期刊
ANNALS OF EPIDEMIOLOGY
卷 20, 期 10, 页码 750-758出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.annepidem.2010.06.012
关键词
Age Factors; Arsenicals; Environmental Exposure; Epidemiologic Methods; Monte Carlo Method; Residential Mobility; Uncertainty; Urinary Bladder
资金
- National Cancer Institute [R01 CA96002-10, R43CA132341, R44 CA135818, R44-CA132347-02]
PURPOSE: Epidemiologic analyses traditionally rely on point estimates of exposure for assessing risk despite exposure error. We present a strategy that produces a range of risk estimates reflecting distributions of individual-level exposure. METHODS: Quantitative estimates of exposure and its associated error are used to create for each individual a normal distribution of exposure estimates which is then sampled using Monte Carlo simulation. After the exposure estimate is sampled, the relationship between exposure and disease is evaluated; this process is repeated 99 times generating a distribution of risk estimates and confidence intervals. This is demonstrated in a bladder cancer case-control study using individual-level distributions of exposure to arsenic in drinking water. RESULTS: Sensitivity analyses indicate similar performance for categorical or continuous exposure estimates, and that increases in exposure error translate into a wider range of risk estimates. Bladder cancer analyses yield a wide range of possible risk estimates, allowing quantification of exposure error in the association between arsenic and bladder cancer, typically ignored in conventional analyses. CONCLUSIONS: Incorporating distributions of individual-level exposure error results in a more nuanced depiction of epidemiologic findings. This approach can be readily adopted by epidemiologists assuming distributions of individual-level exposure. Ann Epidemiol 2010;20:750-758. (C) 2010 Elsevier Inc. All rights reserved.
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