Comparative quantification of health risks conceptual framework and methodological issues.
Comparative quantification of health risks conceptual framework and methodological issues.
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DOI：
10.1186/1478-7954-1-1
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发表时间：
2003-04-14
影响因子：
3.3
通讯作者：
Vander Hoorn S
中科院分区：
文献类型：
--
作者：
Murray CJ;Ezzati M;Lopez AD;Rodgers A;Vander Hoorn S
对健康风险进行可靠和可比的分析是预防疾病和伤害的关键。将发病率和死亡率归因于风险因素历来是在个别风险因素的传统方法中进行的，往往是在有限的几种情况下进行的，限制了可比性。在本文中，我们讨论的概念和方法问题，量化的人口健康影响的个人或群体的危险因素，在不同层次的因果关系，使用不同的科学学科的知识。这些问题包括：将观察到的人口接触分布引起的疾病负担与假设分布或一系列分布引起的疾病负担进行比较，而不是将其与单一参考水平（如未接触）进行比较;考虑到风险因素和疾病结果之间相互作用的因果网络中的多个阶段，以便对尚未进行流行病学研究的风险因素的某些组合进行推断，包括多种风险因素的联合影响;将风险因素造成的健康损失计算为按时间指数排列的疾病负担“流”，这是按时间指数排列的接触“流”造成的，包括考虑贴现;以及不确定性的来源。
Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty.