Khosravi A, Nazemipour M, Shinozaki T, Mansournia MA. Population attributable fraction in textbooks: Time to revise.
GLOBAL EPIDEMIOLOGY 2021;
3:100062. [PMID:
37635714 PMCID:
PMC10445975 DOI:
10.1016/j.gloepi.2021.100062]
[Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 01/05/2023] Open
Abstract
Introduction
The population attributable fraction is an important measure for assessing the impact of intervention on the disease risk in populations, but it is frequently misused in the research literature.
Methods
In this study, we review the definition, calculation, interpretation and assumptions of PAF in 43 textbooks and highlight important shortcomings.
Results
While the Levin formula was proposed as a method of calculation in 29 (67%) textbooks, only in 4 (9%) was the Miettinen formula or its generalization for multilevel exposure recommended to calculate a confounding-adjusted population attributable fraction. Other concepts such as generalized impact fraction and prevented and preventable fractions were briefly discussed in few textbooks.
Discussion
We recommend the authors revise the textbooks in light of our proposed framework for teaching the population attributable fraction.
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