Gail M H, Wacholder S, Lubin J H
Epidemiologic Methods Section, National Cancer Institute, Bethesda, Maryland 20892.
Am J Ind Med. 1988;13(1):119-30. doi: 10.1002/ajim.4700130108.
We define a multiplicative model and an additive model for the hazards associated jointly with exposure and with the presence of a confounder like smoking. Under the multiplicative model, the crude relative risk may be adjusted indirectly, by means of a factor proposed by Axelson [1978], and implicitly by Cornfield et al. [1959] and Schlesselman [1978]. We present corresponding indirect correction formulas under the additive risk model for the risk difference and for the excess relative risk. Conditions are established under which these corrections may be applied to age-adjusted rates from composite study populations. We demonstrate that indirect corrections may be no better than crude measures of risk if one assumes the wrong model for the joint action of the exposure and confounding factors. These results are illustrated on an example of occupational exposure to vermiculite. The limitations of the techniques are discussed.
我们定义了一个与暴露以及像吸烟这样的混杂因素共同相关的风险的乘法模型和加法模型。在乘法模型下，粗相对风险可以通过Axelson [1978]提出的一个因子进行间接调整，Cornfield等人[1959]和Schlesselman [1978]也隐含地提及过该因子。我们给出了在加法风险模型下针对风险差和超额相对风险的相应间接校正公式。建立了一些条件，在这些条件下这些校正可应用于来自综合研究人群的年龄调整率。我们证明，如果对于暴露和混杂因素的联合作用假设了错误的模型，间接校正可能并不比风险的粗度量更好。这些结果在一个职业性接触蛭石的例子中得到了说明。讨论了这些技术的局限性。
