Epidemiology最新文献

{"title":"Associations Between Area-level Deprivation at the Census Tract Level and Preterm Birth in the Biosocial Impact of Black Births Study.","authors":"Jazib Gohar, Carmen Giurgescu, Sue C Grady, Zhehui Luo, Sarah Vaughan, Dawn P Misra","doi":"10.1097/EDE.0000000000002031","DOIUrl":"10.1097/EDE.0000000000002031","url":null,"abstract":"<p><strong>Background: </strong>US-born Black women are more likely to have a preterm birth (PTB) and reside in deprived neighborhoods than their White counterparts. Our objectives were to examine the effect of area-level deprivation on the risk of PTB and to determine if this association was modified by mother's educational level and/or annual household income.</p><p><strong>Methods: </strong>Our population consisted of 1239 Black women in the Biosocial Impact on Black Births study, a prospective cohort study of pregnant Black women in Detroit, Columbus, and Orlando. To quantify deprivation, an area-level deprivation index was developed from a principal components analysis of area-level characteristics at the Census tract level. To examine the association between area-level deprivation index and PTB, multilevel generalized linear models were estimated using the generalized estimating equations method, controlling for mother's age, education, and income. The best-fit model included two 2-way interactions for the individual-level factors of maternal education and annual household income.</p><p><strong>Results: </strong>Findings show that among women with no college education making at least $30,000/year, those who resided in high-deprivation neighborhoods had over three times greater risk of delivering preterm than their counterparts in low-deprivation neighborhoods. Education and income were both important moderators and operated in the opposite direction on risk of PTB: Having some college education was a protective association on PTB in women living in high-deprivation tracts, while having a higher income (at least $30,000/year) was harmful.</p><p><strong>Conclusion: </strong>Future research should seek to confirm the increased vulnerability to PTB for Black women with higher household incomes who also live in highly deprived Census tracts in US metropolitan areas.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"788-795"},"PeriodicalIF":4.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Vacant Lot Care Condition Instrument for Longitudinal Evaluation of Place-based Interventions.","authors":"Hiwot Y Zewdie, Nicole Asa, Christina Brown, Rita Nelson, Hyden Terrell, Maggie Beverly, Amy Caroll-Scott, Shadi Omidvar Tehrani, Ali Rowhani-Rahbar, Andrew G Rundle, Michelle C Kondo, Jane E Clougherty, Charles C Branas, Stephen J Mooney","doi":"10.1097/EDE.0000000000002027","DOIUrl":"10.1097/EDE.0000000000002027","url":null,"abstract":"<p><strong>Background: </strong>Remediating vacant lots is associated with reductions in neighborhood violence and other adverse health outcomes, potentially via increasing visible cues-to-care that signal stewardship. However, accurately measuring these cues over time remains challenging, limiting our ability to measure the sustained effects of lot remediation.</p><p><strong>Methods: </strong>We developed a standardized audit protocol using subject-matter and community experts and assessed vacant lot cues-to-care from Google Street View imagery of vacant lots in Philadelphia from 2007 to 2023. We fit a two-parameter item response theory (IRT) model to combine the observable cues-to-care measured consistently into a single latent score representing the lot care condition. We validated the latent score by testing its sensitivity to a randomized controlled greening trial and a local lot maintenance program.</p><p><strong>Results: </strong>Five raters audited 3,419 images (518 vacant lots; 6,315 ratings) captured from July 2007 to October 2023. We selected reliable and conceptually aligned items to fit an IRT model representing a latent score of lot care condition and evaluated the validity of that score. Average pairwise Cohen's for audited items was 0.31 (SD = 0.14) across all raters, and 0.55 (SD = 0.18) among our most concordant raters. Eight items with above-moderate reliability (K > 0.40) were retained for the final IRT model, which demonstrated high internal reliability (0.96). This IRT-derived care score was sensitive to improvements in lot conditions following greening interventions and enrollment in a lot maintenance program.</p><p><strong>Conclusion: </strong>Our IRT-derived score can be used to measure vacant lot care condition accurately over time. This can support long-term evaluation of vacant lot remediation interventions.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"738-746"},"PeriodicalIF":4.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Survival and \"Recurrence With GLP-1 Receptor Agonists in Breast Cancer\".","authors":"Maret L Maliniak, Julie Barberio, Rebecca Nash, Timothy L Lash","doi":"10.1097/EDE.0000000000002036","DOIUrl":"10.1097/EDE.0000000000002036","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"e22"},"PeriodicalIF":4.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term exposure to ultrafine particles and mortality from neurodegenerative diseases: a population-based cohort study.","authors":"Emmanuelle Batisse, Marshall Lloyd, Christel Renoux, Arman Ganji, Junshi Xu, Marianne Hatzopoulou, Scott Weichenthal, Jill Baumgartner","doi":"10.1097/EDE.0000000000002054","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002054","url":null,"abstract":"<p><strong>Background: </strong>Transportation and industrial activities emit large quantities of air pollutants, including unregulated ultrafine particles (UFP, <0.1 um), which may adversely affect brain health.</p><p><strong>Methods: </strong>We analyzed data from 2.1 million adults in the Canadian Census Health and Environment Cohorts (CanCHECs) living in Montreal and Toronto (2001-2019). Vital status and primary cause of death were obtained from the Canadian Vital Statistics- Death database. We assigned high-resolution estimates of UFP number concentrations and UFP size to participants' residential postal codes using three-year moving averages. Cox proportional hazards models were used to estimates hazard ratios (HRs) between long-term outdoor UFP number concentrations and mortality from dementia, Parkinson's disease, and amyotrophic lateral sclerosis. We further examined associations by dementia sub-types including Alzheimer's disease, vascular dementia and unspecified dementia. Models were used with and without inverse probability of censoring weights for competing events, and adjusted for UFP size, sociodemographic factors, and co-pollutants.</p><p><strong>Findings: </strong>Over 19 million person-years, we identified 20,560 deaths from neurodegenerative diseases. Each 10,000 particle/cm 3 increase in UFP number concentrations was associated with increased dementia mortality (HR = 1.22, 95% CI: 1.17-1.27), with stronger associations observed after adjusting for UFP size. Positive associations were observed for all dementia subtypes, with the largest for vascular dementia (HR = 1.49, 95% CI: 1.27-1.76). We did not observe effects of UFP on mortality from Parkinson's disease or amyotrophic lateral sclerosis.</p><p><strong>Interpretation: </strong>Long-term exposure to outdoor UFPs may contribute to mortality from specific neurodegenerative diseases, particularly dementia. Reducing population exposures to these unregulated pollutants could help mitigate the burden of neurodegenerative mortality.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal and infant mortality in Norway: A steady rate of decline over time.","authors":"Allen J Wilcox, Rolv Terje Lie, Dag Moster","doi":"10.1097/EDE.0000000000002055","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002055","url":null,"abstract":"<p><strong>Background: </strong>Fetal and infant mortality rates have declined dramatically world-wide. On a scale of absolute risk, the declines are diminishing and perhaps even plateauing, raising concerns about public health progress.</p><p><strong>Methods: </strong>We use Norway's national Medical Birth Registry to describe rates of declining stillbirth and infant mortality from 1967 to 2025.</p><p><strong>Results: </strong>For nearly six decades, stillbirth mortality in Norway has declined at an annual rate of about 2.8%, and neonatal mortality has declined by 3.7% a year. Neither rate of decline shows signs of slowing. Postneonatal mortality (28 days to one year) presents a contrasting picture. A steady decline of 3.5% was interrupted in 1973-2000 by a marked excess of deaths coinciding with an epidemic of sudden infant death syndrome (SIDS). This epidemic had resulted from clinical recommendations to place infants to sleep on their stomachs (prone position). After recommendations on sleep position were reversed beginning in the early 1990s, postneonatal mortality rapidly returned to an underlying declining baseline rate of 3.5%. Using the estimated constant declining risk as a benchmark, we calculate that 1367 infants in Norway died due to recommendation of prone sleep position.</p><p><strong>Discussion: </strong>Stillbirth and neonatal mortality have declined in Norway at steady rates. Baseline rates of decline may be useful in detecting the emergence of harmful effects on fetal or newborn survival. The rates of decline observed in Norway during nearly 60 years of national social stability and prosperity may also provide a benchmark for what is possible to achieve in other settings.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced screening and bacterial sexually-transmitted infection diagnoses after HIV pre-exposure prophylaxis initiation.","authors":"Anna M Parker, Samuel M Jenness, Benjamin J Singer, Jennifer J Chang, Katia J Bruxvoort, Joseph A Lewnard","doi":"10.1097/EDE.0000000000002052","DOIUrl":"10.1097/EDE.0000000000002052","url":null,"abstract":"<p><strong>Background: </strong>Recipients of HIV pre-exposure prophylaxis (PrEP) experience higher rates of gonorrhea and chlamydia diagnoses than non-recipients. However, it is unclear if these observations reflect a causal relationship between PrEP initiation and acquisition of sexually transmitted infections (i.e., behavioral \"risk compensation\") or a diagnostic bias related to PrEP recipients screening more frequently than non-recipients.</p><p><strong>Methods: </strong>We conducted a self-controlled case series study comparing rates of gonorrhea and chlamydia diagnoses after versus before PrEP initiation among commercially-insured US males in the Merative MarketScan® Research Databases (2016-2019). We compared matched incidence rate ratio (IRR) estimates after versus before PrEP initiation to model-based expectations under a null hypothesis of no change in infection risk. We derived null expectations via a mathematical model reflecting changes in screening after PrEP initiation, estimating parameters under a Bayesian framework.</p><p><strong>Results: </strong>Individuals experienced increased rates of gonorrhea (IRR=3.47 [95% confidence interval: 2.57-4.72]) and chlamydia (IRR=3.59 [2.50-5.27]) diagnoses after PrEP initiation, with IRR estimates differing by anatomical site (IRR=1.23 [0.71-2.13] and 5.98 [3.63-10.29] for urogenital and extragenital diagnoses of either infection, respectively). After accounting for increased rates of screening after PrEP initiation, rates of gonorrhea and chlamydia diagnoses only modestly exceeded expectations under the null hypothesis of no change in infection risk (8-14% greater-than-expected rates of gonorrhea and chlamydia diagnoses, respectively). Overall, we estimated that 80-81% of observed increases in rates of gonorrhea and chlamydia diagnoses after PrEP initiation, respectively, were attributable to increases in asymptomatic screening.</p><p><strong>Conclusions: </strong>Our findings suggest higher-frequency asymptomatic screening, rather than behavioral risk compensation, may account for increased rates of gonorrhea and chlamydia diagnoses after PrEP initiation.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Data Sources for Monitoring Guideline-Concordant Endometrial Cancer Treatment Among Older Adults.","authors":"Caitlin E Meade, Jennifer A Sinnott, Simran A Kanal, Allison M Quick, Kemi M Doll, Ashley S Felix","doi":"10.1097/EDE.0000000000002051","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002051","url":null,"abstract":"<p><strong>Background: </strong>Guideline-concordant endometrial cancer treatment - care consistent with recommended treatment based on tumor characteristics - is critical for survival. However, cancer registry-based assessments typically determine concordance based on whether a recommended treatment modality was received, without clinical details needed to assess treatment adequacy, including appropriate timing, amount, and duration. These details are observable in claims, raising the possibility that registry-based measures of guideline-concordance may misclassify guideline-concordant treatment. We compared guideline-concordant treatment classifications based on claims data, which capture both treatment receipt and adequacy, with classifications based on SEER registry data, which capture treatment receipt but not adequacy.</p><p><strong>Methods: </strong>Older patients diagnosed with endometrial cancer from 2000-2019 were identified from the Surveillance, Epidemiology, End Results (SEER)-Medicare linked dataset. For Medicare claims, observed surgery and adjuvant treatment were classified using treatment receipt and adequacy criteria, including timing, number of chemotherapy cycles or radiation fractions, and duration. For SEER, observed treatment was classified using registry-coded treatment receipt without adequacy criteria. For each data source, observed treatment was then compared with treatment recommended by the National Comprehensive Cancer Network (NCCN) according to year of diagnosis, stage, histology, and grade to determine guideline concordance. Agreement between data sources was assessed using kappa statistics.</p><p><strong>Results: </strong>Among 29,209 patients for surgery and 14,372 patients for adjuvant treatment, guideline-concordant care was more frequent in SEER than Medicare claims (surgery: 88.2% vs. 79.8%; adjuvant treatment: 85.4% vs. 71.6%). Agreement between SEER and Medicare was moderate for both surgery (kappa=0.46) and adjuvant treatment (kappa=0.47).</p><p><strong>Conclusions: </strong>SEER-based measures that rely solely on treatment fields may overestimate guideline-concordant treatment for older patients with endometrial cancer by failing to account for treatment adequacy.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Fatality Data Systems: A Sensitivity Analysis of North Carolina Data Systems for Occupational Fatality from 1992-2017.","authors":"Catherine S Wolff, Chelsea Leonard Martin, Maryalice Nocera, Shabbar I Ranapurwala, David B Richardson, Elizabeth S McClure, Amelia Martin, Stephen W Marshall","doi":"10.1097/EDE.0000000000002053","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002053","url":null,"abstract":"<p><strong>Background: </strong>Accurate surveillance of occupational fatalities is essential to determine their true burden and target prevention programs. The purpose of this study was to estimate the sensitivity of fatal occupational injuries abstracted from the Office of the Chief Medical Examiner (OCME) data system and death certificates in North Carolina (NC) from 1992-2017 overall, by intent, and by race.</p><p><strong>Methods: </strong>We identified NC occupational fatalities from 1992-2017 through NC OCME data abstractions. From the non-occupational deaths, we sampled 5% of deaths from OCME data even calendar years with estimations applied to odd years. We estimated misclassified non-occupational fatalities using inverse probability of the sampling fraction and calculated sensitivity of the occupational fatalities identified from NC OCME and NC death certificates data by intent and race.</p><p><strong>Results: </strong>Following adjudication of the 5% sample, 41 non-occupational deaths were determined to have been misclassified, suggesting an estimated 1,520 misclassified occupational deaths and an overall sensitivity of 67.8% (66.5%, 69.1%). Sensitivity differed by intent and means [unintentional driving: 62.1%; unintentional non-driving: 73.5%; intentional: 61.3% (58.0%, 64.6%)], and by race [black decedents 63.2%, and white decedents 66.9%].</p><p><strong>Conclusions: </strong>Sensitivity ranged from 61-73% for occupational fatalities, with lower sensitivity observed for unintentional driving and intentional fatalities events among black decedents, indicating higher misclassification of these individuals in the OCME data systems.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Proximity to Animal Agriculture During Pregnancy and Spontaneous Preterm Birth Among Nulliparous Women in a California Cohort.","authors":"Saskia Comess, Joshua L Warren, Gary M Shaw, Daniel E Ho","doi":"10.1097/EDE.0000000000002046","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002046","url":null,"abstract":"<p><strong>Background: </strong>Environmental exposures during pregnancy may influence risk of spontaneous preterm birth, a serious adverse outcome. Concentrated Animal Feeding Operations (CAFOs) near maternal residences may emit pollutants associated with preterm birth.</p><p><strong>Methods: </strong>We analyzed n = 811,953 births to nulliparous women in California (2007-2011), including 7487 spontaneous very preterm (20-31 weeks) and 37,026 spontaneous moderate preterm (32-36 weeks) births. Locations of n = 2121 CAFOs were obtained from a near-census of facilities. Using time-to-event and Bayesian methods, we estimated hazard and odds of preterm birth as a function of distance, density, and wind-based CAFO exposure, adjusting for maternal, temporal, socioeconomic, and environmental covariates. Bayesian models allow inference on both the distance range of association and the association strength.</p><p><strong>Results: </strong>Greater exposure to CAFOs is associated with small increases in hazard of all preterm birth (adjusted hazard ratios, per-unit exposure change - inverse distance: 1.003 [95% confidence interval [CI] = 1.000, 1.005]; downwind-weighted: 1.020 [95% CI = 1.005, 1.035]) with stronger associations for very preterm birth (adjusted hazard ratios - inverse distance: 1.007 [95% CI = 1.002, 1.012]; downwind-weighted: 1.043 [95% CI = 1.008, 1.080]). Among exposed births, less downwind exposure is associated with lower preterm birth hazard compared with being predominantly downwind. Bayesian models suggest births with at least one CAFO within 25.23 km (95% highest density interval [HDI]: 18.21, 32.74 km) have 1.16 times the odds of being very preterm (95% HDI: 1.10, 1.22), with similar distance ranges but smaller odds for moderate preterm birth (adjusted odds ratio: 1.08 [95% HDI: 1.05, 1.10]).</p><p><strong>Conclusions: </strong>Living near a CAFO may increase risk of spontaneous preterm birth in California, with stronger and more consistent associations for very preterm births, particularly when combined with greater downwind exposure.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transportability of Prognostic Markers: Rethinking Common Practices through a Sufficient-Component-Cause Perspective.","authors":"Mohsen Sadatsafavi, Gavin Pereira, Wenjia Chen","doi":"10.1097/EDE.0000000000002044","DOIUrl":"https://doi.org/10.1097/EDE.0000000000002044","url":null,"abstract":"<p><p>Transportability, the ability to maintain performance across populations, is a desirable property of markers of clinical outcomes. However, empirical findings indicate that markers often exhibit varying performances across populations. For prognostic markers that are advertised as predictive risk equations for an outcome of interest, oftentimes a form of updating is required when the equation is transported to populations with different outcome prevalences. Here, we revisit transportability of prognostic markers through the lens of the foundational framework of sufficient-component causes. We argue that transporting a marker \"as is\" implicitly assumes predictive values are transportable, whereas conventional prevalence-adjustment shifts the locus of transportability to accuracy metrics (sensitivity and specificity). Using a minimalist sufficient-cause framework that decomposes risk prediction into broad causal constituents, we show that both approaches rely on strong assumptions about the stability of cause distributions. Such a framework instead invites making transparent assumptions about how different causes vary across populations, leading to different transportability methods. For example, in the absence of any external information other than outcome prevalence, an impartial perspective can assume all causes are responsible for change in prevalence. This assumption leads to a new form of marker transportability method. Numerical experiments demonstrate that different transportability assumptions lead to varying degrees of information loss, depending on the distribution of causes across populations. A sufficient-component-cause perspective challenges common assumptions and practices for marker transportability, and results in novel transportability methods based on explicit assumptions on how different causes vary across populations.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}