Global Epidemiology最新文献

{"title":"Time-varying confounders in association between general and central obesity and coronary heart disease: Longitudinal targeted maximum likelihood estimation on atherosclerosis risk in communities study","authors":"Hossein Mozafar Saadati PhD ,&nbsp;Niloufar Taherpour MSc ,&nbsp;Seyed Saeed Hashemi Nazari MD, MPH, PhD","doi":"10.1016/j.gloepi.2025.100193","DOIUrl":"10.1016/j.gloepi.2025.100193","url":null,"abstract":"<div><h3>Aim</h3><div>This study examines the association between general and central obesity and the risk of cardiovascular diseases, utilizing the Targeted Maximum Likelihood Estimator (TMLE) method to account for time-varying covariates and also we compares the findings with those derived from conventional regression methods in the Atherosclerosis Risk in Communities (ARIC) cohort study.</div></div><div><h3>Methods</h3><div>We considered 15,792 participants 45–75 years of age registered in the Atherosclerosis Risk in Communities study, visit 1 and followed to visit 4. General obesity defined as body mass index and central obesity defined as Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Body Shape Index (BSI) and Body Roundness Index (BRI). The effect of obesity on Coronary Heart Disease (CHD) was estimated and compared by Longitudinal Targeted Maximum Likelihood Estimation (LTMLE) and generalized linear model.</div></div><div><h3>Results</h3><div>The effects of BMI, adjusted for baseline and time-varying confounders, was 1.15 (95 %CI =1.00, 1.34). About the gender groups, the effect of BMI for males and females was 1.17 (95 %CI =0.97,1.40) and 1.19 (95 %CI =0.94,1.52), respectively. Considering age groups, the effect of BMI was 1.21 (95 %CI =0.95, 1.53) and 1.13 (95 %CI = 0.93, 1.36) for age ≤ 54 years and age &gt; 54 years, respectively. With regards to central obesity, the BSI and WC were shown the strongest effects, respectively. Among females and age group≤54 years, WHtR was associated with a higher incidence of CHD.</div></div><div><h3>Conclusions</h3><div>According to the results, the appropriate index for obesity varies based on gender and age. Knowledge about this difference will help to experts to implement appropriate interventions.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of adult asthma within the Hungarian population between 2009 and 2019 – A retrospective financial database analysis","authors":"B. Sánta ,&nbsp;A. Keglevich ,&nbsp;T. Kovács ,&nbsp;B. Engi ,&nbsp;A. Südi ,&nbsp;E. Noémi ,&nbsp;L. Tamási","doi":"10.1016/j.gloepi.2025.100191","DOIUrl":"10.1016/j.gloepi.2025.100191","url":null,"abstract":"<div><h3>Background</h3><div>Asthma is the most common chronic obstructive respiratory disease and is a considerable burden on the patients, caregivers and healthcare providers. However, data on epidemiology, healthcare expenditures, inhalation medication usage and comorbidities are scarce on a country-wide level.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on the Hungarian National Health Insurance Fund's financial database. All patients who had filled at least one prescription for asthma maintenance therapy between 2009-’19 had been enrolled. Prevalence for each year was assessed, based on prescriptions filled for asthma annually. Incidence was assessed only for 2011–’19. Frequency of exacerbations and their costs were calculated.</div></div><div><h3>Results</h3><div>Through the study period 439,977 patients filled at least one prescription for asthma maintenance therapy. The number of patients having at least one prescription in 12 months increased by 20.34 % (from 132,292 to 159,225 patients). Between 2011–’19 an average of 20,742.1 new patients used asthma maintenance medications. Between 2009 and ‘19 an average of 4308 patients were hospitalized due to asthma, on an average 5129 times. Healthcare expenditure on hospitalizations and outpatient treatment of asthmatics increased by 28.05 %.</div></div><div><h3>Conclusion</h3><div>Through our study period a substantial increase in patient numbers and overall expenditure was seen. Number and frequency of exacerbations however decreased over the years.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalized anxiety disorder and associated factors among Sudanese adolescents during the Sudan Army conflict: A cross sectional study","authors":"Mohammed Haydar Awad ,&nbsp;Maram Elmutasim ,&nbsp;Maeen Mohieldin Mohamed ,&nbsp;Lina Hemmeda","doi":"10.1016/j.gloepi.2025.100190","DOIUrl":"10.1016/j.gloepi.2025.100190","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety is the state of being worried and uneasy about anything that happens either now or in the future. It is unclear what exactly causes generalized anxiety disorder (GAD). According to some research, a variety of variables, including heredity, differences in brain chemistry, and environmental influences, could be involved. After the Sudanese army battle began in 2023, the purpose of this study was to determine the prevalence of generalized anxiety disorder among Sudanese teenagers.</div></div><div><h3>Methods</h3><div>A cross-sectional, community-based study was carried out among all Sudanese adolescents between 13 and 18 years old who were living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Generalized Anxiety Disorder-7 checklist for the assessment of GAD symptoms. The questionnaire was translated into Arabic by expert translators, and its validity and reliability were confirmed. Data were analyzed and presented in the form of descriptive and inferential statistics.</div></div><div><h3>Results</h3><div>Among the 855 participants, the mean age was 16.5 years, 66.8 % were female, and 50.8 % had generalized anxiety disorder. There was a significant positive relationship between GAD and age, sex, current residency, and traumatic events exposure. With participants aged 17–18 years old having 82 % higher odds of experiencing GAD in comparison with the reference age group (OR = 1.8 (95 % CI [1.2, 2.7])). Furthermore, females were found to have 92 % higher odds for GAD as compared with men (OR = 1.9 (95 % CI [1.4, 2.6])). Whereas internally displaced participants showed 205 % higher odds of GAD in comparison to those who had not been in a war zone (OR = 3.1 (95 % CI [2.11, 4.4])). In addition, experiencing a traumatic event during the war increases the odds of having GAD by 126 % in comparison to those who did not experience it (OR = 2.3 (95 % CI [1.7, 3.1])).</div></div><div><h3>Conclusion</h3><div>GAD was highly prevalent among the Sudanese adolescents included in the present study. The findings will help the government to provide proper mental health interventions for affected people.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends, prevalence, and determinants of unfavorable tuberculosis treatment outcomes among adult patients in Northeast Ethiopia: The race to achieve a 90 % treatment success rate by 2025","authors":"Tegene Atamenta Kitaw ,&nbsp;Amsalu Baylie ,&nbsp;Addisu Getie ,&nbsp;Ribka Nigatu Haile","doi":"10.1016/j.gloepi.2025.100189","DOIUrl":"10.1016/j.gloepi.2025.100189","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) continues to be a significant public health issue, especially in developing nations like Ethiopia. The country aims to reach a 90 % treatment success rate for TB by 2025. However, there is a considerable lack of recent data on treatment outcomes in the region. Current data on treatment outcomes and their determinants are crucial for guiding early interventions and aligning efforts with national goals and the End TB Strategy. Understanding the current state of TB treatment outcomes and influencing factors is vital for implementing effective interventions and measuring progress toward the target.</div></div><div><h3>Methods</h3><div>A four-year retrospective study (2019–2022) was conducted. From 323 patient files, 312 were eligible to be included in the final analysis, resulting in a response rate of 96.6 %. Data collection utilized a structured checklist, and analysis was performed with STATA version 18. The Mann-Kendall trend test was used to detect trends in TB incidence. Multicollinearity was checked using variance inflation factors (VIFs). A logistic regression model identified determinants of treatment outcomes.</div></div><div><h3>Results</h3><div>The study revealed that 84.94 % of participants achieved favorable treatment outcomes, while 15.06 % had unfavorable outcomes. A decreasing trend in unfavorable outcomes was noted, from 18.84 % in 2019 to 10.71 % in 2022 (Kendall's tau (τ) = −0.0686). Determinants of unfavorable outcomes included older age (AOR: 3.59, 95 % CI: 1.23–10.56), HIV positivity (AOR: 5.43, 95 % CI: 1.65–10.83), and smear-negative pulmonary TB (AOR: 3.82, 95 % CI: 1.39–10.45).</div></div><div><h3>Conclusion</h3><div>The overall treatment success rate of 84.94 % is below the global target of &gt;90 % for 2025. Tailored treatment strategies for older patients and those co-infected with HIV are recommended. Additionally, improving TB diagnostic capabilities is essential for early intervention and achieving better outcomes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on the commentary “On measurement error, PSA doubling time, and prostate cancer”","authors":"Lawrence L. Kupper ,&nbsp;Sandra L. Martin","doi":"10.1016/j.gloepi.2025.100187","DOIUrl":"10.1016/j.gloepi.2025.100187","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All are not created equal: Method descriptions in an epidemiology publication differ among media summaries – A case study comparison","authors":"Lilianne Samad,&nbsp;J.E. Reed","doi":"10.1016/j.gloepi.2025.100188","DOIUrl":"10.1016/j.gloepi.2025.100188","url":null,"abstract":"<div><div>It is common to see mass media headlines about health-related topics in traditional and online news outlets, as well as on social media platforms. What a consumer might not realize is that often these headlines are a distillation of results reported in epidemiologic publications. Journalists make decisions about what information to include and exclude, hopefully without compromising the main conclusions. In this exercise, sixty-three media articles that summarized one peer-reviewed journal publication (Zhang et al., 2021) describing results from a cohort study on coffee and tea consumption and risk of stroke and dementia were compared to determine the consistency of details among them. The most heterogeneity was observed in whether articles compared results with other literature. There was some variation in inclusion of a measure of frequency within the study population, and in details describing measurement of exposure. However, most of the articles were consistent in either including or excluding other methodological details in the main text. The results of the present comparison have implications for readers, researchers, and journalists. Readers must know that media summaries of peer reviewed studies are just that – summaries. It is likely that some information from the original source is not represented by the article, and that additional information might be necessary to craft an informed opinion on a given topic.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the current and future potential of simulations based on directed acyclic graphs","authors":"Lutz P. Breitling ,&nbsp;Anca D. Dragomir ,&nbsp;Chongyang Duan ,&nbsp;George Luta","doi":"10.1016/j.gloepi.2025.100186","DOIUrl":"10.1016/j.gloepi.2025.100186","url":null,"abstract":"<div><div>Real-world data are playing an increasingly important role in regulatory decision making. Adequately addressing bias is of paramount importance in this context. Structural representations of bias using directed acyclic graphs (DAGs) provide a unified approach to conceptualize bias, distinguish between different types of bias, and identify ways to address bias. DAG-based data simulation further enhances the scope of this approach. Recently, DAGs have been used to demonstrate how missing eligibility information can compromise emulated target trial analysis, a cutting edge approach to estimate treatment effects using real-world data. The importance of simulation for methodological research has received substantial recognition in the past few years, and others have argued that simulating data based on DAGs can be especially helpful for understanding various epidemiological concepts. In the present work, we present two concrete examples of how simulations based on DAGs can be used to gain insights into issues commonly encountered in real-world analytics, i.e., regression modelling to address confounding bias, and the potential extent of selection bias. Increasing accessibility and extending the simulation algorithms of existing software to include longitudinal and time-to-event data are identified as priorities for further development. With such extensions, simulations based on DAGs would be an even more powerful tool to advance our understanding of the rapidly growing toolbox of real-world analytics.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, clinical characteristics: A multi-center observational study from Jordan","authors":"Marwan Shalabi ,&nbsp;Salam Ghanem ,&nbsp;Iyad Al-Ammouri ,&nbsp;Amirah Daher ,&nbsp;Enas Al-zayadneh ,&nbsp;Alaa Alsmadi ,&nbsp;Mais Ayyoub ,&nbsp;Samah Abughanam ,&nbsp;Mariam Jabr ,&nbsp;Montaha Al-Iede","doi":"10.1016/j.gloepi.2025.100185","DOIUrl":"10.1016/j.gloepi.2025.100185","url":null,"abstract":"<div><h3>Objective</h3><div>Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease.</div></div><div><h3>Methods</h3><div>A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review.</div></div><div><h3>Results</h3><div>Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit.</div></div><div><h3>Conclusions</h3><div>This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-led medication self-management intervention in the improvement of medication adherence in adult patients with multi-morbidity: A Protocol for a Feasibility Randomized controlled trial","authors":"Kalpana Singh ,&nbsp;George V. Joy ,&nbsp;Asma Al Bulushi ,&nbsp;Albara Mohammad Ali Alomari ,&nbsp;Kamaruddeen Mannethodi ,&nbsp;Jibin Kunjavara ,&nbsp;Nesiya Hassan ,&nbsp;Zeinab Idris ,&nbsp;Mohd Abdel Daem Mohd Yassin ,&nbsp;Badriya Al Lenjawi","doi":"10.1016/j.gloepi.2025.100184","DOIUrl":"10.1016/j.gloepi.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity in adult patients puts them at a considerable risk of not taking their medications as prescribed. It is well known that patients with chronic conditions with self-management help is an excellent way to improve medication compliance. The impact of the medication self-management intervention in adult patients with multimorbidity is not well known, yet. This paper presents the protocol to assess the efficacy of a nurse-led medication self-management intervention in enhancing medication adherence and health outcomes for adult patients with multimorbidity.</div></div><div><h3>Methods</h3><div>The Standard Protocol Items: Guidelines for Interventional Trials 2013 statement is followed by the study protocol. This study is a two-arm, single centre, open label, randomized controlled trial. Adult patients with multimorbidity will be recruited from National Cancer Center Research, QATAR. A total of 100 participants will be randomly assigned to either standard care alone or standard care along with the medication self-management intervention. Clinical nursing specialists will deliver the intervention. Three in-person education sessions and two weekly phone conversations for follow-up are part of the 6-week intervention. Participants in the control group continue to receive all aspects of the standard care provided by healthcare professionals, including consultations regarding patients' diseases and treatments, management of chronic conditions, prescription of medications, referrals to hospital specialists, health education, and management of chronic conditions.</div><div>The 8-item mo-risky-8 Medication Adherence Scale was used to measure medication adherence as the primary outcome. Secondary outcomes include medication self-management capacity (medication knowledge, medication beliefs, and medication self-efficacy), treatment experiences (medication treatment satisfaction and treatment burden), and depressive symptoms. All outcomes will be assessed at baseline, immediately post-intervention, and at 3-month post-intervention.</div></div><div><h3>Discussion</h3><div>This study will offer proof of the merits of a nurse-delivered medication self-management intervention for adult patients with multimorbidity and adherence issues. If the study findings are helpful in enhancing patient adherence and health outcomes, it is anticipated that they will offer healthcare professionals evidence-based self-management support tools for routine chronic condition management.</div><div><strong>Trial registration:</strong> The trial is registered at <span><span>clinicaltrial.org</span><svg><path></path></svg></span> (<span><span>NCT05645653</span><svg><path></path></svg></span>;9Dec2022).</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the determinants of attrition in a two-stage epilepsy prevalence survey in Nairobi using machine learning","authors":"Daniel M. Mwanga ,&nbsp;Isaac C. Kipchirchir ,&nbsp;George O. Muhua ,&nbsp;Charles R. Newton ,&nbsp;Damazo T. Kadengye","doi":"10.1016/j.gloepi.2025.100183","DOIUrl":"10.1016/j.gloepi.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>Attrition is a challenge in parameter estimation in both longitudinal and multi-stage cross-sectional studies. Here, we examine utility of machine learning to predict attrition and identify associated factors in a two-stage population-based epilepsy prevalence study in Nairobi.</div></div><div><h3>Methods</h3><div>All individuals in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) (Korogocho and Viwandani) were screened for epilepsy in two stages. Attrition was defined as probable epilepsy cases identified at stage-I but who did not attend stage-II (neurologist assessment). Categorical variables were one-hot encoded, class imbalance was addressed using synthetic minority over-sampling technique (SMOTE) and numeric variables were scaled and centered. The dataset was split into training and testing sets (7:3 ratio), and seven machine learning models, including the ensemble Super Learner, were trained. Hyperparameters were tuned using 10-fold cross-validation, and model performance evaluated using metrics like Area under the curve (AUC), accuracy, Brier score and F1 score over 500 bootstrap samples of the test data.</div></div><div><h3>Results</h3><div>Random forest (AUC = 0.98, accuracy = 0.95, Brier score = 0.06, and F1 = 0.94), extreme gradient boost (XGB) (AUC = 0.96, accuracy = 0.91, Brier score = 0.08, F1 = 0.90) and support vector machine (SVM) (AUC = 0.93, accuracy = 0.93, Brier score = 0.07, F1 = 0.92) were the best performing models (base learners). Ensemble Super Learner had similarly high performance. Important predictors of attrition included proximity to industrial areas, male gender, employment, education, smaller households, and a history of complex partial seizures.</div></div><div><h3>Conclusion</h3><div>These findings can aid researchers plan targeted mobilization for scheduled clinical appointments to improve follow-up rates. These findings will inform development of a web-based algorithm to predict attrition risk and aid in targeted follow-up efforts in similar studies.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}