American journal of epidemiology最新文献_第5页

Intersectional inequities in suicide ideation by race, sexual orientation, and gender among U.S. high school students in the pre and post 2020 waves of the YRBSS: An application of random effects intersectional MAIHDA. 美国高中生种族、性取向和性别自杀意念的交叉不平等：随机效应交叉MAIHDA的应用

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-04 DOI: 10.1093/aje/kwaf114

Junaid S Merchant, Thu T Nguyen, Katrina Makres, Clare R Evans

{"title":"Intersectional inequities in suicide ideation by race, sexual orientation, and gender among U.S. high school students in the pre and post 2020 waves of the YRBSS: An application of random effects intersectional MAIHDA.","authors":"Junaid S Merchant, Thu T Nguyen, Katrina Makres, Clare R Evans","doi":"10.1093/aje/kwaf114","DOIUrl":"https://doi.org/10.1093/aje/kwaf114","url":null,"abstract":"The U.S. faces a youth mental health crisis. Few studies have examined how the disruptions of 2020 impacted existing mental health inequities. I-MAIHDA (intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy) is a methodological innovation that provides social epidemiology with a theory-informed and rigorous approach to quantify changing intersectional health inequities. Using 2017-2021 data from the Youth Risk Behavior Surveillance System, we illustrate the use of logistic I-MAIHDA with random effects to estimate intersectional inequities in suicidal ideation among U.S. high school students by race, sexual orientation, and gender. Before 2020, we found substantial inequities in suicidal ideation prevalence, ranging from 9.8-12.7% among heterosexual boys to over 50% among bisexual Multi-race/Other and White girls. We also found notable changes between the pre-2020 and 2021 waves. Strata at the lowest (heterosexual boys) and highest risk (bisexual girls) showed little change, while middle ranked strata - Black Other/Questioning and lesbian girls, White Other/Questioning boys and girls, and Multi-race/Other gay boys - reported large increases in suicidal ideation. Our findings suggest worsening teen mental health in the 2017-2021 period, particularly among racial and sexual minorities. This study highlights the value of I-MAIHDA and population surveys like YRBSS for understanding changes in intersectional health inequities.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214624","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

From policy to practice: assessing the state innovation models initiative's early success in incorporating social determinants of health in ASCVD hospitalizations in the United States. 从政策到实践：从政策到实践：评估州创新模式倡议在将健康的社会决定因素纳入美国 ASCVD 住院治疗方面取得的早期成功。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae313

Tarang Parekh, Hong Xue, Rishi K Wadhera, Lawrence J Cheskin, Alison E Cuellar

{"title":"From policy to practice: assessing the state innovation models initiative's early success in incorporating social determinants of health in ASCVD hospitalizations in the United States.","authors":"Tarang Parekh, Hong Xue, Rishi K Wadhera, Lawrence J Cheskin, Alison E Cuellar","doi":"10.1093/aje/kwae313","DOIUrl":"10.1093/aje/kwae313","url":null,"abstract":"The study examines effects of the Centers for Medicaid and Medicare Services State Innovation Models (SIM) on capturing social risk factors in adults hospitalized with atherosclerotic cardiovascular disease (ASCVD). Using a difference-in-differences (DID) approach with propensity score weights, the study compared documentation of secondary diagnosis of social determinants of health (SDOH)/social factors using ICD-9 V codes (\"SDOH codes\") in adults hospitalized with ASCVD as a primary diagnosis (n = 1 485 354). Data were gathered from January 1, 2010, to September 30, 2015, covering the period before and after the SIM implementation in October 2013. From January 2010 to September 2015, SDOH codes were infrequently utilized among adults with ASCVD (0.55%; 95% CI, 0.43%-0.67%). The SDOH codes with ASCVD increased from pre- to postperiod in SIM states (0.56%-0.93%) and comparison states (0.46%-0.56%). State Innovation Models implementation was associated with greater improvement in SDOH codes utilization (adjusted OR 1.30; 95% CI, 1.18-1.43) during ASCVD hospitalizations. The odds of SDOH codes utilization were 86% higher in emergency department admissions (AOR, 1.86; 95% CI, 1.76-1.97) than in routine admissions with ASCVD. Findings were similar when limiting population to older adults (≥65 years) enrolled in Medicare (AOR 1.50; 95% CI, 1.31-1.71), whereas not significant for Medicaid beneficiaries. The study points to challenges for healthcare providers in documenting SDOH in adults with ASCVD.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1709-1716"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078792","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

Perspectives on "harm" in personalized medicine. 对个体化医疗“危害”的看法。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwad162

Aaron L Sarvet, Mats J Stensrud

引用次数: 0

A hypothesis-free approach to identifying potential effects of relative age in school year: an instrumental variable phenome-wide association study in the UK Biobank. 识别学年相对年龄潜在影响的无假设方法：英国生物库中的一项工具变量全局关联研究》（A Hypothesis-Free Approach to Identifying Potential Effects of Relative Age in School Year: an Instrumental Variable Phenome-Wide Association Study in the UK Biobank）。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae331

Melanie A de Lange, Neil M Davies, Louise A C Millard, Kate Tilling

{"title":"A hypothesis-free approach to identifying potential effects of relative age in school year: an instrumental variable phenome-wide association study in the UK Biobank.","authors":"Melanie A de Lange, Neil M Davies, Louise A C Millard, Kate Tilling","doi":"10.1093/aje/kwae331","DOIUrl":"10.1093/aje/kwae331","url":null,"abstract":"A child's relative age within their school year (\"relative age\") is associated with educational attainment and mental health. However, hypothesis-driven studies often re-examine the same outcomes and exposure, potentially leading to confirmation and reporting biases and missing unknown effects. Hypothesis-free outcome-wide analyses can potentially overcome these limitations. We conducted a hypothesis-free investigation of the effects of relative age within school year. We performed an instrumental variable (IV) phenome-wide association study in the UK Biobank (participants aged 40-69 years at baseline), using the PHESANT software package. We created 2 IVs for relative age: being born in September vs August (n = 64 075) and week of birth (n = 383 309). Outcomes passing the Bonferroni-corrected P value threshold for either instrument were plotted to identify a discontinuity at the school year transition. Thirteen traits associated with at least 1 of the instruments showed a discontinuity. Previously identified effects included those with a younger relative age being less likely to have educational qualifications and more likely to have started smoking at a younger age. We detected a few associations not explored by previous studies. For example, those of younger relative age had better lung function as adults. Hypothesis-free approaches could help address confirmation and reporting biases in epidemiology.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1673-1680"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103422","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

Association of parity with the timing and type of menopause: a longitudinal cohort study. 奇偶性与绝经时间和类型的关系：纵向队列研究

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae320

Natalie V Scime, Beili Huang, Hilary K Brown, Erin A Brennand

{"title":"Association of parity with the timing and type of menopause: a longitudinal cohort study.","authors":"Natalie V Scime, Beili Huang, Hilary K Brown, Erin A Brennand","doi":"10.1093/aje/kwae320","DOIUrl":"10.1093/aje/kwae320","url":null,"abstract":"We investigated the time-varying association between parity and timing of natural menopause, surgical menopause, and premenopausal hysterectomy among 23 728 women aged 40-65 years at enrollment in the Alberta's Tomorrow Project cohort study (2000-2022), using flexible parametric survival analysis. Overall, natural menopause was most common by study end (57.2%), followed by premenopausal hysterectomy (11.4%) and surgical menopause (5.3%). Risks of natural menopause before age 50 years were elevated for 0 births (adjusted hazard ratio [aHR] at age 45, 1.33; 95% CI, 1.18-1.49) and 1 birth (aHR age 45, 1.21; 95% CI, 1.07-1.38), but similar for ≥3 births (aHR age 45, 0.95; 95% CI, 0.85-1.06) compared to 2 births (reference). Elevated risks of surgical menopause before age 45 years for 0 births (aHR age 40, 1.37; 95% CI, 1.09-1.69) and 1 birth (aHR age 40, 1.11; 95% CI, 0.85-1.45) attenuated when excluding women with past infertility or recurrent pregnancy loss, and reduced risks were observed over time for ≥3 births (aHR age 50, 0.84; 95% CI, 0.75-0.94). Risks of premenopausal hysterectomy were lower before age 50 years for 0 births (aHR age 45, 0.82; 95% CI, 0.76-0.88) but elevated after age 40 years for ≥3 births (aHR age 50, 1.25; 95% CI, 1.08-1.45). These complex associations necessitate additional research on the sociobiological impacts of childbearing on gynecologic health.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1726-1734"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091413","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

Bridged treatment comparisons: an illustrative application in HIV treatment. 桥式治疗比较：在艾滋病治疗中的应用示例。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae340

Paul N Zivich, Stephen R Cole, Jessie K Edwards, Bonnie E Shook-Sa, Alexander Breskin, Michael G Hudgens

{"title":"Bridged treatment comparisons: an illustrative application in HIV treatment.","authors":"Paul N Zivich, Stephen R Cole, Jessie K Edwards, Bonnie E Shook-Sa, Alexander Breskin, Michael G Hudgens","doi":"10.1093/aje/kwae340","DOIUrl":"10.1093/aje/kwae340","url":null,"abstract":"Comparisons of treatments, interventions, or exposures are of central interest in epidemiology, but direct comparisons are not always possible, due to practical or ethical reasons. Here, we detail a fusion approach to compare treatments across studies. The motivating example entails comparing the risk of the composite outcome of death, AIDS, or greater than a 50% CD4 cell count decline in people with HIV when assigned antiretroviral triple vs monotherapy, using data from the AIDS Clinical Trial Group (ACTG) 175 (monotherapy vs dual therapy) and ACTG 320 (dual vs triple therapy). We review a set of identification assumptions and estimate the risk difference using an inverse probability weighting estimator that leverages the shared trial arms (dual therapy). A fusion diagnostic based on comparing the shared arms is proposed that may indicate violation of the identification assumptions. Application of the data fusion estimator and diagnostic to the ACTG trials indicates triple therapy results in a reduction in risk, compared with monotherapy, in individuals with baseline CD4 cell counts between 50 and 300 cells mm-3. Bridged treatment comparisons address questions that none of the constituent data sources could address alone, but valid fusion-based inference requires careful consideration of the underlying assumptions.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1687-1694"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103425","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

Emulations of oncology trials using real-world data: a systematic literature review. 利用真实世界数据模拟肿瘤试验：系统性文献综述。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae346

Jennifer R Rider, Asher Wasserman, Lukas Slipski, Gillis Carrigan, Raymond Harvey, Xiaolong Jiao, Lynn McRoy, Nelson D Pace, Lauren Becnel, Amanda Bruno, Joy C Eckert, Priscilla Hodgkins, Purva Jain, David Merola, Osayi E Ovbiosa, Yanina Natanzon, Simone Pinheiro, Jameson Quinn, Carla Rodriguez-Watson, Ulka Campbell

{"title":"Emulations of oncology trials using real-world data: a systematic literature review.","authors":"Jennifer R Rider, Asher Wasserman, Lukas Slipski, Gillis Carrigan, Raymond Harvey, Xiaolong Jiao, Lynn McRoy, Nelson D Pace, Lauren Becnel, Amanda Bruno, Joy C Eckert, Priscilla Hodgkins, Purva Jain, David Merola, Osayi E Ovbiosa, Yanina Natanzon, Simone Pinheiro, Jameson Quinn, Carla Rodriguez-Watson, Ulka Campbell","doi":"10.1093/aje/kwae346","DOIUrl":"10.1093/aje/kwae346","url":null,"abstract":"By evaluating published emulations of oncology randomized control trial (RCT) studies in which both the active and comparator groups are sourced from real-world data (RWD) and target trial results are available for benchmarking, this systematic review aims to gain insight into factors related to emulation performance. Thirteen oncology emulation studies using various types of RWD were identified through an online database search of PubMed through 2022. Based on the ROBINS-I tool, most studies (n = 8) had a serious risk of overall bias driven by risk of bias from confounding. Approximately half of the studies (n = 6) fully proxied the RCT entry criteria. Of 11 RWD studies that provided sufficient detail to quantify emulation performance, the emulation hazard ratio (HR) estimate fell within the 95% confidence interval (CI) of the trial estimate in 9 of the studies. There were no clear trends between risk of bias or degree to which the entry criteria were proxied and emulation performance. Findings may have been influenced by publication bias and researcher degrees of freedom, as only one emulation study preregistered its protocol. Tools for comprehensively characterizing factors that affect emulation performance, including the real-world clinical context as it relates to the RCT research question, are needed to evaluate the feasibility of a RCT emulation. This article is part of a Special Collection on Pharmacoepidemiology.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1783-1793"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278946","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

Nondifferential misclassification of outcome under (near-) perfect specificity: a simulation study. 在（接近）完全特异性条件下对结果的非差异性错误分类：一项模拟研究。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae328

Weida Ma, Richard F MacLehose, Timothy L Lash, Lindsay J Collin, Ya Tuo, Thomas P Ahern

{"title":"Nondifferential misclassification of outcome under (near-) perfect specificity: a simulation study.","authors":"Weida Ma, Richard F MacLehose, Timothy L Lash, Lindsay J Collin, Ya Tuo, Thomas P Ahern","doi":"10.1093/aje/kwae328","DOIUrl":"10.1093/aje/kwae328","url":null,"abstract":"Mismeasurement of a dichotomous outcome yields an unbiased risk ratio estimate when there are no false positive cases (perfect specificity) and when sensitivity is nondifferential with respect to exposure status. In studies where these conditions are expected, quantitative bias analysis may be considered unnecessary. We conducted a simulation study to explore the robustness of this special case to small departures from perfect specificity and stochastic departures from nondifferential sensitivity. We observed substantial bias of the risk ratio with specificity values as high at 99.8%. The magnitude of bias increased directly with the true underlying risk ratio and was markedly stronger at lower baseline risk. Stochastic departure from nondifferential sensitivity also resulted in substantial bias in most simulated scenarios; downward bias prevailed when sensitivity was higher among unexposed compared with exposed, and upward bias prevailed when sensitivity was higher among exposed compared with unexposed. Our results show that seemingly innocuous departures from perfect specificity (eg, 0.2%) and from nondifferential sensitivity can yield substantial bias of the risk ratio under outcome misclassification. We present a web tool permitting easy exploration of this bias mechanism under user-specifiable study scenarios.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1668-1672"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152999","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 systematic approach to evaluating instrumental variable assumptions: applied example of glucose-lowering medications and risk for hospitalized heart failure in older adults. 评估工具变量假设的系统方法：降糖药物与老年人心力衰竭住院风险的应用实例。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae329

Phyo T Htoo, Jessie K Edwards, Mugdha Gokhale, Virginia Pate, John B Buse, Michele Jonsson-Funk, Til Stürmer

{"title":"A systematic approach to evaluating instrumental variable assumptions: applied example of glucose-lowering medications and risk for hospitalized heart failure in older adults.","authors":"Phyo T Htoo, Jessie K Edwards, Mugdha Gokhale, Virginia Pate, John B Buse, Michele Jonsson-Funk, Til Stürmer","doi":"10.1093/aje/kwae329","DOIUrl":"10.1093/aje/kwae329","url":null,"abstract":"One obstacle to adopting instrumental variable (IV) methods in pharmacoepidemiology is their reliance on strong, unverifiable assumptions. We can falsify IV assumptions by leveraging the causal structure, which can strengthen or refute their plausibility and increase the validity of effect estimates. We illustrate a systematic approach to evaluate calendar-time IV assumptions in estimating the known effect of thiazolidinediones on hospitalized heart failure. Using cohort entry time before and after September 2010, when the US Food and Drug Administration issued a safety communication, as a proposed IV, we estimated IV and propensity score-weighted 2-year risk differences (RDs) using Medicare data (2008-2014). We (1) performed inequality tests, (2) identified the negative control IV/outcome using causal assumptions, (3) estimated RDs after narrowing the calendar time range and excluding patients likely associated with unmeasured confounding, (4) derived bounds for RDs, and (5) estimated the proportion of compliers and their characteristics. The findings revealed that IV assumptions were violated and RDs were extreme, but the assumptions became more plausible upon narrowing the calendar time range and restricting the cohort by excluding prevalent heart failure (the strongest measured predictor of outcome). Systematically evaluating IV assumptions could help detect bias in IV estimators and increase their validity. This article is part of a Special Collection on Pharmacoepidemiology.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1544-1555"},"PeriodicalIF":5.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118789","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

Maro responds to "raising a high-pressure alarm about pediatric hypertension". 马罗回应 "小儿高血压的高压警报"。

IF 5 2区医学

American journal of epidemiology Pub Date : 2025-06-03 DOI: 10.1093/aje/kwae297

Judith C Maro

引用次数: 0