Revisiting the Population Attributable Fraction.

IF 4.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiology Pub Date : 2025-04-01 DOI:10.1097/EDE.0000000000001867

Mark Klose, Paul N Zivich, Stephen R Cole

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引用次数: 0

Abstract

Background: The population attributable fraction corresponds to the reduction of the outcome had individuals (counter-to-fact) not experienced the exposure scaled by the observed incidence. Estimators proposed by Levin and Miettinen implicitly assume the study population is a random sample of the target population, which is not always the case.

Methods: In our example, we estimate the reduction in AIDS or death among women diagnosed with HIV in the United States in 2008 had they not had a history of injection drug use. To transport risk estimates from 1,164 women in the Women's Interagency HIV Study to the 11,282 women diagnosed with HIV in the United States in 2008, we use inverse probability of treatment and the inverse odds of sampling weighting. We estimate the variance of the population attributable fraction with a nonparametric bootstrap and M-estimation using the sandwich variance estimator.

Results: The population attributable fraction estimated in the observed sample was 0.21 (95% CI: 0.13, 0.29). After transporting the population attributable fraction to the target population, it was 0.13 (95% CI: 0.065, 0.19).

Conclusions: Defining the target population and identification conditions allows for a clearer interpretation of the population attributable fraction.

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重新审视人口归因分数。

背景：人群归因分数对应于个体（与事实相反）未经历由观察到的发生率衡量的暴露时结果的减少。Levin和Miettinen提出的估计器隐含地假设研究人群是目标人群的随机样本，但事实并非总是如此。方法：在我们的例子中，我们估计2008年美国被诊断为艾滋病毒的妇女中没有注射吸毒史的艾滋病或死亡的减少。为了将女性跨机构艾滋病研究中的1164名女性的风险估计转移到2008年美国11282名被诊断为艾滋病的女性，我们使用了治疗的逆概率和抽样加权的逆赔率。我们用非参数自举法估计总体归因分数的方差，用三明治方差估计器估计m -估计。结果：在观察样本中估计的总体归因分数为0.21 （95% CI: 0.13, 0.29）。将人群归因分数转移到目标人群后，为0.13 （95% CI: 0.065, 0.19）。结论：确定目标人群和鉴定条件可以更清楚地解释人口归因比例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.70

自引率

3.70%

发文量

177

审稿时长

6-12 weeks

期刊介绍： Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.