Semiparametric estimation of the attributable fraction when there are interactions under monotonicity constraints

Bibliographic Details
Title: Semiparametric estimation of the attributable fraction when there are interactions under monotonicity constraints
Authors: Wei Wang, Dylan S. Small, Michael O. Harhay
Source: BMC Medical Research Methodology, Vol 20, Iss 1, Pp 1-8 (2020)
Publisher Information: BMC, 2020.
Publication Year: 2020
Collection: LCC:Medicine (General)
Subject Terms: Attributable fraction, B-splines, Interaction, Monotonicity constraint, Quadratic programming, Medicine (General), R5-920
More Details: Abstract Background The population attributable fraction (PAF) is the fraction of disease cases in a sample that can be attributed to an exposure. Estimating the PAF often involves the estimation of the probability of having the disease given the exposure while adjusting for confounders. In many settings, the exposure can interact with confounders. Additionally, the exposure may have a monotone effect on the probability of having the disease, and this effect is not necessarily linear. Methods We develop a semiparametric approach for estimating the probability of having the disease and, consequently, for estimating the PAF, controlling for the interaction between the exposure and a confounder. We use a tensor product of univariate B-splines to model the interaction under the monotonicity constraint. The model fitting procedure is formulated as a quadratic programming problem, and, thus, can be easily solved using standard optimization packages. We conduct simulations to compare the performance of the developed approach with the conventional B-splines approach without the monotonicity constraint, and with the logistic regression approach. To illustrate our method, we estimate the PAF of hopelessness and depression for suicidal ideation among elderly depressed patients. Results The proposed estimator exhibited better performance than the other two approaches in the simulation settings we tried. The estimated PAF attributable to hopelessness is 67.99% with 95% confidence interval: 42.10% to 97.42%, and is 22.36% with 95% confidence interval: 12.77% to 56.49% due to depression. Conclusions The developed approach is easy to implement and supports flexible modeling of possible non-linear relationships between a disease and an exposure of interest.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2288
Relation: http://link.springer.com/article/10.1186/s12874-020-01118-4; https://doaj.org/toc/1471-2288
DOI: 10.1186/s12874-020-01118-4
Access URL: https://doaj.org/article/234c23c1f5694a678b9987c80ecdfa4d
Accession Number: edsdoj.234c23c1f5694a678b9987c80ecdfa4d
Database: Directory of Open Access Journals
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More Details
ISSN:14712288
DOI:10.1186/s12874-020-01118-4
Published in:BMC Medical Research Methodology
Language:English