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An alternative test for trend in exposure-response analysis

M Dosemeci1, J Benichou

  • 1Epidemiology and Biostatistics Program, National Cancer Institute, Rockville, MD 20892, USA. DosemecM@epndce.nci.nih.gov

Journal of Exposure Analysis and Environmental Epidemiology
|February 21, 1998
PubMed
Summary

A new test improves the evaluation of monotonic dose-response relationships in epidemiology. This method is more sensitive to incremental risk changes and avoids reliance on exposure category scoring, unlike the standard Mantel-extension test.

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Area of Science:

  • Epidemiology
  • Biostatistics

Background:

  • The Mantel-extension chi-square test is widely used for dose-response trend evaluation in epidemiology.
  • This test is suboptimal for monotonic dose-response and is sensitive to the scoring of exposure categories, potentially leading to misinterpretation.

Purpose of the Study:

  • To propose and illustrate an alternative test for evaluating monotonic dose-response relationships.
  • To develop a test that is sensitive to incremental risk changes without requiring exposure category scores.

Main Methods:

  • Reconfiguration of the Mantel-Haenszel chi-square test for dichotomous series into a polychotomous series.
  • Summation of Mantel-Haenszel chi statistics from adjacent exposure categories (2x2 tables).

Main Results:

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  • The proposed test provides chi values sensitive to incremental risk increases or decreases across exposure categories.
  • The new method does not require the assignment of scores to exposure categories.
  • Illustrative examples show the proposed test yields more realistic chi values compared to the Mantel-extension test.

Conclusions:

  • The proposed test offers a more sensitive and robust approach for assessing monotonic dose-response relationships in epidemiologic studies.
  • This alternative method enhances the reliability of trend analysis in dose-response evaluations.