ReviewInternational journal of epidemiology2015
Understanding variation in disease risk: the elusive concept of frailty.
Review in International journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
45 citing papers in PubMed.
- Development and interpretability of a machine learning-derived model for the identification of latent prostate cancer in patients initially diagnosed with benign prostatic hyperplasia: a retrospective cohort study.BMC medical informatics and decision making · 2026Article
- Infected host competence overshadows heterogeneity in susceptibility in shaping experimental epizootics.Ecology · 2026Article
- Prior pathogen exposure augments inter-individual heterogeneity in antibody levels and reinfection loads in a songbird-pathogen system.Scientific reports · 2026Article
- Host Prior Exposure Augments Gene Expression Heterogeneity of Both Host and Pathogen During In Vivo Infection.Molecular ecology · 2026Article
- Unobserved individual-level variation in cardiovascular mortality in birth cohorts born before and after 1945.BMC cardiovascular disorders · 2026Article
- Infected host competence overshadows heterogeneity in susceptibility in shaping experimental epizootics.bioRxiv : the preprint server for biology · 2025Article
- Host prior exposure augments heterogeneity in gene expression in both host and pathogen duringbioRxiv : the preprint server for biology · 2025Article
- The ghost of infections past: Accounting for heterogeneity in individual infection history improves accuracy in epidemic forecasting.PLoS biology · 2025Article
- Reinfection with a Bacterial Pathogen Augments Heterogeneity in Host Disease Responses.Research square · 2025Article
- Analysis of recurrent events in cluster randomised trials: The PLEASANT trial case study.Statistical methods in medical research · 2025Article
- Individual heterogeneity, educational attainment and cardiovascular mortality: a pooled analysis of Norwegian health surveys.BMJ public health · 2024Article
- Prior exposure to pathogens augments host heterogeneity in susceptibility and has key epidemiological consequences.PLoS pathogens · 2024Article
- Prior exposure to pathogens augments host heterogeneity in susceptibility and has key epidemiological consequences.bioRxiv : the preprint server for biology · 2024Article
- Review
- Chance, ignorance, and the paradoxes of cancer: Richard Peto on developing preventative strategies under uncertainty.European journal of epidemiology · 2023Article
- Complete sources of cluster variation on the risk of under-five malaria in Uganda: a multilevel-weighted mixed effects logistic regression model approach.Malaria journal · 2023Article
- Individual frailty excess hazard models in cancer epidemiology.Statistics in medicine · 2023Article
- Familial autoimmunity in patients with idiopathic inflammatory myopathies.Journal of internal medicine · 2023Article
- A hierarchical process model links behavioral aging and lifespan in C. elegans.PLoS computational biology · 2022Article
- Heterogeneity in coronary heart disease risk.Scientific reports · 2022Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The concept of frailty plays a major role in the statistical field of survival analysis. Frailty variation refers to differences in risk between individuals which go beyond known or measured risk factors. In other words, frailty variation is unobserved heterogeneity. Although understanding frailty is of interest in its own right, the literature on survival analysis has demonstrated that existence of frailty variation can lead to surprising artefacts in statistical estimation that are important to examine. We present literature that demonstrates the presence and significance of frailty variation between individuals. We discuss the practical content of frailty variation, and show the link between frailty and biological concepts like (epi)genetics and heterogeneity in disease risk. There are numerous suggestions in the literature that a good deal of this variation may be due to randomness, in addition to genetic and/or environmental factors. Heterogeneity often manifests itself as clustering of cases in families more than would be expected by chance. We emphasize that apparently moderate familial relative risks can only be explained by strong underlying variation in disease risk between families and individuals. Finally, we highlight the potential impact of frailty variation in the interpretation of standard epidemiological measures such as hazard and incidence rates.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.