Spasoff R A, McDowell I W
Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada.
Am J Prev Med. 1987 Jul-Aug;3(4):182-91.
Health risk appraisal is an attractive health education technique but suffers from methodologic weaknesses. Many of the problems center on the formula that is usually used to estimate the combined effects of different disease precursors. The formula does not reflect current models of disease causation, underestimates the effects of protective factors, and confounds the effects of different precursors. We suggest a modification that resolves these problems by estimating the prevalence and associated composite relative risk for each combination of precursors before calculating the numerical estimate of combined risk. This method can be applied to the many diseases for which the data needed to support a multivariate approach are not available. We recommend its incorporation into existing appraisal instruments.
健康风险评估是一种颇具吸引力的健康教育技术，但存在方法学上的缺陷。许多问题集中在通常用于估计不同疾病先兆综合影响的公式上。该公式未反映当前的疾病因果模型，低估了保护因素的作用，并混淆了不同先兆的影响。我们建议进行一项修改，即在计算综合风险的数值估计之前，通过估计每种先兆组合的患病率和相关的综合相对风险来解决这些问题。这种方法可应用于许多无法获得支持多变量方法所需数据的疾病。我们建议将其纳入现有的评估工具中。
