Beyea J, Greenland S
Consulting in the Public Interest, Lambertville, NJ 08530, USA.
Health Phys. 1999 Mar;76(3):269-74. doi: 10.1097/00004032-199903000-00008.
There are a number of contexts in which interested parties wish to estimate the probability that an individual's injury was caused by radiation or a toxic chemical. It has been shown, however, that such calculations cannot be made based on epidemiologic data alone, without assumption of a biologic model for the disease process and without a specific definition of causation. To illustrate the relevant theorems, we present a number of examples in which different biologic models produce different values for the probability of causation for individuals from the same population-based epidemiologic data and dose-response curves. As a result of these ambiguities, it is important that anyone attempting to calculate probability of causation for individuals explicitly state the biologic model that has been assumed, as well as state the definition of causation being used. The analyst should test the robustness of the calculations by repeating them for a broad range of underlying biologic models.
在许多情况下,相关方希望估算个人受伤是由辐射或有毒化学物质所致的概率。然而,已经表明,如果不假定疾病过程的生物学模型且没有对因果关系进行具体定义,就无法仅基于流行病学数据进行此类计算。为了阐述相关定理,我们给出一些示例,在这些示例中,不同的生物学模型根据相同的基于人群的流行病学数据和剂量反应曲线,对个体因果关系概率得出不同的值。由于存在这些模糊性,任何试图计算个体因果关系概率的人都必须明确说明所假定的生物学模型以及所使用的因果关系定义,这一点很重要。分析人员应通过针对广泛的潜在生物学模型重复计算来测试计算结果的稳健性。