Nordin B E Christopher, Baghurst Peter A, Metcalfe Andrew
Institute of Medical and Veterinary Science, Frome Road, PO Box 14, Rundle Mall, Adelaide, 5000, South Australia, Australia.
Calcif Tissue Int. 2007 Jun;80(6):349-52. doi: 10.1007/s00223-007-9022-4. Epub 2007 May 23.
The relation between fracture risk and bone density is frequently defined in terms of a relative hazard derived from the Cox proportional hazards model. The relative hazard is a multiplicative factor representing the rise in hazard for each standard deviation fall in bone mineral density, which has a typical value of about 1.5. It is not generally appreciated that this hazard may only be equated with absolute risk when risk is very low; at higher risk and over long periods, it is inappropriate to apply a multiplicative factor to absolute risk because risk has a range of 0-1 and cannot exceed unity. Here, we show how "hazard" can be converted to risk and how misleading the current practice of equating relative hazards with relative risks can be.
骨折风险与骨密度之间的关系通常根据Cox比例风险模型得出的相对风险来定义。相对风险是一个乘法因子，代表骨矿物质密度每下降一个标准差时风险的增加，其典型值约为1.5。人们通常没有认识到，只有在风险非常低时，这种风险才可以等同于绝对风险；在较高风险和较长时期内，对绝对风险应用乘法因子是不合适的，因为风险范围为0至1且不能超过1。在此，我们展示了“风险”如何转换为风险，以及将相对风险等同于相对风险的当前做法可能会产生多大的误导性。
