Robins J, Greenland S
Occupational Health Program, Harvard School of Public Health, Boston, MA 02115.
Stat Med. 1991 Jan;10(1):79-93. doi: 10.1002/sim.4780100113.
Expected years of life lost is an important concept in public-health and legal issues. We describe conditions under which the expected years of life lost due to hazardous exposure is estimable (identifiable) from epidemiologic data. We show that, in general, the average years of life lost among exposed subjects dying at a given age (the age-specific expected years of life lost) is not identifiable, although the average years of life lost among all exposed subjects (the unconditional expected years of life lost) is identifiable from an unbiased epidemiologic study. We also show that the average years of life lost among all exposed subjects dying of a specific cause (the cause-specific expected years of life lost) is not identifiable. We discuss the implications of these results for compensation schemes based on years of life lost, and compare such schemes with those based on the probability of causation.
预期寿命损失年数是公共卫生和法律问题中的一个重要概念。我们描述了在哪些条件下，可从流行病学数据中估算（识别）因危险暴露导致的预期寿命损失年数。我们表明，一般来说，在给定年龄死亡的暴露人群中的平均寿命损失年数（特定年龄的预期寿命损失年数）是无法识别的，尽管所有暴露人群中的平均寿命损失年数（无条件预期寿命损失年数）可从无偏流行病学研究中识别出来。我们还表明，死于特定原因的所有暴露人群中的平均寿命损失年数（特定原因的预期寿命损失年数）是无法识别的。我们讨论了这些结果对基于寿命损失年数的补偿方案的影响，并将此类方案与基于因果关系概率的方案进行比较。
