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首页> 外文期刊>Annals of epidemiology >Confounding by season in ecologic studies of seasonal exposures and outcomes: examples from estimates of mortality due to influenza.
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Confounding by season in ecologic studies of seasonal exposures and outcomes: examples from estimates of mortality due to influenza.

机译：在季节性暴露和结果的生态学研究中，按季节混淆：来自流感造成的死亡率估算的示例。

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PURPOSE: Many health outcomes exhibit seasonal variation in incidence, including accidents, suicides, and infections. For seasonal outcomes it can be difficult to distinguish the causal roles played by factors that also vary seasonally, such as weather, air pollution, and pathogen circulation. METHODS: Various approaches to estimating the association between a seasonal exposure and a seasonal outcome in ecologic studies are reviewed, using studies of influenza-related mortality as an example. Because mortality rates vary seasonally and circulation of other respiratory viruses peaks during influenza season, it is a challenge to estimate which winter deaths were caused by influenza. Results of studies that estimated the contribution of influenza to all-cause mortality using different methods on the same data are compared. RESULTS: Methods for estimating associations between season exposures and outcomes vary greatly in their advantages, disadvantages, and assumptions. Even when applied to identical data, different methods can give greatly different results for the expected contribution of influenza to all-cause mortality. CONCLUSIONS: When the association between exposures and outcomes that vary seasonally is estimated, models must be selected carefully, keeping in mind the assumptions inherent in each model.
机译：目的：许多健康结果显示出发病率的季节性变化，包括事故，自杀和感染。对于季节性结果，可能很难区分由季节变化的因素（例如天气，空气污染和病原体循环）所起的因果作用。方法：以流感相关死亡率的研究为例，回顾了生态学研究中估计季节性暴露与季节性结果之间关联的各种方法。由于死亡率随季节变化并且在流感季节其他呼吸道病毒的传播高峰，因此估计哪些冬季死亡是由流感引起的挑战。比较了在相同数据上使用不同方法估算流感对全因死亡率的影响的研究结果。结果：估计季节暴露与结果之间关联的方法在其优点，缺点和假设方面差异很大。即使将其应用于相同的数据，对于流感对全因死亡率的预期贡献，不同的方法也会给出截然不同的结果。结论：当估计暴露量和结果随季节变化之间的关联时，必须谨慎选择模型，同时要牢记每个模型固有的假设。

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