Characterizing the relations between exposures and diseases is the central tenet of epidemiology. Conducted by Ms. Christine Chen, master’s student at National Taiwan University College of Public Health, and her advisor Dr. Wen-Chung Lee, professor of the Institute of Epidemiology and Preventive Medicine in the College of Public Health, this study proposed a novel method to attribute diseases to multiple pathways based on the causal-pie model. The study was published on April 27, in clinical epidemiology.
Epidemiologists investigate exposure-disease causation by examining how the disease under concern is induced by different exposures – so-called “attribution”. For example, when planning intervention strategies, policymakers may want to compare the effectiveness of various intervention programs directed at removing different exposures in the population. The indices such as the attributable fraction and the causal-pie weight can evaluate the probability that the occurrence of the disease was induced by multiple exposures. However, neither of them takes disease pathways into account. In this study, we proposed a method to attribute diseases to multiple pathways based on the causal-pie model. By assessing the attributable fraction of the pathway, the method can be used to evaluate the potential impact of an intervention strategy and to allocate responsibility in tort-law liability issues.
Recently, the molecular pathological epidemiology, which uses molecular pathology tools to dissect disease pathways and mechanisms at molecular, individual, and population levels, is an emerging interdisciplinary science. Casting the causal-pie model in this framework is a promising direction for future research.