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Population attributable fraction: comparison of two mathematical procedures to estimate the annual attributable number of deaths.

ABSTRACT: OBJECTIVE:The purpose of this paper was to compare two mathematical procedures to estimate the annual attributable number of deaths (the Allison et al procedure and the Mokdad et al procedure), and derive a new procedure that combines the best aspects of both procedures. The new procedure calculates attributable number of deaths along a continuum (i.e. for each unit of exposure), and allows for one or more neutral (neither exposed nor nonexposed) exposure categories. METHODS:Mathematical derivations and real datasets were used to demonstrate the theoretical relationship and practical differences between the two procedures. Results of the comparison were used to develop a new procedure that combines the best features of both. FINDINGS:The Allison procedure is complex because it directly estimates the number of attributable deaths. This necessitates calculation of probabilities of death. The Mokdad procedure is simpler because it estimates the number of attributable deaths indirectly through population attributable fractions. The probabilities of death cancel out in the numerator and denominator of the fractions. However, the Mokdad procedure is not applicable when a neutral exposure category exists. CONCLUSION:By combining the innovation of the Allison procedure (allowing for a neutral category) and the simplicity of the Mokdad procedure (using population attributable fractions), this paper proposes a new procedure to calculate attributable numbers of death.

SUBMITTER: Choi BC

PROVIDER: S-EPMC2944136 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Population attributable fraction: comparison of two mathematical procedures to estimate the annual attributable number of deaths.

Choi Bernard Ck BC

Epidemiologic perspectives & innovations : EP+I 20100831

<h4>Objective</h4>The purpose of this paper was to compare two mathematical procedures to estimate the annual attributable number of deaths (the Allison et al procedure and the Mokdad et al procedure), and derive a new procedure that combines the best aspects of both procedures. The new procedure calculates attributable number of deaths along a continuum (i.e. for each unit of exposure), and allows for one or more neutral (neither exposed nor nonexposed) exposure categories.<h4>Methods</h4>Mathe ...[more]

PMID: 20807422

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Project description:BackgroundIn Japan, vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initiated on 17 February 2021, mainly using messenger RNA vaccines and prioritizing health care professionals. Whereas nationwide vaccination alleviated the coronavirus disease 2019 (COVID-19)-related burden, the population impact has yet to be quantified in Japan. We aimed to estimate the numbers of COVID-19 cases and deaths prevented that were attributable to the reduced risk among vaccinated individuals via a statistical modeling framework.MethodsWe analyzed confirmed cases registered in the Health Center Real-time Information-sharing System on COVID-19 (3 March-30 November 2021) and publicly reported COVID-19-related deaths (24 March-30 November 2021). The vaccination coverage over this time course, classified by age and sex, was extracted from vaccine registration systems. The total numbers of prevented cases and deaths were calculated by multiplying the daily risk differences between unvaccinated and vaccinated individuals by the population size of vaccinated individuals.FindingsFor both cases and deaths, the averted numbers were estimated to be the highest among individuals aged 65 years and older. In total, we estimated that 564,596 (95% confidence interval: 477,020-657,525) COVID-19 cases and 18,622 (95% confidence interval: 6522-33,762) deaths associated with SARS-CoV-2 infection were prevented owing to vaccination during the analysis period (i.e., fifth epidemic wave, caused mainly by the Delta variant). Female individuals were more likely to be protected from infection following vaccination than male individuals whereas more deaths were prevented in male than in female individuals.InterpretationThe vaccination program in Japan led to substantial reductions in the numbers of COVID-19 cases and deaths (33% and 67%, respectively). The preventive effect will be further amplified during future pandemic waves caused by variants with shared antigenicity.FundingThis project was supported by the Japan Science and Technology Agency; the Japan Agency for Medical Research and Development; the Japan Society for the Promotion of Science; and the Ministry of Health, Labour and Welfare.

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Population attributable fraction: comparison of two mathematical procedures to estimate the annual attributable number of deaths.

Publications

Population attributable fraction: comparison of two mathematical procedures to estimate the annual attributable number of deaths.

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