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Current Epidemiology Reports

John G Connolly, Shirley V Wang, Candace C Fuller, Sengwee Toh, Catherine A Panozzo, Noelle Cocoros, Meijia Zhou, Joshua J Gagne, Judith C Maro
Purpose of Review: An important component of the Food and Drug Administration's Sentinel Initiative is the active post-market risk identification and analysis (ARIA) system, which utilizes semi-automated, parameterized computer programs to implement propensity-score adjusted and self-controlled risk interval designs to conduct targeted surveillance of medical products in the Sentinel Distributed Database. In this manuscript, we review literature relevant to the development of these programs and describe their application within the Sentinel Initiative...
December 2017: Current Epidemiology Reports
Xiaojuan Li, Jessica G Young, Sengwee Toh
Purpose of review: Pharmacoepidemiologists are often interested in estimating the effects of dynamic treatment strategies, where treatments are modified based on patients' evolving characteristics. For such problems, appropriate control of both baseline and time-varying confounders is critical. Conventional methods that control confounding by including time-varying treatments and confounders in an outcome regression model may not have a causal interpretation, even when all baseline and time-varying confounders are measured...
December 2017: Current Epidemiology Reports
Sengwee Toh
No abstract text is available yet for this article.
December 2017: Current Epidemiology Reports
Jennifer Anne Doherty, Lauren Cole Peres, Chen Wang, Gregory P Way, Casey S Greene, Joellen M Schildkraut
Purpose of review: Only recently has it become clear that epithelial ovarian cancer (EOC) is comprised of such distinct histotypes--with different cells of origin, morphology, molecular features, epidemiologic factors, clinical features, and survival patterns-that they can be thought of as different diseases sharing an anatomical location. Herein, we review opportunities and challenges in studying EOC heterogeneity. Recent findings: The 2014 World Health Organization diagnostic guidelines incorporate accumulated evidence that high- and low-grade serous tumors have different underlying pathogenesis, and that, on the basis of shared molecular features, most high grade tumors, including some previously classified as endometrioid, are now considered to be high-grade serous...
September 2017: Current Epidemiology Reports
Carmen Messerlian, Audrey J Gaskins
PURPOSE: While considerable progress has been made since the advent of assisted reproductive technology (ART), the field remains a complex and challenging one for clinicians and researchers alike. This review discusses some of the most salient issues pertaining to the study of ART and whenever possible suggestions on how to address them. RECENT FINDINGS: More than 5 million babies have been born through ART to date, representing up to 4% of all births worldwide...
June 2017: Current Epidemiology Reports
Anissa I Vines, Julia B Ward, Evette Cordoba, Kristin Z Black
PURPOSE OF REVIEW: Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature...
June 2017: Current Epidemiology Reports
Alexander J Millman, Noele P Nelson, Claudia Vellozzi
PURPOSE OF REVIEW: This review highlights key studies and recently published data, policies, and recommendations related to hepatitis C virus (HCV) epidemiology, transmission, and treatment. RECENT FINDINGS: HCV is a leading cause of liver-related deaths, cirrhosis, and hepatocellular carcinoma. Since 2011 and accelerating since 2013, new, safe, tolerable, and curative therapies have considerably altered clinical and public health frameworks related to the prevention, control and clinical management of HCV...
June 2017: Current Epidemiology Reports
Kelly K Ferguson, Helen B Chin
PURPOSE OF REVIEW: Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context...
March 2017: Current Epidemiology Reports
Joseph M Braun, Carmen Messerlian, Russ Hauser
PURPOSE: Despite accumulating evidence from experimental animal studies showing that paternal environmental exposures induce genetic and epigenetic alterations in sperm which in turn increase the risk of adverse health outcomes in offspring, there is limited epidemiological data on the effects of human paternal preconception exposures on children's health. We summarize animal and human studies showing that paternal preconception environmental exposures influence offspring health. We discuss specific approaches and designs for human studies to investigate the health effects of paternal preconception exposures, the specific challenges these studies may face, and how we might address them...
March 2017: Current Epidemiology Reports
Alexis D Vick, Heather H Burris
PURPOSE OF REVIEW: African Americans disproportionately suffer from leading causes of morbidity and mortality including cardiovascular disease (CVD), cancer, and preterm birth. Disparities can arise from multiple social and environmental exposures, but how the human body responds to these exposures to result in pathophysiologic states is incompletely understood. RECENT FINDINGS: Epigenetic mechanisms, particularly DNA methylation, can be altered in response to exposures such as air pollution, psychosocial stress, and smoking...
March 2017: Current Epidemiology Reports
Jie Zheng, Denis Baird, Maria-Carolina Borges, Jack Bowden, Gibran Hemani, Philip Haycock, David M Evans, George Davey Smith
Purpose of Review: Mendelian randomization (MR) is a strategy for evaluating causality in observational epidemiological studies. MR exploits the fact that genotypes are not generally susceptible to reverse causation and confounding, due to their fixed nature and Mendel's First and Second Laws of Inheritance. MR has the potential to provide information on causality in many situations where randomized controlled trials are not possible, but the results of MR studies must be interpreted carefully to avoid drawing erroneous conclusions...
2017: Current Epidemiology Reports
Sonja A Swanson
Purpose of review: When leveraging observational data to estimate treatment effects, it is useful to explicitly specify the "target trial" the investigators aspire to emulate. One concern is whether a proposed analysis plan can address the realities of the differences between the available non-randomized observational study and the target trial. When large or unknown sources of unmeasured confounding are suspected, investigators might consider turning to instrumental variable (IV) methods...
2017: Current Epidemiology Reports
Joanna Maselko
PURPOSE OF THE REVIEW: The vast majority of research on the social determinants of mental health has been generated from high-income country (HIC) populations, even as the greatest health disparities, and greatest disease burden, is observed in lower- and middle-income countries (LMICs). The goal of this review is to examine the evidence base on how key social epidemiology constructs relate to mental health in LMIC contexts. A special focus is on points of departure from the HIC knowledge base, gaps in overall understanding, and opportunities for social epidemiology to make a significant contribution...
2017: Current Epidemiology Reports
K S Joseph, Neda Razaz, Giulia M Muraca, Sarka Lisonkova
PURPOSE OF REVIEW: Several prestigious agencies routinely rank countries based on crude perinatal and infant mortality rates, while more recently, international neonatal networks have begun comparing neonatal mortality and morbidity rates among very preterm and very low-birth-weight infants. We discuss the methodologic challenges that compromise such comparisons and potential remedies. RECENT FINDINGS: Crude perinatal mortality rates are biased by international variations in birth registration, especially at the borderline of viability...
2017: Current Epidemiology Reports
Chirag J Patel
PURPOSE OF REVIEW: Mixtures, or combinations and interactions between multiple environmental exposures, are hypothesized to be causally linked with disease and health-related phenotypes. Established and emerging molecular measurement technologies to assay the exposome, the comprehensive battery of exposures encountered from birth to death, promise a new way of identifying mixtures in disease in the epidemiological setting. In this opinion, we describe the analytic complexity and challenges in identifying mixtures associated with phenotype and disease...
2017: Current Epidemiology Reports
Tyler M Sharp, Kay M Tomashek, Jennifer S Read, Harold S Margolis, Stephen H Waterman
PURPOSE OF REVIEW: By all measures, the morbidity and mortality due to dengue are continuing to worsen worldwide. Although both early and recent studies have demonstrated regional differences in how dengue affects local populations, these findings were to varying extents related to disparate surveillance approaches. RECENT FINDINGS: Recent studies have broadened the recognized spectrum of disease resulting from DENV infection, particularly in adults, and have also demonstrated new mechanisms of DENV spread both within and between populations...
2017: Current Epidemiology Reports
Jessie K Edwards, Laura L Hester, Mugdha Gokhale, Catherine R Lesko
Risk is an important parameter to describe the occurrence of health outcomes over time. However, many outcomes of interest in healthcare settings, such as disease incidence, treatment initiation, and cause-specific mortality, may be precluded from occurring by other events, often referred to as competing events. Here, we review straightforward approaches to estimate risk in the presence of competing events. We illustrate the application of these methods using timely examples in pharmacoepidemiologic research and compare results to those obtained using analytic simplifications commonly used to handle competing events...
December 2016: Current Epidemiology Reports
M Elizabeth Halloran, Michael G Hudgens
One hundred years ago Sir Ronald Ross published his treatise on a general Theory of Happenings. Dependent happenings are those in which the frequency depends on the number already affected. When there is dependency of events, interventions can have different types of effects. Interventions such as vaccination can have direct protective effects for the person receiving the treatment, as well as indirect/spillover effects for others in the population. Causal inference is a framework for carefully defining the causal effect of a treatment, exposure, or policy, and then determining conditions under which such effects can be estimated from the observed data...
December 2016: Current Epidemiology Reports
Kevin D Shield, D Maxwell Parkin, David C Whiteman, J├╝rgen Rehm, Vivian Viallon, Claire Marant Micallef, Paolo Vineis, Lesley Rushton, Freddie Bray, Isabelle Soerjomataram
The proportions of new cancer cases and deaths that are caused by exposure to risk factors and that could be prevented are key statistics for public health policy and planning. This paper summarizes the methodologies for estimating, challenges in the analysis of, and utility of, population attributable and preventable fractions for cancers caused by major risk factors such as tobacco smoking, dietary factors, high body fat, physical inactivity, alcohol consumption, infectious agents, occupational exposure, air pollution, sun exposure, and insufficient breastfeeding...
September 2016: Current Epidemiology Reports
Antonia M Calafat
In environmental epidemiology, use of biomonitoring (i.e., trace-level measurement of environmental chemicals or their metabolites in biospecimens) for exposure assessment has increased considerably in past decades. Although exposure biomarkers should reflect a person's exposure to the target chemicals (or their precursors) within a specific timeframe, timing, duration, and intensity of exposures are normally unknown and likely vary within the study period. Therefore, evaluating exposure beyond a single time point may require collecting more than one biospecimen...
June 2016: Current Epidemiology Reports
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