Epidemiologic Reviews最新文献_第2页

The measurement of racism in health inequities research. 健康不平等研究中的种族主义测量。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2023-12-20 DOI: 10.1093/epirev/mxad004

Marina Mautner Wizentier, Briana Joy K Stephenson, Melody S Goodman

{"title":"The measurement of racism in health inequities research.","authors":"Marina Mautner Wizentier, Briana Joy K Stephenson, Melody S Goodman","doi":"10.1093/epirev/mxad004","DOIUrl":"10.1093/epirev/mxad004","url":null,"abstract":"There is limited literature on the measures and metrics used to examine racism in the health inequities literature. Health inequities research is continuously evolving, with the number of publications increasing over time. However, there is limited knowledge on the best measures and methods to examine the impact of different levels of racism (institutionalized, personally mediated, and internalized) on health inequities. Advanced statistical methods have the potential to be used in new ways to examine the relationship between racism and health inequities. In this review, we conduct a descriptive examination of the measurement of racism in the health inequities epidemiologic literature. We examine the study design, methods used for analysis, types of measures used (e.g., composite, absolute, relative), number of measures used, phase of research (detect, understand, solutions), viewpoint (oppressor, oppressed), and components of structural racism measures (historical context, geographical context, multifaceted nature). We discuss methods (e.g., Peters-Belson, latent class analysis, difference in differences) that have demonstrated potential for future work. The articles reviewed were limited to the detect (25%) and understand (75%) phases, with no studies in the solutions phase. Although the majority (56%) of studies had cross-sectional designs, many authors pointed to the need for longitudinal and multilevel data for further exploration. We examined study design features as mutually exclusive elements. However, racism is a multifaceted system and the measurement of racism in many studies does not fit into a single category. As the literature grows, the significance of methodological and measurement triangulation to assess racism should be investigated.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":" ","pages":"32-43"},"PeriodicalIF":5.5,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

At the intersection of race and immigration: a comprehensive review of depression and related symptoms within the US Black population. 种族与移民的交汇点：美国黑人抑郁症及相关症状的全面回顾。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2023-12-20 DOI: 10.1093/epirev/mxad006

Precious Esie, Lisa M Bates

{"title":"At the intersection of race and immigration: a comprehensive review of depression and related symptoms within the US Black population.","authors":"Precious Esie, Lisa M Bates","doi":"10.1093/epirev/mxad006","DOIUrl":"10.1093/epirev/mxad006","url":null,"abstract":"Although the literature on the differences between Black people and White people in terms of differences in major depressive disorder and related self-reported symptoms is robust, less robust is the literature on how these outcomes are patterned within the US Black population and why differences exist. Given increased ethnic diversity of Black Americans due to increases in immigration, continued aggregation may mask differences between Black ethnic-immigrant groups and Black Americans with more distant ancestral ties to Africa (African Americans). The purpose of this narrative review was to comprehensively synthesize the literature on depression and related symptoms within the US Black population across immigration- and ethnicity-related domains and provide a summary of mechanisms proposed to explain variation. Findings revealed substantial variation in the presence of these outcomes within the US Black population by nativity, region of birth, age at immigration, and Caribbean ethnic origin. Racial context and racial socialization were identified as important, promising mechanisms for better understanding variations by region of birth and among those born or socialized in the United States, respectively. Findings warrant data collection efforts and measurement innovation to better account for within-racial differences in outcomes under study. A greater appreciation of the growing ethnic-immigrant diversity within the US Black population may improve understanding of how racism differentially functions as a cause of depression and related symptoms within this group.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":" ","pages":"105-126"},"PeriodicalIF":5.5,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9625198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental health burdens among North American Asian adults living with chronic conditions: a systematic review. 北美亚裔成人慢性病患者的心理健康负担：系统综述。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2023-12-20 DOI: 10.1093/epirev/mxad003

Jessica Y Islam, Nina S Parikh, Hope Lappen, Vandana Venkat, Priyanka Nalkar, Farzana Kapadia

{"title":"Mental health burdens among North American Asian adults living with chronic conditions: a systematic review.","authors":"Jessica Y Islam, Nina S Parikh, Hope Lappen, Vandana Venkat, Priyanka Nalkar, Farzana Kapadia","doi":"10.1093/epirev/mxad003","DOIUrl":"10.1093/epirev/mxad003","url":null,"abstract":"Asians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups-an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease-specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":" ","pages":"82-92"},"PeriodicalIF":5.5,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9765749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Misracialization of Indigenous people in population health and mortality studies: a scoping review to establish promising practices. 人口健康和死亡率研究中的土著人种族化误区：确定可行做法的范围审查。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2023-12-20 DOI: 10.1093/epirev/mxad001

Danielle R Gartner, Ceco Maples, Madeline Nash, Heather Howard-Bobiwash

{"title":"Misracialization of Indigenous people in population health and mortality studies: a scoping review to establish promising practices.","authors":"Danielle R Gartner, Ceco Maples, Madeline Nash, Heather Howard-Bobiwash","doi":"10.1093/epirev/mxad001","DOIUrl":"10.1093/epirev/mxad001","url":null,"abstract":"Indigenous people are often misracialized as other racial or ethnic identities in population health research. This misclassification leads to underestimation of Indigenous-specific mortality and health metrics, and subsequently, inadequate resource allocation. In recognition of this problem, investigators around the world have devised analytic methods to address racial misclassification of Indigenous people. We carried out a scoping review based on searches in PubMed, Web of Science, and the Native Health Database for empirical studies published after 2000 that include Indigenous-specific estimates of health or mortality and that take analytic steps to rectify racial misclassification of Indigenous people. We then considered the weaknesses and strengths of implemented analytic approaches, with a focus on methods used in the US context. To do this, we extracted information from 97 articles and compared the analytic approaches used. The most common approach to address Indigenous misclassification is to use data linkage; other methods include geographic restriction to areas where misclassification is less common, exclusion of some subgroups, imputation, aggregation, and electronic health record abstraction. We identified 4 primary limitations of these approaches: (1) combining data sources that use inconsistent processes and/or sources of race and ethnicity information; (2) conflating race, ethnicity, and nationality; (3) applying insufficient algorithms to bridge, impute, or link race and ethnicity information; and (4) assuming the hyperlocality of Indigenous people. Although there is no perfect solution to the issue of Indigenous misclassification in population-based studies, a review of this literature provided information on promising practices to consider.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":" ","pages":"63-81"},"PeriodicalIF":5.5,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Trial and Observational Data to Assess Effectiveness: Trial Emulation, Transportability, Benchmarking, and Joint Analysis. 利用试验和观察数据评估有效性：试验模拟、可迁移性、基准和联合分析。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2023-02-08 DOI: 10.1093/epirev/mxac011

Issa J Dahabreh, Anthony Matthews, Jon A Steingrimsson, Daniel O Scharfstein, Elizabeth A Stuart

{"title":"Using Trial and Observational Data to Assess Effectiveness: Trial Emulation, Transportability, Benchmarking, and Joint Analysis.","authors":"Issa J Dahabreh, Anthony Matthews, Jon A Steingrimsson, Daniel O Scharfstein, Elizabeth A Stuart","doi":"10.1093/epirev/mxac011","DOIUrl":"10.1093/epirev/mxac011","url":null,"abstract":"Comparisons between randomized trial analyses and observational analyses that attempt to address similar research questions have generated many controversies in epidemiology and the social sciences. There has been little consensus on when such comparisons are reasonable, what their implications are for the validity of observational analyses, or whether trial and observational analyses can be integrated to address effectiveness questions. Here, we consider methods for using observational analyses to complement trial analyses when assessing treatment effectiveness. First, we review the framework for designing observational analyses that emulate target trials and present an evidence map of its recent applications. We then review approaches for estimating the average treatment effect in the target population underlying the emulation: using observational analyses of the emulation data alone; and using transportability analyses to extend inferences from a trial to the target population. We explain how comparing treatment effect estimates from the emulation against those from the trial can provide evidence on whether observational analyses can be trusted to deliver valid estimates of effectiveness - a process we refer to as benchmarking - and, in some cases, allow the joint analysis of the trial and observational data. We illustrate different approaches using a simplified example of a pragmatic trial and its emulation in registry data. We conclude that synthesizing trial and observational data - in transportability, benchmarking, or joint analyses - can leverage their complementary strengths to enhance learning about comparative effectiveness, through a process combining quantitative methods and epidemiological judgements.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Closing the Gap Between Observational Research and Randomized Controlled Trials for Prevention of Alzheimer Disease and Dementia. 缩小观察研究与随机对照试验之间的差距，预防阿尔茨海默病和痴呆症。

IF 5.2 2区医学

Epidemiologic Reviews Pub Date : 2022-12-21 DOI: 10.1093/epirev/mxac002

Melinda C Power, Brittany C Engelman, Jingkai Wei, M Maria Glymour

{"title":"Closing the Gap Between Observational Research and Randomized Controlled Trials for Prevention of Alzheimer Disease and Dementia.","authors":"Melinda C Power, Brittany C Engelman, Jingkai Wei, M Maria Glymour","doi":"10.1093/epirev/mxac002","DOIUrl":"10.1093/epirev/mxac002","url":null,"abstract":"Although observational studies have identified modifiable risk factors for Alzheimer disease and related dementias (ADRD), randomized controlled trials (RCTs) of risk factor modification for ADRD prevention have been inconsistent or inconclusive. This finding suggests a need to improve translation between observational studies and RCTs. However, many common features of observational studies reduce their relevance to designing related RCTs. Observational studies routinely differ from RCTs with respect to eligibility criteria, study population, length of follow-up, treatment conditions, outcomes, and effect estimates. Using the motivating example of blood pressure reduction for ADRD prevention, we illustrate the need for a tighter connection between observational studies and RCTs, discuss barriers to using typically reported observational evidence in developing RCTs, and highlight methods that may be used to make observational research more relevant to clinical trial design. We conclude that the questions asked and answered by observational research can be made more relevant to clinical trial design and that better use of observational data may increase the likelihood of successful, or at least definitive, trials. Although we focus on improving translation of observational studies on risk factors for ADRD to RCTs in ADRD prevention, the overarching themes are broadly applicable to many areas of biomedical research.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"44 1","pages":"17-28"},"PeriodicalIF":5.2,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362937/pdf/mxac002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Randomized Trials With Repeatedly Measured Outcomes: Handling Irregular and Potentially Informative Assessment Times. 重复测量结果的随机试验：处理不规则和潜在的信息评估时间。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2022-12-21 DOI: 10.1093/epirev/mxac010

Eleanor M Pullenayegum, Daniel O Scharfstein

{"title":"Randomized Trials With Repeatedly Measured Outcomes: Handling Irregular and Potentially Informative Assessment Times.","authors":"Eleanor M Pullenayegum, Daniel O Scharfstein","doi":"10.1093/epirev/mxac010","DOIUrl":"10.1093/epirev/mxac010","url":null,"abstract":"Randomized trials are often designed to collect outcomes at fixed points in time after randomization. In practice, the number and timing of outcome assessments can vary among participants (i.e., irregular assessment). In fact, the timing of assessments may be associated with the outcome of interest (i.e., informative assessment). For example, in a trial evaluating the effectiveness of treatments for major depressive disorder, not only did the timings of outcome assessments vary among participants but symptom scores were associated with assessment frequency. This type of informative observation requires appropriate statistical analysis. Although analytic methods have been developed, they are rarely used. In this article, we review the literature on irregular assessments with a view toward developing recommendations for analyzing trials with irregular and potentially informative assessment times. We show how the choice of analytic approach hinges on assumptions about the relationship between the assessment and outcome processes. We argue that irregular assessment should be treated with the same care as missing data, and we propose that trialists adopt strategies to minimize the extent of irregularity; describe the extent of irregularity in assessment times; make their assumptions about the relationships between assessment times and outcomes explicit; adopt analytic techniques that are appropriate to their assumptions; and assess the sensitivity of trial results to their assumptions.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"44 1","pages":"121-137"},"PeriodicalIF":5.5,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9854724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

A Qualitative Scoping Review of Early-Terminated Clinical Trials Sponsored by the Department of Veterans Affairs Cooperative Studies Program From 2010 to 2020. 2010年至2020年退伍军人事务部合作研究项目赞助的早期终止临床试验的定性范围审查。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2022-12-21 DOI: 10.1093/epirev/mxac009

Alexa Goldberg, Ludmila N Bakhireva, Kimberly Page, Adam M Henrie

{"title":"A Qualitative Scoping Review of Early-Terminated Clinical Trials Sponsored by the Department of Veterans Affairs Cooperative Studies Program From 2010 to 2020.","authors":"Alexa Goldberg, Ludmila N Bakhireva, Kimberly Page, Adam M Henrie","doi":"10.1093/epirev/mxac009","DOIUrl":"10.1093/epirev/mxac009","url":null,"abstract":"Increasing attention has been paid to the risks and benefits of terminating large clinical trials before reaching prespecified targets, because such decisions can greatly affect the implementation of findings. The Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) is a research infrastructure dedicated to conducting high-quality clinical research. A scoping review was performed to characterize barriers preventing the attainment of prespecified recruitment, statistical power, or sample-size targets in VA CSP trials. A trial was eligible for inclusion if the trial was sponsored by the VA CSP, primary findings were published within the last 10 years, and a decision was made to terminate enrollment or follow-up before meeting a priori recruitment or endpoint targets. In 11 of 29 included trials (37.9%), a decision was made to terminate the trial early. The most common reason for early termination was related to under-recruitment (n = 5). Other reasons included early detection of safety signals (n = 2), futility (n = 1), and benefit (n = 1). This review highlights recruitment as a critical facet of trial conduct that may hinder the production of high-quality data and thus warrant additional attention. Solutions to enhance recruitment now implemented by the VA CSP, including dedicated enrollment infrastructure and screening facilitated by informatics approaches, show promise in reducing this cause for early termination.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"44 1","pages":"110-120"},"PeriodicalIF":5.5,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362930/pdf/mxac009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Comparing the Value of Data Visualization Methods for Communicating Harms in Clinical Trials. 比较数据可视化方法在临床试验中危害沟通中的价值。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2022-12-21 DOI: 10.1093/epirev/mxac005

Riaz Qureshi, Xiwei Chen, Carsten Goerg, Evan Mayo-Wilson, Stephanie Dickinson, Lilian Golzarri-Arroyo, Hwanhee Hong, Rachel Phillips, Victoria Cornelius, Mara Mc Adams DeMarco, Eliseo Guallar, Tianjing Li

{"title":"Comparing the Value of Data Visualization Methods for Communicating Harms in Clinical Trials.","authors":"Riaz Qureshi, Xiwei Chen, Carsten Goerg, Evan Mayo-Wilson, Stephanie Dickinson, Lilian Golzarri-Arroyo, Hwanhee Hong, Rachel Phillips, Victoria Cornelius, Mara Mc Adams DeMarco, Eliseo Guallar, Tianjing Li","doi":"10.1093/epirev/mxac005","DOIUrl":"https://doi.org/10.1093/epirev/mxac005","url":null,"abstract":"In clinical trials, harms (i.e., adverse events) are often reported by simply counting the number of people who experienced each event. Reporting only frequencies ignores other dimensions of the data that are important for stakeholders, including severity, seriousness, rate (recurrence), timing, and groups of related harms. Additionally, application of selection criteria to harms prevents most from being reported. Visualization of data could improve communication of multidimensional data. We replicated and compared the characteristics of 6 different approaches for visualizing harms: dot plot, stacked bar chart, volcano plot, heat map, treemap, and tendril plot. We considered binary events using individual participant data from a randomized trial of gabapentin for neuropathic pain. We assessed their value using a heuristic approach and a group of content experts. We produced all figures using R and share the open-source code on GitHub. Most original visualizations propose presenting individual harms (e.g., dizziness, somnolence) alone or alongside higher level (e.g., by body systems) summaries of harms, although they could be applied at either level. Visualizations can present different dimensions of all harms observed in trials. Except for the tendril plot, all other plots do not require individual participant data. The dot plot and volcano plot are favored as visualization approaches to present an overall summary of harms data. Our value assessment found the dot plot and volcano plot were favored by content experts. Using visualizations to report harms could improve communication. Trialists can use our provided code to easily implement these approaches.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"44 1","pages":"55-66"},"PeriodicalIF":5.5,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/d7/mxac005.PMC9780120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10442120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Review of the Ring Trial Design for Evaluating Ring Interventions for Infectious Diseases. 传染病环形干预措施评价的环形试验设计综述

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2022-12-21 DOI: 10.1093/epirev/mxac003

Zachary Butzin-Dozier, Tejas S Athni, Jade Benjamin-Chung

{"title":"A Review of the Ring Trial Design for Evaluating Ring Interventions for Infectious Diseases.","authors":"Zachary Butzin-Dozier, Tejas S Athni, Jade Benjamin-Chung","doi":"10.1093/epirev/mxac003","DOIUrl":"https://doi.org/10.1093/epirev/mxac003","url":null,"abstract":"In trials of infectious disease interventions, rare outcomes and unpredictable spatiotemporal variation can introduce bias, reduce statistical power, and prevent conclusive inferences. Spillover effects can complicate inference if individual randomization is used to gain efficiency. Ring trials are a type of cluster-randomized trial that may increase efficiency and minimize bias, particularly in emergency and elimination settings with strong clustering of infection. They can be used to evaluate ring interventions, which are delivered to individuals in proximity to or contact with index cases. We conducted a systematic review of ring trials, compare them with other trial designs for evaluating ring interventions, and describe strengths and weaknesses of each design. Of 849 articles and 322 protocols screened, we identified 26 ring trials, 15 cluster-randomized trials, 5 trials that randomized households or individuals within rings, and 1 individually randomized trial. The most common interventions were postexposure prophylaxis (n = 23) and focal mass drug administration and screening and treatment (n = 7). Ring trials require robust surveillance systems and contact tracing for directly transmitted diseases. For rare diseases with strong spatiotemporal clustering, they may have higher efficiency and internal validity than cluster-randomized designs, in part because they ensure that no clusters are excluded from analysis due to zero cluster incidence. Though more research is needed to compare them with other types of trials, ring trials hold promise as a design that can increase trial speed and efficiency while reducing bias.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"44 1","pages":"29-54"},"PeriodicalIF":5.5,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362935/pdf/mxac003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9856188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1