The unknown denominator problem in population studies of disease frequency.

The unknown denominator problem in population studies of disease frequency.
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疾病频率人群研究中未知的分母问题。

DOI:
10.1016/j.sste.2020.100361
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发表时间:
2020-11
影响因子:
3.4
通讯作者:
Li G
Li G
中科院分区:
其他
文献类型:
--
作者:
Morrison CN;Rundle AG;Branas CC;Chihuri S;Mehranbod C;Li G

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与未知或不精确测量的危险人群相关的问题在疾病频率的流行病学研究中很常见。面临风险的人口规模通常被概念化为分母,与疾病病例数(分子)结合使用来计算发病率或患病率。然而,高危人群的规模可能会带来与感兴趣的暴露和计数结果相关的其他流行病学特性,包括混杂、修改和中介。以伤害发生率的空间生态研究为例,我们确定并评估了研究人员用于解决“未知分母问题”的五种方法:忽略、控制代理、近似、通过研究设计控制以及测量面临风险的人群。根据数据以及感兴趣的暴露、计数结果和面临风险的人群之间的假设关系,我们提出了一个案例和选择解决方案的建议。
Problems related to unknown or imprecisely measured populations at risk are common in epidemiologic studies of disease frequency. The size of the population at risk is typically conceptualized as a denominator to be used in combination with a count of disease cases (a numerator) to calculate incidence or prevalence. However, the size of the population at risk can take other epidemiologic properties in relation to an exposure of interest and the count outcome, including confounding, modification, and mediation. Using spatial ecological studies of injury incidence as an example, we identify and evaluate five approaches that researchers have used to address “unknown denominator problems”: ignoring, controlling for a proxy, approximating, controlling by study design, and measuring the population at risk. We present a case example and recommendations for selecting a solution given the data and the hypothesized relationship between an exposure of interest, a count outcome, and the population at risk.
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