Karin Leder1, Robert Steffen, Jakob P Cramer, Christina Greenaway. 1. Infectious Disease Epidemiology Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Victorian Infectious Disease Service, Melbourne Health, Parkville, Australia.
Abstract
BACKGROUND: It has been recommended that numerical risk data should be provided during the pre-travel consultation in order for travelers to make informed decisions regarding uptake of preventive interventions. METHODS: In this article, we review the definitions of the various risk measures, particularly as they relate to travel health, and discuss the study designs and methodological details required to obtain each measure. RESULTS: Risk measures can be broadly divided into absolute risk measures (including incidence rate, attack rate, and incidence density) and risk factor measures (including relative risk, risk ratio, and odds ratio). Although there are limitations inherent to each measure, absolute risk measures estimate the baseline risk for an "average" traveler, and risk factor measures help determine whether the risks for an individual traveler are likely to be higher or lower than this average, which is determined by specific traveler and itinerary characteristics. Incremental risk considerations add additional complexity, and risk communication plus risk perception/risk tolerance have additional impact on the individual traveler's interpretation of risk measures. CONCLUSIONS: Travel health practitioners should be aware of the complexities, limitations, and difficulties in understanding numerical risk data, as these factors are important in travelers' acceptance or rejection of interventions offered.
BACKGROUND: It has been recommended that numerical risk data should be provided during the pre-travel consultation in order for travelers to make informed decisions regarding uptake of preventive interventions. METHODS: In this article, we review the definitions of the various risk measures, particularly as they relate to travel health, and discuss the study designs and methodological details required to obtain each measure. RESULTS: Risk measures can be broadly divided into absolute risk measures (including incidence rate, attack rate, and incidence density) and risk factor measures (including relative risk, risk ratio, and odds ratio). Although there are limitations inherent to each measure, absolute risk measures estimate the baseline risk for an "average" traveler, and risk factor measures help determine whether the risks for an individual traveler are likely to be higher or lower than this average, which is determined by specific traveler and itinerary characteristics. Incremental risk considerations add additional complexity, and risk communication plus risk perception/risk tolerance have additional impact on the individual traveler's interpretation of risk measures. CONCLUSIONS: Travel health practitioners should be aware of the complexities, limitations, and difficulties in understanding numerical risk data, as these factors are important in travelers' acceptance or rejection of interventions offered.
Authors: Andrea K Boggild; Jennifer Geduld; Michael Libman; Cedric P Yansouni; Anne E McCarthy; Jan Hajek; Wayne Ghesquiere; Yazdan Mirzanejad; Jean Vincelette; Susan Kuhn; Pierre J Plourde; Sumontra Chakrabarti; David O Freedman; Kevin C Kain Journal: CMAJ Date: 2017-03-06 Impact factor: 8.262
Authors: Andrea K Boggild; Jennifer Geduld; Michael Libman; Cedric P Yansouni; Anne E McCarthy; Jan Hajek; Wayne Ghesquiere; Jean Vincelette; Susan Kuhn; David O Freedman; Kevin C Kain Journal: CMAJ Open Date: 2016-07-06
Authors: Andrea K Boggild; Eric Caumes; Martin P Grobusch; Eli Schwartz; Noreen A Hynes; Michael Libman; Bradley A Connor; Sumontra Chakrabarti; Philippe Parola; Jay S Keystone; Theodore Nash; Adrienne J Showler; Mirjam Schunk; Hilmir Asgeirsson; Davidson H Hamer; Kevin C Kain Journal: J Travel Med Date: 2019-12-23 Impact factor: 8.490
Authors: Andrea K Boggild; Douglas H Esposito; Phyllis E Kozarsky; Vernon Ansdell; Nicholas J Beeching; Daniel Campion; Francesco Castelli; Eric Caumes; Francois Chappuis; Jakob P Cramer; Effrossyni Gkrania-Klotsas; Martin P Grobusch; Stefan H F Hagmann; Noreen A Hynes; Poh Lian Lim; Rogelio López-Vélez; Denis J M Malvy; Marc Mendelson; Philippe Parola; Mark J Sotir; Henry M Wu; Davidson H Hamer Journal: Ann Intern Med Date: 2015-06-02 Impact factor: 25.391
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Authors: A K Boggild; J Geduld; M Libman; C P Yansouni; A E McCarthy; J Hajek; W Ghesquiere; J Vincelette; S Kuhn; P J Plourde; D O Freedman; K C Kain Journal: Can Commun Dis Rep Date: 2016-08-04