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首页> 美国卫生研究院文献>American Journal of Epidemiology >Point: Incident Exposures Prevalent Exposures and Causal Inference: Does Limiting Studies to Persons Who Are Followed From First Exposure Onward Damage Epidemiology?
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Point: Incident Exposures Prevalent Exposures and Causal Inference: Does Limiting Studies to Persons Who Are Followed From First Exposure Onward Damage Epidemiology?

机译：观点：事故暴露普遍暴露和因果推论：是否仅将研究范围限制于从第一次暴露开始就受到损害的流行病学人员？

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The idea that epidemiologic studies should start from first exposure onward has been advocated in the past few years. The study of incident exposures is contrasted with studies of prevalent exposures in which follow-up may commence after first exposure. The former approach is seen as a hallmark of a good study and necessary for causal inference. We argue that studying incident exposures may be necessary in some situations, but it is not always necessary and is not the preferred option in many instances. Conducting a study involves decisions as to which person-time experience should be included. Although studies of prevalent exposures involve left truncation (missingness on the left), studies of incident exposures may involve right censoring (missingness on the right) and therefore may not be able to assess the long-term effects of exposure. These considerations have consequences for studies of dynamic (open) populations that involve a mixture of prevalent and incident exposures. We argue that studies with prevalent exposures will remain a necessity for epidemiology. The purpose of this paper is to restore the balance between the emphasis on first exposure cohorts and the richness of epidemiologic information obtained when studying prevalent exposures.
机译：过去几年一直提倡流行病学研究应从首次接触开始的想法。事故暴露的研究与普遍暴露的研究形成对比，后者在首次暴露后可以开始随访。前一种方法被视为良好研究的标志，也是因果推理的必要条件。我们认为在某些情况下研究事件暴露可能是必要的，但并非总是必要的，在许多情况下也不是首选方法。进行研究涉及决定应包括哪些人际经验。尽管对流行暴露的研究涉及左截断（左侧缺失），但对事故暴露的研究可能涉及对权利的审查（右侧缺失），因此可能无法评估暴露的长期影响。这些考虑因素对动态（开放）种群的研究具有影响，这些种群涉及普遍暴露和突发事件暴露。我们认为流行病学研究仍然是流行病学的必要条件。本文的目的是恢复对首次暴露人群的重视与研究流行暴露时获得的流行病学信息之间的平衡。

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