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Estimating Attributable Fraction in Partially Ecologic Case-Control Studies

 

作者: Jonas Björk,   Ulf Strömberg,  

 

期刊: Epidemiology  (OVID Available online 2002)
卷期: Volume 13, issue 4  

页码: 459-466

 

ISSN:1044-3983

 

年代: 2002

 

出版商: OVID

 

关键词: etiologic fraction;attributable risk;bias;ecologic studies;job exposure matrix;occupational exposure;epidemiologic method;linear models

 

数据来源: OVID

 

摘要:

Partially ecologic case-control studies combine group-level exposure data with individual-level data on disease status, group membership, and covariates. If the exposure measure is the exposure prevalence of various groups, the attributable fraction (AF; the estimated proportion of cases that are attributable to exposure) can be estimated by classifying all subjects in groups with exposure prevalence above zero as exposed. Such a threshold AF estimator (FIGURET) is unbiased in confounding-free situations if the threshold is 100% sensitive, but it might be imprecise. We propose an alternative AF estimator,FIGUREL, for partially ecologic case-control studies under a linear model for the association between the exposure prevalence and the odds ratio. The proposed estimator can also be applied to situations in which covariate adjustment is necessary.FIGURETandFIGURELare compared with respect to precision and bias.FIGURELis also unbiased when the exposure prevalence is zero in the group(s) assessed as unexposed. UsingFIGURELwill consistently result in improved precision compared withFIGURET, although the results may not differ substantially. The 95% confidence intervals for both AF estimators show satisfactory coverage in bias-free exposure scenarios. Pronounced negative bias and decreased coverage result for both AF estimators even when small fractions (3–9%) of exposed subjects are included in the group assessed as unexposed.Figure. No caption available.Figure. No caption available.Figure. No caption available.Figure. No caption available.Figure. No caption available.Figure. No caption available.Figure. No caption available.

 

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