Assessing the public health relevance of a risk factor

TL;DR

This paper critiques the use of the c-index for public health risk assessment, advocating for traditional epidemiologic measures like RR and PAR as more appropriate tools.

Contribution

It demonstrates that the c-index is inferior to classical epidemiologic measures for assessing public health relevance and recommends their use instead.

Findings

c-index is less suitable than RR and PAR for public health assessment

Classical measures provide clearer insights into risk factor impact

Recommends replacing c-index with traditional epidemiologic metrics

Abstract

In a recent series of high impact public health publications, the c-index was used as measure of prediction to assess the public health relevance of a risk factor. I demonstrate that the c-index is an inferior measure as compared to the classical epidemiologic measures most commonly employed for risk prediction and public health assessment such as disease incidence, relative risk (RR) and population-attributable risk (PAR). I recommend using the latter measures when assessing the public health relevance of a risk factor.