Quantitative risk assessment in epidemiological studies investigating threshold effects

In this paper a method for quantitative risk assessment in epidemiological studies investigating threshold effects is proposed. The simple logistic regression model is used to describe the association between a binary response variable and a continuous risk factor. By defining acceptable levels for the absolute risk and the risk gradient the corresponding benchmark values of the risk factor can be calculated by means of nonlinear functions of the logistic regression coefficients. Standard errors and confidence intervals of the benchmark values are derived by means of the multivariate delta method. The proposed approach is compared with the threshold model of Ulm (1991) for assessing threshold values in epidemiological studies.

[1]  C J Portier,et al.  Characterizing Dose‐Response I: Critical Assessment of the Benchmark Dose Concept , 1998, Risk analysis : an official publication of the Society for Risk Analysis.

[2]  P. Reichard Are there any glycemic thresholds for the serious microvascular diabetic complications? , 1995, Journal of diabetes and its complications.

[3]  Ralph L. Kodell,et al.  Quantitative Risk Assessment for Teratological Effects , 1989 .

[4]  R. Klein,et al.  Relationship of hyperglycemia to the long-term incidence and progression of diabetic retinopathy. , 1994, Archives of internal medicine.

[5]  K. Forrest,et al.  Cumulative glycemic exposure and microvascular complications in insulin-dependent diabetes mellitus. The glycemic threshold revisited. , 1997, Archives of internal medicine.

[6]  Helmut Küchenhoff An Exact Algorithm for Estimating Breakpoints in Segmented Generalized Linear Models , 1997 .

[7]  K Ulm,et al.  A statistical method for assessing a threshold in epidemiological studies. , 1991, Statistics in medicine.

[8]  D. Hosmer,et al.  Applied Logistic Regression , 1991 .

[9]  I. Mühlhauser,et al.  Cigarette Smoking and Progression of Retinopathy and Nephropathy in Type 1 Diabetes , 1996, Diabetic medicine : a journal of the British Diabetic Association.

[10]  E. Guallar,et al.  Re: "Use of two-segmented logistic regression to estimate change-points in epidemiologic studies". , 1998, American journal of epidemiology.

[11]  K S Crump,et al.  A new method for determining allowable daily intakes. , 1984, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[12]  A. Krolewski,et al.  Glycosylated hemoglobin and the risk of microalbuminuria in patients with insulin-dependent diabetes mellitus. , 1995, The New England journal of medicine.

[13]  B. Molitoris,et al.  A statistical method for determining the breakpoint of two lines. , 1984, Analytical biochemistry.