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Attributable risk (AR)
The attributable risk of a disease given an exposure is simply the rate of disease (incidence) in the exposed people minus the rate in the unexposed people. So the attributable risk for lung cancer in smokers is, in essence, simply the rate of lung cancer amongst smokers minus the rate of lung cancer amongst non-smokers. In fact AR shows which proportion of the disease in exposed subjects is due to exposure.
Population Attributable risk (PAR)
Definition: Reduction in incidence that would be achieved if the population had been entirely unexposed, compared with its current (actual) exposure pattern . In 1953, Levin first proposed the concept of population attributable risk. However, PAR refers to a family of concepts, not a single quantity. Greenland and Robins distinguished between excess fraction and etiologic fraction in 1988. Etiologic fraction is the proportion of the cases that the exposure had played a causal role in its development. Excess fraction, however, is the proportion of the cases that occurs among exposed population that is in excess in comparison with the unexposed . All excess cases are etiologic cases, but not vice versa. From the standpoint of both law and biology it is important to measure the etiology fraction. In most epidemiological studies, PAR measures only the excess fraction. (Smaller than etiologic fraction)
Combined PAR: The PAR for a combination of risk factors is the proportion of the disease that can be attributed to any of the risk factors studied. The combined PAR is usually lower than the sum of individual PARs since a diseased case can simultaneously be attributed to more than one risk factor and so be counted twice.
When there is no multiplicative interaction (no departure from multiplicative scale), combined PAR can be manually calculated by this formula:
1-combined PAR = (1-PAR1)*(1-PAR2)*(1-PAR3)*…
Population attributable fraction (PAF), population attributable risk proportion, and population attributable risk percent are all the same as PAR.
New York: Oxford University Press; 1996.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Attributable_risk". A list of authors is available in Wikipedia.|