Global Epidemiology最新文献

{"title":"For a proper use of frequentist inferential statistics in public health","authors":"Alessandro Rovetta ,&nbsp;Mohammad Ali Mansournia ,&nbsp;Alessandro Vitale","doi":"10.1016/j.gloepi.2024.100151","DOIUrl":"10.1016/j.gloepi.2024.100151","url":null,"abstract":"<div><p>As widely noted in the literature and by international bodies such as the American Statistical Association, severe misinterpretations of <em>P</em>-values, confidence intervals, and statistical significance are sadly common in public health. This scenario poses serious risks concerning terminal decisions such as the approval or rejection of therapies. Cognitive distortions about statistics likely stem from poor teaching in schools and universities, overly simplified interpretations, and – as we suggest – the reckless use of calculation software with predefined standardized procedures. In light of this, we present a framework to recalibrate the role of frequentist-inferential statistics within clinical and epidemiological research. In particular, we stress that statistics is only a set of rules and numbers that make sense only when properly placed within a well-defined scientific context beforehand. Practical examples are discussed for educational purposes. Alongside this, we propose some tools to better evaluate statistical outcomes, such as multiple compatibility or surprisal intervals or tuples of various point hypotheses. Lastly, we emphasize that every conclusion must be informed by different kinds of scientific evidence (e.g., biochemical, clinical, statistical, etc.) and must be based on a careful examination of costs, risks, and benefits.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000178/pdfft?md5=4fe0b244a01cff2d2b827052b4f73448&pid=1-s2.0-S2590113324000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398894","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":"Reliability of a short diet and vitamin supplement questionnaire for retrospective collection of maternal nutrient intake","authors":"Rebecca J. Schmidt ,&nbsp;Amanda J. Goodrich ,&nbsp;Lauren Granillo ,&nbsp;Yunru Huang ,&nbsp;Paula Krakowiak ,&nbsp;Adrianne Widaman ,&nbsp;J. Erin Dienes ,&nbsp;Deborah H. Bennett ,&nbsp;Cheryl K. Walker ,&nbsp;Daniel J. Tancredi","doi":"10.1016/j.gloepi.2024.100150","DOIUrl":"10.1016/j.gloepi.2024.100150","url":null,"abstract":"<div><h3>Background</h3><p>Gestational nutrition can protect against adverse neurodevelopmental outcomes.</p></div><div><h3>Objectives</h3><p>We developed a short tool for collecting maternal nutritional intake during pregnancy to facilitate research in this area and compared its retrospective use to prospectively-collected food frequency questionnaires (FFQ).</p></div><div><h3>Methods</h3><p>Maternal nutritional intake was retrospectively assessed using three versions (full interview, full self-administered online, and shortened interview) of the Early Life Exposure Assessment Tool (ELEAT) among participants of the MARBLES pregnancy cohort study of younger siblings of autistic children. Retrospective responses were compared with responses to supplement questions and the validated 2005 Block FFQ prospectively collected in MARBLES during pregnancies 2–7 years prior. ELEAT nutrient values were calculated using reported food intake frequencies and nutrient values from the USDA nutrient database. Correlations between retrospectively- and prospectively-reported intake were evaluated using Kappa coefficients, Youden's J, and Spearman Rank Correlation Coefficients (r_s).</p></div><div><h3>Results</h3><p>MARBLES FFQ dietary intakes were compared among 54 women who completed the ELEAT full form including 12 online, and among 23 who completed the ELEAT short form. Correlations across most foods were fair to moderate. Most ELEAT quantified nutrient values were moderately correlated (r_s = 0.3–0.6) with those on the Block FFQ. Supplement questions in both MARBLES and the ELEAT were completed by 114 women. Kappas were moderate for whether or not supplements were taken, but modest for timing. Correlations varied by version and child diagnosis or concerns, and were higher when mothers completed the ELEAT when their child was 4 years old or younger.</p></div><div><h3>Conclusions</h3><p>With recall up to several years, ELEAT dietary and supplement module responses were modestly to moderately reliable and produced nutrient values moderately correlated with prospectively-collected measures. The ELEAT dietary and vitamin supplements modules can be used to rank participants in terms of intake of several nutrients relevant for neurodevelopment.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000166/pdfft?md5=0d583c28cdbaddd85aaf42f8850125cc&pid=1-s2.0-S2590113324000166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412256","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":"Is the prevalence of risk factors, clinical presentations and severity of coronary artery diseases (CAD) in patients with very early and premature CAD are different from mature CAD patients?: A registry- based cross-sectional study","authors":"Mohammad Haji Aghajani ,&nbsp;Niloufar Taherpour ,&nbsp;Mohammad Parsa Mahjoob ,&nbsp;Naser Kachoueian ,&nbsp;Milad Alipour ,&nbsp;Saman Ghorbani","doi":"10.1016/j.gloepi.2024.100148","DOIUrl":"10.1016/j.gloepi.2024.100148","url":null,"abstract":"<div><h3>Introduction</h3><p>The present study aims to compare the risk factors, clinical presentation, and severity of coronary artery involvement in young compared to elderly CAD patients to assess the cardiovascular health status for better disease management and control of these specific patients.</p></div><div><h3>Methods</h3><p>This registry-based cross-sectional study was conducted using Coronary Angiography and Angioplasty Registry (CAAR) patients in east of Tehran, Iran. The data were extracted from 330 patients with confirmed CAD recorded by the CAAR during July 2021 to August 2023.</p></div><div><h3>Results</h3><p>The majority of patients in MCAD (68.2%) and VECAD (80%) were male, while the majority of PCAD patients were female (51.8%). Among PCAD patients, the prevalence of diabetes (38.1%) was higher than in other groups. The presence of IHD history in the father (38.1%) and mother (26.3%) was higher in the VECAD group. The mean total cholesterol, LDL, and LDL/HDL ratio were higher in the VECAD group. Among MCAD group (75.4%) compared to PCAD (58.1%) and VECAD (47.2%) groups, the multi-vessel disease was more common.MCAD patients had the highest median Gensini score compared to PCAD and VECAD patients. Also, in male compared to female the mean Gensini score was higher by 8 units (ß = 8.26, 95%CI = 0.24, 16.28).</p></div><div><h3>Conclusion</h3><p>Modifiable risk factors in young CAD patients are common. High LDL-C levels and smoking were the common modifiable CVD risk factors in young patients, indicating the significant role of these traditional risk factors in early atherosclerosis development alongside inheritable risk-factors such as positive family history that were more common in young CAD patients. While, the severity of coronary artery involvement in individuals with MCAD was higher, but the priority of involvement based on the type of vessel was almost the same in all CAD groups.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000142/pdfft?md5=abe42c31a4a75ea8cf00cddec3f6bc30&pid=1-s2.0-S2590113324000142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400678","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":"SARS-CoV-2 infection prevalence, risk factors, and outcomes among non-clinical-related service providers in a national healthcare system","authors":"Moza Aishaq ,&nbsp;Hanaa Nafady-Hego ,&nbsp;Fatma Ben Abid ,&nbsp;Jameela Ali Al Ajmi ,&nbsp;Wedad S. Hamdi ,&nbsp;Suni Vinoy ,&nbsp;Anil George Thomas ,&nbsp;Saddam Alrwashdh ,&nbsp;Mohamed Shaheen ,&nbsp;Tintu Elizabeth Mathew ,&nbsp;Mohamed Elgendy ,&nbsp;Sam Joseph ,&nbsp;Christymol Thomas ,&nbsp;Anju K. Alex ,&nbsp;Asmaa Nafady ,&nbsp;Peter V. Coyle ,&nbsp;Hamed Elgendy","doi":"10.1016/j.gloepi.2024.100149","DOIUrl":"10.1016/j.gloepi.2024.100149","url":null,"abstract":"<div><p>Health care workers (HCWs) may be at a variable risk of SARS-CoV2 infection. Regardless of their involvement in providing direct clinical treatment, most of the prior research had included all HCWs. Understanding infection rates, risk factors and outcomes among different subgroups of HCWs is crucial. From February 28, 2020 to January 1, 2022, we conducted a retrospective analysis encompassing all full-time non-clinical staff (NCS) subcontracted with Hamad Medical Corporation (HMC) facilities. To determine current or previous SARS-CoV2 infection, all personnel underwent RT-PCR and/or serology testing. To identify the demographic factors linked to the risk of infection, we utilized Cox-Hazard regression analysis. Herein 3158/6231 (50.7%) subcontracted NCS tested positive for SARS-CoV-2 by RT-PCR or serology during the research period. The median age was 30 years (IQR 25,35), 69.8% of the population were males, 82.4% were from South Asia, 86.6% did not have any concomitant conditions. 6032 (96.8%) of the population lived in shared housing, while 4749 (76.2%) had low to median levels of education. While infection (PCR positive with or without seropositive results) was independently predicted by male gender, working in the catering, laundry, and security sectors and being intermediate (7–12 years of education), lower (0–6 years of education), higher (exposure to confirmed case), and having symptoms. Male gender, working in the security sectors and being intermediate (7–12 years of education) were independently associated with accidently detected cases (PCR negative and seropositive). 299 (4.8%) required hospitalization, of them 3 cases were severe pneumonia and one required ICU admission without mechanical ventilation, with no deaths reported. In conclusion Infection rates among NCS are high. The majority are asymptomatic and may contribute to ongoing illness spread in the public or in healthcare facilities. During a pandemic, routine screening of this population is crucial and may aid in containing the spread of infection.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000154/pdfft?md5=9fe8a5c698ef406b3d33d25b12143840&pid=1-s2.0-S2590113324000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410673","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":"An analysis of paediatric clinical presentations in Northwest Syria and the effect of forced displacement, 2018–2022","authors":"Vinay Kampalath ,&nbsp;Ms Maia C. Tarnas ,&nbsp;Ms Vaibhavee Patel ,&nbsp;Mohamed Hamze ,&nbsp;Randa Loutfi ,&nbsp;Bachir Tajaldin ,&nbsp;Ahmad Albik ,&nbsp;Ayman Kassas ,&nbsp;Anas Khashata ,&nbsp;Aula Abbara","doi":"10.1016/j.gloepi.2024.100146","DOIUrl":"10.1016/j.gloepi.2024.100146","url":null,"abstract":"<div><h3>Background</h3><p>One in six children worldwide lives in a region exposed to armed conflict. In conflicts, children are among the most vulnerable, and at risk of adverse health outcomes. We sought to describe trends in child and adolescent morbidity in northwest Syria (NWS) and understand how forced displacement affects clinical utilisation during the Syrian conflict.</p></div><div><h3>Methods</h3><p>Retrospective data between January 2018 and December 2022 were obtained from the Syrian American Medical Society (SAMS), a non-governmental organisation that operates health facilities in NWS. After initial descriptive analyses were completed, we performed a seasonal-trend decomposition to estimate the seasonality of clinical presentations. We subsequently employed a multivariate regression model incorporating age, gender, residency status, season, and a random district-level intercept to measure the association between the odds of clinical consultation and forced displacement.</p></div><div><h3>Findings</h3><p>Across 51 reporting SAMS facilities, 2,687,807 clinical consultations were studied over a five-year period. Seasonality was demonstrated for every clinical consultation category. Higher levels of forced displacement were associated with increased odds of consultations for nutrition, trauma, NCDs and mental health and decreased odds of consultation for communicable diseases. Aside from traumatic injury, internally displaced persons (IDPs) had higher AORs of clinical consultations compared to host populations.</p></div><div><h3>Interpretation</h3><p>Forced displacement differentially impacts clinical utilisation among children in northwest Syria, and the effects of displacement persist for at least six months. Clinical needs vary by host/IDP status, sex, age, and season. This study can assist policymakers in forecasting the health needs of children in northwest Syria.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000129/pdfft?md5=b2d42f6ebc1c79281f0f8ae3397e2798&pid=1-s2.0-S2590113324000129-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276215","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":"Evaluating algorithms for identifying incident Guillain-Barré Syndrome in Medicare fee-for-service claims","authors":"Samantha R. Eiffert ,&nbsp;Brad Wright ,&nbsp;Joshua Nardin ,&nbsp;James F. Howard ,&nbsp;Rebecca Traub","doi":"10.1016/j.gloepi.2024.100145","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100145","url":null,"abstract":"<div><h3>Objective</h3><p>Claims data can be leveraged to study rare diseases such as Guillain-Barré Syndrome (GBS), a neurological autoimmune condition. It is difficult to accurately measure and distinguish true cases of disease with claims without a validated algorithm. Our objective was to identify the best-performing algorithm for identifying incident GBS cases in Medicare fee-for-service claims data using chart reviews as the gold standard.</p></div><div><h3>Study design and setting</h3><p>This was a multi-center, single institution cohort study from 2015 to 2019 that used Medicare-linked electronic health record (EHR) data. We identified 211 patients with a GBS diagnosis code in any position of an inpatient or outpatient claim in Medicare that also had a record of GBS in their electronic medical record. We reported the positive predictive value (PPV = number of true GBS cases/total number of GBS cases identified by the algorithm) for each algorithm tested. We also tested algorithms using several prevalence assumptions for false negative GBS cases and calculated a ranked sum for each algorithm's performance.</p></div><div><h3>Results</h3><p>We found that 40 patients out of 211 had a true case of GBS. Algorithm 17, a GBS diagnosis in the primary position of an inpatient claim and a diagnostic procedure within 45 days of the inpatient admission date, had the highest PPV (PPV = 81.6%, 95% CI (69.3, 93.9). Across three prevalence assumptions, Algorithm 15, a GBS diagnosis in the primary position of an inpatient claim, was favored (PPV = 79.5%, 95% CI (67.6, 91.5).</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate that patients with incident GBS can be accurately identified in Medicare claims with a chart-validated algorithm. Using large-scale administrative data to study GBS offers significant advantages over case reports and patient repositories with self-reported data, and may be a potential strategy for the study of other rare diseases.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000117/pdfft?md5=0dfb6efc036ab03fd73bfec5b44947a7&pid=1-s2.0-S2590113324000117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140879056","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":"Does recall bias explain the association of mood disorders with workplace harassment?","authors":"Igor Burstyn ,&nbsp;Jean-Michel Galarneau ,&nbsp;Nicola Cherry","doi":"10.1016/j.gloepi.2024.100144","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100144","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the contribution of recall bias to the observed excess in mental ill-health in those reporting harassment at work.</p></div><div><h3>Methods</h3><p>A prospective cohort of 1885 workers in welding and electrical trades was contacted every six months for up to 5 years, asking whether they were currently anxious or depressed and whether this was made worse by work. Only at the end of the study did we ask about any workplace harassment they had experienced at work. We elicited sensitivity and specificity of self-reported bullying from published reliability studies and formulated priors that reflect the possibility of over-reporting of workplace harassment (exposure) by those whose anxiety or depression was reported to be made worse by work (cases). We applied the resulting misclassification models to probabilistic bias analysis (PBA) of relative risks.</p></div><div><h3>Results</h3><p>We observe that PBA implies that it is unlikely that biased misclassification due to the study subjects' states of mind could have caused the entire observed association. Indeed, the results demonstrated that doubling of risk of anxiety or depression following workplace harassment is plausible, with the unadjusted relative risk attenuated with understated uncertainty.</p></div><div><h3>Conclusions</h3><p>It seems unlikely that risk of anxiety or depression following workplace harassment can be explained by the form of recall bias that we proposed.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000105/pdfft?md5=3fc7d2022eca921077b72024765c5435&pid=1-s2.0-S2590113324000105-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140818302","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":"Triangulation of epidemiological evidence and risk of bias evaluation: A proposed framework and applied example using formaldehyde exposure and risk of myeloid leukemias","authors":"Daniel J. Lauer ,&nbsp;Anthony J. Russell ,&nbsp;Heather N. Lynch ,&nbsp;William J. Thompson ,&nbsp;Kenneth A. Mundt ,&nbsp;Harvey Checkoway","doi":"10.1016/j.gloepi.2024.100143","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100143","url":null,"abstract":"<div><p>Evidence triangulation may help identify the impact of study design elements on study findings and to tease out biased results when evaluating potential causal relationships; however, methods for triangulating epidemiologic evidence are evolving and have not been standardized. Building upon key principles of epidemiologic evidence triangulation and risk of bias assessment, and responding to the National Academies of Sciences, Engineering, and Medicine (NASEM) call for applied triangulation examples, the objective of this manuscript is to propose a triangulation framework and to apply it as an illustrative example to epidemiologic studies examining the possible relationship between occupational formaldehyde exposure and risk of myeloid leukemias (ML) including acute (AML) and chronic (CML) types.</p><p>A nine-component triangulation framework for epidemiological evidence was developed incorporating study quality and ROB guidance from various federal health agencies (i.e., US EPA TSCA and NTP OHAT). Several components of the triangulation framework also drew from widely used epidemiological analytic tools such as stratified meta-analysis and sensitivity analysis. Regarding the applied example, fourteen studies were identified and assessed using the following primary study quality domains to explore potential key sources of bias: 1) study design and analysis; 2) study participation; 3) exposure assessment; 4) outcome assessment; and 5) potential confounding. Across studies, methodological limitations possibly contributing to biased results were observed within most domains. Interestingly, results from one study – often providing the largest and least-precise relative risk estimates, likely reflecting study biases, deviated from most primary study findings indicating no such associations. Triangulation of epidemiological evidence appears to be helpful in exploring inconsistent results for the identification of study results possibly reflecting various biases. Nonetheless, triangulation methodologies require additional development and application to real-world examples to enhance objectivity and reproducibility.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000099/pdfft?md5=1a7ead941966ce9014523a5ba67690c0&pid=1-s2.0-S2590113324000099-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140604784","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":"Estimating the effect of realistic improvements of metformin adherence on COVID-19 mortality using targeted machine learning","authors":"Sky Qiu ,&nbsp;Alan E. Hubbard ,&nbsp;Juan Pablo Gutiérrez ,&nbsp;Ganesh Pimpale ,&nbsp;Arturo Juárez-Flores ,&nbsp;Rakesh Ghosh ,&nbsp;Iván de Jesús Ascencio-Montiel ,&nbsp;Stefano M. Bertozzi","doi":"10.1016/j.gloepi.2024.100142","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100142","url":null,"abstract":"<div><h3>Background</h3><p>Type 2 diabetes elevates the risk of severe outcomes in COVID-19 patients, with multiple studies reporting higher case fatality rates. Metformin is a widely used medication for glycemic management. We hypothesize that improved adherence to metformin may lower COVID-19 post-infection mortality risk in this group. Utilizing data from the Mexican Social Security Institute (IMSS), we investigate the relationship between metformin adherence and mortality following COVID-19 infection in patients with chronic metformin prescriptions.</p></div><div><h3>Methods</h3><p>This is a retrospective cohort study consisting of 61,180 IMSS beneficiaries who received a positive polymerase chain reaction (PCR) or rapid test for SARS-CoV-2 and had at least two consecutive months of metformin prescriptions prior to the positive test. The hypothetical intervention is improved adherence to metformin, measured by proportion of days covered (PDC), with the comparison being the observed metformin adherence values. The primary outcome is all-cause mortality following COVID-19 infection. We defined the causal parameter using shift intervention, an example of modified treatment policies. We used the targeted learning framework for estimation of the target estimand.</p></div><div><h3>Findings</h3><p>Among COVID-19 positive patients with chronic metformin prescriptions, we found that a 5% and 10% absolute increase in metformin adherence is associated with a respective 0.26% (95% CI: −0.28%, 0.79%) and 1.26% (95% CI: 0.72%, 1.80%) absolute decrease in mortality risk.</p></div><div><h3>Interpretation</h3><p>Subject to the limitations of a real-world data study, our results indicate a causal association between improved metformin adherence and reduced COVID-19 post-infection mortality risk.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000087/pdfft?md5=a6ec9ca0bb8638bd123b2d043132b7e9&pid=1-s2.0-S2590113324000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140339685","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":"Quantitative recall bias analysis of the talc and ovarian cancer association","authors":"Julie E. Goodman,&nbsp;Leon M. Espira,&nbsp;Ke Zu ,&nbsp;Denali Boon","doi":"10.1016/j.gloepi.2024.100140","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100140","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000063/pdfft?md5=64e99086dc1b3d0a104e4bd42a503427&pid=1-s2.0-S2590113324000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140134651","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}