American journal of epidemiology最新文献_第9页

The association between smoking status and aging cognitive trajectory accounting for bias in attrition. 吸烟状况与衰老认知轨迹之间的关联，说明了损耗偏差。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf107

Rachel Stuckwisch, Aleena Bennett, Anaïs Rouanet, Lloyd J Edwards, Michael Crowe, Suzanne E Judd, Leann D Long

{"title":"The association between smoking status and aging cognitive trajectory accounting for bias in attrition.","authors":"Rachel Stuckwisch, Aleena Bennett, Anaïs Rouanet, Lloyd J Edwards, Michael Crowe, Suzanne E Judd, Leann D Long","doi":"10.1093/aje/kwaf107","DOIUrl":"10.1093/aje/kwaf107","url":null,"abstract":"Studies on the relationship between smoking and cognition yield conflicting results, potentially from survival bias. We examined the effect of smoking status on cognitive evolution, accounting for potential bias in attrition. We analyzed 21 216 Black and White participants from the REGARDS cohort study. In order to account for potential differential attrition, a sensitivity analysis compared the association between smoking status and age-sex-specific composite cognitive trajectories using linear mixed models, robust under missing at random assumption, and joint models, robust under the extended missing at random assumptions. Linear mixed model results indicated current smokers had lower overall composite cognitive scores compared to never smokers at baseline (-0.20, 95% CI, -0.23 to -0.16) and at 14-years duration in the study (-0.26, 95% CI, -0.33 to -0.20), also apparent when comparing current smokers to past smokers, and memory and verbal fluency composite scores. Joint modeling estimates yielded results similar to results from linear mixed models. Joint models are recommended as a potential means to investigate concerns about attrition, particularly in studies of factors associated with both cognition and mortality. This study provides further support that smoking is likely to have negative impacts on cognition.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"927-936"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109402","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

More lessons from the Lung Health Study. 肺部健康研究的更多经验教训。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwag004

Janet T Holbrook

{"title":"More lessons from the Lung Health Study.","authors":"Janet T Holbrook","doi":"10.1093/aje/kwag004","DOIUrl":"10.1093/aje/kwag004","url":null,"abstract":"The 32.5-year follow-up of the Lung Health Study (LHS) published in this issue highlights the long-term impact of a well-executed randomized clinical trials (RCTs) evaluating a smoking cessation intervention. Between 1986 and 1989, the LHS enrolled 5887 smokers aged 35-59 with mild-to-moderate airway obstruction across ten North American sites and randomized them to a 10-day smoking cessation intervention with placebo inhaler, the same intervention with ipratropium bromide, or usual care. The latest 32.5-year analysis confirms a reduction in respiratory-related mortality, though the earlier observed all-cause mortality benefit observed at 14.5 years was not seen. The updated analysis excludes 608 participants from the one Canadian clinic and their baseline smoking characteristics differed from the US participants. Regardless, qualitative effect modification is unlikely. Shifts in leading causes of death over time, competing risks, and potential postrandomization selection bias are challenges inherent in extended follow-up, yet the findings of reduced respiratory mortality for participants assigned to smoking cessation stood the test of time. This publication highlights the importance of trial conduct, data preservation, and the value of long-term follow-up using the National Death Index. Congratulations to the authors for this fourth update and to all LHS researchers who contributed to this landmark clinical trial.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"980-981"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958502","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 framework for the rigorous assessment of heterogeneous treatment effects from a single randomized controlled trial. 从单一随机对照试验中严格评估异质性治疗效果的框架。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf253

Jane W Liang, Lu Tian, Manjula Kurella Tamura, Maria Montez-Rath, Constantine Frangakis, Vivek Charu

{"title":"A framework for the rigorous assessment of heterogeneous treatment effects from a single randomized controlled trial.","authors":"Jane W Liang, Lu Tian, Manjula Kurella Tamura, Maria Montez-Rath, Constantine Frangakis, Vivek Charu","doi":"10.1093/aje/kwaf253","DOIUrl":"10.1093/aje/kwaf253","url":null,"abstract":"Randomized controlled trials are the gold standard for estimating the average effect of a treatment in a target population, but the same treatment may benefit some patients while having no effect on or even harming others. This phenomenon, termed heterogeneous treatment effects, can be quantified by estimating treatment effects within subgroups of patients, defined by various combinations of baseline covariates. One approach for quantifying heterogeneous treatment effects is to develop \"effect models\" that directly model complex interactions between baseline covariates and treatment assignment. \"Effect scores,\" derived from effect models, can then be used to rank patients based on their predicted treatment benefit, enabling targeted treatment regimens. In this article, we provide a rigorous general framework for developing and evaluating effect models to characterize heterogeneous treatment effects from a single randomized control trial. We address challenges in valid model development, such as overfitting, and illustrate our approach in a real-world dataset with time-to-event outcomes subject to right-censoring.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1098-1107"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562316","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

Poverty and ethnic patterns in COVID-19 excess mortality: evidence from Chile, 2020-2022. 贫困和族裔模式与COVID-19高死亡率的关系：来自智利的证据，2020-2022年。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf274

Raj Kumar Subedi, Svenn-Erik Mamelund, Iris Delgado, Isabel Matute, Carla Castillo Laborde, Elienai Joaquin-Damas, Gerardo Chowell

{"title":"Poverty and ethnic patterns in COVID-19 excess mortality: evidence from Chile, 2020-2022.","authors":"Raj Kumar Subedi, Svenn-Erik Mamelund, Iris Delgado, Isabel Matute, Carla Castillo Laborde, Elienai Joaquin-Damas, Gerardo Chowell","doi":"10.1093/aje/kwaf274","DOIUrl":"10.1093/aje/kwaf274","url":null,"abstract":"The COVID-19 pandemic highlighted deep-rooted health inequities globally, with marginalized populations showing disproportionate disease burden. We employed Serfling regression models and multivariable analyses to estimate excess mortality across geographic, demographic, and poverty groups from 2020 to 2022 in Chile. Elderly populations (80+ years) experienced the highest excess mortality (267.35 per 10 000 population), more than 8 times higher than those under 80 years (30.80 per 10 000 population). Multivariable linear regression models showed both Indigenous proportion (coefficient = 53.66, P < .001) and elderly population proportion (coefficient = 5.68, P < .01) as the strong predictors of comuna level excess mortality. Poverty correlated significantly with excess mortality (r = 0.23, P < .001) but this association weakened after adjustment for other covariates in multivariable models. Excess mortality peaked in 2021 rather than in 2020 for most groups, with males initially experiencing higher rates during early pandemic waves. Spatial analyses revealed statistically significant clustering (Moran's I = 0.119, P < .001) with identifiable hotspots in northern Chile and parts of the south. These findings indicated persistent mortality disparities by age and Indigenous status, independent of poverty, and highlight the urgent need for equity-focused pandemic preparedness. An effective pandemic response should integrate biomedical measures, such as vaccination, with culturally grounded strategies that address structural barriers and the broader social determinants of health.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1136-1146"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713011","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

California mortality and the Healthy Places Index. 加州死亡率与健康场所指数。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwae418

Neil Maizlish, Adrienne Damicis

{"title":"California mortality and the Healthy Places Index.","authors":"Neil Maizlish, Adrienne Damicis","doi":"10.1093/aje/kwae418","DOIUrl":"10.1093/aje/kwae418","url":null,"abstract":"We investigated California mortality and social determinants of health, as measured by the Healthy Places Index (HPI), which is a composite measure of 23 indicators of neighborhood (census tract) economic conditions, education, transportation, housing, social capital, environmental pollution, built environment, and access to health care. We aggregated deaths to 2010 census tract boundaries for leading causes during 2015 to 2019, and for COVID-19 during 2020-2021, from death certificates, and populations from the American Community Survey, 2015 to 2019. We age-adjusted and stratified death rates by HPI deciles, age, sex, and race/ethnicity, and examined HPI dose-response with segmental regression. For all causes, cancer, cardiovascular disease, COVID-19, diabetes, cirrhosis of the liver, injuries, and Alzheimer's disease (ages 65-74 years), mortality rates were inversely related to HPI decile. For all-cause mortality, the rate ratio between the 1st and 10th deciles (reference) was 1.63 (95% CI, 1.60-1.66); for COVID-19, the rate ratio was 7.61 (95% CI, 7.14-8.12). The population attributable fraction was 24% for all causes and 72% for COVID-19. Age, sex, and race/ethnicity modified the steepness and shape of dose-response curves. The findings illustrate opportunities to incorporate area-based socioeconomic measures in routine public health surveillance and to reinforce policies and programs that reduce health inequities.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"881-893"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638475","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

The effects of a smoking cessation intervention on mortality after a 32.5-year follow-up period: a randomized clinical trial. 戒烟干预对32.5年随访期后死亡率的影响：一项随机临床试验。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf240

Jeffrey Zhang, John Connett, Dylan Small

{"title":"The effects of a smoking cessation intervention on mortality after a 32.5-year follow-up period: a randomized clinical trial.","authors":"Jeffrey Zhang, John Connett, Dylan Small","doi":"10.1093/aje/kwaf240","DOIUrl":"10.1093/aje/kwaf240","url":null,"abstract":"The Lung Health Study was a randomized clinical trial of smoking cessation that took place between 1986 and 1988. Special intervention participants received the smoking intervention program and were compared with usual care participants. Vital status was followed up to 32.5 years. Previous work sought to assess the effect of the cessation program on all-cause and cause-specific mortality at 14.5 years. Our objective was to do so at 32.5 years. We analyzed data from 5279 participants from the United States from the Lung Health Study. The three arms were smoking intervention plus bronchodilator, smoking intervention plus placebo, or no intervention. We compared all-cause and cause-specific mortality at 32.5 years between the combined special intervention groups and usual care group. The hazard ratio for the usual care group compared with the special intervention group was 1.05 (95% CI, 0.97-1.18) at 32.5 years. The cause-specific hazard ratio for the usual care group compared with the special intervention group for death due to respiratory disease that was not lung cancer was 1.21 (95% CI, 1.04-1.42) at 32.5 years, indicating that the smoking cessation program had a protective effect against death due to non-lung cancer respiratory disease, even after a long period.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"975-979"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399878","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

Comparative risk of nonvertebral fractures associated with oral anticoagulants in patients with venous thromboembolism. 静脉血栓栓塞患者口服抗凝剂相关的非椎体骨折的比较风险。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf235

Zhifei Zeng, Sungho Bea, Sushama K Sreedhara, Katsiaryna Bykov

{"title":"Comparative risk of nonvertebral fractures associated with oral anticoagulants in patients with venous thromboembolism.","authors":"Zhifei Zeng, Sungho Bea, Sushama K Sreedhara, Katsiaryna Bykov","doi":"10.1093/aje/kwaf235","DOIUrl":"10.1093/aje/kwaf235","url":null,"abstract":"Oral anticoagulants are widely used to prevent recurrence in patients with venous thromboembolism (VTE), but studies of these drugs in patients with atrial fibrillation have raised concerns that warfarin may be associated with higher risk of fractures than direct oral anticoagulants. Using the United States administrative claims data from Medicare and Optum Clinformatics (January 2016 to June 2024), we conducted a cohort study that emulated a three-arm target trial of VTE patients who initiated apixaban (N = 73 668), rivaroxaban (N = 30 849), or warfarin (N = 20 872). The primary outcome was nonvertebral fractures. Propensity score matching weights were used to balance baseline covariates. Patients were followed while on treatment; intention-to-treat (ITT) analyses were also conducted. Weighted hazard ratios while on treatment were 1.12 (95% CI, 0.89-1.41) for apixaban vs. warfarin, 1.13 (95% CI, 0.87-1.46) for rivaroxaban vs. warfarin, and 0.99 (95% CI, 0.80-1.23) for apixaban vs rivaroxaban. Results were consistent for ITT and other sensitivity analyses and across subgroups of age, sex, osteoporosis, and chronic kidney disease. Our findings suggest that apixaban, rivaroxaban, and warfarin are comparable with regards to nonvertebral fracture risk when used for VTE secondary prevention.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1027-1036"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328155","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

Modeling the impact of vaccine dose prioritization strategies during the 2022 mpox outbreak. 2022年麻疹暴发期间疫苗剂量优先策略的影响建模

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf054

Patrick A Clay, Emily D Pollock, Enrique M Saldarriaga, Preeti Pathela, Michelle Macaraig, Jane R Zucker, Bindy Crouch, Ian Kracalik, Ian H Spicknall

{"title":"Modeling the impact of vaccine dose prioritization strategies during the 2022 mpox outbreak.","authors":"Patrick A Clay, Emily D Pollock, Enrique M Saldarriaga, Preeti Pathela, Michelle Macaraig, Jane R Zucker, Bindy Crouch, Ian Kracalik, Ian H Spicknall","doi":"10.1093/aje/kwaf054","DOIUrl":"10.1093/aje/kwaf054","url":null,"abstract":"Early in the 2022 mpox outbreak, the US recommendation was to administer two doses of the JYNNEOS vaccine 4 weeks apart. However, because of limited vaccine supply, New York City (NYC) prioritized single dose vaccination. We estimated mpox cases averted by this strategy compared to strategies that prioritized 2-dose vaccination for a smaller portion of the population. We fit a network transmission model to incident mpox cases in NYC. Model output consisted of predicted cases over time when vaccine doses were administered with the \"first-dose priority\" strategy, compared with counterfactual simulations, where doses were administered to those eligible for a second dose ahead of those waiting for a first dose (\"intermediate\" strategy), or where individuals were preallocated full courses of the vaccine (\"second-dose priority\" strategy). We estimate that NYC's strategy averted 66% (IQR, 47%-78%) of potential mpox cases compared to no vaccination. This \"first-dose priority\" strategy averted 0.6% (IQR, -11% to 9.8%) more cases than the \"intermediate\" strategy, and 17% (IQR, 2.9%-38%) more cases than the \"second-dose priority\" strategy. Thus, for the 2022 mpox outbreak in NYC, preallocating vaccine doses to ensure full vaccination in a high-priority subset of the population would have increased the size of the outbreak.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"948-955"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603458","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

A three-part model for the self-controlled case series design to estimate and characterize adverse event risk in an overlapping risk period after multiple vaccines: application to ischemic stroke following Pfizer-BioNTech bivalent COVID-19 vaccine and influenza vaccine. 一种自我控制病例系列设计的三部分模型，用于评估和表征多种疫苗接种后重叠风险期的不良事件风险：辉瑞- biontech二价COVID-19疫苗和流感疫苗在缺血性卒中中的应用。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf115

Stanley Xu, Lina S Sy, Xuan Huang, Vennis Hong, Bing Han, Katia J Bruxvoort, Bruno Lewin, Kimberly J Holmquist, Lei Qian

{"title":"A three-part model for the self-controlled case series design to estimate and characterize adverse event risk in an overlapping risk period after multiple vaccines: application to ischemic stroke following Pfizer-BioNTech bivalent COVID-19 vaccine and influenza vaccine.","authors":"Stanley Xu, Lina S Sy, Xuan Huang, Vennis Hong, Bing Han, Katia J Bruxvoort, Bruno Lewin, Kimberly J Holmquist, Lei Qian","doi":"10.1093/aje/kwaf115","DOIUrl":"10.1093/aje/kwaf115","url":null,"abstract":"This study proposes a three-part model to assess and characterize the risk of serious adverse events when 2 vaccines are administered on the same day or in close proximity within a self-controlled case series framework. Simulations showed that the three-part model yielded unbiased relative incidences (RIs) after each vaccination and during the overlapping risk period, while censoring follow-up at dose 2 reduced estimation precision but produced unbiased point estimates. Assuming positive multiplicative and positive additive effects, including the overlapping risk period in the first risk interval overestimated the RI after the first dose by 6.0%-26.0%, while including it in the second overestimated the second RI by 7.3%-34.0%. Overall analysis using the three-part model found no increased ischemic stroke risk 42 days after Pfizer-BioNTech bivalent COVID-19 vaccination or after influenza vaccination or during the overlapping risk period among Kaiser Permanente Southern California members <65 years. Among those with a prior-year history of SARS-CoV-2 infection, the overlapping period showed a significantly increased risk (RI = 2.74 [95% CI, 1.07-7.07]), indicating both positive multiplicative and additive effects. Further research is needed to validate these ischemic stroke findings with chart review confirmation and to apply the model to other vaccination scenarios.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"956-965"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214622","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

Augmenting fact and date of death in electronic health records using internet media sources: a validation study from two large healthcare systems. 利用互联网媒体来源增强电子健康记录中的事实和死亡日期：来自两个大型医疗保健系统的验证研究。

IF 4.8 2区医学

American journal of epidemiology Pub Date : 2026-03-17 DOI: 10.1093/aje/kwaf258

Michele LeNoue-Newton, Mohammed Al-Garadi, Kerry Ngan, Haritha Pillai, Ruth M Reeves, Daniel Park, Dax M Westerman, José J Hernández-Muñoz, Xi Wang, Aida Kuzucan, Shirley V Wang, Kueiyu Joshua Lin, Candace C Fuller, Melissa McPheeters, Michael E Matheny, Rishi J Desai

{"title":"Augmenting fact and date of death in electronic health records using internet media sources: a validation study from two large healthcare systems.","authors":"Michele LeNoue-Newton, Mohammed Al-Garadi, Kerry Ngan, Haritha Pillai, Ruth M Reeves, Daniel Park, Dax M Westerman, José J Hernández-Muñoz, Xi Wang, Aida Kuzucan, Shirley V Wang, Kueiyu Joshua Lin, Candace C Fuller, Melissa McPheeters, Michael E Matheny, Rishi J Desai","doi":"10.1093/aje/kwaf258","DOIUrl":"10.1093/aje/kwaf258","url":null,"abstract":"This study evaluated death ascertainment from publicly available internet sources for patients in two large tertiary care US healthcare systems, Mass General Brigham (MGB) and Vanderbilt University Medical Center (VUMC), benchmarked against state and federal vital statistics data. Names, dates of birth, and dates of death were extracted from 8.1 million internet media records using previously developed natural language processing models. Internet records were matched to 78 848 deceased patients from MGB and VUMC on first name, last name, and date of birth. Dates of death were validated against state vital statistics databases or the National Death Index as reference standards. We calculated sensitivity and positive predicted values (PPV) of internet sources in identifying dates of death within 7 days of the reference standard. Exact matching of records between internet media and reference standards on first name, last name, and date of birth, resulted in 30 067 (38.8%) matches, which showed PPV for death identification (98.2%-MGB; 98.9%-VUMC) in internet media and increased sensitivity of death capture over EHR alone by 24% at MGB and 18% at VUMC. In conclusion, using internet sources to augment mortality data increased capture of death meaningfully over reliance on EHR records alone.","PeriodicalId":7472,"journal":{"name":"American journal of epidemiology","volume":" ","pages":"1120-1128"},"PeriodicalIF":4.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627647","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