RSS-Feed abonnieren
DOI: 10.1055/s-0038-1634095
The Attributable Risk in a Multifactorial Situation
Evaluation of Different Methods of PartitioningPublikationsverlauf
Publikationsdatum:
06. Februar 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035037/200604/lookinside/thumbnails/10-1055-s-0038-1634095-1.jpg)
Summary
Objectives: Different approaches to partition the attributable risk into exposure-specific components are methodologically evaluated.
Methods: Two methods of partitioning the attributable risk in a multifactorial situation have been suggested. One is based on a solution adopted from game theory, the Shapley value, whereas the other recently suggested approach uses a heuristically motivated proportional weighting scheme. These two concepts are reviewed and compared in a situation with three exposure factors. A hypothetical numerical example is discussed illustrating differences in the case of complex interaction structures.
Results: The two methods are found to differ in two critical features that affect the outcome of partitioning: i) including or ignoring the full interaction structure between exposure factors involved in the partitioning, ii) using an equal or proportional weighting scheme for the marginal excess risks of the exposures. As a result, not only the individual partial attributable risks for the exposure factors may be quantitatively different between the methods, but also their ranking depends on the partitioning approach.
Conclusions: The epidemiologic properties of the partitioning procedure based on the Shapley value are known and fit to the needs of epidemiologic applications. The alternative approach recently suggested can lead to considerably different results. As long as its epidemiologic properties are not fully understood, the traditional partitioning method should be given preference in practical applications.
-
References
- 1 Levin ML. The occurrence of lung cancer in man. Acta Unio Int Contr 1953; 9: 531-41.
- 2 Basu S, Landis JR. Model-based estimation of population attributable risk under cross-sectional sampling. American J Epidemiol 1995; 142 (012) 1338-43.
- 3 Benichou J. A Review of adjusted estimators of attributable risk. Stat Methods Med Res 2001; 10: 195-216.
- 4 Bruzzi P, Green SB, Byar DP, Brinton LA, Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol 1985; 122 (05) 904-14.
- 5 Greenland S, Drescher K. Maximum likelihood estimation of the attributable fraction from logistic models. Biometrics 1993; 49 (03) 865-72.
- 6 Vogel C, Gefeller O. Implications of nondifferential misclassification on estimates of attributable risk. Methods Inf Med 2002; 41 (04) 342-8.
- 7 Eide GE, Gefeller O. Sequential and average attributable fractions as aids in the selection of preventive strategies. J Clin Epidemiol 1995; 48 (05) 645-55.
- 8 Llorca J, Delgado-Rodriguez M. A new way to estimate the contribution of a risk factor in populations avoided nonadditivity. J Clin Epidemiol 2004; 57: 479-83.
- 9 McElduff P, Attia J, Ewald B, Cockburn J, Heller R. Estimating the contribution of individual risk factors to disease in a person with more than one risk factor. J Clin Epidemiol 2002; 55: 588-92.
- 10 Cox JLA. A new measure of attributable risk for public health application. Managment Sci 1985; 31 (07) 800-13.
- 11 Gefeller O, Land M, Eide GE. Averaging attributable fractions in the multifactorial situation: assumptions and interpretation. J Clin Epidemiol 1998; 51 (05) 437-41.
- 12 Land M, Vogel C, Gefeller O. A multifactorial variant of the attributable risk for groups of exposure variables. Biometrical J 2001; 43 (04) 461-81.
- 13 Shapley L. A value for n-person games. In Kuhn H, Tucker A. (eds.) Contributions to the theory of games II. Annals of Mathematics Studies 1953; 28: 307-17.
- 14 Land M, Gefeller O. A game-theoretic approach to partitioning attributable risks. Biometrical J 1997; 39 (07) 777-92.
- 15 Ramroth H, Dietz A, Becher H. Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany. Methods Inf Med 2004; 43 (05) 499-504.
- 16 Land M, Vogel C, Gefeller O. Partitioning methods for multifactorial risk attribution. Stat Methods Med Res 2001; 10: 217-30.
- 17 Rothman K. Causes. Am J Epidemiol 1976; 104: 587-92.