American journal of epidemiology最新文献

Improving classification of myocardial infarction with machine learning in a diverse population. 用机器学习改进不同人群中心肌梗死的分类。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-10-07 DOI: 10.1093/aje/kwaf223

Alicia Chen, Chuan Hong, Yuk Lam Ho, Nicholas Link, Jacqueline P Honerlaw, Vidisha Tanukonda, Ariela R Orkaby, Saadia Qazi, Connor Melley, Ashley Galloway, Lauren Costa, Monika Maripuri, Xuan Wang, Yichi Zhang, Petra Schubert, Tianrun Cai, Zeling He, Vidul A Panickan, Morgan Rosser, Laura Tarko, Sharon Dowell, Candace Feldman, Gail Kerr, J Michael Gaziano, Peter W F Wilson, Kelly Cho, Tianxi Cai, Katherine P Liao

{"title":"Improving classification of myocardial infarction with machine learning in a diverse population.","authors":"Alicia Chen, Chuan Hong, Yuk Lam Ho, Nicholas Link, Jacqueline P Honerlaw, Vidisha Tanukonda, Ariela R Orkaby, Saadia Qazi, Connor Melley, Ashley Galloway, Lauren Costa, Monika Maripuri, Xuan Wang, Yichi Zhang, Petra Schubert, Tianrun Cai, Zeling He, Vidul A Panickan, Morgan Rosser, Laura Tarko, Sharon Dowell, Candace Feldman, Gail Kerr, J Michael Gaziano, Peter W F Wilson, Kelly Cho, Tianxi Cai, Katherine P Liao","doi":"10.1093/aje/kwaf223","DOIUrl":"https://doi.org/10.1093/aje/kwaf223","url":null,"abstract":"Phenotype classification with electronic health record (EHR) data is increasingly performed with ML, however their performance in diverse populations remains understudied. We compared an ICD-based algorithm with an ML phenotyping pipeline to classify myocardial infarction (MI) in a general and self-reported Black population. We determined the impact of differential performance by replicating a published MI risk factor study with MI defined by the ICD or ML algorithms. Individuals followed in the Veterans Health Administration (VHA) EHR with data from 2002 to 2019 were examined: 11,523,175 Veterans, mean age 67.5 years, 93.8% male, 14.3% Black, 79.1% White. MI was classified using a published rule-based ICD algorithm and an ML pipeline, PheCAP which incorporates natural language processing. Algorithms were trained and validated against n=403 Veterans randomly selected and chart-reviewed for MI (gold standard), oversampled for self-reported Black. Among chart-reviewed Veterans, the ICD algorithm had high PPV and low sensitivity (all race, PPV:0.97, sensitivity:0.17; Black Veterans, PPV:0.94, sensitivity:0.24). PheCAP MI had good PPV and higher sensitivity (all race, PPV:0.90, sensitivity:0.66; Black, PPV:0.81, sensitivity:0.79). Applying PheCAP MI to the entire VHA population to classify MI provided increased power to replicate findings from the published MI risk factor study compared to the ICD algorithm.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237569","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

The authors' replies to comments on "Prenatal exposure to green space and mental health in early adolescence: findings from the TRAILS study". 作者对“产前接触绿地和青少年早期心理健康：来自TRAILS研究的发现”的评论的回复。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-10-06 DOI: 10.1093/aje/kwaf219

Yi Zeng, Gonneke W J M Stevens, Tomáš Paus, Marco Helbich

引用次数: 0

Spillovers and effect attenuation in firearm policy research in the United States. 美国枪支政策研究的溢出效应与效应衰减。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-10-06 DOI: 10.1093/aje/kwaf220

Lee Kennedy-Shaffer, Alan H Kennedy

{"title":"Spillovers and effect attenuation in firearm policy research in the United States.","authors":"Lee Kennedy-Shaffer, Alan H Kennedy","doi":"10.1093/aje/kwaf220","DOIUrl":"https://doi.org/10.1093/aje/kwaf220","url":null,"abstract":"In the United States, firearm-related deaths and injuries are a major public health issue. Because of limited federal action, state policies are particularly important, and their evaluation informs the actions of other policymakers. The movement of firearms across state and local borders, however, can undermine the effectiveness of these policies and have statistical consequences for their empirical evaluation. This movement causes spillover and bypass effects of policies, wherein interventions affect nearby control states and the lack of intervention in nearby states reduces the effectiveness in the intervention states. While some causal inference methods exist to account for spillover effects and reduce bias, these do not necessarily align well with the data available for firearm research or with the most policy-relevant estimands. Integrated data infrastructure and new methods are necessary for a better understanding of the effects these policies would have if widely adopted. In the meantime, appropriately understanding and interpreting effect estimates from quasi-experimental analyses is crucial for ensuring that effective policies are not dismissed due to these statistical challenges.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231365","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

Pre-diagnostic Body Mass Index Trajectories and Associations with Lung Cancer Risk. 诊断前体重指数轨迹及其与肺癌风险的关系。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-10-01 DOI: 10.1093/aje/kwaf084

Wen Zhou, Lorelei A Mucci, Mingyang Song, Hongbing Shen, Christopher I Amos

{"title":"Pre-diagnostic Body Mass Index Trajectories and Associations with Lung Cancer Risk.","authors":"Wen Zhou, Lorelei A Mucci, Mingyang Song, Hongbing Shen, Christopher I Amos","doi":"10.1093/aje/kwaf084","DOIUrl":"https://doi.org/10.1093/aje/kwaf084","url":null,"abstract":"Mendelian randomization can reveal the etiological association between body mass index (BMI) and lung cancer. However, the associations between the trajectories of BMI and the risk of lung cancer remain inconclusive. We employed growth mixture modeling to identify trajectories of pre-diagnostic BMI in 163,545 individuals (117,445 women from the Nurses' Health Study and 46,100 men from the Health Professionals Follow-Up Study). We assessed the associations between BMI trajectories and lung cancer risk, as well as the effects within subgroups. Four trajectories were identified: normal-moderate increasing (Class 1), overweight-marked increasing (Class 2), overweight-obese turning (Class 3), and obese-persistent (Class 4). We observed a decreased risk of lung cancer in Class 2 (adjusted hazard ratio [aHR] = 0.53, 95% confidence interval [CI] = 0.38-0.75, P = 2.32×10-4) and Class 3 (aHR = 0.67, 95% CI = 0.48-0.94, P = 0.022). In stratification analysis, we observed that the effects of Class 4 on lung cancer risk vary among histological subtypes. Additionally, within the Class 1 population, the top quintile of BMI also demonstrated different effects among histological subtypes. Increasing lifetime BMI was associated with a decreased risk of lung cancer, with this association varying by histological subtypes, indicating histology-specific mechanisms in lung carcinogenesis.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197930","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

Eviction, inability to pay rent, and youth mental health: a fixed effects study. 驱逐、无力支付房租与青少年心理健康：一项固定效应研究。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf212

Gabriel L Schwartz, Nigel Walsh Harriman, Bruce Ramphal, Natalie Slopen

{"title":"Eviction, inability to pay rent, and youth mental health: a fixed effects study.","authors":"Gabriel L Schwartz, Nigel Walsh Harriman, Bruce Ramphal, Natalie Slopen","doi":"10.1093/aje/kwaf212","DOIUrl":"https://doi.org/10.1093/aje/kwaf212","url":null,"abstract":"Housing insecurity is now widespread among US youth. Evidence is limited, however, on how that is affecting their mental health. Longitudinal analyses examining specific, policy-modifiable forms of housing insecurity are especially lacking. We thus estimated associations between two housing exposures (1. eviction, 2. family inability to pay housing bills) and youth mental health over time, including sleep disturbances. To do so, we analyzed all available waves of the Adolescent Brain and Cognitive Development Study, a national cohort of US youth (n=11,868, aged 9-13; 2016-2021). Models adjusted for individual-level fixed effects and time-varying sociodemographic characteristics. Results show eviction and inability to pay rent/mortgage were both associated with worse mental health, including more severe internalizing, externalizing, and sleep disturbance symptoms. In models including both housing exposures, eviction associations were attenuated, while estimates for inability to pay were effectively unchanged. Given the prevalence of families having difficulty paying housing bills, findings suggest a large pool of young people whose mental well-being may be adversely affected. If these associations reflect cause, government efforts to prevent evictions (e.g., right to counsel in housing court) or lower housing cost burden (cash assistance, public housing, zoning reform, etc.) would have important benefits for young people's psychological wellness.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197932","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

Risk-based guidance for choosing FIT or colonoscopy in colorectal cancer screening: a modelling study. 结直肠癌筛查中选择FIT或结肠镜检查的风险指导：一项模型研究

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf214

Luuk A van Duuren, Jean-Luc Bulliard, Matthias Harlass, Ekaterina Plys, Douglas A Corley, Florian Froehlich, Kevin Selby, Iris Lansdorp-Vogelaar

{"title":"Risk-based guidance for choosing FIT or colonoscopy in colorectal cancer screening: a modelling study.","authors":"Luuk A van Duuren, Jean-Luc Bulliard, Matthias Harlass, Ekaterina Plys, Douglas A Corley, Florian Froehlich, Kevin Selby, Iris Lansdorp-Vogelaar","doi":"10.1093/aje/kwaf214","DOIUrl":"https://doi.org/10.1093/aje/kwaf214","url":null,"abstract":"In colorectal cancer (CRC) screening settings offering both colonoscopy and fecal immunochemical test (FIT), guidance on who should get colonoscopy could optimize resource use. This study aimed to identify efficient guidance strategies, maximizing quality-adjusted lifeyears (QALYs) gained for given colonoscopy demand. Using the MISCAN-Colon microsimulation model for Switzerland, we evaluated three strategy types: age-based, starting biennial FIT and switching to 10-yearly colonoscopy at a certain age; risk-score-based, where only individuals with high CRC risk scores undergo colonoscopy; FIT-based, switching to colonoscopy after a quantitative FIT result just below the positivity cutoff and, in some strategies, also at a certain age. Reference strategies included (1) colonoscopy-only and (2) equal proportions of individuals choosing FIT or colonoscopy at age 50. Age- and risk-score-based strategies with switches or risk assessments at ages 54, 64 or 74 were efficient. Compared to the reference strategies, QALYs gained could increase by (1) 10.0% or (2) 6.7% without increasing colonoscopy demand. FIT-based switching strategies were not efficient. Therefore, screening programs like those in Switzerland and the US can improve efficiency by guiding individuals towards FIT or colonoscopy simply based on age. More complex approaches using prior FITs or risk scores would not outperform age-based approaches. 199 words.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197945","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

Association Between exposure to VOCs mixture and impaired renal function in Korean adults. 韩国成人接触挥发性有机化合物混合物与肾功能受损的关系。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf215

Seong-Uk Baek, Jin-Ha Yoon

{"title":"Association Between exposure to VOCs mixture and impaired renal function in Korean adults.","authors":"Seong-Uk Baek, Jin-Ha Yoon","doi":"10.1093/aje/kwaf215","DOIUrl":"https://doi.org/10.1093/aje/kwaf215","url":null,"abstract":"Evidence suggests that volatile organic compounds (VOCs) is linked to negative health outcomes. This study investigated the association of exposure to VOC mixtures with renal function parameters. Our study included a nationwide sample of Korean adults (n = 1758). The following nine urinary VOC metabolites were measured: SPMA, BMA, 3,4-MHA, 2-MHA, MA, 3-HPMA, BPMA, DHBMA, and PGA. Estimated glomerular filtration rate (eGFR) was calculated based on the serum creatinine levels. Urine albumin-to-creatinine ratio (ACR) was calculated. For mixture analysis, the Quantile g-computation (qgcomp) method and Bayesian kernel machine regression (BKMR) were conducted. Results from the qgcomp method indicated that a quartile increase in the levels of VOC metabolites was linked to a 1.33-point (95% CI: -2.46,-0.20) decrease in the eGFR and a 14.67% (95% CI: 4.25, 26.15) increase in the ACR. BKMR analyses also indicated that the overall increase in urinary VOC metabolite concentrations was related to a reduce in eGFR and an increase in ACR in a dose-dependent manner. Among the individual urinary VOC metabolites, SPMA and MA contributed the most to the decreased eGFR, whereas DHBMA was the primary contributor to the increased ACR. Policy efforts are needed to reduce environmental VOC exposure.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197899","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

Comment on "accuracy of COVID-19 vaccination self-report compared with data from VSD electronic health Records for Pregnant Women and non-pregnant adults, 2021-2022". 评论“与2021-2022年孕妇和非孕妇成人VSD电子健康记录数据相比，COVID-19疫苗接种自我报告的准确性”。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf217

Hinpech Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Studies based on health administrative data regarding rare outcomes in inflammatory bowel disease significantly underestimate the true risk - the importance of specificity. 基于炎症性肠病罕见结局的健康管理数据的研究明显低估了真正的风险——特异性的重要性。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf216

Mikkel Malham, Eric I Benchimol, Matthew P Fox, David C Wilson

{"title":"Studies based on health administrative data regarding rare outcomes in inflammatory bowel disease significantly underestimate the true risk - the importance of specificity.","authors":"Mikkel Malham, Eric I Benchimol, Matthew P Fox, David C Wilson","doi":"10.1093/aje/kwaf216","DOIUrl":"https://doi.org/10.1093/aje/kwaf216","url":null,"abstract":"Background: Health administrative data (HAD) have significantly increased our knowledge of rare outcomes in inflammatory bowel disease (IBD), such as cancer and mortality. We aimed to assess the information bias imposed by misclassification of the IBD diagnosis in HAD studies by performing quantitative bias analysis (QBA).Design: In a narrative review, we identified pediatric-onset IBD (PIBD) HAD studies assessing cancer risk in which the PIBD case identification was based on published validation studies. We then performed QBA to adjust for non-differential exposure misclassification using the sensitivity and specificity values from country or region-specific validation studies.Results: We present QBA on four recent studies reporting on cancer outcomes. Generally, we found the reported cancer risks biased towards the null. In the most extreme example, the relative risk changed from 2.0 (95% confidence interval [CI]: 1.2-3.4) to 5.8 (95%CI: 2.5-13.7) after bias adjustment. The risk difference for this example rose from 1.0% (95%CI: 0.1-1.9) to 3.8% (95%CI: 1.4-7.9) after bias adjustment.Conclusion: The results from this study indicate that most HAD-based studies on rare long-term consequences of IBD significantly underestimate the true risk of the outcomes. These results can be extrapolated to other HAD-based studies with imperfect specificity of the case assertion algorithms.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197934","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

All-cause mortality around the anniversary of a Sibling's death: findings from Swedish National Register Data. 兄弟姐妹死亡周年前后的全因死亡率：来自瑞典国家登记数据的调查结果。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2025-09-30 DOI: 10.1093/aje/kwaf213

Sandra Rogne, Alessandra Grotta, Can Liu, Lisa Berg, Jan Saarela, Ichiro Kawachi, Ayako Hiyoshi, Mikael Rostila

{"title":"All-cause mortality around the anniversary of a Sibling's death: findings from Swedish National Register Data.","authors":"Sandra Rogne, Alessandra Grotta, Can Liu, Lisa Berg, Jan Saarela, Ichiro Kawachi, Ayako Hiyoshi, Mikael Rostila","doi":"10.1093/aje/kwaf213","DOIUrl":"https://doi.org/10.1093/aje/kwaf213","url":null,"abstract":"Death anniversaries may trigger stress responses that negatively affect health in bereaved individuals. Little is known about such reactions after adult sibling loss. This study examined whether mortality risk increases around the anniversary of a sibling's death. Using Swedish national register data (1990-2016), we conducted a time-stratified case-crossover study including 12,789 adults who experienced sibling loss and later died. Conditional logistic regression estimated associations between mortality and death anniversaries (including pre- and post-anniversary periods), adjusting for time-invariant confounders. Analyses were stratified by the bereaved's sex and age, the sibling's sex, sibling order, and whether ≥1 parent was alive at the bereaved's death. Among women, mortality risk was lower on the anniversary date (OR 0.44; 95% CI 0.21-0.93), and in the period from one day before and up to the anniversary date for women who lost a younger or same-age sibling (OR 0.45; 95% CI 0.20-1.00). In contrast, men bereaved before age 50 had a heightened risk in the period ranging from 12 days before and up to the anniversary (OR 1.40; 95 % CI 1.05-1.86). Overall, sibling-death anniversaries were not associated with elevated mortality, though observed sex- and age-specific patterns merits further investigation.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197906","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