Definitions of attributable risk--revisited.
BACKGROUND
The concept of attributable risk is a popular approach to describe the disease risk associated with an exposure factor on the population level. The paper reviews this epidemiologic concept.


METHODS
Definitions and interpretations of four measures of association term "attributable risk" in the epidemiologic literature are compared. By introducing the notation of exposure-specific disease events, the intrinsic relationship between these definitions in unveiled from a new perspective. In addition, the terminologic confusion relating to this concept is discussed.


RESULTS
It is shown that all four definitions focus on the exposure-specific disease incidence, but all in different subpopulations of the study population. Data of a German cohort study on the relationship between lipoprotein fractions and myocardial infarction further illustrate the different measures of attributable risk.


CONCLUSIONS
It is pointed out that the evaluation of the public health impact of an exposure under study by means of attributable risk calculations should form an integral part of the epidemiologic analysis.
Gefeller
O
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Department of Medical Statistics, George-August-University of Göttingen, Germany.
D000328:Adult; D015984:Causality; D003627:Data Interpretation, Statistical; D005544:Forecasting / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012307:Risk Factors; D009626:Terminology as Topic