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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 (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
In the citing paper
“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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Items 301–400 of 998
Voskamp, B. J., Kazemier, B. M., Ravelli, A. C. J., Schaaf, J. M., Mol, B. W., & Pajkrt, E. (2013) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2013.01.045 · Cited by 69
Shield, K. D., Parkin, D. M., Whiteman, D. C., Rehm, J. T., Viallon, V., Micallef, C. M., Vineis, P., Rushton, L., Bray, F., & Soerjomataram, I. (2016) · Current Epidemiology Reports · doi:10.1007/s40471-016-0085-5 · Cited by 65
“Funding Sources French National Cancer Institute [contract number 2015-002]. 208 Curr Epidemiol Rep (2016) 3:201–211”
InfluentialFactor V Leiden in central venous catheter‐associated thrombosis
Fijnheer, R., Paijmans, B., Verdonck, L. F., et al. (2002) · British Journal of Haematology · doi:10.1046/j.1365-2141.2002.03591.x · Cited by 65
“The population-attributable risk was calculated as a parameter for the fraction of thrombotic complications that was attributable to the factor V Leiden mutation (Mietinen, 1974).”
MethodAge specific and attributable risks of familial prostate carcinoma from the family‐cancer database
Hemminki, K., & Czene, K. (2002) · Cancer · doi:10.1002/cncr.10819 · Cited by 65
“The expected numbers were calculated from 5-year standard incidence rates that were specific for age, gender, tumor type, period (10-year bands), socioeconomic status (4 groups), and residential area (2 groups) for sons with no family history of prostate carcinoma in the Family-Cancer Database.42 The 95% confidence in…”
Occupation and lung cancer in two industrialized areas of northern Italy
Ronco, G., Ciccone, G., Troia, B., et al. (1988) · International Journal of Cancer · doi:10.1002/ijc.2910410306 · Cited by 65
Attributable Risk Estimation from Matched Case-Control Data
Kuritz, S. J., & Landis, J. R. (1988) · Biometrics · doi:10.2307/2531850 · Cited by 64
Population attributable fraction in textbooks: Time to revise
Khosravi, A., Nazemipour, M., Shinozaki, T., & Mansournia, M. A. (2021) · Global Epidemiology · doi:10.1016/j.gloepi.2021.100062 · Cited by 67
“,I, with 0 corresponds to non-exposure) were provided by Walter [64] and Miettinen [65], respectively:”
MethodTobacco smoking, chewing habits, alcohol drinking and the risk of head and neck cancer in Nepal
Chang, C.-P. E., Siwakoti, B., Sapkota, A., Gautam, D. K., Lee, Y. A., Monroe, M. M., & Hashibe, M. (2019) · International Journal of Cancer · doi:10.1002/ijc.32823 · Cited by 64
“The population attributable fractions (PAFs) were estimated for tobacco smoking, chewing habits and alcohol drinking based on the Miettinen formula PAF = p(ec) × (1 – 1/OR), where p(ec) is the proportion of exposure among cases.(24,39,40) ORs adjusted for potential confounding factors were used in the equations.”
MethodFrom Exposures to Population Interventions: Pregnancy and Response to HIV Therapy
Westreich, D. J. (2014) · American Journal of Epidemiology · doi:10.1093/aje/kwt328 · Cited by 64
Prevalence of chronic kidney disease risk factors among low birth weight adolescents
Khalsa, D., Beydoun, H., & Carmody, J. (2016) · Pediatric nephrology (Berlin, West) · doi:10.1007/s00467-016-3384-7 · Cited by 59
Cherpitel, C. J., Ye, Y., & Bond, J. (2005) · American Journal of Public Health · doi:10.2105/ajph.2003.031179 · Cited by 62
Hammitt, J., Morfeld, P., Tuomisto, J., & Erren, T. (2019) · Risk Analysis · doi:10.1111/risa.13427 · Cited by 47
“160), the article that introduced the term “etiologic fraction” (Miettinen, 1974) produced confusion by equating etiologic, excess, and attributable cases (though without using the latter term).”
BackgroundReplication of Prostate Cancer Risk Loci in a Japanese Case–Control Association Study
Yamada, H., Penney, K. L., Takahashi, H., Katoh, T., Yamano, Y., Yamakado, M., Kimura, T., Kuruma, H., Kamata, Y., Egawa, S., et al. (2009) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djp287 · Cited by 61
Silverman, J. G., Decker, M. R., Cheng, D. M., Wirth, K., Saggurti, N., McCauley, H. L., Falb, K. L., Donta, B., & Raj, A. (2011) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpediatrics.2010.261 · Cited by 61
“The PAF was calculated using the following computation: pc([RR−1]/RR), where pc represents the IPV prevalence among the cases, and RR indicates risk ratio.(35,36) To estimate the effect of IPV on infant and child mortality during the 20-year period (December 1985 to August 2005), the PAF was then multiplied by the cor…”
ALCOHOL CONSUMPTION AND RISK OF BREAST CANCER
Webster, L. A. (1983) · The Lancet · doi:10.1016/s0140-6736(83)92258-4 · Cited by 62
Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis
Fell, M. J., Dack, K., Chummun, S., Sandy, J. R., Wren, Y. E., & Lewis, S. J. (2021) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656211040015 · Cited by 62
“The population attributable fraction (PAF) was calculated to assess the public health impact (Mansournia and Altman, 2018) using the pooled odds ratio and the prevalence of exposure among cases (Miettinen, 1974).”
MethodPopulation attributable fraction of infection-related cancers in Korea
Shin, A., Park, S., Shin, H. R., et al. (2010) · Annals of Oncology · doi:10.1093/annonc/mdq592 · Cited by 61
“sinensis simultaneously, an extended version of the formula was used to account for the joint effect among all three [48, 49].”
MethodNutrition and the burden of disease in New Zealand: 1997–2011
Stefanogiannis, N., Lawes, C. M. M., Turley, M. L., Tobias, M. I., Hoorn, S. V., Mhurchú, C. N., & Rodgers, A. (2005) · Public Health Nutrition · doi:10.1079/phn2004694 · Cited by 61
Risk factors in early childhood for sensitization to airborne allergens
Wickman, M. C., Nordvall, S. L., & Pershagen, G. (1992) · Pediatric Allergy and Immunology · doi:10.1111/j.1399-3038.1992.tb00036.x · Cited by 61
on behalf of the CHANCES consortium, Arnold, M., Freisling, H., Stolzenberg-Solomon, R., Kee, F., O’Doherty, M. G., Ordóñez-Mena, J. M., Wilsgaard, T., May, A. M., Bueno-de-Mesquita, H. B., et al. (2016) · European Journal of Epidemiology · doi:10.1007/s10654-016-0169-z · Cited by 58
“Lastly, and based on the assumption that the association between overweight and the cancer sites included in our study is causal [19], population attributable fractions (PAF) and their 95 % CIs were calculated [20, 21] using the maximum likelihood method [22] and the ‘punaf’ command in Stata.”
The current burden of cancer attributable to occupational exposures in Canada
Labrèche, F., Kim, J., Song, C., Pahwa, M., Ge, C., Arrandale, V. H., McLeod, C., Peters, C., Lavoué, J., Davies, H., et al. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2019.03.016 · Cited by 63
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Attributable risk function in the proportional hazards model for censored time-to-event
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Day-care centers and diarrhea: A public health perspective
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Bladder cancer among workers in the textile industry: Results of a spanish case‐control study
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Community-Level Predictors of Pneumococcal Carriage and Resistance in Young Children
Huang, S. S. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh088 · Cited by 60
Etiologic fractions for physical work load, sports and overweight in the occurrence of coxarthrosis.
Olsen, O., Vingård, E., Köster, M., et al. (1994) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.1410 · Cited by 58
Estimating the Generalized Impact Fraction from Case-Control Data
Drescher, K., & Becher, H. (1997) · Biometrics · doi:10.2307/2533576 · Cited by 57
Decreasing perinatal mortality in The Netherlands, 2000–2006: a record linkage study
Ravelli, A. C. J., Tromp, M., van Huis, M., Steegers, E. A. P., Tamminga, P., Eskes, M., & Bonsel, G. J. (2009) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.080440 · Cited by 57
“In addition, we calculated the population-attributive risk (PAR) percentage based on the prevalence (P) and relative risk (RR) {PAR % = [P*(RR21)/(P*(RR21)+1)]*100} for each factor.(16) Subsequently, the prevalence and mortality risk for the five risk groups were analysed.”
Fatalities from non-use of seat belts and helmets in greece: A nationwide appraisal
Petridou, E. T., Skalkidou, A., Ioannou, N. G., et al. (1998) · Accident Analysis & Prevention · doi:10.1016/s0001-4575(97)00065-1 · Cited by 57
Interaction between IRF6 and TGFA Genes Contribute to the Risk of Nonsyndromic Cleft Lip/Palate
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Cervical Carcinogenesis and Immune Response Gene Polymorphisms: A Review
Mehta, A., Mooij, M., Branković, I., Ouburg, S., Morré, S. A., & Jordanova, E. S. (2017) · Journal of Immunology Research · doi:10.1155/2017/8913860 · Cited by 59
“If unavailable in the original studies, these ratios were calculated along with the population attributable faction (PAF), according to Miettinen’s formula [56].”
MethodHemminki, K., Granström, C., & Czene, K. (2002) · International Journal of Cancer · doi:10.1002/ijc.10467 · Cited by 56
Ibarrola‐Villava, M., Hu, H., Guedj, M., Fernández, L. P., Descamps, V., Basset‐Séguin, N., Bagot, M., Benssussan, A., Saïag, P., Fargnoli, M. C., et al. (2012) · European Journal of Cancer · doi:10.1016/j.ejca.2012.03.006 · Cited by 56
Adjibade, M., Lemogne, C., Julia, C., Herçberg, S., Galan, P., Assmann, K. E., & Kesse‐Guyot, E. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.05.038 · Cited by 55
The Impact of a Prevention Effort on the Community
Wacholder, S. (2004) · Epidemiology · doi:10.1097/01.ede.0000147633.09891.16 · Cited by 55
“ACR is sensitive to misspecification of the risk model, poor exposure assessment, and lack of reliable estimates of the required parameters in the setting of interest.(5,11,12) In particular, ACR requires measures of frequency of exposure, exposure-disease relationship and absolute risk of disease in the relevant sett…”
BackgroundSeason of Birth and Neurodevelopmental Disorders: Summer Birth is Associated with Dyslexia
LIVINGSTON, R. L., Adam, B. S., & Bracha, H. S. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199305000-00018 · Cited by 56
Estimating the contribution of occupational solar ultraviolet exposure to skin cancer
Milon, A., Bulliard, J., Vuilleumier, L., Danuser, B., & Vernez, D. (2013) · British Journal of Dermatology · doi:10.1111/bjd.12604 · Cited by 54
Low drug attributability of aplastic anemia in Thailand. The Aplastic Anemia Study Group.
Issaragrisil, S., Kaufman, D. W., Anderson, T. E., Chansung, K., Thamprasit, T., Sirijirachai, J., Piankijagum, A., Porapakkham, Y., Vannasaeng, S., Leaverton, P. E., et al. (1997) · PubMed · doi:10.1182/blood.v89.11.4034 · Cited by 53
Impact of smoke-free workplace legislation on exposures and health: possibilities for prevention
Jaakkola, M. S., & Jaakkola, J. J. K. (2006) · European Respiratory Journal · doi:10.1183/09031936.06.00001306 · Cited by 54
Risk Factors for Diarrhea Among Children in an Industrialized Country
Ethelberg, S., Olesen, B. R. S., Neimann, J., Schiellerup, P., Helms, M., Jensen, C., ttiger, B. B., Olsen, K. E. P., Scheutz, F., Gerner‐Smidt, P., et al. (2005) · Epidemiology · doi:10.1097/01.ede.0000187621.41373.0a · Cited by 54
“We also calculated the population attributable risk percent (PAR%) as described by Miettinen.(10)”
MethodAsthma as a risk factor for zoster in adults: A population-based case-control study
Kwon, H. J., Bang, D. W., Kim, E. N., Wi, C., Yawn, B. P., Wollan, P. C., Lahr, B. D., Ryu, E., & Juhn, Y. J. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.10.032 · Cited by 54
Lemay, V., Caru, M., Samoilenko, M., Drouin, S., Alos, N., Lefebvre, G., Levy, E. H., Lippé, S., Marcil, V., Sultan, S., et al. (2019) · Journal of Pediatric Hematology/Oncology · doi:10.1097/mph.0000000000001426 · Cited by 55
Abrishamchian, A. R., Khoury, M. J., & Calle, E. E. (1994) · Genetic Epidemiology · doi:10.1002/gepi.1370110404 · Cited by 53
Khoury, M. J., Becerra, J. E., & d'Almada, P. J. (1989) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.1989.tb00528.x · Cited by 53
Mitchell, L. E., Healey, S. C., & Chenevix‐Trench, G. (1995) · PubMed · Cited by 53
Marginal Structural Models for Sufficient Cause Interactions
VanderWeele, T. J., Vansteelandt, S., & Robins, J. M. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp396 · Cited by 53
Familial predisposition to breast cancer in a British population
Pharoah, P. D. P., Lipscombe, J., Redman, K., et al. (2000) · European Journal of Cancer · doi:10.1016/s0959-8049(00)00023-x · Cited by 52
“It can be shown that the proportion of the population in a given at risk group can be estimated from the proportion of cases in that at risk group if the cases come from a population-based case series [19].”
BackgroundA review of family history of cardiovascular disease: risk factor and research tool
Banerjee, A. (2012) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2012.02908.x · Cited by 55
Puig‐Barberà, J., Díez‐Domingo, J., Arnedo-Pena, A., Ruiz‐García, M., Pérez-Vilar, S., Micó-Esparza, J. L., Belenguer‐Varea, Á., Carratalá‐Munuera, C., Gil-Guillén, V. F., & Chávarri, H. S. (2012) · Vaccine · doi:10.1016/j.vaccine.2012.07.006 · Cited by 50
“IVE was defined as 100 × (1 − adjusted odds ratio [OR]) [31, 32] .”
BackgroundSantabárbara, J., Lipnicki, D. M., Bueno‐Notivol, J., Olaya, B., Villagrasa, B., & López‐Antón, R. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.065 · Cited by 58
The application of methods to quantify attributable risk in medical practice
Uter, W., & Pfahlberg, A. (2001) · Statistical Methods in Medical Research · doi:10.1177/096228020101000305 · Cited by 55
Issaragrisil, S., Chansung, K., Kaufman, D. W., et al. (1997) · American Journal of Public Health · doi:10.2105/ajph.87.9.1551 · Cited by 51
Tsai, C., Griswold, S., Clark, S., & Camargo, C. A. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0191-7 · Cited by 52
“Our results suggest that both disease and health care-related factors were associated with FEDV.”
MethodInfluentialExposure to organic solvents and adverse pregnancy outcomes
Ahmed, P., & Jaakkola, J. J. K. (2007) · Human Reproduction · doi:10.1093/humrep/dem200 · Cited by 51
“The population attributable fraction (Miettinen, 1974) was estimated by: AFpop ¼ p AFexp, where p is the proportion of exposed cases.”
MethodMoons, K. G. M., Bots, M. L., Salonen, J. T., Elwood, P. C., de Concalves, A. F., Nikitin, Y., Sivenius, J., Inzitari, D., Benetou, V., Tuomilehto, J., et al. (2002) · Journal of Epidemiology & Community Health · doi:10.1136/jech.56.suppl_1.i30 · Cited by 51
Communicating risks at the population level: application of population impact numbers
Heller, R. F., Buchan, I. E., Edwards, R., Lyratzopoulos, G., McElduff, P., & Leger, S. S. (2003) · BMJ · doi:10.1136/bmj.327.7424.1162 · Cited by 51
Heller, R. F., Dobson, A. J., Attia, J., & Page, J. (2002) · Journal of Epidemiology & Community Health · doi:10.1136/jech.56.8.606 · Cited by 51
Sobue, T., Suzuki, T., Fujimoto, I., et al. (1994) · Japanese Journal of Cancer Research · doi:10.1111/j.1349-7006.1994.tb02381.x · Cited by 51
Belaunzarán-Zamudio, P. F., Caro-Vega, Y. N., Shepherd, B. E., Rebeiro, P. F., Crabtree‐Ramírez, B., Cortés, C. P., Grinsztejn, B. G. J., Gotuzzo, E., Mejía, F., Padgett, D., et al. (2019) · American Journal of Epidemiology · doi:10.1093/aje/kwz252 · Cited by 50
“mortality was estimated using Miettinen ́s formula (18).”
MethodThe Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort
Pierre, J. L., Tymejczyk, O., Rouzier, V., Smith, C., Preval, F., Inddy, J., Raynold, J. B., Victor, J., Sévère, P., Apollon, S., et al. (2020) · BMC Public Health · doi:10.1186/s12889-020-09734-x · Cited by 50
The Role of Conventional Risk Factors in Explaining Social Inequalities in Coronary Heart Disease
Singh‐Manoux, A., Nabi, H., Shipley, M. J., Guéguen, A., Sabia, S., Dugravot, A., Marmot, M. G., & Mika Kivimaki, B. (2008) · Epidemiology · doi:10.1097/ede.0b013e3181761cdc · Cited by 50
“The formula used was pd (RR – 1)/RR, where pd is the proportion of cases exposed to risk factor and RR is the associated relative risk, estimated here using Cox regression.(13,14) The PAR was estimated for each risk factor separately and then for having at least one of the 4 risk factors.”
MethodDeterminants of vulnerability in early childhood development in Ireland: a cross-sectional study
Curtin, M., Madden, J. M., Staines, A. S., & Perry, I. J. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002387 · Cited by 49
Work-Related Psychosocial Risk Factors for Long-Term Sick Leave
Aagestad, C., Johannessen, H. A., Tynes, T., Gravseth, H. M., & Sterud, T. (2014) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000000212 · Cited by 49
Impact of social network on cardiovascular mortality in middle aged Danish men.
Olsen, O. (1993) · Journal of Epidemiology & Community Health · doi:10.1136/jech.47.3.176 · Cited by 50
Psychosocial work environment and registered absence from work: Estimating the etiologic fraction
Nielsen, M. L., Rugulies, R., Smith‐Hansen, L., et al. (2006) · American Journal of Industrial Medicine · doi:10.1002/ajim.20252 · Cited by 49
Powles, J. W., Zatoński, W. A., Hoorn, S. V., & Ezzati, M. (2005) · BMC Public Health · doi:10.1186/1471-2458-5-116 · Cited by 49
“population attributable fraction, PAF, defined as the proportional reduction in population disease or mortality that would occur if exposure to the risk factor were reduced to an alternative exposure scenario [12-14]) is given by the generalized "potential impact fraction" in Table 1: Global Burden of Disease sub-regi…”
BackgroundA case‐control study of cancer of the nose and paranasal sinuses and occupational exposures
Comba, P., Battista, G., Belli, S., et al. (1992) · American Journal of Industrial Medicine · doi:10.1002/ajim.4700220406 · Cited by 49
Associations between Class I, II, or III Obesity and Health Outcomes
Yao, Z., Tchang, B. G., Albert, M. H., Blumenthal, R. S., Nasir, K., & Blaha, M. J. (2025) · NEJM Evidence · doi:10.1056/evidoa2400229 · Cited by 53
Hyman, S., Acevedo, J. M., Giannarelli, C., & Trasande, L. (2025) · EBioMedicine · doi:10.1016/j.ebiom.2025.105730 · Cited by 63
Occupation and the risk of bothersome tinnitus: results from a prospective cohort study (HUNT)
Engdahl, B., Krog, N., Kvestad, E., Hoffman, H., & Tambs, K. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000512 · Cited by 49
Nygård, M., Hansen, B. T., Dillner, J., Munk, C., Oddsson, K., Tryggvadóttír, L., Hortlund, M., Liaw, K., Dasbach, E. J., & Kjær, S. K. (2014) · PLoS ONE · doi:10.1371/journal.pone.0088323 · Cited by 50
“As the risk of cervical, vulvar, and vaginal cancer and pre-invasive neoplasia is high among HPV16/18-positive women, and as current knowledge suggests that the presence of HPV16/18 in these lesions is sufficient to infer causality [1], we defined the PAF as the proportion of cancers and pre-invasive neoplasias positi…”
MethodEstimating Attributable Mortality Due to Nosocomial Infections Acquired in Intensive Care Units
Januel, J., Harbarth, S., Allard, R., Voirin, N., Lepape, A., Allaouchiche, B., Guérin, C., Lehot, J.-J., Robert, M.-O., Fournier, G., et al. (2010) · Infection Control and Hospital Epidemiology · doi:10.1086/650754 · Cited by 47
Sasazuki, S., Inoue, M., Iwasaki, M., Sawada, N., Shimazu, T., Yamaji, T., & Tsugane, S. (2011) · Preventive Medicine · doi:10.1016/j.ypmed.2011.11.003 · Cited by 51
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Familial and second lung cancers: a nation-wide epidemiologic study from Sweden
Li, X., & Hemminki, K. (2003) · Lung Cancer · doi:10.1016/s0169-5002(02)00535-4 · Cited by 48
“The population attributable proportion of cases with a family history of lung cancer was estimated as follows: proportion of familial cases / (familial SIR-1)/familial SIR [22,23].”
BackgroundRothenberg, R. B., Wasserheit, J. N., Louis, M. E. S., & Douglas, J. M. (2000) · Sexually Transmitted Diseases · doi:10.1097/00007435-200008000-00006 · Cited by 49
INDUCED ABORTION AND SECONDARY INFERTILITY
Trichopoulos, D., Handanos, N., Danezis, J. M., et al. (1976) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1976.tb00904.x · Cited by 48
“Estimates of relative risks for the various categories of women (Mantel and Haenszel, 1959) as well as their lower confidence limits (Miettinen, 1974) are shown in Table I.”
BackgroundExploring gene—gene interactions in the etiology of neural tube defects
Botto, L. D., & Mastroiacovo, P. (1998) · Clinical Genetics · doi:10.1111/j.1399-0004.1998.tb02594.x · Cited by 48
Hospitalizations for Aplastic Anemia and Agranulocytosis in Saskatchewan
Rawson, N. S. B., Harding, S. R., Malcolm, E., et al. (1998) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(98)00072-9 · Cited by 48
“The estimated etiologic fraction [58] attributable to the drugs listed in Table 7 was 57%.”
BackgroundLelong, H., Blacher, J., Baudry, J., Adriouch, S., Galan, P., Fezeu, L., Herçberg, S., & Kesse‐Guyot, E. (2019) · Nutrients · doi:10.3390/nu11071687 · Cited by 51
“PARs were calculated using the standard equation from Miettinen [28]: PAR= pE”
MethodAlcohol-attributable and alcohol-preventable mortality in Italy: A balance in 1983 and 1996
Corrao, G. (2002) · European Journal of Public Health · doi:10.1093/eurpub/12.3.214 · Cited by 47
HLA-A and -B antigens in inflammatory bowel disease.
Biemond, I., Burnham, W. R., D'Amaro, J., et al. (1986) · Gut · doi:10.1136/gut.27.8.934 · Cited by 47
Attributable fractions for partitioning risk and evaluating disease prevention: a practical guide
Eide, G. E. (2008) · The Clinical Respiratory Journal · doi:10.1111/j.1752-699x.2008.00091.x · Cited by 46
“While the theory of adjusted, sequential and average AFs was well developed, a similar development was not done for the AFE, although for the unadjusted versions equation (5) gives a simple relationship.”
InfluentialWall, K. M., Kilembe, W., Vwalika, B., et al. (2017) · International Journal of Epidemiology · doi:10.1093/ije/dyx045 · Cited by 46
Methods matter: population attributable fraction (PAF) in sport and exercise medicine
Khosravi, A., Nielsen, R. O., & Mansournia, M. A. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-101977 · Cited by 46
Moore, C. A., Khoury, M. J., & Liu, Y. (1997) · PEDIATRICS · doi:10.1542/peds.99.4.e11 · Cited by 46
The Phenotypic Course of Age-Related Macular Degeneration for ARMS2/HTRA1
Thee, E. F., Colijn, J. M., Cougnard‐Grégoire, A., Meester‐Smoor, M. A., Verzijden, T., Hoyng, C. B., Fauser, S., Hense, H., da Silva, R. M., Creuzot-Garcher, C. P., et al. (2022) · Ophthalmology · doi:10.1016/j.ophtha.2022.02.026 · Cited by 47
Estimating and displaying population attributable fractions using the R package: graphPAF
Ferguson, J. P., & O’Connell, M. (2024) · European Journal of Epidemiology · doi:10.1007/s10654-024-01129-1 · Cited by 49
Wilson, L. F., Page, A., Dunn, N., Pandeya, N., Protani, M. M., & Taylor, R. J. (2013) · Maturitas · doi:10.1016/j.maturitas.2013.09.002 · Cited by 45
Boyes, R., O'Sullivan, D. E., Linden, B., McIsaac, M. A., & Pickett, W. (2017) · SSM - Population Health · doi:10.1016/j.ssmph.2017.08.006 · Cited by 46
“We applied Miettinen’s formula for adjusted relative risks (Miettinen, 1974) and weighted prevalence estimates of substance-use behaviors from the HBSC. Confidence intervals were estimated through application of the lower and upper confidence limits of the relative risk estimates.”
MethodReadily treatable reproductive tract infections and preterm birth among black women
French, J. I., McGregor, J., & Parker, R. M. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.03.004 · Cited by 45
Effects of maternal education on infant mortality and stillbirths in Denmark
Olsen, O., & Madsen, M. (1999) · Scandinavian Journal of Public Health · doi:10.1177/14034948990270021301 · Cited by 45
“The aetiological fraction was calculated according to Miettinen (21).”
MethodStillbirths in the United States, 1981–2000: An Age, Period, and Cohort Analysis
Ananth, C. V., Liu, S., Kinzler, W. L., & Kramer, M. S. (2005) · American Journal of Public Health · doi:10.2105/ajph.2004.043885 · Cited by 45
Hsieh, C. (1991) · Statistics in Medicine · doi:10.1002/sim.4780100308 · Cited by 44
Association of leprosy with HLA-DR2 in a Southern Brazilian population
Visentainer, J. E. L., Tsuneto, L. T., Serra, M. F., et al. (1997) · Brazilian Journal of Medical and Biological Research · doi:10.1590/s0100-879x1997000100008 · Cited by 45
“The etiologic fraction (EF) of the population was estimated according to Miettinen (31) and Green (32).”
MethodProblems in the Definition, Interpretation, and Evaluation of Genetic Heterogeneity
Whittemore, A. S., & Halpern, J. (2001) · The American Journal of Human Genetics · doi:10.1086/318186 · Cited by 45
“…on populations of individuals, rather than on populations of families; for example, one can estimate the population attributable risk for the gene, which is the fraction of the total disease burden that would be prevented if no family member carried its deleterious mutations (Miettinen 1974).”
BackgroundColorectal cancer mortality prevented by use and attributable to nonuse of colonoscopy
Stock, C., Knudsen, A. B., Lansdorp‐Vogelaar, I., et al. (2011) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2010.12.005 · Cited by 44
Dietary fat and early-onset prostate cancer risk
Lophatananon, A., Archer, J. S., Easton, D., et al. (2010) · British Journal Of Nutrition · doi:10.1017/s0007114509993291 · Cited by 44
“Finally, etiologic fractions, related to total fat and fat subtypes, were calculated using the Miettinen formula for multi-category indicator: EF 1⁄4 SiCFi £ ðSMRi 2 1Þ=SMRi, where EF is the etiologic fractions, CF is the proportion of cases with the marker of increased risk and SMR is the standardised morbidity ratio…”
Metadata
- 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
- Health Sciences › Medicine › Epidemiology › 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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