Journal of epidemiology and biostatistics最新文献

{"title":"Projecting severe sequelae of injection-related hepatitis C virus epidemic in the UK. Part 2: Preliminary UK estimates of prevalent injection-related hepatitis C carriers, and derivation of progression rates to liver cirrhosis by gender and age at hepatitis C virus infection.","authors":"Sheila M. Bird, Goldberg Dj, Sharon J. Hutchinson","doi":"10.1080/135952201317080373","DOIUrl":"https://doi.org/10.1080/135952201317080373","url":null,"abstract":"BACKGROUND In Part 2, we illustrate how available data can be used to obtain preliminary estimates for Scotland of prevalent injection-related hepatitis C carriers and of maternally hepatitis C virus (HCV)-infected infants. Novel approaches to reducing uncertainty about the number of Scotland's HCV infected children of injector parents are discussed in brief. Three approaches, one direct and two indirect, to estimating the number of current and ever-injectors are presented for England and Wales. METHODS Diagnosed HCV infections in injectors and HCV test uptake by current injectors are combined with survey estimates for the ratio of ever-injectors to current injectors to estimate prevalent injection-related hepatitis C carriers. Household surveys give direct but potentially biased estimates of the number of current and ever-injectors. Indirect estimates make use of hepatitis C diagnoses in injectors, HCV prevalence and test-uptake by injectors, or exploit international comparisons. We comment on key reporting problems that inhibit synthesis of HCV progression studies; and suggest how to derive preliminary gender-and-age specific progression rates to liver cirrhosis for use in projections. RESULTS Preliminary estimates for Scotland of prevalent injection-related hepatitis C carriers are: central estimate 39,000, inner uncertainty 16,000-59,000; of maternally hepatitis C virus (HCV)-infected infants central estimate 260, uncertainty 110-1100; and for England and Wales estimates of the number of prevalent ever-injectors are central estimate 360,000, uncertainty 240,000-835,000. Both hepatitis C prevalence in injectors and estimated numbers of current injectors are similar in Australia, and England and Wales (but not so for Scotland), Australian work on projections of severe HCV sequelae from hepatitis C infections may therefore be a suitable starting point for projections for England and Wales. Australia anticipates a doubling in the number of persons living with hepatitis C cirrhosis from 8500 in 1997 to over 17,000 in 2010. DISCUSSION Australian projections of severe HCV sequelae used progression rates that, for simplicity, were independent of gender and of age at HCV infection. Faster HCV progression for males, and their higher injector prevalence, means that the impact of HCV infection on, for example, liver cancer may be evident to a greater extent and earlier in males.","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59835139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical issues of quality control in organised breast cancer screening.","authors":"W. Rittgen, N. Becker","doi":"10.1080/135952201317225453","DOIUrl":"https://doi.org/10.1080/135952201317225453","url":null,"abstract":"BACKGROUND European guidelines for breast-cancer screening recommend an integrated approach of mammography screening with subsequent assessment and biopsy, if required, in one screening unit under permanent quality control, for which target values are released. Although the calculation of the respective rates (e.g. for participation, assessment, biopsy, or cancer detection) appears trivial, the statistical assessment of their compatibility with the target values is less obvious. This is especially true if subjects with a positive diagnostic result leave the screening-assessment chain prematurely, and information about further diagnostic results outside the organised screening is lacking. METHOD Statistical models for the basic situation, in which complete information about the screening and assessment outcome is available, as well as for when information is incomplete, are presented. The statistical methods for obtaining the confidence limits, statistical tests and sample sizes needed to obtain a desired power of tests for the process parameters of interest are also given. RESULTS The sample-size calculations indicate that large numbers of enrolled subjects are required to obtain reasonably narrow confidence limits, and that incomplete information about the outcome of diagnostic procedures among screening positives considerably worsens the feasibility of quality control. CONCLUSIONS Although the methodology is specified for breast-cancer screening, it should be adaptable easily to other screening issues.","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59835592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projecting cancer incidence and mortality using Bayesian age-period-cohort models.","authors":"Bashir Sa, J. Estève","doi":"10.1080/135952201317080698","DOIUrl":"https://doi.org/10.1080/135952201317080698","url":null,"abstract":"BACKGROUND We present a practical application of an age-period-cohort model in a Bayesian frame-work for making cancer-burden projections. METHODS Second degree autoregressive smoothing was used on the age, period and cohort effects for estimating future incidence and mortality. RESULTS We are able to demonstrate the feasibility, flexibility and strengths of this approach. Compared with previously used methods, it performed better for providing point estimates when past trends continued into the future. However, the extremely wide credible intervals need careful interpretation. DISCUSSION Part of the uncertainty is attributable to the possible inadequacy of the model and not necessarily relevant in the prediction of what would happen if the present trends continue into the future.","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59835687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension as a risk factor for chronic symmetric polyneuropathy.","authors":"M. Zarrelli, L. Amoruso, E. Beghi, F. Apollo, P. Di Viesti, P. Simone","doi":"10.1080/135952201753337158","DOIUrl":"https://doi.org/10.1080/135952201753337158","url":null,"abstract":"OBJECTIVE To assess whether arterial hypertension (AH) is an independent risk factor for chronic symmetric polyneuropathy (CSP) in the elderly. BACKGROUND A strong relationship has been detected between AH and distal symmetric polyneuropathy in insulin-dependent and non-insulin-dependent diabetes. However, the correlation between AH and polyneuropathy caused by other clinical conditions has not yet been studied. METHODS Four thousand one hundred and ninety-one subjects aged > or = 55 years seen in office consultations by 25 general practitioners (GPs) from two separate areas in Italy were interviewed, using a pretested semistructured questionnaire covering conditions commonly associated with neuropathy and symptoms of peripheral nerve disease. A neurologist later visited individuals with > or = 2 symptoms of polyneuropathy and a diagnosis of CSP was made in the presence of bilateral, fairly symmetric impairment of at least two among strength, sensation and tendon reflexes. AH was ascertained when known to the GP and/or if the patient was being treated with antihypertensive drugs. RESULTS One hundred and fifty one subjects had CSP (3.6%). Diabetes was the commonest associated condition (18%). AH was present in 47 patients with CSP (31%). The odds ratio (OR) of AH in patients with CSP was 4.5 [95% confidence interval (CI) 3.1-6.6]. The OR of AH was 3.2 (95% CI 1.5-6.9) in patients with diabetes, and 5.7 (95% CI 3.6-9.3) in those without diabetes. The OR of AH was 4.8 (95% CI 4.4-5.2) after adjusting for the commonest risk factors for CSP. CONCLUSION AH may be an independent risk factor for CSP in the elderly.","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59837135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical HIV prevalence in Edinburgh Prison: a database-linkage study.","authors":"S R Seaman,&nbsp;S M Bird,&nbsp;R P Brettle","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of HIV in prisons is often higher than in the surrounding community, because prisons contain a high proportion of injecting drug users (IDUs). Reliable estimation of HIV prevalence in UK prisons only began in the 1990s. Edinburgh, Scotland, experienced a major IDU-related HIV epidemic which began in 1983. We sought retrospectively to estimate HIV prevalence in Edinburgh Prison over the period 1983-94.</p><p><strong>Methods: </strong>Prison records of all 477 male HIV-positive patients (332 IDUs) in the Edinburgh City Hospital Cohort (believed to include three-quarters of HIV-positive Edinburgh IDUs) were abstracted from Edinburgh Prison. Using this information and the seroconversion intervals of the patients, the number of person-years spent inside the prison by these individuals while HIV-positive was estimated for each calendar month. From this, HIV prevalence was inferred.</p><p><strong>Results: </strong>HIV prevalence in the prison rose from January 1983, as prevalence among Edinburgh IDUs increased, reaching a peak of 8% in December 1984. Prevalence during 1985-86 was 5-6% and then gradually declined, as the surviving HIV-infected IDUs spent less time in the prison.</p><p><strong>Discussion: </strong>These figures are probably underestimates, as some HIV-positive prisoners are not in the cohort. However, the degree of underestimation should not be great and trends over time are reliable. Our estimate for August 1991, 4.1%, compares favourably with the estimate 4.5%, from an anonymous unlinked survey conducted in the prison that month. Prevalence estimates from other UK prisons are reviewed and suggestions made for other uses of database linkage in HIV and IDU epidemiology.</p>","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifty years of research on tobacco.","authors":"R Doll","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics in epidemiology: common misconceptions, paradoxes and unresolved questions.","authors":"S S Coughlin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21727592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating birth prevalence of Down's syndrome.","authors":"D E Wright,&nbsp;I Bray","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Estimates of maternal age-specific prevalence of Down's syndrome are needed for the assessment of environmental factors, for counselling and monitoring screening programmes. The estimates should relate to populations of women who have not received prenatal screening. This is normally achieved by using data collected before the widespread use of screening. The problem of under-ascertainment in some data-sets has been recognised in the literature, but has not been dealt with satisfactorily in the statistical models used to estimate live-birth prevalence.</p><p><strong>Methods: </strong>In this paper we develop a model that takes explicit account of under-ascertainment and apply this model to data from nine published studies. The primary aim of our analysis is to provide an improved model for live-birth prevalence. A secondary aim is to examine the ascertainment rates in the nine studies.</p><p><strong>Results: </strong>The proposed model provides a good fit to all but one of the nine studies, although exclusion of this study does not affect the estimated risks. The estimate of risk weighted across the maternal age distribution is 1.41 in 1000 live-births [90% confidence interval (CI) 1.37-1.49].</p><p><strong>Discussion: </strong>Comparing this figure with those obtained from published rate schedules suggests that the proposed model predicts rates that are some 10% higher than those obtained when ascertainment is assumed to be complete in all studies. The predicted rates are similar to those calculated when only those studies known to have high levels of acertainment are included.</p>","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21732221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer registration in Germany: current status, perspectives and trends in cancer incidence 1973-93.","authors":"J Schüz,&nbsp;D Schön,&nbsp;W Batzler,&nbsp;C Baumgardt-Elms,&nbsp;B Eisinger,&nbsp;M Lehnert,&nbsp;C Stegmaier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A federal law effective in 1995 makes it mandatory for all German States to build up population-based cancer registries. Although the law provides a model of cancer registration, each State may modify this by State-specific regulations, as long as they ensure data exchange between the registries and between registries and scientific institutions. The 'Network of German Population-Based Cancer Registries' constitutes the basis for cooperation among the German cancer registries. In order to improve the cooperation between physicians and epidemiologists, and to demonstrate the benefits of cancer registration, the network published a booklet containing facts on time-trends in cancer incidence during the last two decades.</p><p><strong>Methods: </strong>Information on cancer incidence and mortality was derived from the population-based cancer registries of Saarland, the former German Democratic Republic (until 1989), the City of Hamburg and the region of Münster. Altogether these registries cover a population of about 23 million. Sixteen types of cancer were selected for the analyses.</p><p><strong>Results: </strong>Major increases in cancer incidence were observed for female lung cancer, testicular cancer, cancer of the oral cavity, malignant melanoma of the skin and non-Hodgkin's lymphoma. Incidence rates also increased for cancer of the female breast, prostate cancer and colorectal cancer. A decrease was observed for stomach and cervical cancer.</p><p><strong>Discussion: </strong>In 1998, only a small fraction of all German adults were monitored by a population-based cancer registry, making it impossible to work out accurate incidence rates for the whole of Germany. Several new cancer registries have been built up recently. Data summaries of existing German population-based cancer registries assist in enhancing the completeness of new cancer registries.</p>","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21732222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over the counter non-steroidal anti-inflammatory drugs and risk of gastrointestinal bleeding.","authors":"W J Blot,&nbsp;J K McLaughlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Independent analyses of data from a case-control study conducted by the American College of Gastroenterology (ACG) were performed to evaluate and quantify potential risks of gastrointestinal (GI) bleeding associated with use of analgesics at over the counter (OTC) doses.</p><p><strong>Methods: </strong>Information on recent (within the past week) use of multiple analgesics, plus data on tobacco, alcohol and other factors, were obtained from 627 patients enrolled in the ACG GI bleeding registry and from 590 procedure-matched controls. Odds ratios (OR) were calculated as the measure of association between GI bleeding and the exposures of interest.</p><p><strong>Results: </strong>Risk of GI bleeding was increased 2-3 fold among recent users of aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) at OTC doses, with risk increasing in a dose-related manner. In contrast, no excess was found among acetaminophen (paracetamol) users. Alcohol consumption was also a risk factor, with doubled risks of GI bleeding among drinkers.</p><p><strong>Discussion: </strong>While these study results are not definitive, the findings are consistent with limited other data also reviewed, and suggest the need for further epidemiologic research to clarify the association between use of NSAIDs at OTC levels and risk of GI bleeding, and to determine whether NSAIDs and alcohol may interactively combine to enhance risk.</p>","PeriodicalId":80024,"journal":{"name":"Journal of epidemiology and biostatistics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21732227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}