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American Journal of Epidemiology Vol. 129, No. 1: 183-190
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

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ON THE MEASUREMENT OF SUSCEPTIBILITY IN EPIDEMIOLOGIC STUDIES

MUIN J. KHOURY1,, W. DANA FLANDERS2, SANDER GREENLAND3 and MYRON J. ADAMS1

1Division of Birth Defects and Developmental Disabilities, Center for Environmental Health and Injury Control, Centers for Disease Control Atlanta, GA 30333
2Division of Chronic Disease Control, Center for Environmental Health and Injury Control, Centers for Disease Control Atlanta, GA
3Division of Epidemiology, UCLA School of Public Health Los Angeles, CA

Send reprint requests to Dr. Mum J. Khoury at this address.

Khoury, M. J. (CDC, Atlanta, GA 30333), W. D. Flanders, S. Greenland, and M. J. Adams. On the measurement of susceptibility in epidemiologic studies. Am J Epidemiol 1989;129:183–90.

Although relative effects of risk factors (relative risks) are commonly used in epidemiologic studies of disease, these measures do not provide estimates of the proportion of persons who are "susceptible" to the risk factor. Susceptibility may be defined under a simple sufficient cause model as the underlying factor (or set of factors) sufficient to make a person contract a disease following exposure. The authors derive simple estimates of the proportion of susceptibles in a population based on relative risk, and disease and exposure frequencies. The proportion of susceptibles increases with increasing disease frequency and relative risk but declines at high exposure frequency. For many chronic diseases with a lifetime risk in the range of 1–10 per cent, rare exposures suggest the presence of a large proportion of susceptibles, whereas common exposures suggest fewer susceptibles in the population. The estimation of the proportion of susceptibles is important in the search for genetic and environmental factors that interact with measured risk factors in etiologic studies of disease.

epidemiologic methods; family; genetics; risk


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