Use and misuse of population attributable fractions.
American Journal of Public HealthPublished 1 January 1998Open access
Beverly Rockhill, Beth Newman, Clarice R. Weinberg
Citations1,700
SJR quartileQ1
SJR score1.93
SNIP1.60
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Computational and conceptual issues relevant to population attributable fraction estimation that are infrequently discussed elsewhere are considered, with illustrations from the breast cancer literature.
Abstract
Use and misuse of population attributable fractions. B Rockhill, B Newman, and C WeinbergCopyRight https://doi.org/10.2105/AJPH.88.1.15 Published Online: October 07, 2011
Keywords
MathematicsMedicineHealth Professions
International Journal of EpidemiologySick individuals and sick populations
3,653 Citations2001Geoffrey Rose
Aetiology confronts two distinct issues: the determinant of individual cases, and the determinants of incidence rate: if exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it.
International Journal of EpidemiologySick Individuals and Sick Populations
2,610 Citations1985Geoffrey Rose
Empirical research into the causes and mechanisms of illness is often defined in terms of study of the determinants of the distribution of the disease; but the authors should not forget that the more widespread is a particular cause, the less it explains the Distribution of cases.
Journal of the American Statistical AssociationCase-Control Studies: Design, Conduct, Analysis.
2,380 Citations1983Lee Youkeles, James J. Schlesselman
Case-control studies, often called 'retrospective' studies, provide a research method for investigating factors that may prevent or cause disease.
American Journal of EpidemiologyESTIMATING THE POPULATION ATTRIBUTABLE RISK FOR MULTIPLE RISK FACTORS USING CASE-CONTROL DATA
1,229 Citations1985Paolo Bruzzi, Sylvan B. Green +3 more
A straightforward and unified approach is presented for the calculation of the population attributable risk per cent in the general multivariate setting, with emphasis on using data from case-control studies, so that risks need not be estimated separately in a large number of strata.
American Journal of EpidemiologyPROPORTION OF DISEASE CAUSED OR PREVENTED BY A GIVEN EXPOSURE, TRAIT OR INTERVENTION1
1,030 Citations1974Olli S. Miettinen
It is shown that both parameters depend—in different ways—on the frequency of the marker among cases of the disease, and on the "standardized morbidity ratio" for those with the marker.
JNCI Journal of the National Cancer InstituteProportion of Breast Cancer Cases in the United States Explained by Well-Established Risk Factors
662 Citations1995M. Patricia Madigan, Regina G. Ziegler +3 more
The RRs for most of these risk factors were modest, but their prevalence as a group was high, leading to estimates that suggest that a substantial proportion of breast cancer cases in the United States are explained by well-established risk factors.
JNCI Journal of the National Cancer InstituteContribution of the Environment to Cancer Incidence: An Epidemiologic Exercise
478 Citations1977Ernst L. Wynder, Gio Batta Gori
BiometricsThe Estimation and Interpretation of Attributable Risk in Health Research
454 Citations1976Stephen D. Walter
Methods to analyse confounded, polytomous and interacting risk factors are proposed and it shown that there is a simple relationship between two distinct estimators previously suggested for use with deleterious and beneficial (or preventive) factors.
American Journal of EpidemiologyCONCEPTUAL PROBLEMS IN THE DEFINITION AND INTERPRETATION OF ATTRIBUTABLE FRACTIONS
428 Citations1988Sander Greenland, James M. Robins
It appears that the excess fraction will be most relevant in situations that require only consideration of whether disease occurs by a particular time, and direct measures of effect on incidence time may be as relevant as or more relevant than any attributable fraction.
JAMAThe Relative Effects of Left Ventricular Hypertrophy, Coronary Artery Disease, and Ventricular Dysfunction on Survival Among Black Adults
330 Citations1995Youlian Liao
Left ventricular hypertrophy was associated with a greater RR and attributable risk than the traditional measures of coronary disease severity and may account for much of the black-white differential among black patients with heart disease.
American Journal of Public HealthPublic health methods--attributable risk as a link between causality and public health action.
214 Citations1995Mary E. Northridge
JNCI Journal of the National Cancer InstituteEnvironmental Carcinogenesis: Misconceptions and Limitations to Cancer Control
196 Citations1979John Higginson, C S Muir
American Journal of EpidemiologyAttributable Risk: Advantages of a Broad Definition of Exposure
179 Citations1994Sholom Wacholder, Jacques Bénichou +3 more
A simple and robust method for estimating the overall attributable risk from several exposures that is based on a division of subjects into two groups, a baseline consisting of those unexposed to all exposures and everyone else is justified.
BiometricsVariance Calculations and Confidence Intervals for Estimates of the Attributable Risk Based on Logistic Models
171 Citations1990Joseph Bénichou, Mitchell H. Gail
Simulations indicate that those asymptotic procedures yield reliable variance estimates and confidence intervals with near nominal coverage in selecting a logistic model that is neither so simplified as to exhibit systematic lack of fit nor so complicated as to inflate the variance of the estimate of AR.
CancerCancer of the breast in poor black women
163 Citations1989Harold P. Freeman, Tarik Wasfie
It is concluded that breast cancer survival in this population of poor black women is low compared to the survival rate of black women nationally and very lowCompared to white women.
Epidemiologic ReviewsAttributable Risk Estimation in Case-Control Studies
159 Citations1994Steven S. Coughlin, Jacques Bénichou +1 more
CA A Cancer Journal for CliniciansA Different Perspective on Breast Cancer Risk Factors: Some Implications of the Nonattributable Risk
154 Citations1982Herbert Seidman, S. D. Stellman +1 more
International Journal of EpidemiologyRisk Factors for Preterm and Term Low Birthweight in Ahmedabad, India
149 Citations1992Dileep Mavalankar, Ronald H. Gray +1 more
It is suggested that a substantial proportion of term and preterm LBW births may be averted by improving maternal nutritional status, anaemia and antenatal care.
Sexually Transmitted InfectionsThe association of gonorrhoea and syphilis with premature birth and low birthweight.
120 Citations1993Gilbert Donders, Jan Desmyter +2 more
At least in countries where the prevalence of genital infections is high, genital infections as well as the risk factors for acquiring them play a major role in the aetiogenesis of prematurity and low birth weight.
Statistics in MedicineMethods of adjustment for estimating the attributable risk in case‐control studies: A review
117 Citations1991Jacques Bénichou
Methods of adjustment for estimation of the AR in case-control studies are reviewed and it is argued that this latter method has the greatest generality and flexibility, and includes the two other approaches as special cases.
Statistics in MedicineStatistical methods for estimating attributable risk from retrospective data
111 Citations1982Alice S. Whittemore
Levin's measure of attributable risk is extended to adjust for confounding by aetiologic factors other than the exposure of interest and there appears no advantage in using the log-based interval suggested by Walter which is always longer than the simpler symmetric interval.
American Journal of EpidemiologyEFFECTS OF INTERACTION, CONFOUNDING AND OBSERVATIONAL ERROR ON ATTRIBUTABLE RISK ESTIMATION1
86 Citations1983Stephen D. Walter
It is shown that bias in attributable risk through misclassification of exposure arises primarily through insensitivity errors and the attributable risk estimate is unbiased; however, a larger standard error pertains to the estimate based on misclassified data.
Journal of HepatologyHepatitis C virus infection, HBsAg carrier state and hepatocellular carcinoma
65 Citations1992Tommaso Stroffolini, M. Chiaramonte +10 more
Findings indicate that HCV and HBsAg are independent risk factors for HCC, and 25% of HCC cases occurring in Italy could be attributed to anti-HCV positivity alone and 20% toHBsAg carrier state alone.
PubMedPoverty and death in the United States--1973 and 1991.
47 Citations1995Robert A. Hahn, Elaine D. Eaker +4 more
Statistics in MedicineThe effect of non‐differential outcome misclassification on estimates of the attributable and prevented fraction
45 Citations1991Chung‐heng Hsieh
The bias in the attributable and the prevented fraction derived from a risk ratio estimate is examined as a function of the sensitivity and specificity of the outcome classification, the true risk ratio, the prevalence of the exposure, and the baseline disease frequency.
Statistics in MedicineThe effect of non‐differential exposure misclassification on estimates of the attributable and prevented fraction
34 Citations1988Chung‐Cheng Hsieh, Stephen D. Walter
This paper considers the effect of non-differential exposure misclassification on the population attributable fraction and the population prevented fraction as a function of the sensitivity and specificity of the exposure classification, the true relative risk, and the true prevalence of the Exposure.
Cancer Causes & ControlAtributable risk of breast, prostate, and lung cancer in Hawaii due to saturated fat
34 Citations1992Jean H. Hankin, Lue Ping Zhao +2 more
Although the calculated AR due to saturated fat was higher among the Caucasians than among the Japanese, all persons in the population would derive considerable benefit by reducing their intake of this nutrient.
EpidemiologyPoverty and Death in the United States—1973 and 1991
33 Citations1995Robert A. Hahn, Elaine D. Eaker +4 more
The proportion of mortality attributable to poverty among U.S. black and white adults has increased in recent decades and is comparable to that attributable to cigarette smoking and must be explained by conditions other than commonly recognized risk factors.
CA A Cancer Journal for CliniciansPerspectives on cancer prevention
28 Citations1995Lawrence Garfinkel
The best way to control cancer is to find means to reduce the risk of cancer, and authoritative groups must now seriously consider making recommendations about chemopreventive substances to reduce cancer risk, according to the accumulated evidence.
Hematology/Oncology Clinics of North AmericaUse of Risk Factors in Counseling Patients
4 Citations1989Susan M. Love
Topics included in this article are a definition and interpretations of relative risk, including which risk factors are most important, the contribution of family history, and prior benign breast disease.