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Clinical Epidemiology

Sebastian Schneeweiss
Background: Decision makers in health care increasingly rely on nonrandomized database analyses to assess the effectiveness, safety, and value of medical products. Health care data scientists use data-adaptive approaches that automatically optimize confounding control to study causal treatment effects. This article summarizes relevant experiences and extensions. Methods: The literature was reviewed on the uses of high-dimensional propensity score (HDPS) and related approaches for health care database analyses, including methodological articles on their performance and improvement...
2018: Clinical Epidemiology
Line Tang Møllehave, Allan Linneberg, Tea Skaaby, Nils Knudsen, Torben Jørgensen, Betina Heinsbæk Thuesen
Background: Long-term iodine exposure may influence the frequency of thyroid disease treatments through fluctuations in thyroid diseases. Yet, the long-term fluctuations in thyroid disease treatments upon iodine fortification (IF) are not fully known. We aimed to examine the development in thyroid disease treatments in Denmark before and following the implementation of IF in 2000. Methods: Nationwide data on antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment were obtained from Danish registries...
2018: Clinical Epidemiology
Claire L Burton, Linda S Chesterton, Ying Chen, Danielle A van der Windt
Purpose: Carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve. This study investigated the value of candidate prognostic factors (PFs) in predicting carpal tunnel release surgery. Patients and methods: This is a retrospective cohort study set in the Clinical Practice Research Datalink. Patients ≥18 years presenting with an incident episode of CTS were identified between 1989 and 2013. Candidate PF's defined in coded electronic patient records were identified following literature review and consultation with clinicians...
2018: Clinical Epidemiology
Le Ma, Gang Liu, Geng Zong, Laura Sampson, Frank B Hu, Walter C Willett, Eric B Rimm, JoAnn E Manson, Kathryn M Rexrode, Qi Sun
Importance: Glucosinolates, a group of phytochemicals abundant in cruciferous vegetables, may have cardioprotective properties. However, no prospective study has evaluated the association of intake of glucosinolates with the risk of coronary heart disease (CHD). Objective: The objective of the study was to evaluate the association between the intake of glucosinolates and incident CHD in US men and women. Design: Prospective longitudinal cohort study...
2018: Clinical Epidemiology
Maral Adel Fahmideh, Giorgio Tettamanti, Catharina Lavebratt, Mats Talbäck, Tiit Mathiesen, Birgitta Lannering, Kimberly J Johnson, Maria Feychting
Purpose: Phacomatoses are genetic syndromes that are associated with increased risk of developing nervous system tumors. Phacomatoses are usually inherited, but many develop de novo, with unknown etiology. In this population-based study, we investigated the effect of parental age on the risk of phacomatoses in offspring. Patients and methods: The study was a population-based nested case-control study. All individuals born and residing in Sweden between January 1960 and December 2010 were eligible for inclusion...
2018: Clinical Epidemiology
Qiao-Li Wang, Shao-Hua Xie, Karl Wahlin, Jesper Lagergren
Background and aims: Esophageal squamous cell carcinoma (ESCC) is the dominant histological type of esophageal cancer worldwide (90%). We aimed to provide an update of the global temporal trends in the incidence of ESCC. Methods: Incidence data for ESCC were collected from 30 well-established cancer registries from 20 countries in Europe, Northern America, Australia, or Asia for 1970-2015. Time trends in annual age-standardized incidence rates of ESCC were assessed using joinpoint analysis and log-linear regression...
2018: Clinical Epidemiology
Mohammadhossein Hajiebrahimi, Marie Linder, David Hägg, Ina Anveden Berglind, Sean McElligott, Valgard Sverrir Valgardsson, Reginald Villacorta, Anders Sundström
Background: Association between psoriasis severity and cerebro- and cardiovascular comorbidities has rarely been investigated. Aim: We aimed to investigate differences in cerebro- and cardiovascular comorbidities by psoriasis severity. Materials and methods: Using Swedish nationwide health-care registers, new adult users of anti-psoriatic drugs (2007-2013) with a recorded diagnosis of psoriasis/psoriatic arthritis or a filled prescription for calcipotriol were included...
2018: Clinical Epidemiology
Edward Burn, Christopher J Edwards, David W Murray, Alan Silman, Cyrus Cooper, Nigel K Arden, Daniel Prieto-Alhambra, Rafael Pinedo-Villanueva
Purpose: To assess whether rheumatoid arthritis (RA) is associated with a greater risk of adverse events following total knee replacement (TKR) and total hip replacement (THR) than osteoarthritis (OA). Patients and methods: Individuals with a diagnosis of RA or OA were identified using primary care records. TKR and THR following diagnosis were identified using linked hospital records. Myocardial infarction (MI), prosthetic joint infection (PJI), venous thromboembolism (VTE), and death were identified within 90 days following surgery, and revision procedures over 10 years following surgery...
2018: Clinical Epidemiology
Andreas Ebbehoj, Sarah Forslund Jacobsen, Christian Trolle, Maciej Grzegorz Robaczyk, Åse Krogh Rasmussen, Ulla Feldt-Rasmussen, Reimar Wernich Thomsen, Per Løgstrup Poulsen, Kirstine Stochholm, Esben Søndergaard
Background: Pheochromocytoma and catecholamine-secreting paraganglioma (PPGL) are rare but potentially life-threatening tumors. We aimed to validate diagnosis codes for PPGL in the Danish National Patient Registry, the Danish National Pathology Registry, and the Danish Registry of Causes of Death and to create a national cohort of incident PPGL patients by linking these three registries. Patients and methods: We obtained data from the three abovementioned registries for all individuals registered with pheochromocytoma or catecholamine hypersecretion in Denmark during 1977-2016 (average population 5...
2018: Clinical Epidemiology
Mira Y Friedman, Maya Leventer-Roberts, Joseph Rosenblum, Nir Zigman, Iris Goren, Vered Mourad, Natan Lederman, Nurit Cohen, Eran Matz, Doron Z Dushnitzky, Nirit Borovsky, Moshe B Hoshen, Gili Focht, Malka Avitzour, Yael Shachar, Yehuda Chowers, Rami Eliakim, Shomron Ben-Horin, Shmuel Odes, Doron Schwartz, Iris Dotan, Eran Israeli, Zohar Levi, Eric I Benchimol, Ran D Balicer, Dan Turner
Background: Before embarking on administrative research, validated case ascertainment algorithms must be developed. We aimed at developing algorithms for identifying inflammatory bowel disease (IBD) patients, date of disease onset, and IBD type (Crohn's disease [CD] vs ulcerative colitis [UC]) in the databases of the four Israeli Health Maintenance Organizations (HMOs) covering 98% of the population. Methods: Algorithms were developed on 5,131 IBD patients and 2,072 controls, following independent chart review (60% CD and 39% UC)...
2018: Clinical Epidemiology
Angela Lupattelli, Michael J Twigg, Ksenia Zagorodnikova, Myla E Moretti, Mariola Drozd, Alice Panchaud, Andre Rieutord, Romana Gjergja Juraski, Marina Odalovic, Debra Kennedy, Gorazd Rudolf, Herbert Juch, Hedvig Nordeng
Purpose: This study aimed at exploring the prevalence of self-reported antenatal and postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Materials and methods: This was a multinational web-based study conducted across 12 European countries (n=8069). Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate...
2018: Clinical Epidemiology
Elisa Martín-Merino, Amaia Calderón-Larrañaga, Samuel Hawley, Beatriz Poblador-Plou, Ana Llorente-García, Irene Petersen, Daniel Prieto-Alhambra
Background: Missing data are often an issue in electronic medical records (EMRs) research. However, there are many ways that people deal with missing data in drug safety studies. Aim: To compare the risk estimates resulting from different strategies for the handling of missing data in the study of venous thromboembolism (VTE) risk associated with antiosteoporotic medications (AOM). Methods: New users of AOM (alendronic acid, other bisphosphonates, strontium ranelate, selective estrogen receptor modulators, teriparatide, or denosumab) aged ≥50 years during 1998-2014 were identified in two Spanish (the Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria [BIFAP] and EpiChron cohort) and one UK (Clinical Practice Research Datalink [CPRD]) EMR...
2018: Clinical Epidemiology
Fu-Chao Liu, Huan-Tang Lin, Chang-Fu Kuo, Mei-Yun Hsieh, Lai-Chu See, Huang-Ping Yu
Background: Individuals with a family history of Parkinson's disease (PD) appear to have a higher risk of developing PD and other neuropsychiatric diseases. However, estimates of the relative risks (RRs) of PD and the roles of genetic and environmental factors in PD susceptibility are unclear. The aim of this study was to examine familial aggregation and genetic contributions to PD and the RRs of other neuropsychiatric diseases in relatives of PD patients. Methods: In this population-based family cohort study, the records of all individuals actively registered in the Taiwan National Health Insurance Research Database in 2015 were queried (N=24,349,599)...
2018: Clinical Epidemiology
Pauline Wm Voskamp, Friedo W Dekker, Maarten B Rookmaaker, Marianne C Verhaar, Willem Jan W Bos, Merel van Diepen, Gurbey Ocak
Purpose: A post hoc analysis of a recent trial on direct oral anticoagulants versus vitamin K antagonists showed that amongst patients with mildly decreased kidney function, use of vitamin K antagonists was associated with a greater decline in renal function than use of direct oral anticoagulants. Whether these vitamin K antagonist effects are the same in pre-dialysis patients is unknown. Therefore, the aim of this study was to investigate the association between vitamin K antagonist use and the rate of renal function decline and time until start of dialysis in incident pre-dialysis patients...
2018: Clinical Epidemiology
Cynthia J Janmaat, Merel van Diepen, Cheyenne Ce van Hagen, Joris I Rotmans, Friedo W Dekker, Olaf M Dekkers
Purpose: Substantial heterogeneity exists in reported kidney function decline in pre-dialysis chronic kidney disease (CKD). By design, kidney function decline can be studied in CKD 3-5 cohorts or dialysis-based studies. In the latter, patients are selected based on the fact that they initiated dialysis, possibly leading to an overestimation of the true underlying kidney function decline in the pre-dialysis period. We performed a systematic review and meta-analysis to compare the kidney function decline during pre-dialysis in CKD stage 3-5 patients, in these two different study types...
2018: Clinical Epidemiology
Charlotte Suppli Ulrik, Søren N Lophaven, Zorana Jovanovic Andersen, Thorkild Ia Sørensen, Jennifer L Baker
Background: Excess body weight in adulthood is associated with risk for asthma admission (AA). Our aim was to investigate if this association also applies to the relation between body mass index (BMI) in childhood and AAs in early adulthood (age 20-45 years). Methods: This was a prospective study of 310,211 schoolchildren (born 1930-1989) from the Copenhagen School Health Records Register. Height and weight were measured annually, and generated BMI z -scores were categorized as low (lower quartile), normal (interquartile) and high (upper quartile)...
2018: Clinical Epidemiology
Ruoqing Chen, Katja Fall, Kamila Czene, Beatrice Kennedy, Unnur Valdimarsdóttir, Fang Fang
Background: A parental cancer diagnosis is a stressful life event, potentially leading to increased risks of mental and physical problems among children. This study aimed to investigate the associations of parental cancer with IQ, stress resilience, and physical fitness of the affected men during early adulthood. Materials and methods: In this Swedish population-based study, we included 465,249 men born during 1973-1983 who underwent the military conscription examination around the age of 18 years...
2018: Clinical Epidemiology
Tzu-Yi Wu, Chia-Hua Chung, Chia-Ni Lin, Jing-Shiang Hwang, Jung-Der Wang
Background: The mortality rates for different cancers are no longer an efficient tool for making national policy. The purpose of this study were to quantify the lifetime risks, life expectancies (LEs) after diagnosis, expected years of life lost (EYLL), and lifetime health care expenditures for 19 major cancers in Taiwan. Methods: A total of 831,314 patients with 19 pathologically proven cancers were abstracted from the Taiwan Cancer Registry from 1998 to 2012. They were linked to the National Mortality Registry (1998-2014) and National Health Insurance reimbursement database (1998-2013) for survival and health care costs...
2018: Clinical Epidemiology
Alexander M Walker, Sebastian Schneeweiss, Maral DerSarkissian, Mei Sheng Duh
Background: When an exclusionary criterion is an imperfect screen, some ineligible patients will remain in a study. Medical record review for outcome adjudication can reveal such individuals. Objective: To ascertain the circumstances under which it is advisable to remove outcome cases first found to be ineligible on chart review. Methods: The impact on the relative risk caused by removal of ineligible outcome cases was examined under different circumstances of confounding, prevalence, and efficacy of the screening criterion for exclusions...
2018: Clinical Epidemiology
Aurélien Belot, Laurent Remontet, Bernard Rachet, Olivier Dejardin, Hadrien Charvat, Simona Bara, Anne-Valérie Guizard, Laurent Roche, Guy Launoy, Nadine Bossard
Background: Describing the relationship between socioeconomic inequalities and cancer survival is important but methodologically challenging. We propose guidelines for addressing these challenges and illustrate their implementation on French population-based data. Methods: We analyzed 17 cancers. Socioeconomic deprivation was measured by an ecological measure, the European Deprivation Index (EDI). The Excess Mortality Hazard (EMH), ie, the mortality hazard among cancer patients after accounting for other causes of death, was modeled using a flexible parametric model, allowing for nonlinear and/or time-dependent association between the EDI and the EMH...
2018: Clinical Epidemiology
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