，通常使用任意的相对危险度值来确定检测特定接触与疾病结果之间的关联所需的样本量。这种方法可能不会产生足够的统计能力来检测关联。在这篇评论中，作者指出了使用归因分数来确定用于样本量计算的适当的相对风险值的价值。这种方法在聚类调查中特别有用，在聚类调查中，预期归因比例的大小可以很容易地从观察到的和预期的发病率中估计出来。在设计病因异质性疾病的病例对照研究时，特别是当怀疑有共同暴露时，说明可归因部分也很有用。最后，归因分数、相对风险和暴露频率之间的关系在解释流行病学研究结果和深入了解各种研究中发现的相对风险估计的差异方面是有价值的。
Because of the etiologic heterogeneity present in many diseases and the interaction among causal factors in the development of disease, relative risks relating any one exposure to a disease may be low, especially in the presence of common exposures. Nevertheless, in the design of epidemiologic studies, arbitrary values of relative risks are often used to determine the sample size required to detect an association between a particular exposure and a disease outcome. Such an approach may not yield adequate statistical power to detect an association. In this commentary, the authors point out the value of using the attributable fraction to determine an appropriate value of relative risk to use for sample size calculations. The approach is particularly useful in cluster investigations where the magnitude of the expected attributable fraction can be readily estimated from the observed and expected rates of disease. Specification of an attributable fraction is also useful in the design of case-control studies of etiologically heterogeneous diseases, especially when common exposures are suspected. Finally, the relationship among attributable fraction, relative risk and exposure frequency is valuable in interpreting results of an epidemiologic study and gaining insight into the differences in relative risk estimates found in various studies.