Applying Risk Prediction Models to Optimize Lung Cancer Screening: Current Knowledge, Challenges, and Future Directions
AbstractPurpose of ReviewRisk prediction models may be useful for facilitating effective and high-quality decision-making at critical steps in the lung cancer screening process. This review provides a current overview of published lung cancer risk prediction models and their applications to lung cancer screening and highlights both challenges and strategies for improving their predictive performance and use in clinical practice.Recent FindingsSince the 2011 publication of the National Lung Screening Trial results, numerous prediction models have been proposed to estimate the probability of developing or dying from lung can...
Source: Current Epidemiology Reports - October 24, 2017 Category: Epidemiology Source Type: research
Data Science, Design, and Causal Inference
(Source: Current Epidemiology Reports)
Source: Current Epidemiology Reports - October 24, 2017 Category: Epidemiology Source Type: research
Pharmacoepidemiology in the Era of Real-World Evidence
(Source: Current Epidemiology Reports)
Source: Current Epidemiology Reports - October 19, 2017 Category: Epidemiology Source Type: research
Estimating Effects of Dynamic Treatment Strategies in Pharmacoepidemiologic Studies with Time-Varying Confounding: a Primer
AbstractPurpose of ReviewPharmacoepidemiologists 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. This problem occurs when time-varying confounders are, themselves, affected by past treatme...
Source: Current Epidemiology Reports - October 17, 2017 Category: Epidemiology Source Type: research
Instrumental Variable Analyses in Pharmacoepidemiology: What Target Trials Do We Emulate?
AbstractPurpose of reviewWhen 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, i nvestigators might consider turning to instrumental variable (IV) methods. Of course, the interpretation and appropriateness of IV analyses need to be considered carefully. The purpose of this review...
Source: Current Epidemiology Reports - October 17, 2017 Category: Epidemiology Source Type: research
Development and Application of Two Semi-Automated Tools for Targeted Medical Product Surveillance in a Distributed Data Network
AbstractPurpose of ReviewAn 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 t he Sentinel Distributed Database. In this manuscript, we review literature relevant to the development of these programs and describe their application within the Sentinel Initiative.Recent FindingsThese quality-checked and publicly available to...
Source: Current Epidemiology Reports - October 6, 2017 Category: Epidemiology Source Type: research
An Evaluation of the Evidence Relating to Physical Inactivity, Sedentary Behavior, and Cancer Incidence and Mortality
AbstractPurpose of ReviewThis review provides an up-to-date overview of the evidence relating to physical inactivity, sedentary behavior, and cancer, both in terms of risk and mortality. A summary of the postulated biological mechanisms underpinning these associations is also presented.Recent FindingsEpidemiologic evidence suggests that physical activity is inversely associated with cancers of the esophagus (adenocarcinoma), liver, lung, kidney, gastric cardia, endometrium, colon, rectum, head and neck, bladder, and breast, as well as myeloid leukemia and myeloma. Physical activity prior to a cancer diagnosis is related to...
Source: Current Epidemiology Reports - August 18, 2017 Category: Epidemiology Source Type: research
Prevention of Cardiovascular Disease Among Cancer Survivors: the Role of Pre-existing Risk Factors and Cancer Treatments
AbstractPurpose of ReviewThe two leading causes of death in North America are cardiovascular disease (CVD) and cancer. As a result of necessary cancer treatments, survivors are at an increased risk of CVD. The contribution of cardio-toxic chemotherapy, targeted therapy, and radiation therapy to CVD is discussed. This paper addresses shared CVD and cancer risk factors (smoking tobacco, diet, obesity, sedentary lifestyle, hypertension, alcohol consumption, and hyperlipidemia) and the influence on cardiovascular outcomes in those treated with cardio-toxic cancer therapies.Recent FindingsStrategies for prevention of CVD in can...
Source: Current Epidemiology Reports - August 7, 2017 Category: Epidemiology Source Type: research
Cardiovascular Health During Pregnancy: Future Health Implications for Mothers
AbstractPurpose of ReviewHealthy pregnancy requires profound maternal vascular, immune, and metabolic adaptations to support placentation and fetal growth. It is now well established that an impaired ability to mount these adaptations contributes to adverse pregnancy outcomes. Pregnancy now can be viewed as a “stress test,” with adverse pregnancy outcomes being a harbinger of excess cardiovascular disease (CVD) risk. Thus, we review the current evidence that links pregnancy features to maternal CVD risk.Recent FindingsThe most recent work demonstrates that cardiovascular risk is detectable within 1 to 5 years after p...
Source: Current Epidemiology Reports - July 25, 2017 Category: Epidemiology Source Type: research
Challenges and Opportunities in Studying the Epidemiology of Ovarian Cancer Subtypes
AbstractPurpose of ReviewOnly 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 FindingsThe 2014 World Health Organization diagnostic guidelines incorporate accumulated evidence that high- and low-grade serous tumors have different underlying pathogenesis, and that, on the ...
Source: Current Epidemiology Reports - July 10, 2017 Category: Epidemiology Source Type: research
E-cigarette Use and Indicators of Cardiovascular Disease Risk
AbstractPurpose of ReviewThe aim is to provide a detailed review of literature from studies examining the relation of electronic cigarette (e-cigarette) use to indicators of risk for cardiovascular disease. In addition to discussing clinical and cell culture studies, we discuss possible mechanisms for the observed effects.Recent FindingsStudies have compared the effect of e-cigarette use (or vapor) and combustible cigarette smoking on a range of measures. These include heart rate, blood pressure, and vagal tone; aortic stiffness and endothelial function; platelet aggregation and adhesion; expression of genes for antioxidan...
Source: Current Epidemiology Reports - July 7, 2017 Category: Epidemiology Source Type: research
Age-Based Reproductive Healthcare Stereotype Threat (HCST) as a Stressor Affecting Prenatal Mental Health in Pregnant Women of Advanced Maternal Age: Measurement, Process, Outcomes, and Interactions with Ethnicity/Race, SES, and Other Social Identities
AbstractPurpose of ReviewReproductive health, and pregnancy more specifically, is the first critical link between generations. Beginning with this first critical link, pregnancy acts as a domino, affecting the expression of genes and determining the lifespan mental and physical health and reproductive potential of offspring and, likely, of subsequent generations. Given the powerful intergenerational domino that is pregnancy, the development of innovative models to enhance reproductive health and outcomes is an invaluable public health investment.Recent FindingsWhile US pregnancy and birth outcomes have improved dramaticall...
Source: Current Epidemiology Reports - May 30, 2017 Category: Epidemiology Source Type: research
Causal Mediation Analysis in Pregnancy Studies: the Case of Environmental Epigenetics
AbstractPurpose of ReviewStudies on the mechanisms of action of environmental exposures in pregnancy are increasingly popular. In particular, it is of interest to investigate the role of genetic and epigenetic factors as mediators of the maternal environmental exposures ’ effects on perinatal outcomes. Causal mediation analysis lies at the center of environmental epigenetics research, and the methodological challenges that arise in this context have not yet been fully articulated.Recent FindingsMeasurement error, unmeasured confounding, reverse causation, and multiple mediators are often disregarded issues in environment...
Source: Current Epidemiology Reports - April 29, 2017 Category: Epidemiology Source Type: research
Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology
AbstractPurpose of ReviewRecent 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.Recent FindingsMetrics and analytic approaches used to assess disc...
Source: Current Epidemiology Reports - April 27, 2017 Category: Epidemiology Source Type: research
Impact of Periconceptional Exposure to Phthalates on Pregnancy, Birth, and Neonatal Outcomes
AbstractPurpose of ReviewThe purpose of this review was to evaluate recent available evidence on exposure to phthalates during pregnancy and the immediate periconceptional period and the health effects in the mother and offspring during the peripartum period. Articles were included if they included biospecimen-based exposure assessment and consideration of quantifiable health effects in either the mother or the offspring.Recent FindingsOutcome assessment variables were indicators of fetal growth and indicators of hormonal effects —including genital endpoints and pregnancy duration. The studies reviewed provided inconsist...
Source: Current Epidemiology Reports - April 26, 2017 Category: Epidemiology Source Type: research
