Kroke A, Schulz M, Hoffmann K, Bergmann M M, Boeing H
Department of Epidemiology, German Institute of Human Nutrition, Arthur-Scheunert-Allee 114-116, D-14558 Bergholz-Rehbruecke, Germany.
Maturitas. 2001 Oct 31;40(1):39-46. doi: 10.1016/s0378-5122(01)00228-6.
Gynaecologic surgeries and hormone medication increasingly interfere with the concept of determining menopausal status based on self-reported data about the last menstrual period-an approach frequently applied in epidemiological studies. This analysis compared different approaches of menopausal status determination, including a probabilistic approach that was developed to reduce misclassification of menopausal status.
Interview and questionnaire data relating to hormone status from about 16,000 German women were used to determine menopausal status using different approaches: menses based, age based, self-assessment based, and a probabilistic approach.
Applying strict menses-based criteria, 29.1% of the women were found to be with undetermined menopausal status. The probabilistic approach was applied to determine menopausal status and age at menopause for these women. The proposed approach uses the current age of the women with undetermined menopausal status, and the relative age-dependent frequencies of pre- or postmenopausal status among those with natural menopausal status to calculate weighting factors, which represent the probabilities of being pre- and postmenopausal of each woman previously undetermined. Correspondingly, the missing age at menopause was estimated with the same probabilistic approach. Applying various approaches to determine menopausal status, the ratio of pre- to postmenopausal women differed considerably, ranging from 1.03 to 1.61. In addition, considerable differences were observed with respect to the number of missing values for both menopausal status and age at menopause.
The probabilistic approach allowed to estimate menopausal status and age at menopause with the advantage that all available information from the entire study population and from the individual is used.
妇科手术和激素药物越来越多地干扰了基于末次月经自我报告数据来确定绝经状态的概念——这种方法在流行病学研究中经常使用。本分析比较了不同的绝经状态确定方法，包括一种为减少绝经状态误分类而开发的概率方法。
使用来自约16000名德国女性的与激素状态相关的访谈和问卷数据，采用不同方法确定绝经状态：基于月经、基于年龄、基于自我评估以及概率方法。
应用严格的基于月经的标准时，发现29.1%的女性绝经状态未确定。对这些女性应用概率方法来确定绝经状态和绝经年龄。所提出的方法使用绝经状态未确定女性的当前年龄，以及自然绝经状态女性中绝经前或绝经后状态的相对年龄相关频率来计算权重因子，这些权重因子代表了每个之前未确定的女性处于绝经前和绝经后的概率。相应地，用相同的概率方法估计缺失的绝经年龄。应用不同方法确定绝经状态时，绝经前与绝经后女性的比例差异很大，范围从1. 如果您还有其他需求，请随时告诉我。03到1.61。此外，在绝经状态和绝经年龄的缺失值数量方面也观察到了显著差异。
概率方法能够估计绝经状态和绝经年龄，其优点是使用了来自整个研究人群和个体的所有可用信息。
