Hoffmann Kurt, Heidemann Christin, Weikert Cornelia, Schulze Matthias B, Boeing Heiner
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany.
Am J Epidemiol. 2006 Jan 1;163(1):76-83. doi: 10.1093/aje/kwj011. Epub 2005 Nov 17.
Disease can be caused by different mechanisms. A possible causal model proposed by Rothman is a complete causal mechanism or a so-called "sufficient cause" consisting of a set of component causes that can be illustrated in a pie chart. However, this model does not allow finding out what sufficient causes produce the majority of cases. The authors' objective was to extend Rothman's work by quantifying the proportion of disease that can be attributed to a class of sufficient causes. The underlying idea was to consider all combinations of a given set of known risk factors and to assign each combination to a class of sufficient causes. This assignment makes it possible to evaluate a class of sufficient causes by the population attributable fraction of the corresponding combination of risk factors. The approach presented was applied to sufficient causes of myocardial infarction by use of data on participants recruited between 1994 and 1998 into the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. As a result, 51.8% of cases were attributed to only four different classes of sufficient causes. In conclusion, the statistical method described in the paper may be beneficial for quantifying the importance of different sufficient causes and for improving the efficiency of public health programs.
疾病可由不同机制引起。罗斯曼提出的一种可能的因果模型是一种完整的因果机制,即所谓的“充分病因”,它由一组可在饼状图中展示的组成病因构成。然而,该模型无法找出导致大多数病例的充分病因。作者的目标是通过量化可归因于一类充分病因的疾病比例来扩展罗斯曼的研究。其基本思路是考虑给定一组已知风险因素的所有组合,并将每个组合归入一类充分病因。这种归类使得通过相应风险因素组合的人群归因分数来评估一类充分病因成为可能。所提出的方法通过使用1994年至1998年招募到欧洲癌症与营养前瞻性调查 - 波茨坦研究中的参与者数据,应用于心肌梗死的充分病因研究。结果,51.8%的病例仅归因于四类不同的充分病因。总之,本文描述的统计方法可能有助于量化不同充分病因的重要性,并提高公共卫生项目的效率。