American journal of epidemiology最新文献

{"title":"Associations of metal mixtures in early pregnancy with lung function and asthma in mid-childhood in Project Viva.","authors":"Ruwan Thilakaratne, Pi-I D Lin, Sheryl L Rifas-Shiman, Robert O Wright, Patrick T Bradshaw, John R Balmes, Diane R Gold, Alan Hubbard, Emily Oken, Andres Cardenas","doi":"10.1093/aje/kwaf070","DOIUrl":"https://doi.org/10.1093/aje/kwaf070","url":null,"abstract":"<p><p>Whether fetal lung development may be vulnerable to gestational exposure to metals is unknown. We analyzed mother-child pairs in Project Viva, a prospective pre-birth cohort in eastern Massachusetts, USA. Concentrations of 11 essential and non-essential metals were measured in maternal first-trimester erythrocytes (~10 weeks). Measures of lung function were obtained by spirometry, and asthma status by recall, at the mid-childhood visit (~8 years). We fit both Bayesian hierarchical models (BHMs) with weakly informative priors, and conventional multivariable linear and logistic regressions (MLRs), to estimate associations of the metals with lung function and asthma. The analytic sample included 804 mother-child pairs (76.0% non-Hispanic White; 16.7% of children had current asthma). Each standard deviation (SD) increase in magnesium was associated with higher forced vital capacity (FVC) (mean difference: 26 mL, 95% credible interval (CrI); 5, 47), higher forced expiratory volume in 1 second (FEV1) (25 mL, 95% CrI: 6, 44), and lower odds of current asthma (odds ratio: 0.88, 95% CrI: 0.71, 1.1). BHMs provided more modest and precise estimates than MLRs. Our results suggest early pregnancy intake of magnesium may enhance fetal lung development, and may confer a modest reduction in the risk of asthma.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794455","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}

{"title":"A primer on using balancing weights to estimate inverse probability weights.","authors":"Haedi E Thelen, Todd A Miano, Luke Keele","doi":"10.1093/aje/kwaf060","DOIUrl":"https://doi.org/10.1093/aje/kwaf060","url":null,"abstract":"","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794403","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}

{"title":"Rejoinder to \"'Harm' in personalized medicine-an alternative perspective\".","authors":"Aaron L Sarvet, Mats J Stensrud","doi":"10.1093/aje/kwae366","DOIUrl":"https://doi.org/10.1093/aje/kwae366","url":null,"abstract":"<p><p>In our original article, we examine twin definitions of \"harm\" in personalized medicine: a first based on predictions of individuals' unmeasurable response types (counterfactual harm), and a second based solely on the observations of experiments (interventionist harm). In their commentary, Mueller and Pearl read our review as an argument that \"counterfactual logic should…be purged from consideration of harm and benefit\" and \"strongly object…that a rational decision maker may well apply the interventional perspective to the exclusion of counterfactual considerations.\" Here, we show that this objection is misguided. We analyze the examples in Mueller and Pearl's commentary and derive a general result showing that determinations of harm through interventionist and counterfactual analyses concur. Therefore, individuals who embrace counterfactual formulations and those who object to their use will make equivalent decisions in uncontroversial settings.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794460","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}

{"title":"The meaning of \"harm\" in personalized medicine-an alternative perspective.","authors":"Scott Mueller, Judea Pearl","doi":"10.1093/aje/kwae441","DOIUrl":"https://doi.org/10.1093/aje/kwae441","url":null,"abstract":"<p><p>This commentary examines an article by Sarvet and Stensrud in which they discuss the concept of \"harm\" and its application in medical practice. They advocate for an intervention-based interpretation of harm, downplaying its counterfactual interpretation. We take issue with this stance. We show that the counterfactual approach is vital for effective decision-making policies and that neglecting it might lead to flawed decisions. In response to the contention of Sarvet and Stensrud that \"when the outcome is death and a counterfactual approach is used…more people will die,\" we demonstrate how counterfactual reasoning can actually prevent deaths. Additionally, we highlight the advantages of counterfactual thinking in the fields of medical malpractice, legal reasoning, and general diagnoses. Relying solely on intervention-based analyses limits our ability to accurately represent reality and hinders productive discussions about evidence, assumptions, and consensus building.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802206","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}

{"title":"Misleading and avoidably: design-induced biases in observational studies evaluating cancer screening-the example of site-specific effectiveness of screening colonoscopy.","authors":"Malte Braitmaier, Sarina Schwarz, Vanessa Didelez, Ulrike Haug","doi":"10.1093/aje/kwaf069","DOIUrl":"https://doi.org/10.1093/aje/kwaf069","url":null,"abstract":"<p><p>Observational studies evaluating the effectiveness of cancer screening are often biased due to non-alignment at time zero, which can be avoided by target trial emulation (TTE). We aimed to illustrate this by evaluating site-specific effectiveness of screening colonoscopy regarding colorectal cancer (CRC) incidence. Based on a German health care database, we assessed the effect of screening colonoscopy vs. no screening colonoscopy in preventing CRC in the distal and the proximal colon over 12 years of follow-up in 55-69-year-old persons. We compared four different study designs: cohort and case-control study, each with/without alignment at time zero. In both analyses with time zero-alignment, screening colonoscopy showed a rather similar effectiveness in reducing the incidence of distal and proximal CRC (cohort analysis: 32% (95% CI: 27-37%) vs. 28% (20-35%); case-control analysis: 27% vs. 33%). Both analyses without alignment suggested a difference by site: Incidence reduction regarding distal and proximal CRC, respectively, was 65% (61-68%) vs. 37% (31-43%) in the cohort analysis and 77% (67-84%) vs. 46% (25-61%) in the case-control analysis. Violations of basic design principles can substantially bias the results of observational studies. In our example, it falsely suggested a much stronger preventive effect of colonoscopy in the distal vs. the proximal colon. Our study illustrates that TTE avoids such design-induced biases.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771038","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}

{"title":"Absolute Risk of Developing a Second Primary Cancer After a First Primary Melanoma: An Australian Population-Based Cohort Study.","authors":"Yuan Ni, Caroline G Watts, Alexander H R Varey, Anne E Cust, Serigne N Lo","doi":"10.1093/aje/kwaf068","DOIUrl":"https://doi.org/10.1093/aje/kwaf068","url":null,"abstract":"<p><p>Understanding the absolute risk of developing a second primary cancer is important to guide patient surveillance and education. We aimed to examine the cumulative incidence and factors associated with development of a second primary cancer (melanoma versus other) after diagnosis of a first primary melanoma (invasive or in situ). We analysed a population-based study cohort of 154,695 people diagnosed with a first primary melanoma in New South Wales, Australia, between 1982-2019. The cohort was followed for future cancer incidence and vital status for a median of 7.0 years. We used Fine-Gray models to account for death as a competing risk. After a first primary melanoma, 23.7% developed a second primary cancer, including 12.7% who developed a second primary invasive or in situ melanoma (mean 5-year risk: 7.6%). The next most common second primary cancer types were prostate, breast and colon cancers, with mean 5-year risks after the initial melanoma diagnosis of 2.8% (male-specific incidence), 0.7% (2.8% female-specific incidence), and 0.6%, respectively. The most common second primary cancer among people with a first primary melanoma was another melanoma (invasive or in situ), requiring long-term careful surveillance of their skin even if the probability of recurrence from the first melanoma is low.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771035","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}

{"title":"Changing educational attainment as a driver of cohort changes in healthy longevity: a decomposition analysis of US birth cohorts.","authors":"Tianyu Shen, Alyson Van Raalte, Collin F Payne","doi":"10.1093/aje/kwaf066","DOIUrl":"https://doi.org/10.1093/aje/kwaf066","url":null,"abstract":"<p><p>An anticipated health boost from the increasing educational attainment of the US population has not materialized, with life expectancy and healthy longevity both stagnating over the past decade. We seek to understand how changes in the level of educational attainment across successive birth cohorts in the US have impacted disability-free life expectancy (DFLE) among older Americans. We analyzed data from the US Health and Retirement Study spanning 2000 to 2020, focusing on four ten-year birth cohorts. We then decomposed changes in population-level expectancies into contributions from shifts in educational composition, health status at midlife, and health and mortality transitions at older ages across different educational groups. DFLE increased notably for females but not for males, with disabled life expectancy (DLE) remaining stable. Shifts in educational composition primarily drove increases in DFLE and total life expectancy. However, deteriorating midlife health among those without a high school diploma reduced DFLE for this group, which tempered overall population-level gains. Health and mortality transitions among the less educated contributed to increased DLE. Our findings show that educational attainment is a major structural factor influencing US population health. Expanding access to higher education and reducing education inequality will play a significant role in future changes to healthy longevity.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735533","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}

{"title":"Interactions Between Genetic and Epidemiological Factors Influencing Mammographic Density.","authors":"Austin Hammermeister Suger, Hongjie Chen, Cameron B Haas, Shaoqi Fan, Christopher G Scott, Manjeet K Bolla, Joe Dennis, Alison M Dunning, Kyriaki Michailidou, Qin Wang, Peter A Fasching, Lothar Haeberle, Jennifer Stone, Manuela Gago-Dominguez, Jose E Castelao, Rachel A Murphy, Kristan Aronson, Fergus J Couch, Siddhartha Yadav, Roger L Milne, John L Hopper, Aaron Norman, A Heather Eliassen, William J Tapper, Diana M Eccles, D Gareth Evans, Susan Astley, Per Hall, Kamila Czene, Paul D P Pharoah, Antonis C Antoniou, Montserrat García-Closas, Amy Berrington, Douglas F Easton, Gretchen L Gierach, Rulla M Tamimi, Celine M Vachon, Sara Lindström, Tabitha A Harrison","doi":"10.1093/aje/kwaf067","DOIUrl":"https://doi.org/10.1093/aje/kwaf067","url":null,"abstract":"<p><p>Studies have identified genetic and epidemiological factors associated with mammographic density (MD) phenotypes. However, MD-associated genetic variants only account for a small proportion of the total estimated heritability. Interrogating interactions between genetic and epidemiological factors could potentially identify additional MD-associated loci, expand our understanding of the genetic basis of MD phenotypes, and clarify how epidemiological factors modulate relationships between genetic variants and MD. We conducted six separate genome-wide, gene-environment (GxE) interaction analyses, applying 2 degrees of freedom (df) and 1df interaction tests, for each of three MD phenotypes (percent density (PD), dense area (DA), and non-dense area (NDA)). The six epidemiological factors considered were height, ever parous, parity, ever menopausal hormone therapy (MHT), ever breastfeeding, and months of breastfeeding. We included European ancestry participants from multiple studies within the Markers of Density (MODE) consortium and the Breast Cancer Association Consortium (BCAC) (n = 4,895 - 16,218 depending on specific analyses). We identified 11 loci with genome-wide significant (P < 5 × 10-8) interaction tests including two novel common genetic signals interacting with parity (8p21.2) and ever breastfeeding (19p13.2) for NDA. Our results suggest that epidemiological risk factors might influence relationships between common genetic variants and MD phenotypes at particular genomic loci.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735534","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}

{"title":"Pubertal timing and tempo and body mass index trajectories: investigating the confounding role of childhood body mass index.","authors":"Anne Gaml-Sørensen, Nis Brix, Andreas Ernst, Lea Lykke Harrits Lunddorf, Onyebuchi A Arah, Katrine Strandberg-Larsen, Cecilia Høst Ramlau-Hansen","doi":"10.1093/aje/kwaf063","DOIUrl":"https://doi.org/10.1093/aje/kwaf063","url":null,"abstract":"<p><p>Earlier pubertal timing and faster pubertal tempo (pace of progression through puberty) might be associated with increased body mass index (BMI) later in life. In a follow-up study of 13 219 boys and girls from the Danish National Birth Cohort (DNBC), we investigated the association between pubertal timing and tempo and BMI trajectories from puberty to adulthood and explored the potential confounding role of childhood BMI. Based on half-yearly information on self-reported current Tanner stages, pubertal timing and tempo were estimated using non-linear mixed effect growth models. In total, 136 457 height and weight measurements from 7 to 18 years were included. BMI trajectories from 11 to 18 years were fitted according to pubertal timing and tempo while adjusting for potential confounders, including childhood BMI at age 7 years. Children with earlier pubertal timing had higher, and children with later pubertal timing had lower BMI trajectories from 11 to 18 years than children with average pubertal timing. After adjustment for childhood BMI, the difference disappeared in boys but persisted in girls, suggesting that earlier pubertal timing may be independently associated with later BMI in girls only. Faster pubertal tempo was associated with slightly higher BMI in young women only.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676805","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}

{"title":"The effect of melatonin supplement use on pubertal timing: target trial emulation in the Adolescent Brain Cognitive Development study.","authors":"Ekaterina Sadikova, Alejandro Szmulewicz, Divyangana Rakesh, Henning Tiemeier","doi":"10.1093/aje/kwaf062","DOIUrl":"https://doi.org/10.1093/aje/kwaf062","url":null,"abstract":"<p><p>Sustained melatonin supplement use may delay pubertal onset, but evidence is limited. In the Adolescent Brain Cognitive Development study, we assessed if melatonin use for 38 months affected the timing of pubertal onset in males (N=3,134) and menarche in females (N=4,424). Pubertal outcomes were parent-reported using the Pubertal Development Scale. We emulated sequential target trials to evaluate the effect of initiating and continuing melatonin supplement use. Findings were contrasted with comparisons of ever- to never-users and initiators to non-initiators using Cox models. In sequentially emulated trials with 1,037,709 person-months among males and 1,818,084 person-months among females, there were 1,872 and 3,377 instances of melatonin use initiation among 186 males and 333 females, respectively. Observational analogues of intention-to-treat and per-protocol effects from target trial emulation showed no difference in risk of pubertal onset in males (end-of-follow-up per-protocol RR=1.00, 95%CI=0.87,1.13) or menarche in females (RR=0.93, 95%CI=0.80,1.07). By contrast, Cox models suggested a delay in menarche among 335(7.74%) melatonin ever-users after adjustment for child, family, and neighborhood characteristics collected at the enrollment visit (HR=0.80, 95%CI=(0.69,0.94)). In large samples, rigorous causal analyses that aligned eligibility criteria with treatment initiation and adjusted for time-varying confounding showed no effect of melatonin supplement use on pubertal timing.</p>","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668650","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}