RISK FACTOR: THEORY AND PRACTICE IN THE APPLICATION IN EPIDEMIOLOGICAL STUDIES

The category “risk factor” is widely used in the clinical epidemiological studies. To date, a large number of applied studies on the specific characteristics of risk factors for individual nosological forms has been published. At the same time, there is a minimum of publications concerning dealing with a general pattern concerning the theoretical basis for the application of this epidemiological category. In connection with this, the purpose of this report is the theoretical presentation and justification for the use in the epidemiological studies of the category “risk factor”. The authors give an epidemiological definition to this term. The risk factor is any property or feature of the human population, any impact on it, which increases the probability of a negative effect on the incidence and/or its consequences on the prevalence of any epidemiological phenomenon. The article considers the main variants of grouping risk factors and their detailing by various classification criteria (external and internal factors, managed and unmanaged factors). The need to study the complex impact of risk factors, especially in combination and/or comorbidity diseases, is shown. The authors gave an epidemiological interpretation of the risk-related concepts: “risk determinant” and “risk marker”, the areas of correct application of these terms in clinical epidemiological studies are indicated. A proposal was made to use the term “determinant of risk” only in those cases when the investigated factor has a high degree of evidence of causality with the event being studied and is not disputed by other specialists. Examples of the substitution of the concepts “risk factor” and “risk marker” are given. There is marked the situation in which clinical and epidemiological studies mask real risk factors. In conclusion, the authors indicate to the evident level of designation and identification of risk factors as a necessary condition for the success of anti-epidemic measures and the adoption of adequate management decisions in the epidemiological surveillance system.

epidemiology, risk, risk factor, risk determinant, risk marker