Pekkanen J, Sunyer J
Environmental Epidemiology Unit, National Public Health Institute, P.O. Box 95, 70701 Kuopio, Finland.
Eur J Epidemiol. 2008;23(9):581-4. doi: 10.1007/s10654-008-9280-0. Epub 2008 Aug 14.
The most common practice to analyze epidemiological follow-up studies is to analyze risk factors of new, i.e. incident, cases of disease. However, analysis of incidence assumes that diseases exist in true dichotomies, which is unlikely to be true. It has also recently been shown that in many typical situations it is very difficult to separate the association between risk factors of disease at baseline and during follow-up using analyses of incidence. Situation is especially problematic for diseases that have large misclassification and low incidence, like asthma. We suggest that reliance on analysis of incidence may be a major obstacle into discovering causes of such disease. Only with greater attention into how to define and how to analyze prospective studies are we likely to learn sufficiently of risk factors of such disease to finally arrive at means for their prevention.
分析流行病学随访研究最常见的做法是分析新发病例（即疾病的发病病例）的风险因素。然而，发病率分析假定疾病存在真正的二分法，但这很可能并不成立。最近也有研究表明，在许多典型情况下，使用发病率分析很难区分疾病在基线期和随访期的风险因素之间的关联。对于哮喘这类存在大量错误分类且发病率较低的疾病，情况尤其棘手。我们认为，依赖发病率分析可能是发现此类疾病病因的主要障碍。只有更加关注如何定义和分析前瞻性研究，我们才有可能充分了解此类疾病的风险因素，最终找到预防方法。
