Risk factor

Source: Wikipedia, the free encyclopedia.
This article is about the concept in epidemiology. For other uses, see Risk factor (disambiguation).

In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection.[1]: 38 

Due to a lack of harmonization across disciplines, determinant, in its more widely accepted scientific meaning, is often used as a synonym. The main difference lies in the realm of practice: medicine (clinical practice) versus public health. As an example from clinical practice, low ingestion of dietary sources of vitamin C is a known risk factor for developing scurvy. Specific to public health policy, a determinant is a health risk that is general, abstract, related to inequalities, and difficult for an individual to control.[2][3][4] For example, poverty is known to be a determinant of an individual's standard of health.

Risk factors may be used to identify high-risk people.

Correlation vs causation

Risk factors or determinants are

study of the link between smoking and lung cancer. Statistical analysis along with the biological sciences can establish that risk factors are causal. Some prefer the term risk factor to mean causal determinants of increased rates of disease, and for unproven links to be called possible risks, associations, etc.[citation needed
]

When done thoughtfully and based on research, identification of risk factors can be a strategy for medical screening.[5]

Terms of description

Mainly taken from risk factors for breast cancer, risk factors can be described in terms of, for example:

  • Relative risk, such as "A woman is more than 100 times more likely to develop breast cancer in her 60s than in her 20s."[6]
  • Fraction of incidences occurring in the group having the property of or being exposed to the risk factor, such as "99% of breast cancer cases are diagnosed in women."[7]
  • Increase in incidence in the exposed group, such as "each daily alcoholic beverage increases the incidence of breast cancer by 11 cases per 1000 women."[8]
  • Hazard ratio, such as "an increase in both total and invasive breast cancers in women randomized to receive estrogen and progestin for an average of 5 years, with a hazard ratio of 1.24 compared to controls."[9]

Example

At a wedding, 74 people ate the chicken and 22 of them were ill, while of the 35 people who had the fish or vegetarian meal only 2 were ill. Did the chicken make the people ill?

[10]

So the chicken eaters' risk = 22/74 = 0.297
And non-chicken eaters' risk = 2/35 = 0.057.

Those who ate the chicken had a risk over five times as high as those who did not, that is, a relative risk of more than five. This suggests that eating chicken was the cause of the illness, but this is not proof.

This example of a risk factor is described in terms of the relative risk it confers, which is evaluated by comparing the risk of those exposed to the potential risk factor to those not exposed.

General determinants

The probability of an outcome usually depends on an interplay between multiple associated variables. When performing

stratification. The potentially confounding determinants varies with what outcome is studied, but the following general confounders are common to most epidemiological associations, and are the determinants most commonly controlled for in epidemiological studies:[citation needed
]

Other less commonly adjusted for possible confounders include:

Risk marker

A risk marker is a variable that is quantitatively associated with a disease or other outcome, but direct alteration of the risk marker does not necessarily alter the risk of the outcome. For example, driving-while-intoxicated (DWI) history is a risk marker for pilots as epidemiologic studies indicate that pilots with a DWI history are significantly more likely than their counterparts without a DWI history to be involved in aviation crashes.[13]

History

The term "risk factor" was coined by former Framingham Heart Study director, William B. Kannel in a 1961 article in Annals of Internal Medicine.[14]

See also

References

  1. ^
    OCLC 960031712.{{cite book}}: CS1 maint: location missing publisher (link
    )
  2. ISBN 978-0309055345
    . Unlike a biomedical model that views health as the absence of disease, this dynamic framework includes functional capacity and well-being as health outcomes of interest. It also presents the behavioral and biologic responses of individuals as factors that influence health but are themselves influenced by social, physical, and genetic factors that are beyond the control of the individual.
  3. ^ "Health Impact Assessment (HIA): Glossary of terms used". World Health Organization. Retrieved July 20, 2019.
  4. ^ "Health Impact Assessment (HIA): The determinants of health". World Health Organization. Archived from the original on May 30, 2004. Retrieved July 20, 2019.
  5. PMID 10591726
    .
  6. ISBN 1-55009-113-1
    . Retrieved 27 January 2011.
  7. S2CID 972345
    .
  8. PMID 19244173
    .
  9. PMID 18319414
    .
  10. PMID 28613574
    , retrieved 2020-06-10
  11. ^
    OCLC 1022139949.{{cite book}}: CS1 maint: location missing publisher (link
    )
  12. PMID 34011457
    .
  13. ^ Li G., Baker S. P., Qiang Y., Grabowski J. G., McCarthy M. L. Driving-while-intoxicated history as a risk marker for general aviation pilots. Accid Anal Prev. 2005;37(1):179-84./McFadden K. L. Driving while intoxicated (DWI) convictions and job-related flying performance – a study of commercial air safety. J Oper Res Soc. 1998;49:28–32
  14. ^ Husten, Larry (23 August 2011). "William Kannel, Former Director of the Framingham Heart Study, Dead at 87". Forbes.

Further reading

  • S. P. Case; K. R. Haines (2009). Understanding Youth Offending: Risk Factor Research, Policy and Practice. Willan. 2009.
    ISBN 9781843923428
    .
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