Point and interval estimates of partial population attributable risks in cohort studies: examples and software

Spiegelman, Donna; Hertzmark, Ellen; Wand, Handan

doi:10.1007/s10552-006-0090-y

Cited by 257 publications

(227 citation statements)

References 27 publications

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“…Expected population-level effects of preventing exposure to multiple (but not all) risk factors simultaneously were also estimated (Spiegelman et al, 2007). Risk factors were eligible for inclusion in these analyses if the PAF estimate was sufficiently precise to draw a conclusion and indicated at least a modestly-sized population effect.…”

Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

“…The adjusted relative risks, joint distributions and partial PAF were then estimated within an Excel® spreadsheet. The formula used is shown in Equation 2 (Spiegelman et al, 2007).…”

Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

“…For each of the (T=4) strata of background risk factor categories, represents the relative risk compared to the lowest-risk stratum and is the proportion of observations in each stratum. For each stratum, (Spiegelman et al, 2007).…”

Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

“…changing all animals to the lowest risk category), while not changing the distribution of exposure to other risk factors (Spiegelman et al, 2007) (for example, risk factors less amenable to changes in management practice). This method allows a more meaningful interpretation of population-level effects of risk factors for complex multifactorial diseases such as BRD.…”

Section: Introductionmentioning

confidence: 99%

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Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle

Hay

Morton

Clements

et al. 2017

Preventive Veterinary Medicine

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Please cite this article as: Hay, K.E., Morton, J.M., Clements, A.C.A., Mahony, T.J., Barnes, T.S., Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle.Preventive Veterinary Medicine http://dx.doi.org/10. 1016/j.prevetmed.2017.03.001 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HighlightsPopulation-level effects of risk factors for BRD in feedlot cattle were determined Risk factors with large effects were shared pen water, breed, mixing and move timing BVDV in the pen, prior group size and weight had moderate or modest effects 82% of BRD incidence was attributed to management-related risk factors 2 AbstractResults obtained from a nationwide longitudinal study were extended to estimate the population-level effects of selected risk factors on the incidence of bovine respiratory disease (BRD) during the first 50 days at risk in medium-sized to large Australian feedlots.Population attributable fractions (PAF) and population attributable risks (PAR) were used to rank selected risk factors in order of importance from the perspective of the Australian feedlot industry within two mutually exclusive categories: 'intervention' risk factors had practical strategies that feedlot managers could implement to avoid exposure of cattle to adverse levels of the risk factor and a precise estimate of the population-level effect while 'others' did not. An alternative method was also used to quantify the expected effects of simultaneously preventing exposure to multiple management-related factors whilst not changing exposure to factors that were more difficult to modify. Other important risk factors identified and prioritised for further research were feedlot region, season of induction and cohort formation patterns.3 An estimated 82% of BRD incidence was attributable to management-related risk factors, whereby the lowest risk category of a composite management-related variable comprised animals in the lowest risk category of at least four of the five component variables (shared pen water, mixing, move timing, BVDV-1 in the cohort and the number of animals in the animal's group-13). This indicated that widespread adoption of appropriate interventions including ensuring pen water is not shared between pens, optimising animal mixing before induction, timing of the animal's move to the vicinity of the feedlot, and group size prior to placing animals in feedlot pens, and avoiding BVDV-1 in cohorts could markedly reduce the incidence of BRD in medium-sized to large Australian feedlots.

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Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

“…The adjusted relative risks, joint distributions and partial PAF were then estimated within an Excel® spreadsheet. The formula used is shown in Equation 2 (Spiegelman et al, 2007).…”

Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

Section: Simultaneous Effects Of Multiple Risk Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle

Hay

Morton

Clements

et al. 2017

Preventive Veterinary Medicine

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“…Lastly, since smoking may be causally related to mortality, we investigated the population attributable risk for mortality of smoking after RA/index date. Population attributable risk and 95% CIs were calculated according to methods previously described (23). We considered any smoking after RA or index date and analyzed RA and comparators separately in these analyses.…”

Section: Significance and Innovationsmentioning

confidence: 99%

Smoking Behavior Changes in the Early Rheumatoid Arthritis Period and Risk of Mortality During Thirty‐Six Years of Prospective Followup

Chang

Nguyen

Barbhaiya

et al. 2017

Arthritis Care & Research

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Objective. To investigate whether rheumatoid arthritis (RA) diagnosis influences smoking behavior changes and whether these changes were associated with mortality. Methods. We identified an incident RA cohort in the Nurses' Health Study (NHS; 1976-2012. Behavioral data were collected through biennial questionnaires. We created a comparison cohort, matching RA cases to women without RA by age and calendar year at the index date of RA diagnosis. To investigate smoking behavior changes in the early RA period, sustained cessation was defined as permanently quitting within 4 years of the RA/index date. We used Cox regression to obtain hazard ratios (HRs) for mortality, comparing sustained smoking cessation to continued smoking. Results. Among 121,700 women in the NHS, we identified 938 with incident RA matched to 8,951 non-RA comparators. Among current smokers, 40.0% with RA permanently quit smoking in the early RA period, compared to 36.1% of comparators (odds ratio for sustained cessation 1.18 [95% confidence interval (95% CI) 0.88, 1.58]). There were 313 deaths (33.4%) in the RA cohort and 2,042 (22.8%) among comparators. Compared to continued smoking, sustained cessation was associated with similarly decreased mortality in both the RA (HR 0.58 [95% CI 0.33, 1.01]) and comparison (HR 0.47 [95% CI 0.39, 0.58]) cohorts. Women with RA had higher mortality for >5 post-RA pack-years (HR 3.67 [95% CI 2.80, 4.81]) than comparators with >5 post-index pack-years (HR 1.88 [95% CI 1.62, 2.17]; P < 0.001 for interaction; reference: ever-smoker non-RA women with 0 post-index pack-years). Conclusion. Sustained smoking cessation within 4 years of RA diagnosis reduced mortality risk, with a similar effect observed among non-RA comparators. Smoking >5 pack-years after RA diagnosis significantly increased mortality beyond the risk of non-RA comparators.

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Red Meat Consumption and Mortality

Sun

Bernstein²,

Schulze³

et al. 2012

Arch Intern Med

580

168

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Background Red meat consumption has been associated with an increased risk of chronic diseases. However, its relationship with mortality remains uncertain. Methods We prospectively followed 37698 men from the Health Professionals Follow-up Study (1986-2008) and 83644 women from the Nurses' Health Study (1980-2008), who were free of cardiovascular disease (CVD) and cancer at baseline. Diet was assessed by validated food-frequency questionnaires and updated every four years. Results We documented 23926 deaths (including 5910 CVD and 9464 cancer deaths) during 2.96 million person-years of follow-up. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) and 95% confidence interval of total mortality was 1.13 (1.07-1.20) for 1-serving per day increase of unprocessed red meat, 1.20 (1.15-1.24) for processed red meat. The corresponding HRs were 1.18 (1.13-1.23) and 1.21 (1.13-1.31) for CVD mortality, 1.10 (1.06-1.14) and 1.16 (1.09-1.23) for cancer mortality. We estimated that substitutions of 1-serving per day of other foods (including fish, poultry, nuts, legumes, low-fat dairy, and whole grains) for 1-serving per day of red meat were associated with a 7%-19% lower mortality risk. We also estimated that 9.3% of deaths in men and 7.6% in women in our cohorts could be prevented at the end of follow-up if all individuals consumed <0.5 serving/d (≈42 g/d) of red meat. Conclusions Red meat consumption is associated with an increased risk of total, CVD and cancer mortality. Substitution of other healthy protein sources for red meat is associated with a lower mortality risk.

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Point and interval estimates of partial population attributable risks in cohort studies: examples and software

Cited by 257 publications

References 27 publications

Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle

Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle

Smoking Behavior Changes in the Early Rheumatoid Arthritis Period and Risk of Mortality During Thirty‐Six Years of Prospective Followup

Red Meat Consumption and Mortality

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