JSM 2004 - Toronto

Abstract #300020

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Activity Number: 395
Type: Invited
Date/Time: Thursday, August 12, 2004 : 8:30 AM to 10:20 AM
Sponsor: International Indian Statistical Association
Abstract - #300020
Title: Models and Uses of Absolute Risk in Guiding Clinical Management
Author(s): Mitchell H. Gail*+
Companies: National Cancer Institute
Address: 6120 Executive Blvd., Room 8032, Bethesda, MD, 20892-7244,
Keywords: absolute risk ; crude risk ; clinical risk and benefit ; calibration ; concordance statistic ; discriminatory power
Abstract:

Absolute risk is the probability that a subject of age "a" with particular risk factors will develop the disease of interest in a defined age interval, say (a,a+b). Absolute risk is a "crude" risk of disease in the presence of competing risks. We review study designs and analytical methods used to estimate absolute risk, methods to determine if absolute risk models are well-calibrated, and methods to assess how well absolute risk models can predict who will and who will not develop disease. We consider the decision of whether or not to take tamoxifen to prevent breast cancer as an example of the use of models of absolute risk to guide clinical decision-making, and we highlight some areas in need of further methodologic and clinical epidemiologic research.

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Revised March 2004