Revisiting the relationship between baseline risk and risk under treatment 英文参考文献.docVIP

Emerging Themes in Epidemiology BioMedCentral Hypothesis Open Access Revisiting the relationship between baseline risk and risk under treatment Hao Wang1, Jean-Pierre Boissel2 and Patrice Nony*2 Address: 1Pharmacology Department, Shanghai Second Medical University, Shanghai, PR China and 2Clinical Pharmacology Department, UMR CNRS 5558 Claude Bernard University Lyon 1, Cardiovascular Hospital, Lyon, France Email: Hao Wang - hw@upcl.univ-lyon1.fr; Jean-Pierre Boissel - jpb@upcl.univ-lyon1.fr; Patrice Nony* - pn@upcl.univ-lyon1.fr * Corresponding author Published: 17 February 2009 Received: 7 August 2008 Accepted: 17 February 2009 Emerging Themes in Epidemiology 2009, 6:1 doi:10.1186/1742-7622-6-1 This article is available from: /content/6/1/1 ? 2009 Wang et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: In medical practice, it is generally accepted that the effect model describing the relationship between baseline risk and risk under treatment is linear, i.e. relative risk is constant. Absolute benefit is then proportional to a patients baseline risk and the treatment is most effective among high-risk patients. Alternatively, the effect model becomes curvilinear when odds ratio is considered to be constant. However these two models are based on purely empirical considerations, and there is still no theoretical approach to support either the linear or the non- linear relation. Presentation of the hypothesis: From logistic and sigmoidal Emax (Hill) models, we derived a phenomenological model which includes the possibility of integrating both beneficial and harmful effects. Instead of a linear relation, our model suggests that the relationship is curviline