Journal of Epidemiology最新文献

{"title":"Cohort Profile: The Tongji Carbon Peaking and Carbon Neutrality (TJCC) Cohort Study of Community Residents.","authors":"Bin Wang, Jiahao Song, Ruyi Liang, Xiuqing Cui, Min Zhou, Dunxi Yu, Yongfang Zhang, Yuxin Yao, Shijie Yang, Zijian Zhou, Shuhui Wan, Xiaojie You, Wei Liu, Linling Yu, Bingdong Chen, Quanhong Liu, Xuezan Huang, Qiyou Tan, Yueru Yang, Jiake Zhang, Ming Zhang, Lieyang Fan, Yucao Zheng, Le Hong, Qing Liu, Gaoyin Xiong, Bingxin Shang, Yanjun Guo, Xuejie Ding, Zhiying Huo, Zhaomin Chen, Kaiji Lang, Liangliang Ju, Haoxiang Liu, Weihong Chen","doi":"10.2188/jea.JE20260002","DOIUrl":"https://doi.org/10.2188/jea.JE20260002","url":null,"abstract":"<p><p>Low-carbon development of coal-fired power generation (CPG) is essential in achieving carbon peaking and carbon neutrality. While greatly reducing the emissions of carbon dioxide and homologous conventional pollutants, low-carbon CPG may change emitted-pollutants profiles, increase certain emitted-pollutants levels, and even emit new pollutants, bringing both health risks and benefits, which are largely unknown and warrant exigent elucidation by initiating the Tongji carbon peaking and carbon neutrality (TJCC) cohort. Two mainly deployed low-carbon (high-efficiency low-carbon [HLC-] and coal-biomass coupling [CBC-]) and one traditional (Trad-) CPG stations with similar CPG scale in Hubei province, China were randomly chosen. From May to November 2023 (baseline), 3262 adult residents (mean age: 54.4 years; 67.0% female) in communities located 8.5±1.5km downwind of the stations along the annual prevailing wind direction were recruited (1076, 1177, and 1009 around HLC-CPG, CBC-CPG, and Trad-CPG stations, respectively) for survey (questionnaire; health checkup; blood and urine collection for biochemistry and pollutants measurements). A panel (n=150; 50 around each station) was randomly convened from the cohort for additional elaborate survey, like 24-hour personal health and environmental exposure monitoring. Additionally, we established three fixed-sites (at about 1km and 5km downwind of each station, plus community center) to monitor CPG-emitted pollutants. This cohort followed up every 2~3 years will provide novel exquisite data for illuminating emitted-pollutants profile and relevant health risk from CPG and particularly health benefit from low-carbon CPG, which has great significance in identifying priority pollutants for CPG emission control and achieving carbon peaking and carbon neutrality while safeguarding public health.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110519","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":"Relationships between area deprivation and stillbirth, neonatal mortality, infant mortality, and child mortality rates in Japan from 2015 to 2022: A descriptive epidemiological study.","authors":"Hiromitsu Nagano, Naomi Matsumoto, Tomoka Kadowaki, Soshi Takao, Tomoki Nakaya, Takashi Yorifuji","doi":"10.2188/jea.JE20260033","DOIUrl":"https://doi.org/10.2188/jea.JE20260033","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the associations between area deprivation and child mortality in Japan after 2014 is limited. This study aimed to clarify the trends in stillbirth and neonatal, infant, and child mortality rates by municipal-level area deprivation index (ADI) after 2014.</p><p><strong>Methods: </strong>We calculated the ADI for different municipalities using 2015 and 2020 Japanese census data, and applied the ADI to the analysis periods of 2015-2019 and 2020-2022. We then stratified the municipalities into quintiles by ADI, and calculated the stillbirth and neonatal, infant, and child mortality rates for each quintile from 2015 to 2022 using 3-year moving averages of data from the Vital Statistics of Japan.</p><p><strong>Results: </strong>Throughout the study period, the stillbirth rates were higher in areas with higher ADI. The stillbirth rates decreased across all quintiles during 2019-2021 and 2020-2022, but disparities by ADI remained. For neonates, infants, and children, no clear associations were consistently observed between ADI and mortality rates until 2018-2020. From 2018-2020 onward, the mortality rates became higher in areas with higher ADI.</p><p><strong>Conclusion: </strong>Municipal disparities in stillbirth rates according to ADI were observed throughout 2015 to 2022. In contrast, disparities in neonatal, infant, and child mortality according to ADI were not apparent from 2015 to 2019 but observed from 2020 to 2022. This period coincided with the COVID-19 pandemic period. Because this study was descriptive, the reasons for these temporal changes cannot be determined. Further studies are needed to clarify the underlying mechanisms.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110568","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":"Validation of Japanese Claims-Based Mortality Definitions Against Death Records from Vital Statistics: The LIFE Study.","authors":"Megumi Maeda, Futoshi Oda, Haruhisa Fukuda","doi":"10.2188/jea.JE20260210","DOIUrl":"https://doi.org/10.2188/jea.JE20260210","url":null,"abstract":"<p><strong>Background: </strong>Secondary healthcare databases are increasingly used in health-related research, but ensuring data validity is essential for generating accurate real-world evidence. This study aimed to validate mortality definitions based on Japanese medical and long-term care (LTC) claims data.</p><p><strong>Methods: </strong>Using claims data between April 2015 and March 2023 from 13 Japanese municipalities, we developed eight algorithms to identify death. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each algorithm were calculated using vital statistics death records as the reference standard. These metrics were calculated for the overall cohort, and also stratified by age (0-39, 40-74, and ≥75 years) and place/cause of death.</p><p><strong>Results: </strong>We analyzed 1,894,123 participants (mean age: 61.2 years; women: 55.9%) with 68,966,581 person-months of claims. Specificity, PPV, and NPV were consistently high (≥0.97) across age groups, but sensitivity varied by algorithm, age, and place/cause of death. Medical claims-based algorithms identified approximately 90% of deaths in medical facilities, while the addition of LTC claims captured >95% of deaths in LTC facilities. Sensitivity for home deaths was generally low at 0.52-0.56 for individuals aged 0-39 years, which may have been due to sudden deaths (suicides or accidents) before medical services could be provided. However, home deaths among those receiving ongoing home-based care (e.g., cancer) were more accurately identifiable.</p><p><strong>Conclusions: </strong>Claims-based algorithms to identify death can be effectively used in epidemiological research in Japan by strategically applying different definitions according to type of death and target age.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030655","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":"Low-density lipoprotein cholesterol and risk of cardiovascular disease in a working population.","authors":"Huan Hu, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Takeshi Kochi, Takayuki Ogasawara, Naoki Gommori, Makoto Yamamoto, Toshiaki Miyamoto, Hiroko Okazaki, Hiroshi Ide, Seitaro Dohi, Maki Konishi, Isamu Kabe, Tetsuya Mizoue","doi":"10.2188/jea.JE20260221","DOIUrl":"https://doi.org/10.2188/jea.JE20260221","url":null,"abstract":"<p><p>BackgroundElevated low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for coronary heart disease, but its role in stroke remains unclear. This study examined the association between LDL-C levels and the risk of cardiovascular disease (CVD) and its subtypes in a large cohort of Japanese workers.MethodsWe analyzed data from 69,605 participants in the Japan Epidemiology Collaboration on Occupational Health study. Baseline LDL-C levels were categorized as <70, 70-99, 100-119, 120-139, 140-159, and ≥160 mg/dL. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsOver a mean follow-up of 8.5 years (range, 0.1-13.4 years), 406 participants developed CVD. Compared with LDL-C levels of 100-119 mg/dL, participants with LDL-C <70 mg/dL had a higher risk of intracerebral hemorrhage (HR, 3.56; 95% CI, 1.31-9.66), whereas no association was observed between LDL-C levels and subarachnoid hemorrhage. For ischemic stroke, a U-shaped association was observed; adjusted HRs (95% CIs) versus 100-119 mg/dL were 2.26 (0.97-5.25), 1.53 (0.92-2.56), 0.95 (0.56-1.60), 1.71 (1.04-2.81), and 1.52 (0.85-2.72) for LDL-C levels of <70, 70-99, 120-139, 140-159, and ≥160 mg/dL, respectively. In contrast, the risk of myocardial infarction increased linearly with increasing LDL-C levels.ConclusionsVery low LDL-C levels were associated with an increased risk of intracerebral hemorrhage, whereas a suggestive U-shaped association was observed between LDL-C levels and ischemic stroke. The risk of myocardial infarction increased with higher LDL-C levels.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030748","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":"Associations of Major Disease Diagnoses (Myocardial Infarction, Stroke, and Cancer) and Surgery with Smoking Cessation: A population-based cohort study in Japan.","authors":"Eriya Imai, Yoko Yamagiwa, Larbi Aluariachy, Hiromu Okano, Tsutomu Yamazaki, Taiki Yamaji, Motoki Iwasaki, Manami Inoue, Kazumasa Yamagishi, Hiroyasu Iso, Shoichiro Tsugane, Norie Sawada","doi":"10.2188/jea.JE20260165","DOIUrl":"https://doi.org/10.2188/jea.JE20260165","url":null,"abstract":"<p><strong>Background: </strong>Smoking increases the risk of cancer and cardiovascular disease, and cessation after diagnosis improves prognosis. However, long-term associations of disease diagnoses and surgery with smoking cessation remain unclear. We evaluated associations of major disease diagnoses (myocardial infarction, stroke, and cancer) and surgery with smoking cessation at the 10-year follow-up among adults who smoked at baseline.</p><p><strong>Methods: </strong>This prospective cohort study followed 17,779 participants aged 40-69 years who current smoking at baseline in the Japan Public Health Center-based Prospective Study for 10 years. Participants had no history of major diseases or surgery at baseline. Smoking status was assessed at baseline and 10-year follow-up. Incident myocardial infarction, stroke, and cancer were ascertained from questionnaire-reported diagnosis timing and population-based registries. Surgeries were identified from self-administered questionnaires. Multivariable logistic regression with multiple imputation estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between incident disease diagnoses or surgeries and smoking cessation.</p><p><strong>Results: </strong>During follow-up, 4,789 participants (26.9%) quit smoking. Any major disease diagnosis (N = 1,726) was associated with cessation compared with no diagnosis (OR 5.39, 95% CI 4.80-6.05), including myocardial infarction (OR 6.87, 95% CI 5.18-9.12), stroke (OR 4.03, 95% CI 3.40-4.78) and cancer (OR 2.91, 95% CI 2.53-3.34). Lung cancer (OR 7.41, 95% CI 4.44-12.51) and lung surgery (OR 16.60, 95% CI 9.08-30.36) showed strong associations.</p><p><strong>Conclusions: </strong>Major disease diagnoses and surgery were strongly associated with long-term smoking cessation over 10 years. These events may provide potential \"teachable moments\" for health professionals to encourage cessation.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030728","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":"Healthcare Providers' Advice for Tobacco Cessation and Its Association With Quit Attempts: A Cross-sectional Study in Japan, 2024.","authors":"Satomi Odani, Takahiro Tabuchi","doi":"10.2188/jea.JE20250277","DOIUrl":"10.2188/jea.JE20250277","url":null,"abstract":"<p><strong>Background: </strong>Despite guideline recommendations to deliver cessation advice, implementation in Japan remains inconsistent. We examined tobacco use prevalence, receipt of healthcare providers' advice, and its association with quit attempts.</p><p><strong>Methods: </strong>We analyzed the 2024 wave of a nationwide web-based survey (N = 27,374; ages 16-74 years). Non-probability quota sampling and post-stratification weighting were used to approximate national population distributions. Current (past 30-day) tobacco use was assessed for heated tobacco products (HTPs), cigarettes, non-cigarette combustible tobacco, and dual use (HTPs plus combustible). Exposure was receipt of healthcare providers' advice, and outcome was quit attempt in the past year. Associations were analyzed using multivariable Poisson regression to obtain adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Overall, 24.2% reported current any tobacco product use: 12.9% HTPs, 17.8% cigarettes, 3.7% non-cigarette combustible, and 7.3% dual use. Among any tobacco users (N = 6,361), 13.2% received advice and 26.7% attempted to quit. Among any tobacco users currently receiving medical care (N = 2,779), 20.9% received advice, primarily from doctors (10.3%) and nurses (8.0%), and 29.9% attempted to quit. Compared with no advice, quit attempts were more likely when advice came from one professional (APR 1.28; 95% CI, 1.05-1.58) or multiple professionals (APR 1.61; 95% CI, 1.17-2.23). Exclusive HTP users were less likely than exclusive combustible tobacco smokers to attempt quitting (APR 0.57; 95% CI, 0.41-0.81).</p><p><strong>Conclusion: </strong>Receipt of providers' advice remains low in Japan yet is strongly associated with quit attempts, especially with multi-professional involvement. Policy, training, and system-level supports are needed to strengthen provider engagement.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"273-280"},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142668","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":"Cohort Profile: The Community Empowerment and Care for Well-being and Healthy Longevity Study.","authors":"Akihiro Kakuda, Yuko Sawada, Rika Okumura, Tokie Anme","doi":"10.2188/jea.JE20250357","DOIUrl":"10.2188/jea.JE20250357","url":null,"abstract":"<p><p>The Community Empowerment and Care for Well-being and Healthy Longevity (CEC) Study is an ongoing, multigenerational, population-based cohort designed to evaluate community-driven lifespan developmental care in a rapidly aging society. Conducted in Village T, Aichi Prefecture, Japan, whose demographic structure broadly resembles national patterns, the study includes residents from infancy to older adulthood. Since 2017, the CEC Study has maintained three age-specific sub-cohorts (0-19, 20-64, and ≥65 years), integrating questionnaire surveys, health examinations, home visits, and administrative records from medical, health, and long-term care systems. A total of 4,638 residents participated in the baseline survey, with 4,079 subjects responding. The study adopts a community empowerment approach, in which residents serve as co-designers and co-implementers of local health initiatives through workshops, monitoring activities, and public feedback sessions. Triennial follow-up surveys and continuous administrative data linkage enable long-term tracking of health trajectories and contextual influences across the life course. The dataset provides detailed information on physical and cognitive function, mental health, lifestyle, social participation, and environmental factors. Although generalizability may be greatest for regions with demographic and socioeconomic profiles similar to Village T, the CEC Study offers a valuable platform for evaluating real-world, community-led health strategies. Its integration of longitudinal data with empowerment-oriented practice provides insights relevant to evidence-based community health policy and global healthy aging initiatives.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"298-305"},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046820","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":"Integrating polygenic and machine learning-derived nutrient risk scores for colorectal cancer risk stratification: Evidence from Korean adults.","authors":"Vu Anh Trong Dam, Madhawa Gunathilake, Jeonghee Lee, Jae Hwan Oh, Hee Jin Chang, Dae Kyung Sohn, Aesun Shin, Jeongseon Kim","doi":"10.2188/jea.JE20260064","DOIUrl":"https://doi.org/10.2188/jea.JE20260064","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a machine learning (ML)-derived nutrient risk score (NRS) and examine the association of genetic susceptibility and dietary intake with colorectal cancer (CRC) risk in Korean adults.</p><p><strong>Methods: </strong>This hospital-based case-control study included 1,420 cases and 2,840 controls. Polygenic risk scores (PRS) were used to examine genetic susceptibility. The NRS was developed by combining five algorithms, nested cross-validation (CV), and recursive feature elimination with CV. Model performance was primarily assessed using AUC. Logistic regression was used to derive the NRS and assess the association of PRS, NRS, and their combined effect on CRC risk.</p><p><strong>Results: </strong>A total of 15 nutrients were retained to construct the NRS. In mutually adjusted analyses, both scores remained independently associated with CRC risk (IV-weighted PRS: OR = 1.50; 95% CI, 1.10-2.06; NRS: OR = 3.67; 95% CI, 2.64-5.15 for the highest versus lowest tertile). NRS showed robust discriminative performance (AUC = 0.852; 95% CI, 0.833-0.872). While no significant PRS-NRS interaction was observed, the model integrating both scores significantly enhanced individual-level risk reclassification (IDI = 0.005, Continuous NRI = 0.120, P<0.005).</p><p><strong>Conclusion: </strong>Both PRS and NRS showed independent associations with CRC risk, and their integration significantly improved risk reclassification. NRS may serve as a useful composite metabolic marker for CRC risk stratification. Future studies incorporating longitudinal designs, larger sample sizes, and multi-omic data are warranted to further elucidate CRC risk determinants and to inform personalized risk assessment strategies.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900661","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":"Validation of the Diagnosis Procedure Combination Database in Japan for ICU Research: A Multicenter Comparison With the Japanese Intensive care PAtient Database (JIPAD).","authors":"Hiroyuki Ohbe, Junji Kumasawa, Hiroshi Okamoto, Eiji Hashiba, Shinichiro Ohshimo, Takashi Tagami, Taisuke Yasaka, Satoru Hashimoto, Naoya Kobayashi, Daisuke Kudo","doi":"10.2188/jea.JE20250425","DOIUrl":"10.2188/jea.JE20250425","url":null,"abstract":"<p><strong>Background: </strong>The Diagnosis Procedure Combination (DPC) database is Japan's most widely used administrative inpatient dataset supporting epidemiological and health services research. While its validity is established for various diagnoses and procedures, accuracy for intensive care unit (ICU) variables has not been directly evaluated using a clinical registry as the gold standard.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective validation study using four Japanese ICUs. Patient records from the national ICU registry, the Japanese Intensive care PAtient Database (JIPAD), were matched with corresponding DPC data, retaining only successfully matched patients to evaluate coding accuracy rather than case ascertainment. We assessed binary variables (demographics, comorbidities, diagnoses, interventions, ICU admission, mortality) and continuous variables (demographics, Sequential Organ Failure Assessment [SOFA] scores). We calculated sensitivity and specificity for binary variables and intraclass correlation coefficients (ICCs) for continuous variables.</p><p><strong>Results: </strong>We included 14,070 ICU admissions. Most binary variables, including demographics, major diagnostic categories, ICU interventions, and mortality, had high sensitivity and specificity (≥80%). Comorbidity specificity exceeded 95%, but sensitivity was <30% for several diseases. Sensitivity was 83.3% for invasive mechanical ventilation but low for noninvasive positive pressure ventilation (5.5%) and high-flow nasal cannula (36.1%), although specificity was high across respiratory supports (97.3-99.9%). SOFA scores showed moderate agreement (ICC, 0.61). Sensitivity/specificity were 99.1%/100.0% for in-hospital mortality and 96.2%/99.9% for ICU mortality.</p><p><strong>Conclusion: </strong>The DPC administrative inpatient database accurately captures most key ICU variables, but comorbidities, noninvasive respiratory support, and SOFA scores require caution. These findings support its use for ICU clinical and epidemiological research in Japan.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"289-297"},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046825","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":"Descriptive Epidemiology of solitary death (kodokushi) in Tokyo's 23 wards, Japan, 2016-2023.","authors":"Haruka Ninomiya, Ryusuke Ae, Hideto Suzuki","doi":"10.2188/jea.JE20260157","DOIUrl":"https://doi.org/10.2188/jea.JE20260157","url":null,"abstract":"<p><strong>Background: </strong>Solitary death (kodokushi) has emerged as a public health and social issue in Japan with rapid population aging. However, recent epidemiological data on solitary deaths remain limited.</p><p><strong>Methods: </strong>We conducted a population-based descriptive epidemiological study using records from the Tokyo Medical Examiner's Office from 2016 to 2023. All cases that met the study definition were selected from 110,024 records and included in the analysis. Data on demographic characteristics, postmortem interval (PMI), manner and cause of death, and underlying diseases were analyzed.</p><p><strong>Results: </strong>Among 46,313 solitary death cases, 32,345 were male (69.8%, median age 70 years) and 13,968 were female (30.2%, median age 80 years). Crude mortality rates per 100,000 persons increased from 69.3 to 102.5 in males and 29.7 to 41.4 in females between 2016 and 2023. Solitary deaths exhibited seasonal variation, with peaks in summer and winter. Most cases involved pensioners and welfare recipients. PMI was longer in males than females (5 days vs. 3 days). Cardiovascular diseases were the leading cause of death for both sexes. Heat stroke predominated in summer, whereas natural deaths were more frequent in winter. More than half of cases had underlying diseases, most commonly hypertension.</p><p><strong>Conclusions: </strong>Solitary death in Tokyo's 23 wards increased over the study period. Seasonal, demographic, and clinical patterns highlight the need for season-specific prevention strategies and the potential role of primary care in mitigating risk.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900643","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}