Hamajima N
Department of Public Health, Gifu University School of Medicine.
Nihon Koshu Eisei Zasshi. 1992 Jun;39(6):302-6.
Among civil trials there are cases which are influenced by evidence derived from epidemiologic studies. In such cases, causality of a factor (X) illegitimately introduced by defendants is considered to be measured with an epidemiologic measure, attributable risk percent (AR%) expressing the level of risk. This paper aims to discuss calculations and interpretations of AR% in complicated cases where plaintiffs themselves introduced an additional risk factor (Y) for the alleged health injury. When X is not an effect modifier, AR% of X adjusted for Y can be simply adopted for arriving at a judgement of causality. Where Y is an effect modifier, and is not an indispensable item in the plaintiffs' daily life (e.g., smoking), the AR% of X for those not exposed to Y and also the AR% for those exposed to Y may both need to exceed a legally determined threshold, in order for X to be legally acknowledged as being causal to the alleged injury. The role of epidemiologists for such trials is to determine the AR% of X for each level of Y, and to advise the court on a realistic range of the AR%s.
在民事审判中，有些案件会受到流行病学研究证据的影响。在此类案件中，被告非法引入的某个因素（X）的因果关系被认为要用一种流行病学指标——归因风险百分比（AR%）来衡量，该指标体现了风险水平。本文旨在探讨在原告自身为所声称的健康损害引入了额外风险因素（Y）的复杂案件中AR%的计算和解读。当X不是效应修饰因素时，为判定因果关系可直接采用针对Y校正后的X的AR%。当Y是效应修饰因素且并非原告日常生活中的必需项（如吸烟）时，为使X在法律上被认定为与所声称的损害存在因果关系，未接触Y者的X的AR%以及接触Y者的X的AR%可能都需要超过法定阈值。流行病学家在此类审判中的作用是确定针对Y的每个水平的X的AR%，并就AR%的实际范围向法庭提供建议。
