CAUSAL AND PREVENTIVE INTERDEPENDENCE - ELEMENTARY PRINCIPLES
CAUSAL AND PREVENTIVE INTERDEPENDENCE - ELEMENTARY PRINCIPLES
复制标题
DOI：
10.5271/sjweh.2479
复制
发表时间：
1982-01-01
影响因子：
6.3
通讯作者：
MIETTINEN, OS
中科院分区：
文献类型：
--
作者：
MIETTINEN, OS
两个因素在导致或预防全有或全无事件中的协同作用是指两个因素都需要产生效果的情况的存在，而对抗是指至少一个因素可以阻止另一个因素的单独作用。两者都是流行病学家非常感兴趣的。在事件发生率方面，这种相互依赖性，或它们的互补性，独立性的表现，由于对这两个因素的敏感性的相关性而变得复杂。因此，给定代表单独效应的风险差（RD）值，与联合暴露相对应的RD具有与独立性一致的范围，因此即使从非常充足的数据中也无法在不了解敏感性相关程度的情况下推断出独立性。这一范围的定义与因果因素和预防因素的定义非常相似。然而，当利用相互依存的知识来推断产生效果的机制中各因素之间的相互关系时，可能必须在因果因素和预防因素之间作出明确的区分。在每种情况下，相互依赖都是这两个因素的相互关系和/或它们之间相互作用的结果。与联合暴露的智慧有关的操作决策可以通过了解因素的相互依赖性来指导；然而，了解与各种暴露相对应的风险就足够了，不需要对因果关系或预防性相互依赖进行任何推论。
Synergism of 2 factors in the causation or prevention of an all-or-none event means the existence of instances in which both factors are needed for the effect, while antagonism means that at least one can block the solo effect of the other. Both are of great interest to epidemiologists. The manifestation of such interdependences, or of their complement, independence, in terms of event rates is complicated by the correlation of the susceptibilities to the 2 factors. Thus, given the risk difference (RD) values representing the solo effects, the RD corresponding to the joint exposure has a range consistent with independence so that independence cannot be inferred even from very ample data without knowledge of the degree of correlatedness of the susceptibilities. The definition of this range is closely analogous for causal and preventive factors, respectively. However, when knowledge about interdependence is used in inference about the factors'' interrelation in the mechanisms for the effect, sharp distinctions may have to be made between causal and preventive factors. In each case, the interdependence is a result of the interrelation of the actions of the 2 factors and/or interaction between them. Operational decisions, having to do with the wisdom of the joint exposure, can be guided by knowledge about the interdependence of the factors; however, knowledge of the risks corresponding to the various exposures is a sufficient guide, without any need for inferences about causal or preventive interdependence.