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Disease risk score as a confounder summary method: systematic review and recommendations
Mina Tadrous1, Joshua J Gagne, Til Stürmer
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Pharmacoepidemiology and Drug Safety
|November 23, 2012
Summary
Disease risk score (DRS) use has increased but remains low. More applications, especially in comparative effectiveness research and case-control studies, are needed to understand effect modification by outcome risk.
Area of Science:
- Epidemiology
- Biostatistics
- Health Services Research
Background:
- Disease risk scores (DRS) are used to summarize confounder information.
- Understanding trends in DRS application is crucial for epidemiological research.
Purpose of the Study:
- To systematically review the trends and applications of disease risk scores (DRS) as a confounder summary method.
- To identify common methodologies and study designs utilizing DRS.
Main Methods:
- Systematic literature search of MEDLINE and Web of Science.
- Tabulation of publications by year and type (empirical, methodological, review).
- Summary of DRS derivation and application methods in empirical studies.
Main Results:
- 97 articles examined DRS methods out of 714 identified; 86 were empirical applications.
- Publication trends show a bimodal distribution with a resurgence since 2000.
- Logistic regression was common for DRS derivation (47%); DRS was mostly used as a categorical variable (93%) in cohort (47%) and case-control (42%) studies.
Conclusions:
- Disease risk score (DRS) utilization has grown but remains limited.
- Comparative effectiveness research could benefit from increased DRS application, particularly for effect modification by outcome risk.
- Standardized terminology and further research in case-control studies are recommended for DRS methods.
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