Epidemiology最新文献_第4页

Erratum: Methodological challenges in Mendelian randomization.

IF 4.7 2区医学

Epidemiology Pub Date : 2025-03-01 Epub Date: 2025-01-29 DOI: 10.1097/EDE.0000000000001805

引用次数: 0

Parameterization of Beta Distributions for Bias Parameters of Binary Exposure Misclassification in Probabilistic Bias Analysis. 概率偏差分析中二元暴露误分类偏差参数的贝塔分布参数化。

IF 4.7 2区医学

Epidemiology Pub Date : 2025-03-01 Epub Date: 2024-11-26 DOI: 10.1097/EDE.0000000000001818

Qi Zhang, Richard F MacLehose, Lindsay J Collin, Thomas P Ahern, Timothy L Lash

{"title":"Parameterization of Beta Distributions for Bias Parameters of Binary Exposure Misclassification in Probabilistic Bias Analysis.","authors":"Qi Zhang, Richard F MacLehose, Lindsay J Collin, Thomas P Ahern, Timothy L Lash","doi":"10.1097/EDE.0000000000001818","DOIUrl":"10.1097/EDE.0000000000001818","url":null,"abstract":"Background: To account for misclassification of dichotomous variables using probabilistic bias analysis, beta distributions are often assigned to bias parameters (e.g., positive and negative predictive values) based on data from an internal validation substudy. Due to the small sample size of validation substudies, zero-cell frequencies can occur. In these scenarios, it may be helpful to assign prior distributions or apply continuity corrections to the predictive value estimates.Methods: We simulated cohort studies of varying sizes, with a binary exposure and outcome and a true risk ratio (RR) = 2.0, as well as internal validation substudies, to account for exposure misclassification. We conducted bias adjustment under five approaches assigning prior distributions to the positive and negative predictive value parameters: (1) conventional method (i.e., no prior), (2) uniform prior beta ( α = 1, β = 1), (3) Jeffreys prior beta ( α = 0.5, β = 0.5), (4) using Jeffreys prior as a continuity correction only when zero cells occurred, and (5) using the uniform prior as a continuity correction only when zero cells occurred. We evaluated performance by measuring coverage probability, bias, and mean squared error.Results: For sparse validation data, methods (2)-(5) all had better coverage and lower mean squared error than the conventional method, with the uniform prior (2) yielding the best performance. However, little difference between methods was observed when the validation substudy did not contain zero cells.Conclusion: If sparse data are expected in a validation substudy, using a uniform prior for the beta distribution of bias parameters can improve the validity of bias-adjusted measures.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"237-244"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715610","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}

引用次数: 0

Rates of Receiving Medication for Opioid Use Disorder and Opioid Overdose Deaths During the Early Synthetic Opioid Crisis: A County-level Analysis. 早期合成阿片类药物危机期间阿片类药物使用障碍接受药物治疗的比率和阿片类药物过量死亡：一项县级分析。

IF 4.7 2区医学

Epidemiology Pub Date : 2025-03-01 Epub Date: 2023-11-22 DOI: 10.1097/EDE.0000000000001816

Julian Santaella-Tenorio, Ariadne Rivera-Aguirre, Staci A Hepler, David M Kline, Jonathan Cantor, Maria DeYoreo, Silvia S Martins, Noa Krawczyk, Magdalena Cerda

{"title":"Rates of Receiving Medication for Opioid Use Disorder and Opioid Overdose Deaths During the Early Synthetic Opioid Crisis: A County-level Analysis.","authors":"Julian Santaella-Tenorio, Ariadne Rivera-Aguirre, Staci A Hepler, David M Kline, Jonathan Cantor, Maria DeYoreo, Silvia S Martins, Noa Krawczyk, Magdalena Cerda","doi":"10.1097/EDE.0000000000001816","DOIUrl":"10.1097/EDE.0000000000001816","url":null,"abstract":"Background: Medications for opioid use disorder are associated with a lower risk of drug overdoses at the individual level. However, little is known about whether these effects translate to population-level reductions. We investigated whether county-level efforts to increase access to medication for opioid use disorder in 2012-2014 were associated with opioid overdose deaths in New York State during the first years of the synthetic opioid crisis.Methods: We performed an ecologic county-level study including data from 60 counties (2010-2018). We calculated rates of people receiving medication for opioid use disorder among the population misusing opioids in 2012-2014 and categorized counties into quartiles of this exposure. We modeled synthetic and nonsynthetic opioid overdose death rates using Bayesian hierarchical models.Results: Counties with higher rates of receiving medications for opioid use disorder in 2012-2014 had lower synthetic opioid overdose deaths in 2016 (highest vs. lowest quartile: rate ratio [RR] = 0.33, 95% credible interval [CrI] = 0.12, 0.98; and second-highest vs. lowest: RR = 0.20, 95% CrI = 0.07, 0.59) and 2017 (quartile second-highest vs. lowest: RR = 0.22, 95% CrI = 0.06, 0.83), but not 2018. There were no differences in nonsynthetic opioid overdose death rates comparing higher quartiles versus lowest quartile of exposure.Conclusions: A spatio-temporal modeling approach incorporating counts of the population misusing opioids provided information about trends and interventions in the target population. Higher rates of receiving medications for opioid use disorder in 2012-2014 were associated with lower rates of synthetic opioid overdose deaths early in the crisis.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"186-195"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946620","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}

引用次数: 0

Body Shapes of Multiple Anthropometric Traits and All-cause and Cause-specific Mortality in the UK Biobank.

IF 4.7 2区医学

Epidemiology Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1097/EDE.0000000000001810

Patricia Bohmann, Michael J Stein, Andrea Weber, Julian Konzok, Emma Fontvieille, Laia Peruchet-Noray, Quan Gan, Béatrice Fervers, Vivian Viallon, Hansjörg Baurecht, Michael F Leitzmann, Heinz Freisling, Anja M Sedlmeier

{"title":"Body Shapes of Multiple Anthropometric Traits and All-cause and Cause-specific Mortality in the UK Biobank.","authors":"Patricia Bohmann, Michael J Stein, Andrea Weber, Julian Konzok, Emma Fontvieille, Laia Peruchet-Noray, Quan Gan, Béatrice Fervers, Vivian Viallon, Hansjörg Baurecht, Michael F Leitzmann, Heinz Freisling, Anja M Sedlmeier","doi":"10.1097/EDE.0000000000001810","DOIUrl":"10.1097/EDE.0000000000001810","url":null,"abstract":"Background: Individual traditional anthropometric measures such as body mass index and waist circumference may not fully capture the relation of adiposity to mortality. Investigating multitrait body shapes could overcome this limitation, deepening insights into adiposity and mortality.Methods: Using UK Biobank data from 462,301 adults (40-69 years at baseline: 2006-2010), we derived four body shapes from principal component analysis on body mass index, height, weight, waist and hip circumference, and waist-to-hip ratio. We then used multivariable-adjusted Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between body shapes and mortality for principal component scores of +1 and -1.Results: During 6,114,399 person-years of follow-up, 28,807 deaths occurred. A generally obese body shape exhibited a U-shaped mortality association. A tall and centrally obese body shape showed increased mortality risk in a dose-response manner (comparing a score of +1 and 0: HR = 1.16, 95% CI = 1.14, 1.18). Conversely, tall and lean or athletic body shapes displayed no increased mortality risks when comparing a score of +1 and 0, with positive relations for the comparison between a score of -1 and 0 in these shapes (short and stout shape: HR = 1.12, 95% CI = 1.10, 1.14; nonathletic shape: HR = 1.15, 95% CI = 1.13, 1.17).Conclusion: Four distinct body shapes, reflecting heterogeneous expressions of obesity, were differentially associated with all-cause and cause-specific mortality. Multitrait body shapes may refine our insights into the associations between different adiposity subtypes and mortality.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":"36 2","pages":"264-274"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064636","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}

引用次数: 0

How Do Early Weight Trajectories Explain Social Inequalities in Lung Function in Children With Cystic Fibrosis?: A Longitudinal Interventional Disparity Effects Analysis With Time-varying Mediators and Intermediate Confounders. 早期体重轨迹如何解释囊性纤维化儿童肺功能的社会不平等？具有时变介质和中间混杂因素的纵向干预差异效应分析。

IF 4.7 2区医学

Epidemiology Pub Date : 2025-03-01 Epub Date: 2021-12-31 DOI: 10.1097/EDE.0000000000001826

Daniela K Schlüter, Ruth H Keogh, Rhian M Daniel, Schadrac C Agbla, David Taylor-Robinson

{"title":"How Do Early Weight Trajectories Explain Social Inequalities in Lung Function in Children With Cystic Fibrosis?: A Longitudinal Interventional Disparity Effects Analysis With Time-varying Mediators and Intermediate Confounders.","authors":"Daniela K Schlüter, Ruth H Keogh, Rhian M Daniel, Schadrac C Agbla, David Taylor-Robinson","doi":"10.1097/EDE.0000000000001826","DOIUrl":"10.1097/EDE.0000000000001826","url":null,"abstract":"Background: Children with cystic fibrosis (CF) from socioeconomically deprived areas have poorer growth, worse lung function, and shorter life expectancy than their less-deprived peers. While early growth is associated with lung function around age 6, it is unclear whether improving early growth in the most deprived children reduces inequalities in lung function.Methods: We used data from the UK CF Registry, tracking children born 2000-2010 up to 2016. We extended the interventional disparity effects approach to the setting of a longitudinally measured mediator. Applying this approach, we estimated the association between socioeconomic deprivation (children in the least vs. most deprived population quintile; exposure) and lung function at first measurement (ages 6-8, outcome), and the role of early weight trajectories (ages 0-6) as mediators of this relationship. We adjusted for baseline confounding by sex, birthyear, and genotype and time-varying intermediate confounding by lung infection.Results: The study included 853 children, with 165 children from the least and 172 from the most deprived quintiles. The average lung function difference between the least and most deprived quintiles was 4.5% of predicted forced expiratory volume in 1 second (95% confidence interval: 1.1-7.9). If the distribution of early weight trajectories in the most deprived children matched that in the least deprived children, this difference would reduce to 4% (95% confidence interval: 0.57- 7.4).Conclusion: Socioeconomic deprivation has a strong negative association with lung function for children with CF. We estimate that improving early weight trajectories in the most deprived children would only marginally reduce these inequalities.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":"275-285"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930962","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}

引用次数: 0

Erratum: Using Limited Trial Evidence to Credibly Choose Treatment Dosage when Efficacy and Adverse Effects Weakly Increase with Dose. 勘误：当疗效和不良反应随剂量增加而减弱时，利用有限的试验证据选择可靠的治疗剂量。

IF 4.7 2区医学

Epidemiology Pub Date : 2025-02-25 DOI: 10.1097/EDE.0000000000001842

引用次数: 0

Does Adjusting for Causal Intermediate Confounders Resolve the Perinatal Crossover Paradox?

IF 4.7 2区医学

Epidemiology Pub Date : 2025-02-25 DOI: 10.1097/EDE.0000000000001848

Wen Wei Loh, Cande V Ananth

{"title":"Does Adjusting for Causal Intermediate Confounders Resolve the Perinatal Crossover Paradox?","authors":"Wen Wei Loh, Cande V Ananth","doi":"10.1097/EDE.0000000000001848","DOIUrl":"https://doi.org/10.1097/EDE.0000000000001848","url":null,"abstract":"Background: Mediation analyses of the pre-eclampsia-perinatal outcome association through preterm birth (PTB) have produced paradoxical findings. For example, pre-eclamptic births at preterm gestations show a lower risk of adverse outcomes than normotensive births. These results have been explained by unmeasured baseline confounding between PTB and outcomes, with PTB as the sole mediator. However, other intermediate variables, such as placental abruption, small for gestational age (SGA) births, and chorioamnionitis, are confounders yet are excluded because they occur after pre-eclampsia.Methods: Using data from the Consortium on Safe Labor (2002-2008; ), we utilized interventional indirect effects to examine whether adjusting for causal intermediates mitigates confounding bias to resolve the perinatal paradox. We compared two approaches to handle intermediate confounding by abruption, SGA, and chorioamnionitis when PTB is the focal mediator: as exposure-induced confounders or as multiple mediators. We developed bias formulas to assess unmeasured confounding for interventional effects.Results: When PTB was the sole mediator, the estimated protective direct effect of pre-eclampsia (risk ratio = 0.60; 95% confidence interval = 0.52, 0.71) was in line with previous paradoxical findings. The estimated protective effect persisted even after adjusting for intermediate confounders. Sensitivity analyses suggested an unmeasured confounder must strongly influence the outcome to resolve the paradox.Conclusion: Adjusting for causal intermediates such as abruption, SGA, and chorioamnionitis is inadequate to eliminate unmeasured PTB-perinatal mortality confounding. The paradox of pre-eclampsia's protective direct effect on mortality remains unresolved. Sensitivity analyses to unmeasured confounding are effective in bolstering conclusions from causal mediation analyses and should be more widely applied.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491350","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}

引用次数: 0

Long-term Economic Distress and Growing Educational Inequity in Life Expectancy.

IF 4.7 2区医学

Epidemiology Pub Date : 2025-02-10 DOI: 10.1097/EDE.0000000000001843

Arline T Geronimus, Timothy A Waidmann, John Bound, Vincent Pancini, Meifeng Yang

{"title":"Long-term Economic Distress and Growing Educational Inequity in Life Expectancy.","authors":"Arline T Geronimus, Timothy A Waidmann, John Bound, Vincent Pancini, Meifeng Yang","doi":"10.1097/EDE.0000000000001843","DOIUrl":"https://doi.org/10.1097/EDE.0000000000001843","url":null,"abstract":"Background: The nature and timing of increasing educational inequity in US life expectancy prior to the COVID-19 pandemic suggests that long-term adverse labor market conditions secondary to globalization and technological change played a role for less-educated workers, but this has not been tested.Methods: We exploit spatiotemporal variation in mortality and long-term economic conditions at the year and commuting zone level to estimate the relationship between macroeconomic restructuring and diverging mortality trends, 1990-2017, by race, gender, and education. Our measure of macroeconomic restructuring is based on the baseline industrial mix of an area, a measure that is plausibly exogenous to mortality.Results: Mortality trends were substantially worse in commuting zones experiencing long-term economic stagnation than in others. For both White and Black adults, this relationship was strongest in the lowest quartile of the education distribution. Residence in commuting zones in the top quartile of our measure of economic conditions was associated with an additional 1-2 years lived between ages 25 and 84 compared to living in a commuting zone in the bottom quartile. The primary mediators of these divergent mortality trends were cancer, cardiovascular and metabolic diseases, and diseases of other internal body systems. Deaths from suicide or substance abuse did not contribute importantly toward accounting for the estimated impact of long-term economic stagnation on mortality.Conclusions: In our study, diverging trends in US life expectancy were associated with macroeconomic changes witnessed over the last half-century. The causes of death mediating this link were largely found in rates of death from stress-related internal diseases.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390547","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}

引用次数: 0

Plant-Capture Methods for Estimating Homeless Population Size From Uncertain Plant Captures.

IF 4.7 2区医学

Epidemiology Pub Date : 2025-02-10 DOI: 10.1097/EDE.0000000000001836

Yiran Wang, Martin Lysy, Audrey B Eliveau

引用次数: 0

Evaluating the effect of public health and social measures under rapid changes in population-level immunity against SARS-CoV-2: a mathematical modeling study.

IF 4.7 2区医学

Epidemiology Pub Date : 2025-02-03 DOI: 10.1097/EDE.0000000000001846

Sung-Mok Jung, Jaehun Jung, Justin Lessler

{"title":"Evaluating the effect of public health and social measures under rapid changes in population-level immunity against SARS-CoV-2: a mathematical modeling study.","authors":"Sung-Mok Jung, Jaehun Jung, Justin Lessler","doi":"10.1097/EDE.0000000000001846","DOIUrl":"10.1097/EDE.0000000000001846","url":null,"abstract":"Background: Public health and social measures are crucial for controlling the spread of pathogens. However, well-tailored assessments of their impact remain elusive, particularly considering time-varying immunity established from prior exposures and its waning.Methods: We developed a mathematical model to estimate the time-varying basic reproduction number, accounting for the dynamics of underlying immunity. Applying this framework, we retrospectively assessed the impact of public health and social measures implemented from November 2021-April 2022 on SARS-CoV-2 transmission in Korea and discussed potential biases from ignoring underlying immunity.Results: Our proposed model estimated a notable attenuation in the impact of public health on social measures on SARS-CoV-2 transmission in Korea with the emergence of the Omicron variants while remaining effective throughout the Delta and Omicron periods. These changes during the Omicron period became evident only upon adjusting for underlying immunity and were correlated with observed human mobility patterns in Korea.Conclusions: Our findings support the importance of incorporating underlying immunity in evaluating public health and social measures, particularly in the presence of substantial changes over a short period such as widespread infections or vaccination. This model would stand as a tool for informing public health planning, capable of mitigating the overall disease burden in future epidemics.","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078989","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}

引用次数: 0