PROPORTION OF DISEASE CAUSED OR PREVENTED BY A GIVEN EXPOSURE, TRAIT OR INTERVENTION1
Abstract
The structures of two epidemiologic parameters are explored. One, the “etiologic fraction, ” relates to markers of increased risk, and it is the proportion of disease attributable to the marker and/or to factors associated with it. The other, the “prevented fraction, ” is the equivalent of this for a marker of reduced risk. It is shown that both parameters depend—in different ways—-on the frequency of the marker among cases of the disease, and on the “standardized morbidity ratio” for those with the marker. Point estimation of these parameters is often straight-forward, particularly in case-control studies.
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ETT has been used in econometrics to evaluate the effectiveness of social programs on their participants and has long been the target of research in epidemiology, where it came to be known as 'the effect of exposure on the exposed,' or 'standardized morbidity'.
“ETT has been used in econometrics to evaluate the effectiveness of social programs on their participants (Heckman, 1992) and has long been the target of research in epidemiology, where it came to be known as 'the effect of exposure on the exposed,' or 'standardized morbidity' (Miettinen, 1974; Greenland and Robins, 1986).”
From Causal inference in statistics: An overview (2009) · cites this paper as Miettinen, 1974
Population-attributable fractions were calculated using Miettinen's formula, adjusted prevalence ratios, and weighted prevalence estimates of each health condition and risk behavior by each cumulative ACEs count level.
“Population-attributable fractions, adjusted for aforementioned model covariates, were calculated using Miettinen’s formula, aPRs, and weighted prevalence estimates of each health condition and risk behavior by each cumulative ACEs count level”
From Adverse childhood experiences and health conditions and risk behaviors among high school students—Youth Risk Behavior Survey, United States, 2023 (2024) · cites this paper as [11]
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“For a given condition and risk factor [15], the attributable fraction may be calculated as: (Prevalence of exposure among cases) · [(Risk ratio 1)/(Risk ratio)].”
BackgroundGlobal burden of cancers attributable to infections in 2008: a review and synthetic analysis
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“The preventable proportion of deaths and causespecific deaths attributable to a low fruit and vegetable intake was calculated using the formula proposed by Miettinen.(85) Further information about these calculations is provided in the Supplementary Methods, available at IJE online.”
MethodCausal inference in statistics: An overview
Pearl, J. (2009) · Statistics Surveys · doi:10.1214/09-ss057 · Cited by 2,336 · see citing works
“…to evaluate the effectiveness of social programs on their participants (Heckman, 1992) and has long been the target of research in epidemiology, where it came to be known as “the effect of exposure on the exposed,” or “standardized morbidity” (Miettinen, 1974; Greenland and Robins, 1986).”
BackgroundFleming, D. T., & Wasserheit, J. N. (1999) · Sexually Transmitted Infections · doi:10.1136/sti.75.1.3 · Cited by 2,271 · see citing works
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Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy Men and Women
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Common West African HLA antigens are associated with protection from severe malaria
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Watts, N., Amann, M. C., Arnell, N. W., Ayeb‐Karlsson, S., Belesova, K., Boykoff, M., Byass, P., Cai, W., Campbell-Lendrum, D. H., Capstick, S., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)32596-6 · Cited by 1,499 · see citing works
A Prospective Study of Obesity and Risk of Coronary Heart Disease in Women
Manson, J. E., Colditz, G. A., Stampfer, M. J., Willett, W. C., ROSNER, B. A., Monson, R. R., Speizer, F. E., & Hennekens, C. H. (1990) · New England Journal of Medicine · doi:10.1056/nejm199003293221303 · Cited by 1,403 · see citing works
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Association scan of 14,500 nonsynonymous SNPs in four diseases identifies autoimmunity variants
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Estimating the population attributable risk for multiple risk factors using case-control data.
BRUZZI, P., GREEN, S. B., BYAR, D. P., BRINTON, L. A., & SCHAIRER, C. (1985) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114174 · Cited by 1,214 · see citing works
Increased Risk of Endometrial Carcinoma among Users of Conjugated Estrogens
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Smoking‐Attributable Periodontitis in the United States: Findings From NHANES III
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“The basic statistic obtained in this approach is the population attributable fraction (PAF) defined as the proportional reduction in disease or death that would occur if exposure to the risk factor were reduced to zero, ceteris paribus (Cole and MacMahon 1971; Eide and Heuch 2001; Greenland 1984; Levin 1953; MacMahon…”
BackgroundTroeger, C., Khalil, I. A., Rao, P. C., Cao, S., Blacker, B. F., Ahmed, T., Armah, G. E., Bines, J. E., Brewer, T. G., Colombara, D. V., et al. (2018) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2018.1960 · Cited by 854 · see citing works
“7) 6 903 717 (4 707 088-9 978 464) High-income Asia Pacific 10 (8-13) 0.”
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Roglić, G., Unwin, N. C., Bennett, P. H., Mathers, C. D., Tuomilehto, J. O., Nag, S., Connolly, V. M., & King, H. O. M. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2130 · Cited by 809 · see citing works
“To validate the DisMod II method, separate calculations of the number of deaths due to diabetes were performed according to the formula proposed by Miettinen for estimating the proportion of a disease or event caused by a given exposure (15):”
MethodTroeger, C., Forouzanfar, M. H., Rao, P. C., Khalil, I., Brown, A., Swartz, S. J., Fullman, N., Mosser, J. F., Thompson, R. L., Reiner, R. C., et al. (2017) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(17)30396-1 · Cited by 768 · see citing works
Drug-Drug Interactions Among Elderly Patients Hospitalized for Drug Toxicity
Juurlink, D. N., Mamdani, M., Kopp, A., Laupacis, A., & Redelmeier, D. A. (2003) · JAMA · doi:10.1001/jama.289.13.1652 · Cited by 759 · see citing works
“NSAIDs 510 (56) 21 636 (49) 558 (53) 23 941 (46) 295 (56) 12 945 (50)”
An Introduction to Causal Inference
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The Contribution of Mild and Moderate Preterm Birth to Infant Mortality
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“The EF is the proportion of all cases of the outcome occurring in a given population that can be attributed to exposure to the risk factor; it is sometimes referred to as the population-attributable risk.(19) Because the EF is a function of both the RR and the population prevalence of exposure to the risk factor, comm…”
BackgroundThe global prevalence of hepatitis D virus infection: Systematic review and meta-analysis
Stockdale, A. J., Kreuels, B., Henrion, M., Giorgi, E., Kyomuhangi, I., de Martel, C., Hutin, Y. J., & Geretti, A. M. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.04.008 · Cited by 693 · see citing works
“We used methodology recommended by the WHO, where PAF = prevalence among cases × [(odds ratio − 1)/odds ratio].(18,19) where OR is used as an approximation for the disease risk ratio of exposed (anti-HDV positive) vs.”
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“Age at interview (yr; n % ) 18 to 24 5 (1) 14 (2) 5 (2) 6 (2) 25 to 34 34 (6) 32 (5) 29 (9) 26 (8) 35 to 44 59 (10) 62 (9) 36 (11) 35 (10) 45 to 54 131 (22) 116 (18) 62 (19) 70 (20) 55 to 64 124 (21) 134 (21) 62 (19) 70 (20) 65 to 74 244 (41) 295 (45) 135 (41) 138 (40) Education (yr; n % ) 9 350 (59) 355 (54) 187 (57)…”
BackgroundSaeedi, P., Salpea, P., Karuranga, S., Petersohn, I., Malanda, B., Gregg, E. W., Unwin, N. C., Wild, S. H., & Williams, R. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108086 · Cited by 666 · see citing works
Estimates of global and regional potential health gains from reducing multiple major risk factors
Ezzati, M., Vander Hoorn, S., Rodgers, A., Lopez, A. D., Mathers, C. D., & Murray, C. J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13968-2 · Cited by 610 · see citing works
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A Prospective Study of Exercise and Incidence of Diabetes Among US Male Physicians
Manson, J. E. (1992) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1992.03490010065031 · Cited by 778 · see citing works
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Leite, F. R. M., Nascimento, G. G., Scheutz, F., & López, R. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.02.014 · Cited by 567 · see citing works
Dai, X., Gakidou, E., & Lopez, A. D. (2022) · Tobacco Control · doi:10.1136/tobaccocontrol-2021-056535 · Cited by 535 · see citing works
Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants
Huang, S. S. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.18.1945 · Cited by 516 · see citing works
“In addition, we calculated the excess risks and population attributable risks (etiologic fractions) of MRSA and VRE acquisition associated with a prior occupant’s MRSA and VRE status.(30-32) Excess risk was calculated as the difference between acquisition risk in patients whose prior room occupant was a carrier of MRS…”
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Eder, W., Klimecki, W. J., Yu, L., von Mutius, E., Riedler, J., Braun‐Fahrländer, C., Nowak, D., & Martínez, F. D. (2004) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2003.12.374 · Cited by 509 · see citing works
Pittet, D. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.155.11.1177 · Cited by 115 · see citing works
Meat consumption and colorectal cancer risk: Dose‐response meta‐analysis of epidemiological studies
Norat, T., Lukanova, A., Ferrari, P., & Ríboli, E. (2001) · International Journal of Cancer · doi:10.1002/ijc.10126 · Cited by 499 · see citing works
Population attributable fraction
Mansournia, M. A., & Altman, D. G. (2018) · BMJ · doi:10.1136/bmj.k757 · Cited by 478 · see citing works
Genetic Risk of Primary Open-angle Glaucoma
Wolfs, R. C. W. (1998) · Archives of Ophthalmology · doi:10.1001/archopht.116.12.1640 · Cited by 469 · see citing works
“The attributable proportion of genetic factors to the occurrence of glaucoma in the exposed and the general population was estimated using the formulas developed by Miettinen.29 The attributable proportion for the genetically exposed (Ape) was calculated with the formula Ape = (RR − 1) / RR, where RR is the relative r…”
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The Estimation and Interpretation of Attributable Risk in Health Research
Walter, S. D. (1976) · Biometrics · doi:10.2307/2529268 · Cited by 449 · see citing works
Risk factors for pancreatic cancer: a summary review of meta-analytical studies
Maisonneuve, P., & Lowenfels, A. B. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu240 · Cited by 447 · see citing works
“the fraction of PCs attributable to exposure.(4) In case of protective factors (such as allergy), we calculated the population preventable fraction (PPF1⁄4Pe(1-RRe)), i.”
BackgroundA review of adjusted estimators of attributable risk
Bénichou, J. (2001) · Statistical Methods in Medical Research · doi:10.1177/096228020101000303 · Cited by 440 · see citing works
Association of Intrauterine Exposure to Maternal Diabetes and Obesity With Type 2 Diabetes in Youth
Dabelea, D., Mayer-Davis, E. J., Lamichhane, A. P., D'Agostino, R. B., Liese, A. D., Vehik, K. S., Narayan, K. M. V., Zeitler, P., & Hamman, R. F. (2008) · Diabetes Care · doi:10.2337/dc07-2417 · Cited by 415 · see citing works
“This formula produces internally valid estimates when confounding exists and, as a result, adjusted ORs must be used (15,16).”
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Roglić, G., & Unwin, N. C. (2009) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2009.10.006 · Cited by 400 · see citing works
Aune, D., Keum, N., Giovannucci, E. L., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., VATTEN, L. J., Ríboli, E., & Norat, T. (2016) · BMC Medicine · doi:10.1186/s12916-016-0730-3 · Cited by 402 · see citing works
“The formula by Miettinen [55] was used to calculate the population-attributable risk of mortality due to low nut consumption: PAR = p(rr–1)/(1 + p(rr–1)), where p is the prevalence of the exposure in the population, and rr is the relative risk.”
TUYNS, A. J., Estève, J., Raymond, L., et al. (1988) · International Journal of Cancer · doi:10.1002/ijc.2910410403 · Cited by 400 · see citing works
Knowns and unknowns on burden of disease due to chemicals: a systematic review
Prüss-Ustün, A., Vickers, C., Haefliger, P., & Bertollini, R. (2011) · Environmental Health · doi:10.1186/1476-069x-10-9 · Cited by 397 · see citing works
“In most disease burden estimates for risk factors, the basic method can be summarized in the following steps: (a) estimating the exposure distribution in a population; (b) selecting one or more appropriate relative risk estimates from the literature, generally from a recent metaanalysis; and (c) estimating the populat…”
MethodHow many cancer cases and deaths are potentially preventable? Estimates for Australia in 2013
Wilson, L. F., Antonsson, A., Green, A. C., Jordan, S. J., Kendall, B. J., Nagle, C. M., Neale, R. Ε., Olsen, C. M., Webb, P. M., & Whiteman, D. C. (2017) · International Journal of Cancer · doi:10.1002/ijc.31088 · Cited by 391 · see citing works
Hibberd, M. L., Sumiya, M., Summerfield, J. A., Booy, R., & Levin, M. (1999) · The Lancet · doi:10.1016/s0140-6736(98)08350-0 · Cited by 368 · see citing works
Is hyperhomocysteinaemia a risk factor for recurrent venous thrombosis?
den Heijer, M., Gerrits, W. B. J., Haak, H. L., Wijermans, P., Bos, G. M. J., Blom, H. J., & Rosendaal, F. R. (1995) · The Lancet · doi:10.1016/s0140-6736(95)90008-x · Cited by 364 · see citing works
An Overview of Methods for Calculating the Burden of Disease Due to Specific Risk Factors
Steenland, K., & Armstrong, B. (2006) · Epidemiology · doi:10.1097/01.ede.0000229155.05644.43 · Cited by 370 · see citing works
“where pc is the percentage of cases exposed in the combined population.(8) This expression is a valid estimate in the presence of confounding affecting exposed versus nonexposed if the RR is adjusted for confounding.”
BackgroundMethodMC1R variants, melanoma and red hair color phenotype: A meta‐analysis
Raimondi, S., Sera, F., Gandini, S., Iodice, S., Caini, S., Maisonneuve, P., & Fargnoli, M. C. (2008) · International Journal of Cancer · doi:10.1002/ijc.23396 · Cited by 349 · see citing works
“The attributable risk in the population was computed with Miettinen’s formula (OR2 1/OR 3 proportion of exposed cases).(45)”
MethodHnizdo, E. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf105 · Cited by 348 · see citing works
Anenberg, S. C., Henze, D. K., Tinney, V., Kinney, P. L., Raich, W., Fann, N., Malley, C. S., Roman, H., Lamsal, L., Duncan, B., et al. (2018) · Environmental Health Perspectives · doi:10.1289/ehp3766 · Cited by 337 · see citing works
“We found six additional meta-analyses reporting relationships between asthma ERVs and PM2:5 and NO2 for children only (Fan et al. 2016; Favarato et al. 2014; Gehring et al. 2015; Lim et al. 2016; Mölter et al. 2015; Weinmayr et al. 2010).”
BackgroundThe effect of the increasing prevalence of maternal obesity on perinatal morbidity
Lu, G., Rouse, D. J., DuBard, M. B., Cliver, S., Kimberlin, D. F., & Hauth, J. C. (2001) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2001.117351 · Cited by 332 · see citing works
Prospective Study of Oral Contraceptives and Hypertension Among Women in the United States
Chasan-Taber, L., Willett, W. C., Manson, J. E., Spiegelman, D., Hunter, D. J., Curhan, G., Colditz, G. A., & Stampfer, M. J. (1996) · Circulation · doi:10.1161/01.cir.94.3.483 · Cited by 328 · see citing works
Population-Attributable Fractions of Risk Factors for Hepatocellular Carcinoma in the United States
Welzel, T. M., Graubard, B. I., Quraishi, S. M., Zeuzem, S., Davila, J. A., El‐Serag, H. B., & McGlynn, K. A. (2013) · The American Journal of Gastroenterology · doi:10.1038/ajg.2013.160 · Cited by 326 · see citing works
Genetic Risk of Age-related Maculopathy: Population-Based Familial Aggregation Study
Klaver, C. C. W. (1998) · Archives of Ophthalmology · doi:10.1001/archopht.116.12.1646 · Cited by 323 · see citing works
“The attributable proportion of genetic factors to the occurrence of late ARM in the exposed and general population was estimated using the formulas presented by Miettinen.(23) The attributable proportion for the genetically exposed (Ape) was calculated with the formula Ape = (RR − 1)/RR, where RR is the relative risk.”
MethodBlack, M. H., Sacks, D. A., Xiang, A. H., & Lawrence, J. M. (2012) · Diabetes Care · doi:10.2337/dc12-0741 · Cited by 326 · see citing works
“AORs from these models were used to calculate the partial populationattributable fraction (PAF) for each group (24,25).”
MethodWei, F., Georges, D., Man, I., Baussano, I., & Clifford, G. M. (2024) · The Lancet · doi:10.1016/s0140-6736(24)01097-3 · Cited by 317 · see citing works
Makridakis, N. M., Ross, R. K., Pike, M. C., et al. (1999) · The Lancet · doi:10.1016/s0140-6736(98)11282-5 · Cited by 314 · see citing works
Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland
Nurminen, M. M., & Karjalainen, A. (2001) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.605 · Cited by 310 · see citing works
“If the unadjusted RR were available, then an unbiased estimate can be obtained by replacing Pc in equation 2 by the expression P × RR / [P (RR – 1) + 1] to obtain (20):”
BackgroundMethodInfluentialSpiegelman, D., Hertzmark, E., & Wand, H. C. (2007) · Cancer Causes & Control · doi:10.1007/s10552-006-0090-y · Cited by 298 · see citing works
“used in case-control studies uses an estimate of the proportion of cases that are exposed [24], rather than an estimate of the exposure prevalence in the study basis as the cohort study version does.”
MethodLin, H.-H., Murray, M. B., Cohen, T., Colijn, C., & Ezzati, M. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61345-8 · Cited by 303 · see citing works
Determinants of Peripheral Arterial Disease in the Elderly
Meijer, W. T., Grobbee, D. E., Hunink, M. G. M., Albert Hofman, D., & Hoes, A. W. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.19.2934 · Cited by 2 · see citing works
“where the relative risk (RR) is taken as the OR of the risk indicator resulting from the multiple logistic regression analyses, and the case fraction is the prevalence of the risk indicator in subjects with PAD.(29) Analyses were performed using commercially available software (BMDP Statistical Software, Inc, Los Ange…”
MethodPredictors of late development of heart failure in stable survivors of myocardial infarction
Lewis, E. F., Moyé, L. A., Rouleau, J. L., Sacks, F. M., Arnold, J. M. O., Warnica, J. W., Flaker, G. C., D, E. B. M., & Pfeffer, M. A. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)01057-x · Cited by 299 · see citing works
“The attributable risk of hypertension, diabetes, and exercise was calculated using the difference between the cumulative incidence rate of HF in the exposed group from the cumulative incidence rate of HF in the non-exposed group (12,13).”
MethodAdolescent suicidal behaviours in 32 low- and middle-income countries
McKinnon, B., Gariépy, G., Sentenac, M., & Elgar, F. J. (2016) · Bulletin of the World Health Organization · doi:10.2471/blt.15.163295 · Cited by 297 · see citing works
Update of mortality attributable to diabetes for the IDF Diabetes Atlas: Estimates for the year 2013
IDF Diabetes Atlas Group (2015) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2015.05.037 · Cited by 298 · see citing works
Intraosseous well-differentiated osteosarcoma
Unni, K. K., Dahlin, D. C., McLeod, R. A., & Pritchard, D. J. (1977) · Cancer · doi:10.1002/1097-0142(197709)40:3 · Cited by 179 · see citing works
Darves‐Bornoz, J., Alonso, J., de Girolamo, G., de Graaf, R., Haro, J. M., Kovess–Masféty, V., Lépine, J., Nachbaur, G., Nègre‐Pagès, L., Vilagut, G., et al. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20357 · Cited by 284 · see citing works
A heuristic approach to the formulas for population attributable fraction
Hanley, J. A. (2001) · Journal of Epidemiology & Community Health · doi:10.1136/jech.55.7.508 · Cited by 280 · see citing works
Distribution of Major Health Risks: Findings from the Global Burden of Disease Study
Rodgers, A., Ezzati, M., Hoorn, S. V., López, A. D., Lin, R., Murray, C. J. L., & Group Comparative Risk Assessment Collaborating (2004) · PLoS Medicine · doi:10.1371/journal.pmed.0010027 · Cited by 280 · see citing works
Self, W. H., Williams, D. J., Zhu, Y., Ampofo, K., Pavia, A. T., Chappell, J. D., Hymas, W. C., Stockmann, C. R., Bramley, A. M., Schneider, E., et al. (2015) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiv323 · Cited by 273 · see citing works
“An AF of 0.9 indicated that 90% of detections for that virus in patients with CAP were attributable to symptomatic illness, and 10% were due to asymptomatic shedding [23, [28] [29] [30] .”
BackgroundMethodInfluentialNationwide survey of HTLV‐I–associated myelopathy in Japan: Association with blood transfusion
Osame, M., Janssen, R. S., Kubota, H., Nishitani, H., Igata, A., Nagataki, S., Mori, M., Goto, I., Shimabukuro, H., KHABBAZ, R. F., et al. (1990) · Annals of Neurology · doi:10.1002/ana.410280110 · Cited by 267 · see citing works
Steenland, K., Burnett, C. A., Lalich, N. R., Ward, E., & Hurrell, J. (2003) · American Journal of Industrial Medicine · doi:10.1002/ajim.10216 · Cited by 265 · see citing works
Prospective Study of Serum Selenium Levels and Incident Esophageal and Gastric Cancers
Mark, S. D. (2000) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/92.21.1753 · Cited by 267 · see citing works
Occupation and cancer in Britain
Rushton, L., Bagga, S., Bevan, R. J., Brown, T. P., Cherrie, J. W., Holmes, P., Fortunato, L., Slack, R. J., van Tongeren, M., Young, C., et al. (2010) · British Journal of Cancer · doi:10.1038/sj.bjc.6605637 · Cited by 267 · see citing works
Rural Industries Research and Development Corporation
Griffith, R., Ryan, P., Mitchell, M. S., Walkerden, G., Robinson, S., Brown, V. A., & Walker, B. (2011) · Cited by 265 · see citing works
Global Cardiovascular and Renal Outcomes of Reduced GFR
Thomas, B., Matsushita, K., Abate, K. H., Al-Aly, Z., Ärnlöv, J., Asayama, K., Atkins, R., Badawi, A. F., Ballew, S. H., Banerjee, A., et al. (2017) · Journal of the American Society of Nephrology · doi:10.1681/asn.2016050562 · Cited by 267 · see citing works
Rosas‐Salazar, C., Chirkova, T., Gebretsadik, T. S., Chappell, J. D., Peebles, R. S., Dupont, W. D., Jadhao, S. J., Gergen, P. J., Anderson, L. J., & Hartert, T. V. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00811-5 · Cited by 262 · see citing works
Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
Aleksandrova, K., Pischon, T., Jenab, M., Bueno-de-Mesquita, H. B., Fedirko, V., Norat, T., Romaguera, D., Knüppel, S., Boutron‐Ruault, M., Dossus, L., et al. (2014) · BMC Medicine · doi:10.1186/s12916-014-0168-4 · Cited by 257 · see citing works
“PARs are calculated by reversing the coding of the protective factors and taking into account the relative proportion of exposed cases based on the formula from Miettinen et al .”
Shi, T., McLean, K. A., Campbell, H. J., & Nair, H. (2015) · Journal of Global Health · doi:10.7189/jogh.05.010408 · Cited by 254 · see citing works
“Furthermore, strict interpretation would entail construal of negative values as indicative of the percentage of ALRI prevented by viral exposure [56] , which is biologically implausible.”
BackgroundExogenous estrogen and endometrial carcinoma: Case-control and incidence study
McDonald, T. W., Annegers, J. F., O’Fallon, W. M., et al. (1977) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(77)90351-9 · Cited by 245 · see citing works
Measuring the strength of associations between HLA antigens and diseases
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Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis
Li, X., Zhong, X., Wang, Y., Zeng, X., Luo, T., & Liu, Q. (2021) · PLOS ONE · doi:10.1371/journal.pone.0250602 · Cited by 236 · see citing works
“PAF 1⁄4 Pc� RR 1 RR where Pc is the prevalence of the risk factors in the population [10].”
BackgroundMuwonge, R., Ramadas, K., Sankila, R. J., Somanathan, T., Thomas, G., Vinoda, J., & Sankaranarayanan, R. (2008) · Oral Oncology · doi:10.1016/j.oraloncology.2007.06.002 · Cited by 232 · see citing works
Trichopoulos, D., Bamia, C., Λάγιου, Π., Fedirko, V., Trépo, E., Jenab, M., Pischon, T., Nöthlings, U., Overved, K., Tjønneland, A. M., et al. (2011) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djr395 · Cited by 226 · see citing works
“We used the formula suggested by Miettinen (23) and extended by Bruzzi et al.”
MethodGonzalez, E., Dhanda, R., Bamshad, M., Mummidi, S., Geevarghese, R., Catano, G., Anderson, S. A., Walter, E. A., Stephan, K. T., Hammer, M. F., et al. (2001) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.091056898 · Cited by 225 · see citing works
Kearns, K., Dee, A., Fitzgerald, T., Doherty, E., & Perry, I. J. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-143 · Cited by 224 · see citing works
“To calculate the proportion of risk attributed to overweight and obesity, PAFs for the chronic diseases associated with overweight and obesity were calculated [17,18] using the ‘punaf ’ command in Stata.”
MethodArbes, S. J., Gergen, P. J., Vaughn, B. J., & Zeldin, D. C. (2007) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2007.07.056 · Cited by 224 · see citing works
HCV burden of infection in Egypt: results from a nationwide survey
Guerra, J., Garenne, M., Mohamed, M. K., & Fontanet, A. L. (2012) · Journal of Viral Hepatitis · doi:10.1111/j.1365-2893.2011.01576.x · Cited by 214 · see citing works
Proportion of Community-Acquired Pneumonia Cases Attributable to Tobacco Smoking
Almirall, J., Gonzalez, C. A., Balanzó, X., & Bolíbar, I. (1999) · CHEST Journal · doi:10.1378/chest.116.2.375 · Cited by 208 · see citing works
Risk of disability and mortality due to overweight in a Finnish population.
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Obesity and underweight are associated with an increased risk of death after lung transplantation
Lederer, D. J., Wilt, J. S., D'Ovidio, F., Bacchetta, M. D., Shah, L., Ravichandran, S., Lenoir, J., Klein, B., Sonett, J. R., & Arcasoy, S. M. (2009) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200903-0425oc · Cited by 198 · see citing works
“Population attributable fractions were calculated using adjusted hazard ratios from Cox models (16).”
MethodOpportunities for Cost-effective Prevention of Late-Life Depression
Smit, F., Ederveen-Grochowska, A., Cuijpers, P. J., Deeg, D. J. H., & Beekman, A. T. F. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.3.290 · Cited by 200 · see citing works
- Authors
- MIETTINEN, O. S.
- Corresponding author
- MIETTINEN, OLLI S.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1974-05
- Volume
- 99
- Issue
- 5
- Pages
- 325-332
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W1953501928
- Cited by
- 1,036
- References
- 0
- Citations by year
- 2026: 24 · 2025: 34 · 2024: 41 · 2023: 35 · 2022: 26 · 2021: 35 · 2020: 39 · 2019: 40 · 2018: 31 · 2017: 22 · 2016: 27 · 2015: 25 · 2014: 28 · 2013: 22 · 2012: 26
- FWCI
- 7.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Sociology and Political Science › Historical and modern epidemiology studies
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Keywords
- population attributable fraction, prevented fraction, attributable fraction, risk indicators, standardized morbidity ratio, case-control study, disease prevention
- MeSH terms
- Coffee, Coronary Disease, Drinking, Epidemiologic Methods, Humans, Hypercholesterolemia, Hypertension, Models, Theoretical, Morbidity, Myocardial Infarction, Population, Preventive Medicine, Smoking, Statistics as Topic
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