Attributable Risk Percent (AR%) Percentage Population Attributable Risk (PAR) Number Population Attributable Risk Percent (PAR%) Percentage Measures of Public Health Impact
IMPORTANT!
They all assume (require) that a cause-effect
relationship exists between the exposure and the outcome. Relative Risk vs. Attributable Risk
Relative Risk: Measure of the strength of
association, and indicator used to assess the possibility of a causal relationship. Attributable Risk: Measure of the potential for prevention of disease if the exposure could be eliminated (assuming a causal relationship). Relative Risk vs. Attributable Risk
Relative Risk: Etiology Attributable Risk: Policy decisions Funding decisions (e.g. prevention programs) Tipe ukuran yang digunakan dalam epidemiologi
Ukuran efek/dampak Merefleksikan dampak suatu faktor pada frekuensi atau risiko dari suatu masalah (outcome) kesehatan Merefleksikan kelebihan jumlah kasus karena suatu faktor (attributable) atau jumlah kasus yang dapat dicegah oleh eksposur (pemajan) Ukuran-ukuran dampak
Ukuran perbedaan dampak/efek
Perbedaan risiko = Risk Difference (RD) = Attributable Risk (AR) = Excess Risk (ER) = Absolute Risk (AR) [Risiko pada kelompok terpajan] [Risiko pada kelompok tidak terpajan] Berguna untuk mengukur besarnya masalah kesehatan masyarakat yang disebabkan oleh suatu pemajan bermanfaat untuk penilaian prioritas untuk aksi kesehatan masyarakat (Public Health Action) Attributable Risk (AR)
Among the EXPOSED:
How much of the disease that occurs can be attributed to a certain exposure? AR AR% This is of primary interest to the practicing clinician. Attributable Risk (AR) AR = Iexposed Inonexposed = Risk Difference
Develop CHD ISM = 84 / 3000
Smoke Yes No = 0.028 = 28.0 / 1000 Yes 84 2916 3000 INS = 87 / 5000 No 87 4913 5000 = 0.0174 = 17.4 / 1000 (background risk)
incident cases of CHD are attributed to the fact that these people smoke Among SMOKERS, 10.6 of the 28/1000 incident cases of CHD that occur could be prevented if smoking were eliminated. Ukuran-ukuran dampak
Exposed Unexposed Ukuran-ukuran dampak Population Attributable Risk (PAR) = Attributable Fraction (population) atau Etiologic Fraction (population) = Population Attributable Risk Proportion = Population Attributable Risk Fraction Proporsi (atau fraksi) rate penyakit pada seluruh populasi yang mewakili rate penyakit dalam kelompok terpajan
Rumus PAR
PAR Insidens populasi Insidens tidak terpajan
Ukuran-ukuran dampak Population Attributable Risk Percent (PARP) attributable fraction (population) atau etiologic fraction (population) Berarti proporsi kasus baru yang dapat dicegah jika pada semua orang yang tidak terpajan Rumus PAR%
be attributed to obesity in the population In Tampa, 59% of the cases of diabetes could be prevented if Tampa residents lost sufficient weight. Prevented Fraction (PF) If relative risk <1 Proportion of potential new cases which would have occurred if the exposure had been absent Proportion of potential cases prevented by the exposure Iunexposed - Iexposed PF Iunexposed
