门德尔的随机化分析烟草吸烟对医院费用的因果关系
Padraig Dixon1,2, Hannah Sallis2,3, Marcus Munafò2,3,4
1Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
概括
吸烟显著增加了每年的住院医院费用,每名患者的吸烟成本估计为477英. 这项研究强调了吸烟带来的经济负担,并为禁烟干预提供了信息.
科学领域:
- 遗传学和健康经济学 遗传学和健康经济学
- 公共卫生研究 公共卫生研究
- 流行病学 流行病学
背景情况:
- 了解吸烟对医疗保健成本的影响对于政策评估至关重要.
- 传统方法面临诸如遗漏变量偏差和反向因果关系等挑战.
- 门德尔随机化 (MR) 提供了一个强大的方法来解决这些局限性.
研究的目的:
- 用MR研究吸烟对医疗保健成本的因果关系.
- 量化吸烟开始和累积吸烟对住院医院费用的影响.
- 为吸烟干预措施的成本效益分析提供信息.
主要方法:
- 利用英国生物库数据,最多收集了300,045个人的数据.
- 进行了全基因组关联研究,以确定吸烟开始的遗传变异和复合吸烟指数.
- 采用了以住院费用为结果的仪器变量模型,平均6年跟踪.
主要成果:
- 开始吸烟的遗传责任与平均每年住院费用增加477英有关.
- 对复合吸烟指数的遗传责任增加1个单位与每年住院费用增加204英相关.
- MR 模型显示出相当大的不确定性,其中一些违反了工具变量假设.
结论:
- 这项MR研究提供了吸烟对住院医院费用的重大影响的证据.
- 研究结果表明,与吸烟行为相关的经济外部性显著.
- 结果可以告知戒烟计划和公共卫生政策的成本效益.
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