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Clinical Epidemiology

Daniel Bos, Arjola Bano, Albert Hofman, Tyler J VanderWeele, Maryam Kavousi, Oscar H Franco, Meike W Vernooij, Robin P Peeters, M Arfan Ikram, Layal Chaker
Background: The underlying mechanism of the association between thyroid function and atrial fibrillation (AF) is poorly understood, but epicardial adipose tissue (EAT) could be a promising mediator. Methods: In the 1995 participants (mean age 64.5 years) from the population-based Rotterdam Study, we measured thyroid function (thyroid-stimulating hormone, free thyroxine [FT4]) and performed computed tomography to quantify EAT volumes. All participants were followed for the occurrence of AF...
2018: Clinical Epidemiology
(no author information available yet)
[This corrects the article on p. 331 in vol. 9, PMID: 28652815.].
2018: Clinical Epidemiology
Michael D Kappelman, Aksel Lange, Rachel L Randell, Patricia V Basta, Robert S Sandler, Kristina Laugesen, Anna Byrjalsen, Tina Christensen, Trine Frøslev, Rune Erichsen
Background: Epidemiologic studies combining exposure and outcome data with the collection of biosamples are needed to study gene-environment interactions that might contribute to the etiology of complex diseases such as pediatric Crohn's disease (CD). Nationwide registries, including those in Denmark and other Scandinavian countries, provide efficient and reliable sources of data for epidemiological studies evaluating the environmental determinants of disease. We performed a pilot study to test the feasibility of collecting salivary DNA to augment registry data in established cases of pediatric CD and randomly selected, population-based controls...
2018: Clinical Epidemiology
Riccardo Di Domenicantonio, Francesco Trotta, Silvia Cascini, Nera Agabiti, Anna Kohn, Antonio Gasbarrini, Marina Davoli, Antonio Addis
Background: The comparison of effectiveness and safety of anti-tumor necrosis factor-alpha agents for the treatment of inflammatory bowel disease (IBD) is relevant for clinical practice and stakeholders. Objective: The objective of this study was to compare the risk of abdominal surgery, steroid utilization, and hospitalization for infection in Crohn's disease (CD) or ulcerative colitis (UC) patients newly treated with infliximab (IFX) or adalimumab (ADA). Methods: A retrospective population-based cohort study was performed using health information systems data from Lazio region, Italy...
2018: Clinical Epidemiology
Kathryn E Mansfield, Ian J Douglas, Dorothea Nitsch, Sara L Thomas, Liam Smeeth, Laurie A Tomlinson
Background: The relative risk of acute kidney injury (AKI) following different infections, and whether angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) modify the risk, is unclear. We aimed to determine the risks of hospital admission with AKI following infections (urinary tract infection [UTI], lower respiratory tract infection [LRTI], and gastroenteritis) among users of antihypertensive drugs. Methods: We used UK electronic health records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database...
2018: Clinical Epidemiology
Ing-Mari Dohrn, Lydia Kwak, Pekka Oja, Michael Sjöström, Maria Hagströmer
Background: Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior. Objective: To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time...
2018: Clinical Epidemiology
Yang Peng, Zhiqiang Wang
Background: The American Heart Association (AHA) committee recently set a guideline to define and monitor the cardiovascular health status. This study aimed to estimate cardiovascular health status among Australian adults using the guideline. Methods: We used data from a nationally representative sample of 7499 adults (age ≥18 years) from 2011 to 2012 Australian Health Survey. We applied the modified AHA's definition to estimate the ideal proportions of the seven metrics and the overall cardiovascular health status...
2018: Clinical Epidemiology
Tsung-Kun Lin, Yi-Sheng Liou, Ching-Heng Lin, Pesus Chou, Gwo-Ping Jong
Background: Statins have been linked to new-onset osteoporotic fractures (NOFs), and different statins may alter the risk for the development of NOFs. Aim: In this study, we investigated the association between different statins and the development of NOFs. Patients and methods: This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance, including case patients with NOFs from January 2004 to December 2013 and non-NOF subjects...
2018: Clinical Epidemiology
Melanie L Bell, Amy L Whitehead, Steven A Julious
Background: A pilot study can be an important step in the assessment of an intervention by providing information to design the future definitive trial. Pilot studies can be used to estimate the recruitment and retention rates and population variance and to provide preliminary evidence of efficacy potential. However, estimation is poor because pilot studies are small, so sensitivity analyses for the main trial's sample size calculations should be undertaken. Methods: We demonstrate how to carry out easy-to-perform sensitivity analysis for designing trials based on pilot data using an example...
2018: Clinical Epidemiology
Korbinian Weigl, Jenny Chang-Claude, Phillip Knebel, Li Hsu, Michael Hoffmeister, Hermann Brenner
Background and aim: Family history (FH) and genetic risk scores (GRSs) are increasingly used for risk stratification for colorectal cancer (CRC) screening. However, they were mostly considered alternatively rather than jointly. The aim of this study was to assess the potential of individual and joint risk stratification for CRC by FH and GRS. Patients and methods: A GRS was built based on the number of risk alleles in 53 previously identified single-nucleotide polymorphisms among 2,363 patients with a first diagnosis of CRC and 2,198 controls in DACHS [colorectal cancer: chances for prevention through screening], a population-based case-control study in Germany...
2018: Clinical Epidemiology
Suneela Mehta, Rod Jackson, Sue Wells, Jeff Harrison, Daniel J Exeter, Andrew J Kerr
Background: Despite widespread use of cardiovascular disease (CVD) preventive medications in cohorts used to develop CVD risk prediction models, only some incorporate baseline CVD pharmacotherapy and none account for treatment changes during study follow-up. Therefore, current risk prediction scores may underestimate the true CVD event risk. We examined changes in CVD pharmacotherapy over 5 years in preparation for developing new 5-year risk prediction models. Methods: Anonymized individual-level linkage of eight national administrative health datasets enabled identification of all New Zealanders aged 30-74 years, without prior hospitalization for CVD or heart failure, who utilized publicly funded health services during 2006...
2018: Clinical Epidemiology
Jiancheng Wang, Binyan Wang, Min Liang, Guobao Wang, Jianping Li, Yan Zhang, Yong Huo, Yimin Cui, Xiping Xu, Xianhui Qin
Objective: Whether serum bilirubin and cigarette smoking affect the risk of renal function decline remains inconclusive. We aimed to test the independent and combined effects of bilirubin and cigarette smoking on the progression of chronic kidney disease (CKD) in hypertensive adults. Methods: The study population consisted of 12,633 patients in the renal sub-study of the China Stroke Primary Prevention Trial. The primary outcome was progression of CKD, defined as a decrease in estimated glomerular filtration rate (eGFR) of ≥30% and to a level of <60 mL/min/1...
2018: Clinical Epidemiology
Colin J Crooks, Joe West, Peter Jepsen
Purpose: The CirCom score has been developed from Danish data as a specific measure of comorbidity for cirrhosis to predict all-cause mortality. We compared its performance with the Charlson Comorbidity Index (CCI) in an English cirrhosis population. Patients and methods: We used comorbidity scores in a survival model to predict mortality in a cirrhosis cohort in the Clinical Practice Research Datalink. The discrimination of each score was compared by age, gender, socioeconomic status, cirrhosis etiology, cirrhosis stage, and year after cirrhosis diagnosis...
2018: Clinical Epidemiology
Peter Bager, Giulia Corn, Jan Wohlfahrt, Heather A Boyd, Bjarke Feenstra, Mads Melbye
Background: The tonsils are immunological gatekeepers against pathogens. Immunological response to tonsillitis may vary clinically from no enlargement of the tonsils to nearly obstructive conditions. In this investigation, we studied the familial aggregation of tonsillectomy, as an indicator of the extent to which tonsillar immune responses to infections might be genetically controlled. Methods: Data on kinship relations and vital status from the Danish Civil Registration System were used to establish a cohort of Danes with relatives born since 1977...
2018: Clinical Epidemiology
Alf Inge Hellevik, Marianne Bakke Johnsen, Arnulf Langhammer, Valborg Baste, Ove Furnes, Kjersti Storheim, John Anker Zwart, Gunnar Birkeland Flugsrud, Lars Nordsletten
Objective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. Design: In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR...
2018: Clinical Epidemiology
Médéa Locquet, Charlotte Beaudart, Jean-Yves Reginster, Jean Petermans, Olivier Bruyère
Background: Sarcopenia leads to serious adverse health consequences. There is a dearth of screening tools for this condition, and performances of these instruments have rarely been evaluated. Our aim was to compare the performance of five screening tools for identifying elders at risk of sarcopenia against five diagnostic definitions. Subjects and methods: We gathered cross-sectional data of elders from the SarcoPhAge ("Sarco"penia and "Ph"ysical Impairment with Advancing "Age") study...
2018: Clinical Epidemiology
Boyoung Park, Hye Mi Cho, Eun Hye Lee, Seunghoon Song, Mina Suh, Kui Son Choi, Bong Joo Kang, Kyungran Ko, Ann Yi, Hae Kyoung Jung, Joo Hee Cha, Jae Kwan Jun
Purpose: The purpose of this study was to investigate the effects of breast density on breast cancer risk among women screened via a nationwide mammographic screening program. Patients and methods: We conducted a nested case-control study for a randomly selected population of 1,561 breast cancer patients and 6,002 matched controls from the National Cancer Screening Program. Breast density was measured and recorded by two independent radiologists using the Breast Imaging Reporting and Data System (BI-RADS)...
2018: Clinical Epidemiology
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
Monica C Robotin, Ximena Masgoret, Mamta Porwal, David Goldsbury, Chee Khoo, Jacob George
Background: Approximately 1% of Australians have chronic hepatitis B (CHB), which disproportionately affects people born in hepatitis B-endemic countries. Currently, approximately half of the people affected remain undiagnosed and antiviral treatment uptake is suboptimal (~5%). This increases the likelihood of developing end-stage disease complications, particularly hepatocellular cancer (HCC), and largely accounts for the significant increases in HCC incidence and mortality in Australia over the last decades...
2018: Clinical Epidemiology
Janet Sultana, Andrea Fontana, Francesco Giorgianni, Giorgio Basile, Elisabetta Patorno, Alberto Pilotto, Mariam Molokhia, Robert Stewart, Miriam Sturkenboom, Gianluca Trifirò
Background: Functional and cognitive domains have rarely been evaluated for their prognostic value in general practice databases. The aim of this study was to identify functional and cognitive domains in The Health Improvement Network (THIN) and to evaluate their additional value for the prediction of 1-month and 1-year mortality in elderly people. Materials and methods: A cohort study was conducted using a UK nationwide general practitioner database. A total of 1,193,268 patients aged 65 years or older, of whom 15,300 had dementia, were identified from 2000 to 2012...
2018: Clinical Epidemiology
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