疫学・統計セミナー：疾病と要因との関連

1 ࣬පͱཁҼͱͷؔ࿈ $IVOUBSP !4IVOUBSPPP Ӹֶɾ౷ܭηϛφʔ w ϦεΫࠩ w ϦεΫൺ w
Φοζൺ w ൃੜ཰ൺ

͓͞Β͍ 2

ूஂதͷ࣬පൃੜͭͷࢦඪʢʣ 3 ࣬පͷൃੜ͸جຊతʹͭͷࢦඪͰଌఆ͢Δ ൃੜׂ߹ʢ*1*ODJEFODFQSPQPSUJPOʣ ൃੜΦοζʢ0EET*ODJEFODF0EETʣ ൃੜ཰ʢ*3*ODJEFODFSBUFʣ
༗ප཰ʢ1SFWBMFODFʣ

ूஂதͷ࣬පൃੜͭͷࢦඪʢʣ 4 "͞Μ #͞Μ $͞Μ %͞Μ &͞Μ '͞Μ 0 1
2 3 4 5 Year ٤Ԏ ഏ͕Μͷൃੜ $2 ഏ͕Μͷൃੜ ࣄނࢮˠڝ߹ϦεΫ Ҿӽ͠ˠ-PTTUPGPMMPXVQ ൃੜׂ߹ ൃੜΦοζ ൃੜ཰ IP = 3/6 Odds = (3/6)/(1 − 3/6) IR = 3/(3 + 5 + 2 + 4 + 2 + 2)

ൺֱ͢Δ 5

ԿΛൺֱ͢Δ͔ 6 ݚڀର৅ूஂ മ࿐ʢհೖʣ͋Γ മ࿐ʢհೖʣͳ͠ˠඇമ࿐ w ͋Δݚڀର৅ूஂʹ͓͚Δɼ മ࿐ɾඇമ࿐܈͝ͱͷ࣬පൃੜΛൺֱ͢Δ w ಘΒΕͨ਺஋͸ɼؔ࿈ͷఔ౓Λࣔ͢
࣬පൃੜ / / " " ൃੜ࣌ؒ 5 5

ࠩʢ%J⒎FSFODFʣͱൺʢ3BUJPʣ 7 ൃੜׂ߹ʢ*1*ODJEFODFQSPQPSUJPOʣ ൃੜΦοζʢ0EET*ODJEFODF0EETʣ ൃੜ཰ʢ*3*ODJEFODFSBUFʣ ൃੜׂ߹ Φοζ
ൃੜ཰ ࠩ ʢ%J⒎FSFODFʣ ϦεΫࠩ 3JTLEJ⒎FSFODF 3% 3BUFEJ⒎FSFODF ൺ ʢ3BUJPʣ ϦεΫൺ 3JTLSBUJP 33 Φοζൺ 0EETSBUJP 03 ཰ൺ 3BUFSBUJP 33 ·ͱΊͯ૬ରϦεΫʢ3FMBUJWFSJTLʣͱݴ͏͜ͱ΋͋Δ͕ɼ ਪ঑͞Εͳ͍

%J⒎FSFODFNFBTVSF 8 ݚڀର৅ूஂ മ࿐ ඇമ࿐ ࣬පൃੜ / / " "
ൃੜ࣌ؒ 5 5 ϦεΫࠩʢ3JTLEJ⒎FSFODFʣ RD = A1 N1 − A0 N0 w ΠϕϯτൃੜϦεΫͷ ઈରతͳ૿Ճʢ·ͨ͸ݮগʣΛࣔ͢ࢦඪ w ҧ͍͕ແ͍ͱ͖͸ɼ3% ൃੜ཰ࠩʢ*ODJEFODFSBUFEJ⒎FSFODFʣ Rate difference = A1 T1 − A0 T0 w Πϕϯτൃੜ཰ͷ ઈରతͳ૿Ճʢ·ͨ͸ݮগʣΛࣔ͢ࢦඪ w ҧ͍͕ແ͍ͱ͖͸ɼ3BUFEJ⒎FSFODF

3BUJPNFBTVSFʢʣ 9 ݚڀର৅ूஂ മ࿐ ඇമ࿐ / / " " 5
5 ϦεΫൺʢ3JTLSBUJPʣ RR = A1 /N1 A0 /N0 = R1 R0 w ΠϕϯτൃੜϦεΫ͕Կഒʢ·ͨ͸Կ෼ ͷ̍ʣͱͳ͔ͬͨΛࣔ͢૬ରతͳࢦඪ w ҧ͍͕ແ͍ͱ͖͸ɼ33 Φοζൺʢ0EETSBUJPʣ OR = R1 /(1 − R1 ) R0 /(1 − R0 ) w ΠϕϯτൃੜΦοζ͕Կഒʢ·ͨ͸Կ෼ ͷ̍ʣͱͳ͔ͬͨΛࣔ͢૬ରతͳࢦඪ w ҧ͍͕ແ͍ͱ͖͸ɼ03

3BUJPNFBTVSFʢʣ 10 ݚڀର৅ूஂ മ࿐ ඇമ࿐ / / " " 5
5 ൃੜ཰ൺʢSBUFSBUJP *ODJEFODFSBUFSBUJPʣ Rate ratio = A1 /T1 A0 /T0 w Πϕϯτൃੜ཰͕Կഒʢ·ͨ͸Կ෼ͷ ̍ʣͱͳ͔ͬͨΛࣔ͢૬ରతͳࢦඪ w ҧ͍͕ແ͍ͱ͖͸ɼ3BUFSBUJP

ྫɿ3JTLSBUJP 33 11 Male Female With CHD 40 20 Without
CHD 60 80 Total 100 100 40 100 = 0.4 உੑʹ͓͚Δ$)%ͷϦεΫ 20 100 = 0.2 Կഒʁ ϦεΫൺʢ3JTL3BUJPʣ ঁੑʹର͢Δஉੑͷ$)%ͷϦεΫൺ 0.4 0.2 = 2 ϦεΫൺ͸ղऍ͠΍͍͢ ੑผ ףಈ຺৺࣬ױʢ$)%ʣ $2 ঁੑʹ͓͚Δ$)%ͷϦεΫ

ྫɿ0EETSBUJP 03 12 Male Female With CHD 40 20 Without
CHD 60 80 Total 100 100 40/100 60/100 = 40 60 = 0.67 20/100 80/100 = 20 80 = 0.25 Կഒʁ 0.67 0.25 = 2.7 Φοζൺ͸ղऍͮ͠Β͍ ੑผ ףಈ຺৺࣬ױʢ$)%ʣ $2 உੑʹ͓͚Δ$)%ͷΦοζ Φοζൺʢ0EET3BUJPʣ ঁੑʹର͢Δஉੑͷ$)%ͷΦοζൺ ঁੑʹ͓͚Δ$)%ͷΦοζ

ϦεΫൺͱΦοζൺ 13 • Φοζൺ͸ղऍͮ͠Β͍ • ؔ࿈ͷํ޲ੑ͸ϦεΫൺͱಉ͡ • رগ࣬ױͰ͋ΔͳΒ͹ɼΦοζൺ͸ϦεΫൺʹۙࣅͰ͖Δ Male Female
With CHD 20 40 Without CHD 80 60 Male Female With CHD 50 50 Without CHD 50 50 Male Female With CHD 40 20 Without CHD 60 80 33 03 33 03 33 03 33 03

5BLF)PNFNFTTBHF 14 w ؔ࿈ͷࢦඪʹ͸ɼओʹϦεΫࠩɼϦεΫൺɼΦοζൺɼ͓Αͼൃ ੜ཰ൺ͕͋Δ w ϦεΫൺͱΦοζൺ͸ࣅ͍ͯΔ͚ΕͲ΋ҧ͏

ࢀߟจݙ 3PUINBO ,+ (SFFOMBOE 4 -BTI 5- .PEFSOFQJEFNJPMPHZ
7PM 1IJMBEFMQIJB8PMUFST,MVXFS)FBMUI-JQQJODPUU8JMMJBNT8JMLJOT w Ӹֶʹ͍ͭͯ·ͱ·͍ͬͯΔɽҼՌਪ࿦ʹॏ৺Λஔ͘ςΩετɽ೉ղɽ 3PUINBO ,+ ϩεϚϯͷӸֶՊֶతࢥߟ΁ͷ༠ࣰ͍ݪग़൛ࣾ w ΑΓ؆୯ͳ಺༰ +PIO .- "EJDUJPOBSZPGFQJEFNJPMPHZ0YGPSE6OJWFSTJUZ1SFTT w ࣙॻ͔ͩΒͦ͜ɼͱͯ΋ಡΈ΍͍͢ӳޠͰӸֶ༻ޠΛઆ໌͍ͯ͠Δ ୮ޙढ़࿕ দҪໜ೭ ৽൛ҩֶ౷ܭֶϋϯυϒοΫே૔ॻళ ୮ޙढ़࿕ খ੢ఃଇ ҩֶ౷ܭֶͷࣄయே૔ॻళ 15

16 $IVOUBSPͷ౷ܭɾӸֶνϟϯωϧ IUUQTXXXZPVUVCFDPNDIBOOFM 6$L8+QMZ4JLF4E.5M$G$L,+2

疫学・統計セミナー：疾病と要因との関連

疫学・統計セミナー：疾病と要因との関連

Shuntaro Sato

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1 ࣬පͱཁҼͱͷؔ࿈ $IVOUBSP !4IVOUBSPPP Ӹֶɾ౷ܭηϛφʔ w ϦεΫࠩ w ϦεΫൺ w

͓͞Β͍ 2

ूஂதͷ࣬පൃੜͭͷࢦඪʢʣ 3 ࣬පͷൃੜ͸جຊతʹͭͷࢦඪͰଌఆ͢Δ ൃੜׂ߹ʢ1ODJEFODFQSPQPSUJPOʣ ൃੜΦοζʢ0EETODJEFODF0EETʣ ൃੜ཰ʢ3*ODJEFODFSBUFʣ

ूஂதͷ࣬පൃੜͭͷࢦඪʢʣ 4 "͞Μ #͞Μ $͞Μ %͞Μ &͞Μ '͞Μ 0 1

ൺֱ͢Δ 5

ԿΛൺֱ͢Δ͔ 6 ݚڀର৅ूஂ മ࿐ʢհೖʣ͋Γ മ࿐ʢհೖʣͳ͠ˠඇമ࿐ w ͋Δݚڀର৅ूஂʹ͓͚Δɼ മ࿐ɾඇമ࿐܈͝ͱͷ࣬පൃੜΛൺֱ͢Δ w ಘΒΕͨ਺஋͸ɼؔ࿈ͷఔ౓Λࣔ͢

ࠩʢ%J⒎FSFODFʣͱൺʢ3BUJPʣ 7 ൃੜׂ߹ʢ1ODJEFODFQSPQPSUJPOʣ ൃੜΦοζʢ0EETODJEFODF0EETʣ ൃੜ཰ʢ3*ODJEFODFSBUFʣ ൃੜׂ߹ Φοζ

%J⒎FSFODFNFBTVSF 8 ݚڀର৅ूஂ മ࿐ ඇമ࿐ ࣬පൃੜ / / " "

3BUJPNFBTVSFʢʣ 9 ݚڀର৅ूஂ മ࿐ ඇമ࿐ / / " " 5

3BUJPNFBTVSFʢʣ 10 ݚڀର৅ूஂ മ࿐ ඇമ࿐ / / " " 5

ྫɿ3JTLSBUJP 33 11 Male Female With CHD 40 20 Without

ྫɿ0EETSBUJP 03 12 Male Female With CHD 40 20 Without

ϦεΫൺͱΦοζൺ 13 • Φοζൺ͸ղऍͮ͠Β͍ • ؔ࿈ͷํ޲ੑ͸ϦεΫൺͱಉ͡ • رগ࣬ױͰ͋ΔͳΒ͹ɼΦοζൺ͸ϦεΫൺʹۙࣅͰ͖Δ Male Female

5BLF)PNFNFTTBHF 14 w ؔ࿈ͷࢦඪʹ͸ɼओʹϦεΫࠩɼϦεΫൺɼΦοζൺɼ͓Αͼൃ ੜ཰ൺ͕͋Δ w ϦεΫൺͱΦοζൺ͸ࣅ͍ͯΔ͚ΕͲ΋ҧ͏

ࢀߟจݙ 3PUINBO ,+ (SFFOMBOE 4 -BTI 5- .PEFSOFQJEFNJPMPHZ

16 $IVOUBSPͷ౷ܭɾӸֶνϟϯωϧ IUUQTXXXZPVUVCFDPNDIBOOFM 6$L8+QMZ4JLF4E.5M$G$L,+2