Qiu Hong, Yu Ignatius Tak-Sun, Wang Xiao-Rong, Fu Zhen-Ming, Tse Shelly Lap Ah
Department of Community and Family Medicine, School of Public Health, Chinese University of Hong Kong, H. K. S. A. R.
Zhonghua Liu Xing Bing Xue Za Zhi. 2008 Sep;29(9):934-7.
When study on epidemiological causation is carried out, logistic regression has been commonly used to estimate the independent effects of risk factors, as well as to examine possible interactions among individual risk factor by adding one or more product terms to the regression model. In logistic or Cox's regression model, the regression coefficient of the product term estimates the interaction on a multiplicative scale while statistical significance indicates the departure from multiplicativity. Rothman argues that when biologic interaction is examined, we need to focus on interaction as departure from additivity rather than departure from multiplicativity. He presents three indices to measure interaction on an additive scale or departure from additivity, using logarithmic models such as logistic or Cox's regression model. In this paper, we use data from a case-control study of female lung cancer in Hong Kong to calculate the regression coefficients and covariance matrix of logistic model in SPSS. We then introduce an Excel spreadsheet set up by Tomas Andersson to calculate the indices of interaction on an additive scale and the corresponding confidence intervals. The results can be used as reference by epidemiologists to assess the biologic interaction between factors. The proposed method is convenient and the Excel spreadsheet is available online for free.
在进行流行病学因果关系研究时,逻辑回归通常用于估计风险因素的独立效应,以及通过在回归模型中添加一个或多个乘积项来检验个体风险因素之间可能存在的相互作用。在逻辑回归或Cox回归模型中,乘积项的回归系数在乘法尺度上估计相互作用,而统计显著性则表明偏离了可乘性。罗斯曼认为,在研究生物学相互作用时,我们需要关注偏离可加性而非可乘性的相互作用。他提出了三个指标,使用逻辑回归或Cox回归模型等对数模型,在加法尺度上衡量相互作用或偏离可加性的程度。在本文中,我们使用香港女性肺癌病例对照研究的数据,在SPSS中计算逻辑模型的回归系数和协方差矩阵。然后,我们引入由托马斯·安德森创建的Excel电子表格,以计算加法尺度上的相互作用指标及相应的置信区间。研究结果可供流行病学家评估因素之间的生物学相互作用时参考。所提出的方法简便易行,且Excel电子表格可在网上免费获取。