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Dietary Reference Intakes: Applications in Dietary Assessment (2000)
Institute of Medicine (IOM)

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. "Appendix D: Assessing the Performance of the EAR Cut-Point Method for Estimating Prevalence." Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: The National Academies Press, 2000.

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment

In summary, violating the independence assumption (i.e., a non-zero correlation) is likely to produce relatively minor biases on the estimates of prevalence obtained from applying the EAR cut-point method as long as the correlation between intakes and requirements does not exceed 0.5 or 0.6; the SDr is substantially smaller than the SDi; and the true prevalence is neither very small nor very large. The use of the EAR cut-point method (or the probability approach) is not recommended for investigating the adequacy of energy intakes in any group because for food energy the correlation between intakes and requirements is known to be very high.

VARIANCE OF REQUIREMENTS IS LARGE RELATIVE TO VARIANCE OF INTAKES

To test the effect of violating the assumption that variance of requirements must be substantially smaller than variance of intakes for good performance of the Estimated Average Requirement (EAR) cut-point method, various scenarios were considered. Mean intake was fixed at 90 units and SDi at 30 units, as before, and 0.01 and 0.7 were chosen for the correlation between intakes and requirements. The EAR was fixed at three different values: 55, 70, and 90 units. For each of the six different scenarios, the SDr varied from a low value of 0 to a high value of 40 units, in 5 unit increments.

Again, for each case, a large population was generated, and groups of 2,000 individuals were sampled 200 times. The prevalence estimates shown in each case are obtained as the average over the 200 replicates.

Box D-2 Major findings—Variance of requirement relative to variance of intake

  • The impact of increasing the SDr relative to the SDi on the bias of the prevalence estimates can be large, especially when true prevalence is not close to 50 percent (Figure D-13 and Figure D-15).

  • When the correlation between intake and requirement is high (0.7), the bias in the estimated prevalence can be high, but it does not increase monotonically as SDr increases (Figure D-14 and Figure D-16).

  • When true prevalence is 50 percent, increasing the SDr even to values above the SDi has no impact on the estimates of prevalence.

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224
Front Matter (R1-R14)
Contents (R15-R18)
Summary (1-18)
I. Historical Perspective and Background (19-20)
1 Introduction and Background (21-28)
2 Current Uses of Dietary Reference Standards (29-42)
II. Application of DRIs for Individual Diet Assessment (43-44)
3 Using Dietary Reference Intakes for Nutrient Assessment of Individuals (45-70)
III. Application of DRIs for Group Diet Assessment (71-72)
4 Using the Estimated Average Requirement for Nutrient Assessment of Groups (73-105)
5 Using the Adequate Intake for Nutrient Assessment of Groups (106-112)
6 Using the Tolerable Upper Intake Level for Nutrient Assessment of Groups (113-126)
7 Specific Applications: Assessing Nutrient Intakes of Groups Using the Dietary Reference Intakes (127-144)
IV. Fine-Tuning Dietary Assessment Using the DRIs (145-146)
8 Minimizing Potential Errors in Assessing Group and Individual Intakes (147-161)
9 Research Recommended to Improve the Uses of Dietary Reference Intakes (162-167)
10 References (168-178)
Appendix A: Origin and Framework of the Development of Dietary Reference Intakes (179-184)
Appendix B: Nutrient Assessment of Individuals: Statistical Foundations (185-202)
Appendix C: Assessing Prevalence of Inadequate Intakes for Groups: Statistical Foundations (203-210)
Appendix D: Assessing the Performance of the EAR Cut-Point Method for Estimating Prevalence (211-231)
Appendix E: Units of Observation: Assessing Nutrient Adequacy Using Household and Population Data (232-238)
Appendix F: Rationale for Setting Adequate Intakes (239-253)
Appendix G: Glossary and Abbreviations (254-261)
Appendix H: Biographical Sketches of Subcommittee Members (262-266)
Index (267-281)
Summary Table: Estimated Average Requirements (282-283)
Summary Table: Tolerable Upper Intake Levels (284-286)
Summary Table: Recommended Intakes for Individuals (287-289)