A statistical comparison of different family history scores

Abstract

Family history (FH) scores are used for estimating the familial risk (FR), i.e. the level of risk for a particular disease among members of that family. An FH score is created from reports about the disease status of the relatives in each family. The most commonly used score is the dichotomous score (positive when at least one relative is affected), which does not consider the family size, number of affected relatives nor each relative's risk factor profile. Authors have proposed many other FH scores that overcome these deficiencies by using external expected risks adjusted for important risk factors. We consider the use of FH scores in studies, which investigate risk factors for a disease and where family risk is considered as a confounder, and examine through simulations the performance of a variety of FH scores in controlling the FR status. We also examine performance in predicting true FR status. For both criteria, only small differences were found between most of the FH scores, although the dichotomous score performed the poorest. Since the proportion score (the proportion of first-degree relatives of the index who have the disease) is the simplest to calculate, use of this score seems to be justified.

Prospective cohort studies of association between family history of liver cancer and risk of liver cancer

“…10,11 Second, we applied a proportional FH score approach to classify the risk categories of family history of liver cancer, taking into consideration family size and number of affected first-degree relatives in our study population. By a statistical comparison of different FH scores (Proportion, SR, Reed, Williams, Schwartz and Silberberg scores), Murad et al 59 have found surprisingly little difference in the performance of various scores and strongly recommended the usage of the simpler proportion FH score. The internal consistency of findings in both men and women and the "dose-response" of risk with increasing FH score lend credence to our findings.…”

Adolescent temperament dimensions as stable prospective risk and protective factors for salivary C‐reactive protein

“…Information about incidence of CVD in the participant's first-and second-degree relatives was obtained from parents in an interview. A family history proportion score was calculated for each person to assess familial risk of developing CVD (Murad, Kalter-Leibovici, Chetrit, & Freedman, 2007).…”

Family History in Public Health Practice: A Genomic Tool for Disease Prevention and Health Promotion

“…Combining these factors to determine risk presents a challenge. Current methodologies to assess familial risk for common chronic diseases vary from basic dichotomous categorizations (positive/negative) to risk scores developed through refined statistical techniques (59). Another approach is to stratify the risk into a few categories (e.g., average, moderate, high) according to the number of relatives affected, relatives' ages at diagnosis, and the closeness of the biological relationship (87).…”