Global Epidemiology最新文献

{"title":"Occurrence of COVID-19 and serum per- and polyfluoroalkyl substances: A case-control study among workers with a wide range of exposures","authors":"Anna K. Porter ,&nbsp;Sarah E. Kleinschmidt ,&nbsp;Kara L. Andres ,&nbsp;Courtney N. Reusch ,&nbsp;Ryan M. Krisko ,&nbsp;Oyebode A. Taiwo ,&nbsp;Geary W. Olsen ,&nbsp;Matthew P. Longnecker","doi":"10.1016/j.gloepi.2024.100137","DOIUrl":"https://doi.org/10.1016/j.gloepi.2024.100137","url":null,"abstract":"<div><p><em>Per</em>- and polyfluoroalkyl substances (PFAS) are a broad class of synthetic chemicals; some are present in most humans in developed countries. Some studies suggest that certain PFAS may have immunotoxic effects in humans, which could put individuals with high levels of exposure at increased risk for infectious diseases such as COVID-19. We conducted a case-control study to examine the association between COVID-19 diagnosis and PFAS serum concentrations among employees and retirees from two 3 M facilities, one of which historically generated perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS). Participants completed enrollment and follow-up study visits in the Spring of 2021. Participants were categorized as cases if they reported a COVID-19 diagnosis or became sick with at least one symptom of COVID-19 when someone else in their household was diagnosed, otherwise they were categorized as a control. COVID-19 diagnosis was modeled in relation to concentration of serum PFAS measured at enrollment after adjusting for covariates. The analytic sample comprised 573 individuals, 111 cases (19.4%) and 462 controls (80.6%). In adjusted models, the odds ratio of COVID-19 was 0.94 per interquartile range (14.3 ng/mL) increase in PFOS (95% confidence interval 0.85, 1.04). Results for PFOA, PFHxS, and perfluorononanoic acid (PFNA) were similar. Other PFAS present at lower concentrations were examined as categorical variables (above the limit of quantification [LOQ], yes vs. no [referent category]), and also showed no positive associations. In our study, which used individual-level data and included people with high occupational exposure, the serum concentrations of all PFAS examined were not associated with an increased odds ratio for COVID-19. At this point, the epidemiologic data supporting no association of COVID-19 occurrence with PFAS exposure are stronger than those suggesting a positive association.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000038/pdfft?md5=0b41e758ae31284c9f51cb049c716f3f&pid=1-s2.0-S2590113324000038-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436464","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":"Global prevalence of vasovagal syncope: A systematic review and meta-analysis","authors":"Nader Salari ,&nbsp;Zohre Karimi ,&nbsp;Mahvan Hemmati ,&nbsp;Ali Mohammadi ,&nbsp;Shamarina Shohaimi ,&nbsp;Masoud Mohammadi","doi":"10.1016/j.gloepi.2024.100136","DOIUrl":"10.1016/j.gloepi.2024.100136","url":null,"abstract":"<div><h3>Background</h3><p>Today, vasovagal syncope is a common problem that has become a significant health and social challenge. The present study investigated the global prevalence of vasovagal syncope using a systematic review and meta-analysis.</p><p>Methods: In this systematic review and meta-analysis study, the global prevalence of vasovagal syncope using the keywords Prevalence, Epidemiology, Vasovagal syncope, and Reflex syncope in PubMed, WoS, Scopus, ScienceDirect databases, and Google scholar search engine without time limit until July 20, 2022, was extracted and transferred to the information management software (EndNote). Then the repeated studies were excluded, and researchers evaluated the remaining studies during three stages (i.e., screening, eligibility, and qualitative assessment). The heterogeneity of studies was investigated using the I² index, and the analysis of eligible studies was performed using the random effects model.</p></div><div><h3>Results</h3><p>In the review of 12 studies with a sample size of 36,156 people, the global prevalence of vasovagal syncope was reported as 16.4 (95%CI: 6–37.5), and the study of publication bias in the studies through the Egger test shows the absence of publication bias in the studies.</p></div><div><h3>Conclusion</h3><p>The prevalence reported in the studies shows a high prevalence of vasovagal syncope, which requires serious intervention and preventive, diagnostic, and therapeutic measures. It is necessary for health policymakers to take effective measures in this field.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000026/pdfft?md5=b0863b1ef4032b11730b61751dc55dcb&pid=1-s2.0-S2590113324000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395968","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":"Seroconversion among children with HBsAg-positive mothers in Indonesia and factors affecting the anti-HBs titers","authors":"Angga Wirahmadi,&nbsp;Hartono Gunardi,&nbsp;Bernie Endyarni Medise,&nbsp;Hanifah Oswari,&nbsp;Teny Tjitra Sari,&nbsp;Nastiti Kaswandani,&nbsp;Mulya Rahma Karyanti","doi":"10.1016/j.gloepi.2024.100135","DOIUrl":"10.1016/j.gloepi.2024.100135","url":null,"abstract":"<div><h3>Background and aim</h3><p>Around 2% of newborns are at risk of hepatitis B virus (HBV) infection from their mothers. To prevent this, infants born to HBsAg-positive mothers are given hepatitis B immune globulin (HBIG) and hepatitis B (HB) vaccine as immunoprophylaxis. This study aims to investigate the efficacy of immunoprophylaxis in infants born to HBsAg-positive mothers and the contributing factors.</p></div><div><h3>Methods</h3><p>The study was conducted on a group of 87 children, ranging from nine months to under 36 months, born to HBsAg-positive mothers and received immunoprophylaxis within 24 h after birth followed by a national immunization schedule at the Community Health Center (CHC) in three administrative cities of DKI Jakarta. We measured the levels of HBsAg and anti-HBs, and utilized ordinal logistic regression models to identify factors that influence the anti-HBs titers after vaccination.</p></div><div><h3>Results</h3><p>Out of 87 children, only one child had positive HBsAg results. The data showed that 88.5% of the children had seroprotection with anti-HBs levels ≥10 mIU/mL. Additionally, 48.3% of the children had a high protective response with anti-HBs levels ≥100 mIU/mL, while 11.5% had a non-protective response. Children under one year of age, with a family history of HBV carriers, and who received five doses of the HB vaccine exhibited higher levels of anti-HBs titer category with adjusted OR 3.9 (95%CI: 1.3–11.6), 5.3 (95%CI: 1.1–27.4), and 8.3 (95%CI: 2–34.8), respectively.</p></div><div><h3>Conclusion</h3><p>The administration of HBIG and HB vaccine successfully prevented vertical transmission, resulting in a high seroprotection rate.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113324000014/pdfft?md5=e7ff2f7fcae161d0e32ff0000d0679f6&pid=1-s2.0-S2590113324000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395507","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":"Improved clinical trial race/ethnicity reporting and updated inclusion profile, 2017–2022: A New Jersey snapshot","authors":"Elli Gourna Paleoudis ,&nbsp;Zhiyong Han ,&nbsp;Simon Gelman ,&nbsp;Hernan Arias-Ruiz ,&nbsp;Destiney Carter ,&nbsp;Jovan Bertrand ,&nbsp;Nicole Mastrogiovanni ,&nbsp;Stanley R. Terlecky","doi":"10.1016/j.gloepi.2023.100134","DOIUrl":"https://doi.org/10.1016/j.gloepi.2023.100134","url":null,"abstract":"<div><h3>Background</h3><p>Diverse representation in clinical trials is an important goal in the testing of a medical, diagnostic, or therapeutic intervention. To date, the desired level of trial equity and inclusivity has been unevenly achieved.</p></div><div><h3>Methods</h3><p>Employing the US National Library of Medicine's <span>Clinicaltrials.gov</span><svg><path></path></svg> registry, we examined 481 clinical trials conducted - at least in part - in the state of New Jersey. These trials were initiated after the FDA-mandated Common Rule changes, i.e., between January 2017 and October 2022, were enacted, and had their results posted. We analyzed sex/race/ethnicity reporting as well as applicable enrollment. Using meta-analysis, we estimated group participation proportions of a subset of the 481 identified trials; specifically, the 229 studies that were conducted solely within the US (i.e., without international sites) and compared them to US census data.</p></div><div><h3>Findings</h3><p>Within the 481 clinical trials analyzed, over 97% reported on the race and/or ethnicity of their enrollees; all included information on sex. Reporting was not affected by funding source or therapeutic area. Based on the 229 solely US-based studies, the participants overall were 76.7% White; 14.1% Black; 2.7% Asian; and 15% Hispanic. Inclusion of Black participants did not differ from the 2020 US census data; in contrast, the levels of Asian and Hispanic participation were below the corresponding census percentages.</p></div><div><h3>Interpretation</h3><p>The past five years have seen an overall uptick in the equity of race/ethnicity reporting and inclusivity of clinical trials, as compared to previously reported data, presaging the potential acquisition of ever more powerful and meaningful results of such interventional studies going forward.</p></div><div><h3>Funding</h3><p>Support for this study comes from the Hackensack Meridian <em>Health</em> Research Institute and the Hackensack Meridian School of Medicine.</p></div><div><h3>Research in context</h3><p><em>Evidence before this study</em></p><p>Clinical trials are a critical part of determining whether or not a medical (drug/device/biologic) or socio-behavioral intervention is safe and truly effective. Through their use, scientific understanding is advanced and, ideally, human health is improved. To gain the most impactful information from a clinical trial, it should be sufficiently representative, that is, should enroll an adequate number of participants, and include a diverse population. Without such inclusion, the study is of only limited generalizability. Efforts are underway by funders, sites, and other stakeholders, to enhance reporting and promote inclusive enrollment. The extent to which such attempts are yielding results - at least for clinical trials in the state of New Jersey - is the focus of this data-driven analysis. The <span>ClinicalTrials.gov</span><svg><path></path></svg> registry databa","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000378/pdfft?md5=619535c207850b8ebbb21fa9e4b0c77e&pid=1-s2.0-S2590113323000378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099831","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":"Differences in SARS-COV-2 seroprevalence in the population of Cusco, Peru","authors":"Huamaní Charles ,&nbsp;Concha-Velasco Fátima ,&nbsp;Velásquez Lucio ,&nbsp;K. Antich María ,&nbsp;Cassa Johar ,&nbsp;Palacios Kevin ,&nbsp;Bernable-Villasante Luz ,&nbsp;Giraldo-Alencastre Guido ,&nbsp;Benites-Calderon Eduarda ,&nbsp;Mendieta-Nuñez Sebastian ,&nbsp;Quispe-Jihuallanca Heber ,&nbsp;Quispe-Yana Matilde ,&nbsp;Zavala-Vargas Karla ,&nbsp;Hinojosa-Florez Liesbeth ,&nbsp;Ramírez-Escobar Javier ,&nbsp;Spelucin-Runciman Juan ,&nbsp;Bernabe-Ortiz Antonio","doi":"10.1016/j.gloepi.2023.100131","DOIUrl":"10.1016/j.gloepi.2023.100131","url":null,"abstract":"<div><h3>Background</h3><p>The spread of the coronavirus disease 2019 (COVID-19) in Peru has been reported at the regional level, few studies have evaluated its spread at the provincial level, in which the mechanisms could be different.</p></div><div><h3>Methods</h3><p>We conducted an analytical, cross-sectional, multistage observational population study to assess the seroprevalence of SARS-COV-2 at the provincial and urban/rural levels in a high-altitude setting. The sampling unit was the household, including a randomly selected family member. Sampling was performed using a data collection sheet on clinical and epidemiological variables. Chemiluminescence tests were used to detect total anti-SARS-COV-2 antibodies (IgG and IgM simultaneously). The percentages were adjusted to the sampling design.</p></div><div><h3>Results</h3><p>The overall prevalence in the region of Cusco was 25.9%, with considerably different prevalence between the 13 provinces (from 15.9% in Acomayo to 40.1% in Canchis) and between rural (21.1%) and urban (31.7%) areas. In multivariable model, living in a rural area was a protective factor (adjusted prevalence ratio [aPR], 0.68; 95% confidence interval [CI], 0.61–0.76).</p></div><div><h3>Conclusions</h3><p>Geographic diversity and population density determine different prevalence rates, typically lower in rural areas, possibly due to natural social distancing or limited interaction with people at risk.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000342/pdfft?md5=0d8eb9bd7d89e383599b818e3f7767de&pid=1-s2.0-S2590113323000342-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139015923","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 AI assistant to help review and improve causal reasoning in epidemiological documents","authors":"Louis Anthony Cox Jr.","doi":"10.1016/j.gloepi.2023.100130","DOIUrl":"10.1016/j.gloepi.2023.100130","url":null,"abstract":"<div><p>Drawing sound causal inferences from observational data is often challenging for both authors and reviewers. This paper discusses the design and application of an Artificial Intelligence Causal Research Assistant (AIA) that seeks to help authors improve causal inferences and conclusions drawn from epidemiological data in health risk assessments. The AIA-assisted review process provides structured reviews and recommendations for improving the causal reasoning, analyses and interpretations made in scientific papers based on epidemiological data. Causal analysis methodologies range from earlier Bradford-Hill considerations to current causal directed acyclic graph (DAG) and related models. AIA seeks to make these methods more accessible and useful to researchers. AIA uses an external script (a “Causal AI Booster” (CAB) program based on classical AI concepts of slot-filling in frames organized into task hierarchies to complete goals) to guide Large Language Models (LLMs), such as OpenAI's ChatGPT or Google's LaMDA (Bard), to systematically review manuscripts and create both (a) recommendations for what to do to improve analyses and reporting; and (b) explanations and support for the recommendations. Review tables and summaries are completed systematically by the LLM in order. For example, recommendations for how to state and caveat causal conclusions in the Abstract and Discussion sections reflect previous analyses of the Study Design and Data Analysis sections. This work illustrates how current AI can contribute to reviewing and providing constructive feedback on research documents. We believe that such AI-assisted review shows promise for enhancing the quality of causal reasoning and exposition in epidemiological studies. It suggests the potential for effective human-AI collaboration in scientific authoring and review processes.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000330/pdfft?md5=8c8af7a7619dbcd5390c297899c6e4d5&pid=1-s2.0-S2590113323000330-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615771","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 adjustment for non-differential misclassification of dichotomous exposure induce positive bias if there is no true association?","authors":"Igor Burstyn","doi":"10.1016/j.gloepi.2023.100132","DOIUrl":"https://doi.org/10.1016/j.gloepi.2023.100132","url":null,"abstract":"<div><p>This article is a response to an off-the-record discussion that I had at an international meeting of epidemiologists more than decade ago. It centered on a concern, perhaps widely spread, that adjustment for exposure misclassification can induce a false positive result. I trace the possible history of this supposition and test it in a simulated case-control study under the assumption of non-differential misclassification of binary exposure, in which a Bayesian adjustment is applied. Probabilistic bias analysis is also briefly considered. The main conclusion is that adjustment for the presumed non-differential exposure misclassification of dichotomous does not “induce” positive associations, especially if the focus of the interpretation of the result is taken away from the point estimate. The misconception about positive bias induced by adjustment for exposure misclassification, if more clearly explained during the training of epidemiologists, may promote appropriate (and wider) use of the adjustment techniques. The simple message that can be derived from this paper is: “Exposure misclassification as a tractable problem that deserves much more attention than just a typical qualitative throw-away discussion”.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"7 ","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000354/pdfft?md5=16cbb33547c1b63374f77dc5405dd947&pid=1-s2.0-S2590113323000354-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138549116","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":"Wildfire and child displacement: Still a burning issue","authors":"Sachin C. Sarode ,&nbsp;Namdeo J. Pawar ,&nbsp;Gargi Sarode ,&nbsp;Shruti Singh","doi":"10.1016/j.gloepi.2023.100127","DOIUrl":"https://doi.org/10.1016/j.gloepi.2023.100127","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"6 ","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000305/pdfft?md5=c58a95a9a77c13a1d3303de2a91f51f7&pid=1-s2.0-S2590113323000305-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138423545","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":"Air pollution accountability research: Moving from a chain to a web","authors":"S. Ebelt ,&nbsp;L. Baxter ,&nbsp;H.S. Erickson ,&nbsp;L.R.F. Henneman ,&nbsp;S. Lange ,&nbsp;T.J. Luben ,&nbsp;M. Neidell ,&nbsp;A.M. Rule ,&nbsp;A.G. Russell ,&nbsp;J. Wendt Hess ,&nbsp;C.J. Burns ,&nbsp;J.S. LaKind ,&nbsp;J.E. Goodman","doi":"10.1016/j.gloepi.2023.100128","DOIUrl":"https://doi.org/10.1016/j.gloepi.2023.100128","url":null,"abstract":"<div><p>Air pollution accountability studies examine the relationship(s) between an intervention, regulation, or event and the resulting downstream impacts, if any, on emissions, exposure, and/or health. The sequence of events has been schematically described as an accountability chain. Here, we update the existing framework to capture real-life complexities and to highlight important factors that fall outside the linear chain. This new “accountability web” is intended to convey the intricacies associated with conducting an accountability study to various audiences, including researchers, policy makers, and stakeholders. We also identify data considerations for planning and completing a robust accountability study, including those relevant to novel and innovative air pollution and exposure data. Finally, we present a series of recommendations for the accountability research community that can serve as a guide for the next generation of accountability studies.</p></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"6 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000317/pdfft?md5=2f3f1441171ff86f5c6136a4c87b5d0b&pid=1-s2.0-S2590113323000317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138335388","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 measurement error, PSA doubling time, and prostate cancer","authors":"Lawrence L. Kupper ,&nbsp;Sandra L. Martin ,&nbsp;Christopher J. Wretman","doi":"10.1016/j.gloepi.2023.100129","DOIUrl":"10.1016/j.gloepi.2023.100129","url":null,"abstract":"<div><p>Exposure measurement error is a pervasive problem for epidemiology research projects designed to provide valid and precise statistical evidence supporting postulated exposure-disease relationships of interest. The purpose of this commentary is to highlight an important real-life example of this exposure measurement error problem and to provide a simple and useful diagnostic tool for physicians and their patients that corrects for the exposure measurement error. More specifically, prostate-specific antigen doubling time (PSADT) is a widely used measure for guiding future treatment options for patients with biochemically recurrent prostate cancer. Numerous papers have been published claiming that a low calculated PSADT value (denoted <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span>) is predictive of metastasis and premature death from prostate cancer. Unfortunately, none of these papers have adjusted for the measurement error in <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span>, an estimator that is typically computed using the popular Memorial Sloan Kettering website very often visited by both physicians and their patients. For this website, the estimator <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> of the true (but unknown) PSADT for a patient (denoted PSADT^∗) is computed as the natural log of 2 (i.e., 0.6931) divided by the estimated slope of the straight-line regression of the natural log of PSA (in ng/mL) on time. We utilize <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> to derive an expression for the probability that the unknown PSADT^∗ for a patient is below a specified value C (<span><math><mo>&gt;</mo><mn>0</mn></math></span>) of concern to both the physician and the patient. This probability is easy to interpret and takes into account the fact that <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> is a statistical estimator with variability. This variability introduces measurement error, namely, the difference between a computed value <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> and the true, but unknown, value PSADT^∗. We have developed an Excel calculator that, once the [time, ln(PSA)] values are entered, outputs both the value of <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> and the desired probability. In addition, we discuss problematic statistical issues attendant with PSADT^∗ estimation typically based on at most three or four PSA values. We strongly recommend the use of this probability when physicians are discussing <span><math><mover><mtext>PSADT</mtext><mo>̂</mo></mover></math></span> values and associated treatment options with their patients. And, we stress that future epidemiology research projects involving PSA doubling time should take into account the measurement error problem highlighted in this Comment","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"6 ","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590113323000329/pdfft?md5=71d5903249a9e080067e9347ec66ce2c&pid=1-s2.0-S2590113323000329-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764242","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}