Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical, Okayama, Japan.
Am J Epidemiol. 2012 Mar 15;175(6):567-75. doi: 10.1093/aje/kwr333. Epub 2012 Feb 16.
It has been noted that there is ambiguity in the expression "attributable fraction," and epidemiologic literature has drawn a distinction between "excess fraction" and "etiologic fraction." These quantities do not necessarily approximate one another, and the etiologic fraction is not generally estimable without strong biologic assumptions. In previous studies, researchers have explained the relations between excess and etiologic fractions in the potential-outcome framework, and few authors have explained the relations between these concepts by showing the correspondence between the potential-outcome model and the sufficient-cause model. In this article, the authors thoroughly clarify the conceptual relations between excess, attributable, and etiologic fractions by explicating the correspondence between these 2 models. In so doing, the authors take into account the potential completion time of each sufficient cause, which contributes to further insight to clarify the 2 types of etiologic fraction, i.e., accelerating etiologic proportion and total etiologic proportion. These 2 measures cannot be distinguished in epidemiologic data, and the differences might be subtle. However, they are closely related to a very fundamental issue of causal inference, that is, how researchers define etiology. Further, the authors clarify the relation between 3 distinct assumptions-positive monotonicity, no preventive action (or sufficient-cause positive monotonicity), and no preventive sequence.
有人指出,“归因分数”的表达存在歧义,流行病学文献对“超额分数”和“病因分数”进行了区分。这些量不一定彼此近似,并且如果没有强有力的生物学假设,一般无法估计病因分数。在以前的研究中,研究人员在潜在结果框架中解释了超额分数和病因分数之间的关系,很少有作者通过显示潜在结果模型和充分原因模型之间的对应关系来解释这些概念之间的关系。在本文中,作者通过阐明这两个模型之间的对应关系,彻底澄清了超额分数、归因分数和病因分数之间的概念关系。这样做时,作者考虑了每个充分原因的潜在完成时间,这有助于进一步深入了解,以澄清两种病因分数,即加速病因比例和总病因比例。这两种措施在流行病学数据中无法区分,差异可能很细微。但是,它们与因果推断的一个非常基本的问题密切相关,即研究人员如何定义病因。此外,作者还澄清了三个不同假设——阳性单调性、无预防措施(或充分原因阳性单调性)和无预防序列之间的关系。