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多分类疾病绘图以检测相关疾病的罕见风险因素。

Polytomous disease mapping to detect uncommon risk factors for related diseases.

作者信息

Dreassi Emanuela

机构信息

Department of Statistics G. Parenti, University of Florence, Viale Morgagni 59, I 50134, Florence, Italy.

出版信息

Biom J. 2007 Aug;49(4):520-9. doi: 10.1002/bimj.200610295.

Abstract

A statistical model for jointly analysing the spatial variation of incidences of three (or more) diseases, with common and uncommon risk factors, is introduced. Deaths for different diseases are described by a logit model for multinomial responses (multinomial logit or polytomous logit model). For each area and confounding strata population (i.e. age-class, sex, race) the probabilities of death for each cause (the response probabilities) are estimated. A specic disease, the one having a common risk factor only, acts as the baseline category. The log odds are decomposed additively into shared (common to diseases different by the reference disease) and specic structured spatial variability terms, unstructured unshared spatial terms and confounders terms (such as age, race and sex) to adjust the crude observed data for their effects. Disease specic spatially structured effects are estimated; these are considered as latent variables denoting disease-specic risk factors. The model is presented with reference to a specic application. We considered the mortality data (from 1990 to 1994) relative to oral cavity, larynx and lung cancers in 13 age groups of males, in the 287 municipalities of Region of Tuscany (Italy). All these pathologies share smoking as a common risk factor; furthermore, two of them (oral cavity and larynx cancer) share alcohol consumption as a risk factor. All studies suggest that smoking and alcohol consumption are the major known risk factors for oral cavity and larynx cancers; nevertheless, in this paper, we investigate the possibility of other different risk factors for these diseases, or even the presence of an interaction effect (between smoking and alcohol risk factors) but with different spatial patterns for oral and larynx cancer. For each municipality and age-class the probabilities of death for each cause (the response probabilities) are estimated. Lung cancer acts as the baseline category. The log odds are decomposed additively into shared (common to oral cavity and larynx diseases) and specic structured spatial variability terms, unstructured unshared spatial terms and an age-group term. It turns out that oral cavity and larynx cancer have different spatial patterns for residual risk factors which are not the typical ones such as smoking habits and alcohol consumption. But, possibly, these patterns are due to different spatial interactions between smoking habits and alcohol consumption for the first and the second disease.

摘要

本文介绍了一种统计模型,用于联合分析三种(或更多)疾病发病率的空间变化,这些疾病具有常见和不常见的风险因素。不同疾病的死亡情况通过多项响应的logit模型(多项logit或多分类logit模型)来描述。对于每个地区和混杂分层人群(即年龄组、性别、种族),估计每种病因的死亡概率(响应概率)。一种特定的疾病,即仅具有常见风险因素的疾病,作为基线类别。对数优势被加性分解为共享的(与参考疾病不同的疾病共有的)和特定的结构化空间变异性项、非结构化的非共享空间项以及混杂因素项(如年龄、种族和性别),以调整原始观测数据的影响。估计疾病特定的空间结构效应;这些被视为表示疾病特定风险因素的潜在变量。该模型结合一个特定应用进行介绍。我们考虑了意大利托斯卡纳地区287个市镇中13个男性年龄组的口腔癌、喉癌和肺癌的死亡率数据(1990年至1994年)。所有这些疾病都将吸烟作为共同风险因素;此外,其中两种疾病(口腔癌和喉癌)将饮酒作为风险因素。所有研究表明,吸烟和饮酒是口腔癌和喉癌已知的主要风险因素;然而,在本文中,我们研究这些疾病是否存在其他不同的风险因素,甚至是否存在相互作用效应(吸烟和饮酒风险因素之间),但口腔癌和喉癌具有不同的空间模式。对于每个市镇和年龄组,估计每种病因的死亡概率(响应概率)。肺癌作为基线类别。对数优势被加性分解为共享的(口腔和喉疾病共有的)和特定的结构化空间变异性项、非结构化的非共享空间项以及年龄组项。结果表明,口腔癌和喉癌在残余风险因素方面具有不同的空间模式,这些因素并非吸烟习惯和饮酒等典型因素。但是,这些模式可能是由于第一种和第二种疾病在吸烟习惯和饮酒之间存在不同的空间相互作用。

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