Attributable Risk Estimation in Case-Control Studies

Coughlin, Steven S.; Bénichou, Jacques; Weed, Douglas L.

doi:10.1093/oxfordjournals.epirev.a036144

Cited by 148 publications

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“…For example, 54% (95% CI 29-79%) of der(1;7)(q10;q10) in AML may be attributed to prior iatrogenic genotoxic exposure, but the corresponding fraction for 5q− is only 11% (95% CI 6.2-17%; Table 2). Because AF is usually interpreted as the fraction of disease in a population that might be avoided by reducing or eliminating exposure to an etiologic agent, 33 the observed AFs would, for example, indicate that 54% of all t-AML with der(1;7) would have been avoided if no CT had been given (Table 2). Hence, the use of AF defi- Table 2 Cytogenetic comparisons of de novo and t-AML a Cytogenetic features AML P value AF (%) Type of previous treatment P value (95% CI) de novo t-AML RT n = 64 A n = 228 T n = 51 A + T Other n = 3649 (%) n = 581 (%) (%) (%) (%) n = 128 n = 110 (%) (%) nitely provides more information as regards the impact of exposure than do P values alone.…”

Section: Discussionmentioning

confidence: 99%

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Pooled analysis of clinical and cytogenetic features in treatment-related and de novo adult acute myeloid leukemia and myelodysplastic syndromes based on a consecutive series of 761 patients analyzed 1976–1993 and on 5098 unselected cases reported in the literature 1974–2001

et al. 2002

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To ascertain the frequency of treatment-related acute myeloid leukemias and myelodysplastic syndromes (t-AML/t-MDS) in an unselected series, we have identified all adult cases analyzed in our department from 1976 to 1993. Further aims were to compare karyotypic features of t-AML/t-MDS with de novo AML/MDS, in our material as well as in 5098 unselected, cytogenetically abnormal, published cases, and to analyze associations between type of prior therapy and karyotype. Among our 372 AML and 389 MDS, 47 (13%) were t-AML and 62 (16%) were t-MDS. Clonal abnormalities were significantly more common in t-AML and t-MDS than in de novo disease (68% vs 50%, P Ͻ 0.05 and 84% vs 45%, P Ͻ 0.001, respectively). Among the available 4230 AML and 1629 MDS (the present series and published cases), 14% were t-AML and 15% were t-MDS. In t-AML/t-MDS, the number of anomalies and the ploidy levels differed significantly from de novo cases, with complex and hypodiploid karyotypes being more common in t-AML/t-MDS. In t-AML, unbalanced changes in general, t(1;3), der(1;7), 3p−, −5, 5q−, −7, 7q−, t(9;11), t(11;19), t(11q23), der(12p), −17, der(17p), −18, and −21 were significantly more frequent than in de novo AML. In t-MDS, −5, −7, 7q−, 13q−, der(17p), and −18 were significantly more common. Type of prior treatment correlated significantly with number of anomalies in t-AML and with ploidy levels in t-AML/t-MDS. The frequencies of several aberrations varied with type of therapy, eg, 5q− was more frequent in radiotherapyassociated t-MDS, monosomy 7 was more common in t-AML and t-MDS after treatment with alkylators, and t(11q23) in t-AML was associated with topoisomerase II inhibitors. Abnormalities significantly more common in de novo disease were +8 as a sole anomaly, balanced changes in general, t(8;21), t(9;22), t(15;17), inv(16), and t(21q22) in AML, and −Y, 5q−, and 20q− as sole anomalies and +8 in MDS. The results emphasize the strong association between previous genotoxic exposure and karyotypic features. Leukemia (2002) IntroductionEver since the mid-1970s, when the first case reports describing chromosomal abnormalities in treatment-related acute myeloid leukemias (t-AML) were published, 1,2 the cytogenetic features of t-AML and of therapy-associated myelodysplastic syndromes (t-MDS) have received much attention. 3,4 To date, two distinct karyotypic patterns that correlate with specific types of chemotherapeutic agents have emerged. Previous chemotherapy (CT) with alkylators (alk) has been strongly linked to the development of t-MDS/t-AML harboring unbal- anced changes, mainly whole or partial losses of chromosomes 5 and 7, often in complex, hypodiploid karyotypes, 5-9 whereas prior CT with DNA topoisomerase II inhibitors (topo II) has been associated with t-AML characterized by, in particular, translocations involving chromosome band 11q23 resulting in MLL gene rearrangements. 4,[10][11][12] It has been debated, but remains to be settled, whether prior radiotherapy (RT) alone or exposure to CT other than alk/topo II may correla...

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Section: Discussionmentioning

confidence: 99%

“…AF is often interpreted as the fraction of disease in a population that might be avoided by reducing or eliminating exposure to an etiologic agent, provided that it is causative. 33 …”

Section: Statisticsmentioning

confidence: 99%

Pooled analysis of clinical and cytogenetic features in treatment-related and de novo adult acute myeloid leukemia and myelodysplastic syndromes based on a consecutive series of 761 patients analyzed 1976–1993 and on 5098 unselected cases reported in the literature 1974–2001

et al. 2002

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“…The population attributable risk (PAR) was calculated according to Coughlin 10, where PAR was equal to (p e (OR−1)/(1 + p e (OR−1))*100% and p e was the proportion of the population exposed. As the current study was not designed as a case–control study, we were unable to measure the effects of risk factors.…”

Section: Methodsmentioning

confidence: 99%

Area‐based study shows most parents follow advice to reduce risk of sudden infant death syndrome

et al. 2017

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AimGuidance on reducing the risk of sudden infant death syndrome (SIDS) was successfully introduced to a number of countries in the early 1990s. The most important recommendations were supine sleeping for infants and non‐smoking for mothers. This 2012–2014 study examined adherence to the national Swedish SIDS advice.MethodsWe asked 1000 parents with infants registered at child healthcare centres in western Sweden to complete a questionnaire on infant care from birth to 12 months of age.ResultsWe analysed 710 responses and found that, in the first three months, 1.3% of the infants were placed in the prone sleeping position and 14.3% were placed on their side. By three to five months, this had risen to 5.6% and 23.6%. In the first three months, 83.1% were breastfed, 84.1% used a pacifier and 44.2% shared their parents' bed, while 5.8% slept in another room. Bed sharing was more likely if infants were breastfed and less likely if they used pacifiers. During pregnancy, 2.8% of the mothers smoked and the mothers who had smoked during pregnancy were less likely to bed share.ConclusionOverall adherence to the SIDS advice was good, but both prone and side sleeping practices should be targeted.

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“…Trata-se de um conceito epidemiológico que relaciona o risco relativo de um agravo com a prevalência das exposições que se supõe estarem causalmente relacionadas a ele. É usualmente interpretada como a porcentagem de casos ocorridos em uma população que seriam evitados se fosse eliminada a exposição a um fator causal da doença 12 . Daí decorre sua utilidade em Saúde Pública, parti-cularmente quando se faz necessário escolher entre estratégias alternativas de prevenção 12 .…”

Section: Estimativa De Fração Atribuível a Partir De Estudos Caso-conunclassified

“…É usualmente interpretada como a porcentagem de casos ocorridos em uma população que seriam evitados se fosse eliminada a exposição a um fator causal da doença 12 . Daí decorre sua utilidade em Saúde Pública, parti-cularmente quando se faz necessário escolher entre estratégias alternativas de prevenção 12 . O conceito foi formulado pela primeira vez por Levin em 1953 13 , com o nome de risco atribuível (attributable risk).…”

Section: Estimativa De Fração Atribuível a Partir De Estudos Caso-conunclassified

O mito da doença rara

Cordeiro

2005

Rev. bras. epidemiol.

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ResumoDemonstra-se que estudos caso-controle podem estimar sem viés os parâmetros risco relativo e fração atribuível, sem que a doença estudada seja rara. Argumenta-se que a pressuposição de raridade da doença para que as estimativas de odds ratio obtidas em estudos caso-controles se aproximem da medida de risco relativo é um mito ainda hoje difundido, que teve suas origens nos primeiros trabalhos, estabelecendo e consolidando o método caso-controle, em meados do século XX.Palavras-chave: Palavras-chave: Palavras-chave: Palavras-chave: Palavras-chave: Estudo caso-controle. Estimabilidade. Risco relativo. Odds ratio. Fração atribuível.

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Attributable Risk Estimation in Case-Control Studies

Cited by 148 publications

References 0 publications

Pooled analysis of clinical and cytogenetic features in treatment-related and de novo adult acute myeloid leukemia and myelodysplastic syndromes based on a consecutive series of 761 patients analyzed 1976–1993 and on 5098 unselected cases reported in the literature 1974–2001

Pooled analysis of clinical and cytogenetic features in treatment-related and de novo adult acute myeloid leukemia and myelodysplastic syndromes based on a consecutive series of 761 patients analyzed 1976–1993 and on 5098 unselected cases reported in the literature 1974–2001

Area‐based study shows most parents follow advice to reduce risk of sudden infant death syndrome

O mito da doença rara

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