中华流行病学杂志最新文献

{"title":"[Analysis of the current application of the Consolidated Framework for Implementation Research in the field of public health].","authors":"X P Wang, Y X Wu, W N Cao, X L Wei, S Y Zhan, F Sun","doi":"10.3760/cma.j.cn112338-20241216-00802","DOIUrl":"10.3760/cma.j.cn112338-20241216-00802","url":null,"abstract":"<p><p>Evidence-based public health, as the forefront of modern public health practice, has increasingly important in public health field. However, a significant gap remains between the available evidence and its practical application. Effectively disseminating and implementing evidence-based public health practice in real-world settings has become a key challenge in contemporary public health research. In this context, Implementation Science has emerged as a vital discipline. This paper explores the critical role of Implementation Science in public health, reviews the origins and core components of the Consolidated Framework for Implementation Research (CFIR), and analyzes the current application of CFIR in public health through bibliometric methods. Additionally, it discusses specific examples to further elucidate the steps involved in using the CFIR and its application contexts. The findings indicate that since 2015, research on CFIR in public health has progressively increased, showing a continuous upward trend. CFIR applications mainly address context-specific facilitators, health decision-making, barrier and facilitator identification, and community-based participatory evaluation, predominantly employing qualitative and mixed-methods research. This paper not only reviews and analyzes the current use of CFIR in public health but also provides a detailed discussion on its application. The goal is to offer valuable insights for the development of Implementation Science research within China's public health sector.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1446-1450"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of knowledge and related factors regarding hepatitis C prevention and treatment among female sex workers and men who have sex with men in the Xizang Autonomous Region].","authors":"Dorji Wangmo, X Y Zhao, J Sun, J Peng, S R Li, N Pang, X D Wu, H Q Gong, Y Li, Y Yang","doi":"10.3760/cma.j.cn112338-20250309-00145","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20250309-00145","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the knowledge of hepatitis C prevention and treatment and related factors among two groups of female sex workers (FSW) and men who have sex with men (MSM) in the Xizang Autonomous Region (Xizang) to provide a basis for the subsequent development of Hepatitis C publicity and education strategies. <b>Methods:</b> From August to September 2021, a special survey was conducted among 1 244 FSW and 234 MSM in 5 districts (counties) of 4 regions in Xizang. A one-on-one face-to-face questionnaire survey was adopted, and the <i>χ</i>² test and logistic regression were used to analyze the related factors of awareness of hepatitis C prevention and treatment among FSW and MSM. <b>Results:</b> The awareness rates of hepatitis C prevention and treatment knowledge among FSW and MSM were 35.0% (436/1 244) and 11.1% (26/234), respectively. Multivariate logistic regression analysis revealed that the positive related factors of FSW' awareness of hepatitis C prevention and treatment knowledge among those who had high school or technical secondary school education (a<i>OR</i>=4.72, 95%<i>CI</i>: 3.30-6.74) and college education or above (a<i>OR</i>=2.24, 95%<i>CI</i>: 1.58-3.18), those who experienced self-perceived risk of HCV infection (a<i>OR</i>=1.87, 95%<i>CI</i>: 1.43-2.45), negative related factors included married or cohabiting (a<i>OR</i>=0.58, 95%<i>CI</i>: 0.35-0.95), divorce or windowless (a<i>OR</i>=0.44, 95%<i>CI</i>: 0.27-0.72), no condom was used in the most recent commercial sexual activity (a<i>OR</i>=0.54, 95%<i>CI</i>: 0.43-0.69). The positive related factors of MSM's awareness of hepatitis C prevention and treatment knowledge were over 40 years old (a<i>OR</i>=8.65, 95%<i>CI</i>: 3.19-23.42) and having a self-perceived risk of HCV infection (a<i>OR</i>=6.25, 95%<i>CI</i>: 2.50-15.61). <b>Conclusions:</b> The awareness rate of hepatitis C prevention and treatment among FSW and MSM was relatively low in Xizang in 2021 and urgently needs to be improved. It is necessary to formulate targeted publicity strategies based on the characteristics of these two groups of people, increase publicity efforts, and expand the coverage of knowledge publicity to popularize key points about the clinical manifestations, treatment options, and transmission routes of hepatitis C, and carry out necessary warnings and education.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1417-1421"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The application of machine learning in tuberculosis surveillance, early warning, and evaluation of intervention strategies].","authors":"X Wu, Y Q Zhang, D Y Sun","doi":"10.3760/cma.j.cn112338-20241209-00782","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20241209-00782","url":null,"abstract":"<p><p>As one of the major public health challenges globally, tuberculosis requires epidemiological research for its control and prevention. With the advent of the big data era, machine learning has advantages over traditional methods in handling complex, high-dimensional datasets and providing accurate predictive results. This paper introduces the application of machine learning in the discovery and diagnosis of tuberculosis cases, risk factor analysis, predictive modeling, and evaluation of intervention strategies, providing new means for more in-depth exploration of the value in tuberculosis epidemiological research.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1495-1501"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between tobacco smoking and the need for respiratory support and mortality in patients hospitalized with pneumonia].","authors":"S Li, Y Z Hu, Y Q Zhang, C Q Yu, D J Y Sun, P Pei, H D Du, J S Chen, Z M Chen, L M Li, L Weng, J Lyu","doi":"10.3760/cma.j.cn112338-20250217-00093","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20250217-00093","url":null,"abstract":"<p><p><b>Objective:</b> To explore the impacts of smoking on the need for respiratory support and mortality in patients hospitalized with pneumonia. <b>Methods:</b> A total of 24 367 patients hospitalized with pneumonia from 2009 to 2017 in the China Kadoorie Biobank, were included. Smoking status was self-reported, and data regarding respiratory support during hospitalization and mortality during follow-up were obtained from medical claims and death registries, respectively. <i>OR</i>, <i>HR</i>, and 95%<i>CI</i> were calculated and adjusted for potential confounders using logistic regression models and Cox proportional hazards regression models, respectively. <b>Results:</b> Among males, current smokers or those who quit smoking due to illness had higher risks of requiring respiratory support (<i>OR</i>=1.15, 95%<i>CI</i>: 1.03-1.29), 1-year mortality (<i>HR</i>=1.66, 95%<i>CI</i>: 1.32-2.08), and 5-year mortality (<i>HR</i>=1.32, 95%<i>CI</i>: 1.13-1.54) following pneumonia hospitalization compared to nonsmokers. Male smokers who started smoking at a younger age or with longer smoking duration had the highest mortality risks (trend test both <i>P</i><0.05). Female current smokers or those who quit smoking due to illness had higher risks of 1-year mortality (<i>HR</i>=1.62, 95%<i>CI</i>: 1.17-2.23) and 5-year mortality (<i>HR</i>=1.33, 95%<i>CI</i>: 1.06-1.67). We found no statistically significant difference in 90-day mortality between current smokers/those who quit smoking due to illness and nonsmokers. <b>Conclusions:</b> Smoking was associated with higher risks of requiring respiratory support and mortality in patients hospitalized with pneumonia, especially among males and heavy smokers. These findings highlight the need for targeted strategies to promote smoking cessation in patients hospitalized with pneumonia.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1319-1327"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Study on the immunogenicity and persistence of different types of hepatitis B vaccines in diabetic patients].","authors":"W Liu, T S Zhao, L G Yang, G X Gao, W L Miao, X Y Che, L L Wang, J H Zhang, F Q Cui","doi":"10.3760/cma.j.cn112338-20241031-00679","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20241031-00679","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; Exploration of the immunogenicity and persistence of three different immunization regimens of hepatitis B vaccines in diabetic patients. &lt;b&gt;Methods:&lt;/b&gt; Participants with diabetes and non-diabetic individuals were recruited from study sites and assigned to different vaccination regimens: the diabetic group (①D60Yeast0-1: received 60 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-month schedule; ②D20Yeast0-1-6: received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule; ③D20CHO0-1-6: received 20 μg Chinese hamster ovary (CHO) cell-derived recombinant HBV vaccine on a 0-1-6-month schedule) and the non-diabetic group (ND20Yeast0-1-6: non-diabetic individuals received 20 μg Saccharomyces cerevisiae-derived recombinant HBV vaccine on a 0-1-6-month schedule). Venous blood samples were collected at 1,12, and 48 months post-full vaccination to measure anti-HBs levels. Differences in immunogenicity between diabetic and non-diabetic groups, as well as among diabetic subgroups, were analyzed. &lt;b&gt;Results:&lt;/b&gt; This study enrolled a total of 564 subjects. In the D20CHO0-1-6 group, the seroconversion rate decreased from 90.72% (95%&lt;i&gt;CI&lt;/i&gt;: 84.84%-96.60%) at 1 month to 74.23% (95%&lt;i&gt;CI&lt;/i&gt;: 65.37%-83.08%) at 48 months, and the antibody geometric mean concentration (GMC) decreased from 676.08 (95%&lt;i&gt;CI&lt;/i&gt;: 389.05- 1 148.20) mIU/ml at 1 month to 33.11 (95%&lt;i&gt;CI&lt;/i&gt;: 23.44-46.77) mIU/ml at 48 months. In the D20Yeast0-1-6 group, the seroconversion rate declined from 93.81% (95%&lt;i&gt;CI&lt;/i&gt;: 89.29%-98.32%) at 1 month to 63.72% (95%&lt;i&gt;CI&lt;/i&gt;: 54.71%-72.72%) at 48 months, with antibody GMC dropping from 630.96 (95%&lt;i&gt;CI&lt;/i&gt;: 407.40-954.99) mIU/ml to 25.70 (95%&lt;i&gt;CI&lt;/i&gt;: 17.78-38.02) mIU/ml over the same period. For the D60Yeast0-1 group, seroconversion rate fell from 82.03% (95%&lt;i&gt;CI&lt;/i&gt;: 75.29%-88.77%) to 56.25% (95%&lt;i&gt;CI&lt;/i&gt;: 47.54%-64.96%), and antibody GMC decreased from 81.28 (95%&lt;i&gt;CI&lt;/i&gt;: 51.29-128.82) mIU/ml to 15.49 (95%&lt;i&gt;CI&lt;/i&gt;: 11.75-20.89) mIU/ml between 1 and 48 months. The ND20Yeast0-1-6 group (non-diabetic control) exhibited a higher initial seroconversion rate of 97.56% (95%&lt;i&gt;CI&lt;/i&gt;: 94.80%- 100.00%) at 1 month, but it still declined to 76.42% (95%&lt;i&gt;CI&lt;/i&gt;: 68.82%-84.03%) at 48 months, with antibody GMC decreasing from 1 318.30 (95%&lt;i&gt;CI&lt;/i&gt;: 912.01- 1 905.50) mIU/ml to 34.67 (95%&lt;i&gt;CI&lt;/i&gt;: 25.12-47.86) mIU/ml. Multivariate analysis on factors influencing the GMC of antibodies revealed statistically significant differences in antibody GMC between the D20Yeast0-1-6 group and ND20Yeast0-1-6 group at 12 months (a&lt;i&gt;OR&lt;/i&gt;=0.73, 95%&lt;i&gt;CI&lt;/i&gt;: 0.58-0.93) and 48 months (a&lt;i&gt;OR&lt;/i&gt;=0.79, 95%&lt;i&gt;CI&lt;/i&gt;: 0.63-0.99) post-vaccination (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). As for the diabetic population, when compared with the D20Yeast0-1-6 group, the D60Yeast0-1 group also showed statistically significant differences in antibody GMC at 12 months (a&lt;i&gt;OR&lt;/i&gt;=0.57, 95%&lt;i&gt;CI&lt;/i&gt;: 0.44-0.74) and 48 m","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1409-1416"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association of age at menarche, age at menopause, and reproductive lifespan with frailty index in Chinese adult women].","authors":"P Y Li, S Cheng, C Q Yu, D J Y Sun, P Pei, H D Du, J S Chen, Z M Chen, L M Li, J Lyu","doi":"10.3760/cma.j.cn112338-20250410-00232","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20250410-00232","url":null,"abstract":"<p><p><b>Objective:</b> To identify individuals with accelerated aging under the frailty index (FI) as a proxy indicator of biological age, and to investigate the associations of age at menarche, age at menopause, and reproductive lifespan with frailty status and multi-timepoint FI trajectories among Chinese adult women. <b>Methods:</b> The current study included 302 471 women from the China Kadoorie Biobank 2004-2008 baseline survey data. Their age at menarche and menopause were self-reported, and the duration of reproductive lifespan was calculated by subtracting the two ages. The baseline FI was constructed using 28 baseline variables, including diseases, symptoms, and anthropometric measurements. Frailty status was categorized into three groups: non-frail (FI≤0.10), pre-frail (0.10<FI<0.25), and frail (FI≥0.25). For 18 157 women with the first re-survey data from June to August 2008 and the second re-survey data from August 2013 to September 2014, group-based trajectory modeling was used to characterize FI trajectories. Ordered logistic regression models were used to analyze associations between 3 reproductive factors and frailty status or FI trajectories. <b>Results:</b> After adjusting for potential confounders, compared to women with menarche at 15-16 years old, those with menarche ≤12, 13-14, and ≥17 years old exhibited <i>OR</i>s(95%<i>CI</i>s) for higher frailty status of 1.36 (1.31-1.41), 1.11 (1.09-1.13), and 0.92 (0.90-0.93), respectively. Compared to women with menopause at 46-50 years old, those with menopause ≤40, 41-45, and ≥51 years old had <i>OR</i>s (95%<i>CI</i>s) for higher frailty status of 1.12 (1.07-1.18), 1.04 (1.01-1.07), and 1.07 (1.04-1.10), respectively. Compared to women with a reproductive lifespan of 31-35 years, those with ≤25 and ≥36 years showed <i>OR</i>s (95%<i>CI</i>s) for higher frailty status of 1.09 (1.04-1.14) and 1.07 (1.04-1.10), respectively. Among 18 157 women, three FI trajectories were identified: low growth (60.3%), moderate growth (35.0%), and rapid growth (4.7%). Statistical associations were observed between ≤12 years old of menarche age (<i>OR</i>=1.35, 95%<i>CI</i>: 1.18-1.55) and ≥36 years of reproductive lifespan (<i>OR</i>=1.21, 95%<i>CI</i>: 1.09-1.35) with FI trajectories with higher growth rates. No statistical associations were found for other categories of menarche age, reproductive lifespan, or menopause age. <b>Conclusion:</b> Early menarche, premature or delayed menopause, and extremely short or long reproductive lifespans are associated with increased risks of accelerated aging in women.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1337-1346"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Relationship between ambient air pollution and vitamin D in Chinese adults].","authors":"H J Shi, Y T Huang, C Q Yu, D J Y Sun, P Pei, H D Du, J S Chen, Z M Chen, L M Li, J Lyu","doi":"10.3760/cma.j.cn112338-20250307-00143","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20250307-00143","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the relationship between individual and combined exposure to ambient air pollutants and vitamin D, as well as the potential role of ultraviolet radiation (UVR) in mediating the relationships. <b>Methods:</b> This study included 6 967 participants from the China Kadoorie Biobank, whose baseline (2004-2008) blood 25-hydroxyvitamin D had been tested. The average monthly concentrations of pollutants (PM_2.5, PM₁₀, NO₂, O₃) and the UVR estimates in the month of blood sample collection were derived from the ChinaHighAirPollutants and ultraviolet datasets covering China, respectively. Linear models and multinomial logistic regression models were used to analyze the associations of each air pollutant with vitamin D concentrations and groups. Principal component analysis integrated with quantile-based g-computation was applied to evaluate the co-effects and relative contribution weights of air pollutants. Mediation analyses were performed to investigate the potential role of UVR. <b>Results:</b> PM_2.5, PM₁₀, NO_2, and O₃ were individually associated with vitamin D concentrations, as well as vitamin D groups: insufficiency (20-30 ng/ml) and deficiency (<20 ng/ml). For each 10 μg/m³ increase in monthly PM_2.5, PM₁₀, NO_2, and O₃, the percentage changes (95%<i>CI</i>s) in vitamin D concentrations were -1.71% (-2.16% - -1.26%), -1.30% (-1.60% - -1.00%), -3.77% (-4.60% - -2.93%), and 1.27% (0.91%-1.63%), respectively, with corresponding <i>OR</i>s (95%<i>CI</i>s) for vitamin D deficiency of 1.17 (1.06-1.29), 1.12 (1.05-1.19), 1.66 (1.38-2.00), and 0.81 (0.74-0.89). The mixture of the first principal component of PM_2.5 and PM₁₀ (PM), along with NO₂ and O₃, was negatively correlated with vitamin D. The percentage change (95%<i>CI</i>) in vitamin D concentrations for a one-quintile increase in the mixture was -2.20% (-3.56%- -0.82%), with NO₂ contributing the most (83%), followed by PM (17%). UVR-mediated association was 12.2% (95%<i>CI</i>：2.5%-23.0%) for PM_2.5 and 4.9% (95%<i>CI</i>：2.2%-8.0%) for PM₁₀ with vitamin D concentrations, respectively. <b>Conclusion:</b> Higher concentrations of particulate matter, NO₂, and a mixture of air pollutants were associated with lower vitamin D concentrations in Chinese adults, with reduced UVR acting as a partial mediator in the particulate matter-vitamin D relationship.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1328-1336"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the effect of influenza vaccination on chronic obstructive pulmonary disease].","authors":"S Y Z Qi, J J Feng, S J Wu, M Zhao, T Fang, S S Wang","doi":"10.3760/cma.j.cn112338-20250124-00062","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20250124-00062","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide, causing a significant socioeconomic burden. This article reviews the effects of influenza vaccination on COPD and finds that influenza vaccine can significantly reduce the risk of influenza infection, reduce the number of acute exacerbations, and reduce the hospitalization rate in patients with COPD. The vaccine has a favorable safety profile and significant economic benefits, which can reduce medical costs. Currently, influenza vaccination mainly faces challenges such as insufficient patient awareness, insufficient support from the medical system, and socio-cultural and economic factors. Efforts should be focused on reducing the acute exacerbation of COPD patients and providing a scientific basis for the prevention and management of COPD patients.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1489-1494"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Weighted random forest for estimating individualized treatment rules].","authors":"Z Y Zhao, M Y Lu, F Shao, D F You, Y Zhao","doi":"10.3760/cma.j.cn112338-20250108-00020","DOIUrl":"10.3760/cma.j.cn112338-20250108-00020","url":null,"abstract":"<p><p>With the rapid development of personalized medicine, recommending the optimal treatment regimes among multiple options for individual patients has become a key topic in the study of individualized treatment rules. Existing methods often face challenges such as limited accuracy and robustness when handling multi-category treatment problems. This study proposes a weighted random forest method that formulates the treatment decision problem as a weighted classification task. By incorporating the expected loss differences among treatment outcomes, the method enhances its learning process and improves recommendation performance with the non-parametric nature and flexibility of random forests. The weighted random forest method is further applied to real-world hypertension intervention data to generate personalized antihypertensive treatment recommendations based on the patient's baseline characteristics, demonstrating its potential value in clinical practice. This research aims to provide a new approach for individualized treatment rules in multi-treatment settings and to support the development of data-driven clinical decision-making systems.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1431-1437"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Associations of Life's Crucial 9 and the risk of thyroid dysfunction: a cohort study].","authors":"J J Zhang, Y R He, Z Y Tang, X D Sun, J L Shen, J P Gong, C Liu, Y Xia","doi":"10.3760/cma.j.cn112338-20241217-00807","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20241217-00807","url":null,"abstract":"<p><p><b>Objective:</b> Exploring the association between Life's Crucial 9 (LC9) and the risk of thyroid dysfunction (TD), as well as its potential predictive capacity. <b>Methods:</b> A total of 247 600 TD-free participants from the UK Biobank were enrolled in the study. The LC9 score was divided into three CVH groups: low (0-), medium (50-), and high (80-100). Cox proportional hazards regression models were used to calculate the <i>HR</i>s and 95%<i>CI</i>s of the risk of TD with LC9 CVH status. Calculate Harrell's concordance index (<i>C</i>-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) to evaluate the predictive ability of the LC9 score and Life's Essential 8 (LE8) score. <b>Results:</b> During a median follow-up of 12.3 years, 5 515, 911, and 4 869 new cases of TD, hyperthyroidism, and hypothyroidism were documented, respectively. Participants with a high LE8 CVH group had 57.00% (<i>HR</i>=0.43, 95%<i>CI</i>: 0.38-0.49), 55.00% (<i>HR</i>=0.45, 95%<i>CI</i>: 0.34-0.60), and 58.00% (<i>HR</i>=0.42, 95%<i>CI</i>: 0.37-0.47) lower risk of TD, hyperthyroidism, and hypothyroidism, respectively, than those with low CVH group. Compared with the LE8 score, the improvement in <i>C</i>-index for the LC9 score predicted TD risk was 0.004 (95%<i>CI</i>: 0.001-0.007), the NRI was 0.101 (95%<i>CI</i>: 0.021-0.103), and the IDI was 0.001 (95%<i>CI</i>: 0.000-0.001). <b>Conclusions:</b> The better CVH status, defined by LC9, was associated with a lower risk of TD. Compared to the LE8 score, the LC9 score demonstrated a significant enhancement in both risk discrimination and reclassification capability for TD risk.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 8","pages":"1400-1408"},"PeriodicalIF":0.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}