Hu Xue Feng, Young Kue, Chan Hing Man
Department of Biology, University of Ottawa, 180B, Gendron Hall, 30 Marie Curie, Ottawa, ON, K1N 6 N5, Canada.
School of Public Health, University of Alberta, 3-387, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
BMC Med Res Methodol. 2017 Jan 23;17(1):9. doi: 10.1186/s12874-016-0288-y.
Disease incidence and prevalence are both core indicators of population health. Incidence is generally not as readily accessible as prevalence. Cohort studies and electronic health record systems are two major way to estimate disease incidence. The former is time-consuming and expensive; the latter is not available in most developing countries. Alternatively, mathematical models could be used to estimate disease incidence from prevalence.
We proposed and validated a method to estimate the age-standardized incidence of cardiovascular disease (CVD), with prevalence data from successive surveys and mortality data from empirical studies. Hallett's method designed for estimating HIV infections in Africa was modified to estimate the incidence of myocardial infarction (MI) in the U.S. population and incidence of heart disease in the Canadian population.
Model-derived estimates were in close agreement with observed incidence from cohort studies and population surveillance systems. This method correctly captured the trend in incidence given sufficient waves of cross-sectional surveys. The estimated MI declining rate in the U.S. population was in accordance with the literature. This method was superior to closed cohort, in terms of the estimating trend of population cardiovascular disease incidence.
It is possible to estimate CVD incidence accurately at the population level from cross-sectional prevalence data. This method has the potential to be used for age- and sex- specific incidence estimates, or to be expanded to other chronic conditions.
疾病发病率和患病率都是人群健康的核心指标。发病率通常不像患病率那样容易获取。队列研究和电子健康记录系统是估计疾病发病率的两种主要方法。前者耗时且昂贵；后者在大多数发展中国家无法获得。另外，可以使用数学模型从患病率估计疾病发病率。
我们提出并验证了一种利用连续调查的患病率数据和实证研究的死亡率数据来估计心血管疾病（CVD）年龄标准化发病率的方法。为估计非洲艾滋病毒感染情况而设计的哈雷特方法被修改，用于估计美国人群中心肌梗死（MI）的发病率以及加拿大人群中心脏病的发病率。
模型得出的估计值与队列研究和人群监测系统观察到的发病率密切一致。在有足够多轮横断面调查的情况下，该方法正确地捕捉到了发病率的趋势。美国人群中估计的MI下降率与文献一致。在估计人群心血管疾病发病率趋势方面，该方法优于封闭队列。
利用横断面患病率数据在人群层面准确估计CVD发病率是可行的。该方法有潜力用于特定年龄和性别的发病率估计，或扩展到其他慢性病。
