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The concept of atherothrombotic disease has been associated with new
concepts in recent years : the INTERHEART study suggested the term
potentially modifiable factors (facilitatory and protectors) (Yusuf S et
al. Effect of potentially modifiable risk factors associated with
myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364 : 937).
The methodology would be valuable considering the Rothman model in the
context of component-cause and sufficient-cause associated to the stages
in the context of ' diagnostic anticipation time' in studies
such as INTERHEART. It would be applicable to individual risk factors (exogenous or ambiental factors), and was defined by Feinstein AR as 'trohoc' studies (cohort studies with case-control methodology) (Methodologic problems and standards in case-control research. J Chron Dis
1979 ; 32: 35).
Thus the risk-excess derived from RR in these studies: the study of
total population (exposed and non-exposed) would be valuable considering
the study of risk excess (amount) in the population attributable to the
A very significative result in these studies is the concept of non-linear
relationship curves: J or U-shaped curves (such as BMI, total mortality, total cholesterol and neoplasms) and the precission of estimation of the
-Mantel N. Synthetic retrospective studies and related
topics. Biometrics 1973; 29: 479-486
No competing interests
18 May 2011
Sabino G Echebarria Mendieta
H San Eloy ( Barakaldo-Bizkaia ) district clinics.Osakidetza-Basque Health Service