American journal of epidemiology最新文献

Childhood Social and Economic Disadvantage and the Risk of Uterine Fibroids among Black Women. 黑人妇女的童年社会经济劣势与子宫肌瘤的风险。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-07-03 DOI: 10.1093/aje/kwaf143

Sefanit Admasu, Alexandra Sitarik, Chantel L Martin, Quaker E Harmon, Lauren A Wise, Donna D Baird, Ganesa Wegienka, Anissa I Vines

{"title":"Childhood Social and Economic Disadvantage and the Risk of Uterine Fibroids among Black Women.","authors":"Sefanit Admasu, Alexandra Sitarik, Chantel L Martin, Quaker E Harmon, Lauren A Wise, Donna D Baird, Ganesa Wegienka, Anissa I Vines","doi":"10.1093/aje/kwaf143","DOIUrl":"https://doi.org/10.1093/aje/kwaf143","url":null,"abstract":"The association of childhood social and economic disadvantage (\"disadvantage\") and uterine fibroid risk is understudied. We examined the association between disadvantage and fibroid incidence using standardized ultrasound exams at repeated visits, among 1,230 participants 23-35 years of age in the Study of Environment, Lifestyle and Fibroids. Six disadvantage variables collected at baseline (i.e., food insecurity, neighborhood safety, childhood income, mother's educational attainment, household composition, and quiet bedroom for sleep) were evaluated separately, and using a latent class dichotomous (high/low) disadvantage variable. We also looked at possible modifying effects of a supportive childhood environment. Using Cox models to estimate incidence rate ratios (RR) and 95% confidence intervals (CI), with age as the time scale, we found little evidence for an increased risk of fibroids for any of the disadvantage variables or with the latent class construct. Having a supportive social environment in childhood had little impact on the associations between disadvantage and fibroid incidence. These findings are consistent with and expand upon prior findings from large studies with more limited data on social and economic disadvantage and less accurate data on timing of fibroid incidence.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558799","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

Bidirectional associations of Physical Activity and Cognitive Function in Midlife Adults: A Longitudinal Analysis across 26 years follow-up. 中年成年人身体活动与认知功能的双向关联：一项26年随访的纵向分析。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-07-03 DOI: 10.1093/aje/kwaf144

John J Mitchell, Mark Hamer, Sarah N James, Tom Norris, Barbara J Jefferis, S Goya Wannamethee, Joanna M Blodgett

{"title":"Bidirectional associations of Physical Activity and Cognitive Function in Midlife Adults: A Longitudinal Analysis across 26 years follow-up.","authors":"John J Mitchell, Mark Hamer, Sarah N James, Tom Norris, Barbara J Jefferis, S Goya Wannamethee, Joanna M Blodgett","doi":"10.1093/aje/kwaf144","DOIUrl":"https://doi.org/10.1093/aje/kwaf144","url":null,"abstract":"Prior studies linking physical activity (PA) and cognition typically assume a causal association between PA and subsequent cognition. Yet, there remains speculation regarding the direction of this association. We investigated bidirectional associations between PA and cognition. Participants of the Medical Research Council National Survey of Health and Development cohort, all born in 1946 reported their PA frequency, undertook processing speed and word recall memory tasks throughout midlife (ages 43 years(y), 53y, 63y and 69y). There was evidence of bidirectional associations in initial structural equation models. To quantify this relationship, mixed-effects models were fitted with a lagged predictor and controlling for childhood cognition, socioeconomic and health factors, attrition and mortality. Among 2,888 participants (51% female) we report bidirectional associations between cognition and PA in midlife. A 1-standard deviation increase in verbal memory was associated with an increased probability of being in the mid-active category at the subsequent wave for females (Relative Risk Ratio (RRR):1.30 (95% Confidence Interval (CI):1.15-1.46)), while becoming active was associated with a minimally greater subsequent verbal memory z-score (β= 0.08, 95%CI: 0.01-0.14). Bidirectional associations proved more robust for males. Results suggest that reciprocal associations exist between PA and cognition, yet stronger in the direction of cognition to PA.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558798","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

Evaluating the generalizability of commercial healthcare claims data. 评估商业医疗保健索赔数据的普遍性。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-30 DOI: 10.1093/aje/kwaf142

Alex Dahlen, Yaowei Deng, Vivek Charu

{"title":"Evaluating the generalizability of commercial healthcare claims data.","authors":"Alex Dahlen, Yaowei Deng, Vivek Charu","doi":"10.1093/aje/kwaf142","DOIUrl":"https://doi.org/10.1093/aje/kwaf142","url":null,"abstract":"Commercial healthcare claims datasets area non-random sample of the US population, affecting generalizability. Rigorous comparisons of claims-derived results to ground-truth data that quantify external validity bias are lacking. Our goal is to (1) quantify external validity of commercial healthcare claims data, and (2) evaluate how socioeconomic/demographic factors are related to the bias. We analyzed inpatient discharge records occurring between 01/01/2019 to 12/31/2019 in five states: California, Iowa, Maryland, Massachusetts, and New Jersey, and compared rates (per person-year) of the 250 most common inpatient procedures between claims and reference data for each target population. We used Merative™ MarketScan® Commercial Database for the claims data and State Inpatient Databases (SID) and the US Census as reference. For a target population of all Americans, commercial healthcare claims underestimate the rate of overall inpatient discharges by 23.1%. The extent of bias varied across procedures, with the rates of ~25% of procedures being underestimated by a factor of 2. Socioeconomic factors were significantly associated with the magnitude of bias (${R}^2=69.4%,$p < 0.001). When the target population was restricted to commercially insured Americans, the bias decreased substantially (1.4% of procedures were biased by more than factor of 2), but some variation across procedures remained.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551667","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

Firearm Control Regulations and Firearm-related Mortality: A Cross-National Ecological Study. 枪支管制条例和枪支相关死亡率：一项跨国生态学研究。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-30 DOI: 10.1093/aje/kwaf141

Siddhesh Zadey, Leah E Roberts, Brady Bushover, Adam M Whalen, Christina A Mehranbod, Stan Chihuri, Evan L Eschliman, Christopher N Morrison

引用次数: 0

Decades-Ahead Forecasting of Disease Trend Leveling and Decline: Leveraging Birth-Cohort Effects. 疾病趋势平衡和下降的未来几十年预测：利用出生队列效应。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-30 DOI: 10.1093/aje/kwaf140

Bo-Yu Hsiao, Teng-Yu Tsai, Wen-Chung Lee

{"title":"Decades-Ahead Forecasting of Disease Trend Leveling and Decline: Leveraging Birth-Cohort Effects.","authors":"Bo-Yu Hsiao, Teng-Yu Tsai, Wen-Chung Lee","doi":"10.1093/aje/kwaf140","DOIUrl":"https://doi.org/10.1093/aje/kwaf140","url":null,"abstract":"Background: Accurate long-term prediction of disease trends is crucial for public health planning and resource allocation. Traditional methods like age-standardized rate extrapolation and the Lee-Carter model often face limitations in predictive accuracy. The age-period-cohort model offers a promising alternative.Methods: We employed a Monte Carlo simulation to model disease rate changes from 2001 to 2040 under various scenarios influenced by age, period, and cohort effects. The predictive performance of the age-period-cohort model was compared with linear extrapolation, restricted cubic spline extrapolation of age-standardized rates, and the Lee-Carter model. Evaluation metrics included bias, variance, and mean square error.Results: The age-period-cohort model showed superior predictive accuracy, closely aligning with true values, especially in scenarios dominated by cohort effects. In contrast, restricted cubic spline extrapolation, the Lee-Carter model, and linear extrapolation demonstrated progressively poorer performance.Conclusion: The age-period-cohort model effectively anticipates decades-ahead stabilization and decline of disease rates, outperforming traditional forecasting methods. It is recommended as a robust tool for guiding public health policy and resource distribution.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551666","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

Longitudinal Analysis of Alcohol-Related Emergency Department Visits from 1993 to 2021. 1993年至2021年酒精相关急诊就诊的纵向分析

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-30 DOI: 10.1093/aje/kwaf139

Lucas Rios Rocha, Jingya Gao, Janice A Espinola, Carlos A Camargo

{"title":"Longitudinal Analysis of Alcohol-Related Emergency Department Visits from 1993 to 2021.","authors":"Lucas Rios Rocha, Jingya Gao, Janice A Espinola, Carlos A Camargo","doi":"10.1093/aje/kwaf139","DOIUrl":"https://doi.org/10.1093/aje/kwaf139","url":null,"abstract":"This nationwide, serial cross-sectional study examines long-term trends in alcohol-related ED visits from the National Hospital Ambulatory Medical Care Survey (1993-2021), highlighting demographic differences and distinguishing between chronic and acute conditions. The analysis included patients aged ≥15 years with ED visits classified as alcohol-related using Alcohol-Attributable Fractions (AAFs), determined with the CDC's Alcohol-Related Disease Impact method. Fully alcohol-attributable visits (AAF1, 100% attributable) and partially alcohol-attributable visits were examined. The primary outcome was trends in AAF1 ED visit rates over time, while secondary outcomes included stratifications by demographic characteristics (age, sex, race) and in AAFs by condition type (chronic vs. acute). Comparing 1993-1994 to 2019-2021, 100% alcohol-attributable ED visit rates rose by 139%; from 4.4 to 10.5 per 1,000 U.S. population (p<0.001), exceeding the 28% increase in overall ED visit rates (339 to 433 visits per 1,000). The greatest relative increases were among adults aged ≥50 years (242%), males (146%), and among White patients (190%). Chronic AAF ED visit increased by 158%, while acute visit declined by 12%. The disproportionate growth in alcohol-related ED visits (relative to overall ED visits) underscores the need for targeted prevention and intervention strategies that address high-risk populations and mitigate impact on the healthcare system.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551670","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

Lifestyles Modify the Biological Aging Process: Evidence from Multiple Cohorts. 生活方式改变生物衰老过程：来自多个队列的证据。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-30 DOI: 10.1093/aje/kwaf138

Junlin Jia, Chi Pang Wen, Huakang Tu, Junlong Pan, Wanzhu Lu, Min Yang, Andi Xu, Min Kuang Tsai, Sicong Wang, David Ta-Wei Chu, Wenyuan Li, Xifeng Wu

{"title":"Lifestyles Modify the Biological Aging Process: Evidence from Multiple Cohorts.","authors":"Junlin Jia, Chi Pang Wen, Huakang Tu, Junlong Pan, Wanzhu Lu, Min Yang, Andi Xu, Min Kuang Tsai, Sicong Wang, David Ta-Wei Chu, Wenyuan Li, Xifeng Wu","doi":"10.1093/aje/kwaf138","DOIUrl":"https://doi.org/10.1093/aje/kwaf138","url":null,"abstract":"The impact of lifestyle factors on biological aging is typically assessed one time at enrollment in epidemiological studies, with few studies examining their impact over time. In this prospective study with 143,823 individuals from the Taiwan MJ cohort, we investigate the association between healthy lifestyle scores (HLS) and annualized changes in biological age (ΔMDAge/year), replicated with Phenotypic Age and UK Biobank data. Compared to individuals with HLS of 0, increasing HLS was associated with decreased level of ΔMDAge/year, with the adjusted betas (95%CI) were -0.19 (-0.30 to -0.08), -0.23 (-0.33 to -0.12), -0.29 (-0.39 to -0.18), -0.34 (-0.45 to -0.24), and -0.38 (-0.49 to -0.28) for HLS of 1, 2, 3, 4, and 5, respectively. Those results were also replicated in the UK Biobank. Individuals with accelerated aging at baseline and higher HLS exhibited lower odds ratio of persistent aging acceleration. Moreover, those with a higher HLS and decreased ΔMDAge/year had a 49% reduction in all-cause mortality risk. About 5.05% of the association between HLS and mortality was mediated by ΔMDAge/year. These findings demonstrate that a healthier lifestyle profile is associated with attenuated aging acceleration, potential reversal of accelerated aging status, and reduced mortality risk.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551669","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

Sociodemographic, health-related, and clinical characteristics and their associations with mortality among all of us participants compared with the United States general population. 与美国普通人群相比，我们所有参与者的社会人口学、健康相关和临床特征及其与死亡率的关系。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-23 DOI: 10.1093/aje/kwaf118

Jingxuan Wang, Erin L Ferguson, Peter Buto, Ruijia Chen, Anna Pederson, Minhyuk Choi, Andrew C Stokes, Deborah Blacker, M Maria Glymour

{"title":"Sociodemographic, health-related, and clinical characteristics and their associations with mortality among all of us participants compared with the United States general population.","authors":"Jingxuan Wang, Erin L Ferguson, Peter Buto, Ruijia Chen, Anna Pederson, Minhyuk Choi, Andrew C Stokes, Deborah Blacker, M Maria Glymour","doi":"10.1093/aje/kwaf118","DOIUrl":"https://doi.org/10.1093/aje/kwaf118","url":null,"abstract":"The large and diverse All of Us Research Program offers tremendous opportunities for health research. However, results may not be generalizable to the U.S. population due to the program's targeted recruitment efforts. We compared All of Us participants to those from the nationally representative continuous 1999-2018 National Health and Nutrition Examination Survey (NHANES) with respect to: overall mortality rates; the distribution of sociodemographic, health-related, and clinical characteristics; the association of each characteristic with mortality estimated using Cox proportional-hazards models; and population attributable fractions (PAFs) for each characteristic and mortality. All of Us participants were older, less likely to be Non-Hispanic White, had more years of education, and had a higher prevalence of major chronic conditions than NHANES. Mortality rates were generally lower for All of Us participants, especially at older ages. The direction of associations in All of Us and NHANES matched for almost all comparisons, but differed in magnitude for some conditions, primarily clinical diagnoses. PAFs were generally higher in All of Us. Predictors of mortality in All of Us do not consistently generalize to the U.S. population. Analytical approaches are needed to address non-representativeness and mitigate potential biases associated with the selection into the All of Us cohort.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482790","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

Externalities of polluting cooking fuels, gender, and adult cognitive health in Low- and Middle-Income countries. 低收入和中等收入国家污染烹饪燃料、性别和成人认知健康的外部性。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-23 DOI: 10.1093/aje/kwaf133

Sneha Sarah Mani, Aashish Gupta, Irma T Elo

{"title":"Externalities of polluting cooking fuels, gender, and adult cognitive health in Low- and Middle-Income countries.","authors":"Sneha Sarah Mani, Aashish Gupta, Irma T Elo","doi":"10.1093/aje/kwaf133","DOIUrl":"https://doi.org/10.1093/aje/kwaf133","url":null,"abstract":"Scientific understanding of the relationship between environmental hazards and cognitive health at older ages in low- and middle-income countries (LMICs) is poor. Using data from the Longitudinal Aging Study of India and the World Health Organization's Survey on Global AGEing and adult health for four LMICs, we examine the association of direct and local exposure to polluting cooking fuels with cognitive health at older ages. We document the negative influence of both: cognitive health is poorer among members of households that use polluting fuels and among residents of neighborhoods where the use of polluting fuels is more common. These associations cannot be explained by accounting for individual or local differences in socioeconomic status. Consistent with direct impacts of polluting fuels, we find that women in households where the use of polluting fuels is common have the lowest predicted cognitive scores. Our findings reveal the substantial direct influence and negative externalities of polluting fuel use in LMICs and help understand why overall cognitive health may be poor in these settings. Moving away from polluting fuels toward clean fuels may reduce individual risk and community-level exposure to air pollution, contributing to better cognitive health in older ages.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482789","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

A two-step approach to simultaneously correct for selection and misclassification bias in nonprobability samples from hard-to-reach populations. 从难以到达的人群中同时纠正非概率样本的选择和错误分类偏差的两步方法。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-20 DOI: 10.1093/aje/kwaf132

Christoffer Dharma, Peter Smith, Travis Salway, Dionne Gesink, Michael Escobar, Victoria Landsman

{"title":"A two-step approach to simultaneously correct for selection and misclassification bias in nonprobability samples from hard-to-reach populations.","authors":"Christoffer Dharma, Peter Smith, Travis Salway, Dionne Gesink, Michael Escobar, Victoria Landsman","doi":"10.1093/aje/kwaf132","DOIUrl":"https://doi.org/10.1093/aje/kwaf132","url":null,"abstract":"Researchers studying hard-to-reach or minority populations are increasingly implementing nonprobability sampling strategies which are often prone to selection bias. To address this problem, existing statistical methods suggest integrating data from external probability sample, often collected by government agencies, with the nonprobability sample from the hard-to-reach population. These methods assume that all information collected in the probability sample is recorded without errors. This may not be the case if participants are unwilling to report their minority status, such as sexual orientation, truthfully in large-scale population-based surveys, leading to misclassification bias. In this paper, we propose a novel two-step approach aimed at addressing misclassification bias in the probability sample to improve the performance of the data integration methods aimed at addressing selection bias in the nonprobability sample. By applying the proposed method to simulated data, we demonstrate a significant reduction in bias and validate the proposed bootstrap variance estimator of the estimated mean (prevalence) under low, moderate, and high misclassification rates. This method is particularly beneficial when the misclassification rate is high. Finally, we illustrate the application of the two-step approach to estimate the prevalence of measures of social connectedness among sexual minority men using a real-world nonprobability sample.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511403","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