Mixed Bag “Polypharmacy”: Methodological Pitfalls and Challenges of This Exposure Definition
AbstractPurpose of ReviewThe use of multiple medications is common in older adults but is associated with negative health outcomes. However, polypharmacy is not uniformly defined, and there is scant data on how the variety of definitions and their limitations hinder the development of sound scientific knowledge. The article intends to illustrate the challenges of this exposure definition.Recent FindingsThe array of thresholds for defining polypharmacy renders comparisons between results difficult. Few studies take into account the fact that polypharmacy is a changing exposure over time. In addition, although studies tend t...
Source: Current Epidemiology Reports - July 21, 2019 Category: Epidemiology Source Type: research
Big Data in Cardiovascular Disease
AbstractPurpose of ReviewCardiovascular diseases exert a wide-reaching epidemiological impact as the number one cause of death worldwide. Emerging technologies such as big data and artificial intelligence (AI) are poised to significantly change the field of cardiology. However, their applications are still emerging. We aimed to define the role of big data and AI in cardiovascular disease with a focus on research.Recent FindingsThere are zettabyte levels (1021 bytes) of big data in the US that can be directed towards healthcare research. There are applications of big data analytics already being put to use with genomics, he...
Source: Current Epidemiology Reports - July 17, 2019 Category: Epidemiology Source Type: research
Identifying Heterogeneous Treatment Effects of Drug Policy in Quasi-experimental Settings
AbstractPurpose of ReviewWe sought to describe the difference-in-differences study design and how they can be applied to identify the average treatment effect. We then extend this approach to identify heterogeneity in treatment effects based on (1) an individuals ’ baseline risk of an event using risk scores, (2) the outcome distribution using quantile regression, and (3) prior trajectories of outcomes using group-based trajectory models.Recent FindingsThe methods for the identification of heterogeneous treatment effect have developed in ways that can provide researchers and policymakers a more nuanced understanding of t...
Source: Current Epidemiology Reports - July 17, 2019 Category: Epidemiology Source Type: research
Pregnancy Complication History in 10-Year Cardiovascular Disease Risk Prediction: a Review of Recent Evidence
AbstractPurpose of ReviewWomen with prevalent pregnancy complications (including preterm birth and preeclampsia) have twice the risk of later cardiovascular disease (CVD) compared to unaffected women. Current prevention guidelines recommend that reproductive history should be part of a woman ’s CVD risk assessment. This review synthesizes recent findings on the value of history of pregnancy complications in 10-year CVD risk prediction.Recent FindingsThe associations between several pregnancy complications and CVD are still evident when conventional predictors are considered in middle age. However, comprehensive evaluatio...
Source: Current Epidemiology Reports - July 15, 2019 Category: Epidemiology Source Type: research
Data Science in Environmental Health Research
AbstractPurpose of ReviewData science is an exploding trans-disciplinary field that aims to harness the power of data to gain information or insights on researcher-defined topics of interest. In this paper, we review how data science can help advance environmental health research.Recent FindingsWe discuss the concepts of computationally scalable handling of big data and the design of efficient research data platforms and how data science can provide solutions for methodological challenges in environmental health research, such as high-dimensional outcomes and exposures and prediction models. Finally, we discuss tools for r...
Source: Current Epidemiology Reports - July 14, 2019 Category: Epidemiology Source Type: research
Drug Safety in Pregnancy: Review of Study Approaches Requested by Regulatory Agencies
AbstractPurpose of ReviewWe reviewed postauthorization pregnancy safety studies requested by regulatory agencies to explore which study approaches have been typically requested and to what extent these have changed over time.Recent FindingsThe most common study approach requested by the US Food and Drug Administration (FDA) is pregnancy exposure registries (observational cohorts with prospective data collection), per the FDA ’s Postmarketing Requirements and Commitments (PMR/PMC) database. Since 2017, this requirement has often been paired with a request for a database study (observational study using preexisting electro...
Source: Current Epidemiology Reports - July 12, 2019 Category: Epidemiology Source Type: research
Sex Differences in Melanoma
AbstractPurpose of ReviewThe goal of this review has been to elucidate the sex differences in cancer incidence and mortality in cutaneous melanoma. We have evaluated biological and behavioral research to determine where the critical questions exist.Recent FindingsThe most recent findings, through 2015, are exploratory in nature but seem to indicate that the differences are more likely due to biological variations rather than behavioral. While behavioral studies do show that women are more likely than men to seek health care and practice healthy behaviors, these differences are not sufficiently strong to explain the variati...
Source: Current Epidemiology Reports - May 30, 2019 Category: Epidemiology Source Type: research
Applications for Quantile Regression in Epidemiology
AbstractPurpose of ReviewTo illustrate the utility of quantile regression in epidemiology for outcomes that are continuous and when exposure effects may differ across the distribution of the outcome. Linear regression methods estimate only the effects at the mean level which may be an incomplete and biased summary of the effect of exposures for some continuous health outcomes.Recent FindingsThere are several variations of the quantile regression method including classical linear quantile regression, nonparametric quantile regression for growth trajectories, and the modified quantile regression for case –control designs. ...
Source: Current Epidemiology Reports - May 19, 2019 Category: Epidemiology Source Type: research
Primary and Secondary Prevention of Pancreatic Cancer
AbstractPurpose of ReviewPancreatic cancer remains one of the most lethal of malignancies with 5-year survival of only 8%. A number of reasons account for the high fatality rate including few known modifiable risk factors, no effective screening tools, and lack of early diagnostic symptoms. Therefore, in this review, we aim to summarize existing evidence from major studies concerning (1) risk factors for risk assessment and risk stratification, and (2) screening modalities and early detection markers to better understand the ways to prevent pancreatic cancer or identify it at earlier stages. Improvements in primary and sec...
Source: Current Epidemiology Reports - May 15, 2019 Category: Epidemiology Source Type: research
DNA Methylation and Smoking: Implications for Understanding Effects of Electronic Cigarettes
AbstractPurpose of ReviewUse of electronic cigarettes (e-cigs) has increased sharply recently although understanding of toxicity is limited, particularly target organ effects. Altered DNA methylation is a reversible response to environmental exposures, including smoking, and may be useful as a biomarker of e-cig harm.Recent FindingsAmong studies examining DNA methylation in blood by smoking status, there is considerable variability in differentially methylated CpGs identified; certain CpGs are consistently found. These includeAHRR (aryl hydrocarbon receptor repressor gene), particularly cg05575921, cg0363183 in the F2RL2 g...
Source: Current Epidemiology Reports - May 8, 2019 Category: Epidemiology Source Type: research
Measurement of Bystander Actions in Violence Intervention Evaluation: Opportunities and Challenges
AbstractPurpose of ReviewThis review discusses design and methodological challenges specific to measuring bystander actions in the evaluation of bystander-based violence prevention programming. “Bystanders” are defined as people who are present immediately before, during, and/or after a violent event, but are not a perpetrator nor the intended victim. Bystander-based violence prevention programs seek to prevent or mitigate violent events by empowering bystanders to intervene on acts of violence and social norms that promulgate violence.Recent FindingsEffective bystander-based violence prevention programs demonstrate in...
Source: Current Epidemiology Reports - May 5, 2019 Category: Epidemiology Source Type: research
Involving Firearm Stakeholders in Community-Based Suicide Prevention Efforts
AbstractPurpose of ReviewAbout half of all suicide deaths in the USA are by firearm. Putting time and distance between a person in suicidal crisis and means of inflicting lethal force is an effective suicide prevention strategy. The current review summarizes the emerging literature on the involvement of firearm stakeholders in community-based efforts to reduce access to lethal means for people at risk for suicide.Recent FindingsA small but growing set of scholarly articles indicates that the personal values underlying firearm ownership need not be impediments to firearm suicide prevention. By engaging gun owners in helping...
Source: Current Epidemiology Reports - May 2, 2019 Category: Epidemiology Source Type: research
The Changing Epidemiology of Primary Liver Cancer
AbstractPurpose of ReviewIn prior decades, liver cancer was viewed as a neoplasm that almost exclusively arose among high-risk populations in low- and middle-income countries. Incidence rates in some high-risk populations, however, have been declining, while rates in low-risk populations have been increasing, reflecting changes in underlying etiology. In this review, we highlight the evolving epidemiology of liver cancer, focusing on recent research and advances.Recent FindingsEfforts to reduce or eliminate the risk associated with major risk factors such as hepatitis B virus (HBV), hepatitis C virus (HCV), and aflatoxin B...
Source: Current Epidemiology Reports - May 2, 2019 Category: Epidemiology Source Type: research
Methodological Complexities in Quantifying Rates of Fatal Opioid-Related Overdose
AbstractPurpose of ReviewEffective responses to the US opioid overdose epidemic rely on accurate and timely drug overdose mortality data, which are generated from medicolegal death investigations (MDI) and certifications of overdose deaths. We identify nuances of MDI and certification of overdose deaths that can influence drug overdose mortality surveillance, as well as recent research, recommendations, and epidemiological tools for improved identification and quantification of specific drug involvement in overdose mortality.Recent FindingsDeath certificates are the foundation of drug overdose mortality surveillance. Accor...
Source: Current Epidemiology Reports - May 1, 2019 Category: Epidemiology Source Type: research
Differential Item Functioning and its Relevance to Epidemiology
AbstractPurpose of ReviewIn this review, I trace the origins, applications, limitations, and future prospects for research on measurement item bias or differential item functioning (DIF) in the context of health research. DIF arises in the context of using multiple item or symptom health instruments to rate the level of a particular condition, and describes the situation where not all persons at the same level of the underlying condition have the same probability of endorsing one or more symptoms. The presence of DIF can lead to biased assessment of group differences and confound risk factor and outcomes research.Recent Fi...
Source: Current Epidemiology Reports - April 30, 2019 Category: Epidemiology Source Type: research
