American journal of epidemiology最新文献_第3页

Healthcare Access Domains and Treatment as Mediators of Ovarian Cancer Racial Disparities in Survival: A Structural Equation Modeling Analysis in SEER-Medicare. 作为卵巢癌种族生存差异中介因素的医疗服务领域和治疗：SEER-Medicare 的结构方程模型分析。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-30 DOI: 10.1093/aje/kwae404

Clare Meernik, Quan Chen, Lauren E Wilson, Ashwini Joshi, Fariha Rahman, Maria Pisu, Margaret Liang, Kevin C Ward, Margaret Gates Kuliszewski, Thomas Tucker, Andrew Berchuck, Bin Huang, Tomi Akinyemiju

{"title":"Healthcare Access Domains and Treatment as Mediators of Ovarian Cancer Racial Disparities in Survival: A Structural Equation Modeling Analysis in SEER-Medicare.","authors":"Clare Meernik, Quan Chen, Lauren E Wilson, Ashwini Joshi, Fariha Rahman, Maria Pisu, Margaret Liang, Kevin C Ward, Margaret Gates Kuliszewski, Thomas Tucker, Andrew Berchuck, Bin Huang, Tomi Akinyemiju","doi":"10.1093/aje/kwae404","DOIUrl":"https://doi.org/10.1093/aje/kwae404","url":null,"abstract":"Racial differences in healthcare access (HCA) may contribute to disparities in ovarian cancer (OC) survival. We used structural equation models (SEM) to examine associations between race and HCA domains (affordability, availability, accessibility) in relation to overall and OC-specific mortality. Non-Hispanic (NH)-Black and non-Black (Hispanic, NH-White) women diagnosed with OC in 2008-2015 were identified from SEER-Medicare. Cox proportional hazards regression was used to conduct mediation analysis for associations between race and HCA domains with overall and OC-specific mortality. SEM models adjusting for demographic and clinical covariates were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). A total of 4,629 eligible OC patients were identified, including 255 (5.5%) patients who were NH-Black. In SEM adjusting for demographic, clinical, and HCA latent variables, there was a total effect of NH-Black race on overall (HR: 1.11, 95% CI: 1.03,1.19) and OC-specific mortality (HR: 1.16, 95% CI: 1.08, 1.24), which was primarily driven by a direct effect. There was a modest indirect association between NH-Black race and mortality through decreased treatment receipt, though not through HCA. There is a need for studies investigating additional social and biological mechanisms that contribute to worse cancer survival among NH-Black patients.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543064","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

COVID-19 and sepsis-related excess mortality in the US during the first three years: A national-wide time series study. COVID-19 和美国头三年与败血症相关的超额死亡率：全国时间序列研究。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-30 DOI: 10.1093/aje/kwae411

Zhenhu Chen, Yue Tian, Juan Liu, Jinjun Ran, Shengzhi Sun, Shi Zhao, Yang Ge, Leonardo Martinez, Xin Chen, Peihua Cao

{"title":"COVID-19 and sepsis-related excess mortality in the US during the first three years: A national-wide time series study.","authors":"Zhenhu Chen, Yue Tian, Juan Liu, Jinjun Ran, Shengzhi Sun, Shi Zhao, Yang Ge, Leonardo Martinez, Xin Chen, Peihua Cao","doi":"10.1093/aje/kwae411","DOIUrl":"https://doi.org/10.1093/aje/kwae411","url":null,"abstract":"The COVID-19 pandemic's global impact has been devastating, causing millions of deaths. Our study investigates excess sepsis-related mortality trends over three years during the pandemic. Using CDC's National Vital Statistics System data from January 2018 to March 2023, we projected sepsis-related deaths during the pandemic using a Poisson log-linear regression model. We compared observed versus predicted deaths and analyzed temporal trends by demographics and regions. Among the 753,160 deaths documented between March 2020 and March 2023, a significant downward trend was noted in sepsis-related mortality rates from March 2022 to March 2023, coinciding with the surge of the Omicron variant. The excess mortality rates were 170.6 per million persons (95% CI: 168.2-172.6), 167.5 per million persons (95% CI: 163.6-170.9), and 73.3 per million persons (95% CI: 69.4-76.6) in the first, second, and third years, respectively. Increased sepsis-related mortality was observed across all age subgroups, with the greatest increase noted in those aged 85 years and above compared to middle- and young-aged decedents. Disparities were also observed across racial/ethnic, sex/gender subgroups, and geographic regions. This study highlights the effectiveness of current policies and prevention measures in response to the long-term circulating of SARS-CoV-2 in the community.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543062","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

Methodological challenges and actionable recommendations in studying the health effects of high-concentration THC products. 研究高浓度四氢大麻酚产品对健康影响的方法挑战和可行建议。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-29 DOI: 10.1093/aje/kwae421

Tianjing Li, George Sam Wang, Ashley Brooks-Russell, Gregory Tung, Louis Leslie, Thanitsara Rittiphairoj, Jean-Pierre Oberste, Tsz Wing Yim, Lisa Bero, Jonathan M Samet

{"title":"Methodological challenges and actionable recommendations in studying the health effects of high-concentration THC products.","authors":"Tianjing Li, George Sam Wang, Ashley Brooks-Russell, Gregory Tung, Louis Leslie, Thanitsara Rittiphairoj, Jean-Pierre Oberste, Tsz Wing Yim, Lisa Bero, Jonathan M Samet","doi":"10.1093/aje/kwae421","DOIUrl":"https://doi.org/10.1093/aje/kwae421","url":null,"abstract":"In conducting a scoping review on the health effects of high-concentration cannabis products, we have uncovered pervasive methodological shortcomings within the cannabis literature. This paper begins by defining the 'causal effect' of interest for public health and delineating the desirable features of study design that can address crucial questions pertaining to public health and policy. We further delve into the methodological complexities inherent in studying the health effects of high-concentration cannabis products, describing challenges associated with the measurement of exposures and outcomes, confounding, selection bias, and the generalizability of findings. We introduce causal inference methods to mitigate potential biases in observational cannabis use studies. We identify specific areas that necessitate further development and investigation to deepen our understanding of this topic. Finally, this paper extends actionable recommendations, serving as a roadmap for upcoming research initiatives in this domain.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543065","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

Addressing bias due to measurement error of an outcome with unknown sensitivity in database epidemiological studies. 解决数据库流行病学研究中敏感度未知的结果测量误差造成的偏差。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-29 DOI: 10.1093/aje/kwae423

Giorgio Limoncella, Leonardo Grilli, Emanuela Dreassi, Carla Rampichini, Robert Platt, Rosa Gini

{"title":"Addressing bias due to measurement error of an outcome with unknown sensitivity in database epidemiological studies.","authors":"Giorgio Limoncella, Leonardo Grilli, Emanuela Dreassi, Carla Rampichini, Robert Platt, Rosa Gini","doi":"10.1093/aje/kwae423","DOIUrl":"https://doi.org/10.1093/aje/kwae423","url":null,"abstract":"In epidemiological database studies, the occurrence of an event is measured with error through an indicator whose specificity is often maximised, at the expense of sensitivity. However, if the indicator has low sensitivity, measures of occurrence are underestimated. In association studies, risk difference is biased, and risk ratio may be biased as well, in either direction, if the sensitivity is differential across exposure groups. In this work, we show that if an auxiliary screening indicator can be defined to complement the main indicator, estimates of the positive predictive value of both indicators provide tools to estimate the sensitivity of the primary indicator, or a lower bound thereof. This mitigates bias in estimating the number of cases, prevalence, cumulative incidence, rate (particularly when the event is rare), and in association studies, risk ratio and risk difference. They also allow testing for non-differential sensitivity. While direct estimation of sensitivity is often infeasible, this novel methodology improves evidence based on data obtained from re-use of existing databases, which may prove critical for regulatory and public health decisions.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543061","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

Updated CP*Trends: An Online Tool to Compare Cohort and Period Trends across Cancer Sites. 更新的 CP*Trends：比较不同癌症部位的队列和时期趋势的在线工具。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-28 DOI: 10.1093/aje/kwae398

Theodore R Holford, Huann-Sheng Chen, Michael J Kane, Martin Krapcho, David Annett, Len Esclamado, Asya Melkonyan, Eric J Feuer

{"title":"Updated CP*Trends: An Online Tool to Compare Cohort and Period Trends across Cancer Sites.","authors":"Theodore R Holford, Huann-Sheng Chen, Michael J Kane, Martin Krapcho, David Annett, Len Esclamado, Asya Melkonyan, Eric J Feuer","doi":"10.1093/aje/kwae398","DOIUrl":"https://doi.org/10.1093/aje/kwae398","url":null,"abstract":"CP*Trends is a widely used SEER website used to explore temporal effects of period and cohort on cancer incidence and mortality. It provides a graphical display of smoothed rates, and a C-P Score that helps to assess the magnitude of the effect of cohort and period. This update provides results for African Americans and Whites. The C-P Score has an intrinsic bias favoring cohort because there are many more cohorts than periods. An adjusted C-P Score removes some of this advantage. Bootstrap confidence intervals are given, which allow one to see the effects of different sample sizes on the model results. Finally, users may control window size used in the smoothing algorithm, which helps to avoid over smoothing or masking of trends. The method is illustrated using data on cervical cancer incidence trends for African Americans and Whites, 1975-2018. Rates are higher for African Americans, and both races have contributions for cohort. However, the period effect is only strongly evident in Whites. Visual inspection of White trends suggests possible differences for those older and younger than age 50. These methods are applied in an interactive website displaying incidence and mortality trends for over 20 cancer sites in the US.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543066","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

Spatial and demographic heterogeneity in excess mortality in the United States, 2020-2023: a multi-model approach. 2020-2023 年美国超额死亡率的空间和人口异质性：一种多模型方法。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-28 DOI: 10.1093/aje/kwae422

Sasikiran Kandula, Anja Bråthen Kristoffersen, Gunnar Rø, Marissa LeBlanc, Birgitte Freiesleben de Blasio

{"title":"Spatial and demographic heterogeneity in excess mortality in the United States, 2020-2023: a multi-model approach.","authors":"Sasikiran Kandula, Anja Bråthen Kristoffersen, Gunnar Rø, Marissa LeBlanc, Birgitte Freiesleben de Blasio","doi":"10.1093/aje/kwae422","DOIUrl":"https://doi.org/10.1093/aje/kwae422","url":null,"abstract":"In this study, we assessed the overall impact of the Covid-19 pandemic in the United States between 2020 and 2023 through estimates of excess all-cause mortality. Monthly mortality rates over a 19-year period, stratified by age, sex and state of residence were used to forecast expected mortality for the pandemic years. A combination of models - two timeseries, a spatial random effects and a generalized additive -- was used to better capture uncertainty. Results indicate that US national excess mortality decreased in 2023 to 157 thousand (95% prediction interval: 35K-282K) from 502K (436K-567K), 574K(484K-666K) and 377K (264K-484K) during the years 2020-2022, respectively. Unlike in previous years, deaths with Covid-19 as the underlying-cause-of-death possibly accounted for all excess deaths during 2023. While for the older age groups (75+ years) the year 2020, before vaccines were available, had the highest excess mortality rate, the two younger age groups had the highest excess mortality in 2021. In each age group, women were estimated to have consistently lower excess mortality than men. West Virginia had the highest age-standardized excess mortality among all states in 2021 and 2022. Our findings demonstrate the value of a multi-model approach in capturing heterogeneity in excess mortality.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566899","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

Education, health-based selection, and the widening mortality gap between Americans with and without a four-year college degree. 教育、基于健康的选择以及拥有和未拥有四年制大学学位的美国人之间不断扩大的死亡率差距。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-28 DOI: 10.1093/aje/kwae420

Anne Case, Angus Deaton

{"title":"Education, health-based selection, and the widening mortality gap between Americans with and without a four-year college degree.","authors":"Anne Case, Angus Deaton","doi":"10.1093/aje/kwae420","DOIUrl":"https://doi.org/10.1093/aje/kwae420","url":null,"abstract":"Background: Gaps in life expectancy between Americans with and without a college degree have widened markedly over the past three decades. One explanation points to increasing educational attainment changing the type of people with and without a degree. If pre-existing health in the two education groups changes as the fraction with a degree changes, health selection might explain the widening mortality gap.Methods: We examine this explanation using (a) education and mortality in each birth cohort of men and women from 1940 to 1988, and (b) the natural experiment caused by the Vietnam War, which increased the fractions of men with a degree in affected birth cohorts. For each cohort, we examine the relationship between the mortality gap and the fraction with a degree.Results: We find no relationship between the fraction of a birth cohort with a degree and the corresponding mortality gap. For men, the large increase in college going spurred by Vietnam has no perceptible counterpart in the mortality gap.Conclusion: The evidence from the natural experiment induced by the Vietnam War does not support a health-selection explanation for the widening mortality gap.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543063","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

Wastewater surveillance of antibiotic resistant bacteria for public health action: Potential and Challenges. 废水中的抗生素耐药菌监测，促进公共卫生行动：潜力与挑战。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-28 DOI: 10.1093/aje/kwae419

Betsy Foxman, Elizabeth Salzman, Chelsie Gesierich, Sarah Gardner, Michelle Ammerman, Marisa Eisenberg, Krista Wigginton

{"title":"Wastewater surveillance of antibiotic resistant bacteria for public health action: Potential and Challenges.","authors":"Betsy Foxman, Elizabeth Salzman, Chelsie Gesierich, Sarah Gardner, Michelle Ammerman, Marisa Eisenberg, Krista Wigginton","doi":"10.1093/aje/kwae419","DOIUrl":"https://doi.org/10.1093/aje/kwae419","url":null,"abstract":"Antibiotic resistance is an urgent public health threat. Actions to reduce this threat include requiring prescriptions for antibiotic use, antibiotic stewardship programs, educational programs targeting patients and healthcare providers, and limiting antibiotic use in agriculture, aquaculture, and animal husbandry. Wastewater surveillance might complement clinical surveillance by tracking time/space variation essential for detecting outbreaks and evaluating efficacy of evidence-based interventions; identifying high-risk populations for targeted monitoring; providing early warning of the emergence and spread of antibiotic resistant bacteria and identifying novel antibiotic resistant threats. Wastewater surveillance was an effective early warning system for SARS-CoV-2 spread and detection of the emergence of new viral strains. In this data-driven commentary we explore whether monitoring wastewater for antibiotic resistant genes and/or bacteria resistant to antibiotics might provide useful information for public health action. Using carbapenem resistance as an example, we highlight technical challenges associated with using wastewater to quantify temporal/spatial trends in antibiotic resistant bacteria (ARBs) and antibiotic resistant genes (ARGs) and compare with clinical information. While ARGs and ARBs are detectable in wastewater enabling early detection of novel ARGs, quantitation of ARBs and ARGs with current methods is too variable to reliably track space/time variation.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543067","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 Overlap Weights to Address Extreme Propensity Scores in Estimating Restricted Mean Counterfactual Survival Times. 在估算受限平均反事实生存时间时使用重叠权重解决极端倾向得分问题。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-25 DOI: 10.1093/aje/kwae416

Zhiqiang Cao, Lama Ghazi, Claudia Mastrogiacomo, Laura Forastiere, F Perry Wilson, Fan Li

{"title":"Using Overlap Weights to Address Extreme Propensity Scores in Estimating Restricted Mean Counterfactual Survival Times.","authors":"Zhiqiang Cao, Lama Ghazi, Claudia Mastrogiacomo, Laura Forastiere, F Perry Wilson, Fan Li","doi":"10.1093/aje/kwae416","DOIUrl":"https://doi.org/10.1093/aje/kwae416","url":null,"abstract":"While inverse probability of treatment weighting (IPTW) is a commonly used approach for treatment comparisons in observational data, the resulting estimates may be subject to bias and excessively large variance under lack of overlap. By smoothly down-weighting units with extreme propensity scores, i.e., those that are close (or equal) to zero or one, overlap weighting (OW) can help mitigate the bias and variance issues associated with IPTW. Although theoretical and simulation results have supported the use of OW with continuous and binary outcomes, its performance with survival outcomes remains to be further investigated, especially when the target estimand is defined based on the restricted mean survival time (RMST). We combine propensity score weighting and inverse probability of censoring weighting to estimate the restricted mean counterfactual survival times, and provide computationally-efficient variance estimators when the propensity scores are estimated by logistic regression and the censoring process is estimated by Cox regression. We conduct simulations to compare the performance of weighting methods in terms of bias, variance, and 95% interval coverage, under various degrees of overlap. Under moderate and weak overlap, we demonstrate the advantage of OW over IPTW, trimming and truncation, with respect to bias, variance, and coverage when estimating RMST.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567039","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

Competing classes confront competing risks: unraveling mortality inequities with parametric g-computation. 竞争阶层面对竞争风险：用参数 g 计算揭示死亡率的不平等。

IF 5 2区医学

American journal of epidemiology Pub Date : 2024-10-25 DOI: 10.1093/aje/kwae417

Jerzy Eisenberg-Guyot, Audrey Renson

引用次数: 0