The Author Responds
No abstract available (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Letters Source Type: research

Re: Sponsorship by Big Oil, Like the Tobacco Industry, Should be Banned by the Research Community
No abstract available (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Letters Source Type: research

HIV Viremia and Risk of Stroke Among People Living with HIV Who Are Using Antiretroviral Therapy
Conclusions: Our findings are consistent with the hypothesis that elevated HIV VL may increase stroke risk, regardless of previous VL levels. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Pharmacoepidemiology Source Type: research

Prenatal Opioid Analgesics and the Risk of Adverse Birth Outcomes
Conclusions: Opioid analgesic-exposed pregnancies had a small increased risk of preterm birth and possibly stillbirth after accounting for confounding by indication and sociodemographic factors. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Pharmacoepidemiology Source Type: research

Positive Predictive Value of Sarcoidosis Identified in an Administrative Healthcare Registry: A Validation Study
Conclusions: Using at least 2 visits listing an ICD-10 code for sarcoidosis accurately identified patients with sarcoidosis from administrative health data in Sweden. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Validation Studies Source Type: research

Identification and Validation of Anaphylaxis Using Electronic Health Data in a Population-based Setting
Conclusions: In this population-based setting, ICD-10 diagnosis codes for anaphylaxis from emergency department and inpatient settings had moderate PPV and sensitivity for validated events. These findings have implications for epidemiologic studies that seek to estimate risks of anaphylaxis using electronic health data. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Validation Studies Source Type: research

Validation of LexisNexis Accurint in the Georgia Cancer Registry’s Cancer Recurrence and Information Surveillance Program
Conclusions: LexisNexis Accurint failed to identify the emigration of more than half of deceased CRISP patients who had left Georgia but correctly identified most who had remained. The validity of the state of residence is important for studies using LexisNexis as a tool for follow-up. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Surveillance Source Type: research

Trends in Hip Fracture Incidence, Recurrence, and Survival by Education and Comorbidity: A Swedish Register-based Study
Conclusions: Hip fracture incidence has declined across the Swedish population, but mortality after hip fracture remained high, especially among men. Hip fracture patients constitute a vulnerable population group with increasing comorbidity burden and high mortality risk. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Surveillance Source Type: research

Combining Effect Estimates Across Cohorts and Sufficient Adjustment Sets for Collaborative Research: A Simulation Study
Conclusions: Our findings do not support the reliance of collaborative research on logistic regression results for meta-analyses. Use of DAGs to identify potentially differing minimally sufficient adjustment sets can allow meta-analyses without requiring the exact same covariates. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Causal Organic Indirect and Direct Effects: Closer to the Original Approach to Mediation Analysis, with a Product Method for Binary Mediators
Mediation analysis, which started in the mid-1980s, is used extensively by applied researchers. Indirect and direct effects are the part of a treatment effect that is mediated by a covariate and the part that is not. Subsequent work on natural indirect and direct effects provides a formal causal interpretation, based on cross-worlds counterfactuals: outcomes under treatment with the mediator set to its value without treatment. Organic indirect and direct effects avoid cross-worlds counterfactuals, using so-called organic interventions on the mediator while keeping the initial treatment fixed at treatment. Organic indirect ...
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Instability of Variable-selection Algorithms Used to Identify True Predictors of an Outcome in Intermediate-dimension Epidemiologic Studies
Conclusions: Machine-learning methods instability should concern epidemiologists relying on them for variable selection, as stabilizing a model can impact its performance. For LASSO, stabilization methods based on stability selection procedure (rather than addressing prediction stability) should be preferred to identify true predictors. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Machine Learning for Causal Inference: On the Use of Cross-fit Estimators
Conclusions: Due to the difficulty of properly specifying parametric models in high-dimensional data, doubly robust estimators with ensemble learning and cross-fitting may be the preferred approach for estimation of the average causal effect in most epidemiologic studies. However, these approaches may require larger sample sizes to avoid finite-sample issues. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Generalizability of Subgroup Effects
Generalizability methods are increasingly used to make inferences about the effect of interventions in target populations using a study sample. Most existing methods to generalize effects from sample to population rely on the assumption that subgroup-specific effects generalize directly. However, researchers may be concerned that in fact subgroup-specific effects differ between sample and population. In this brief report, we explore the generalizability of subgroup effects. First, we derive the bias in the sample average treatment effect estimator as an estimate of the population average treatment effect when subgroup effe...
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Deep Learning-based Propensity Scores for Confounding Control in Comparative Effectiveness Research: A Large-scale, Real-world Data Study
This study aimed to investigate whether autoencoders, which are unsupervised deep learning architectures, might be leveraged to compute PS. Methods: We selected patient-level data of 128,368 first-line treated cancer patients from the Flatiron Health EHR-derived de-identified database. We trained an autoencoder architecture to learn a lower-dimensional patient representation, which we used to compute PS. To compare the performance of an autoencoder-based PS with established methods, we performed a simulation study. We assessed the balancing and adjustment performance using standardized mean differences, root mean sq...
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Methods Source Type: research

Sex- and Type-specific Genital Human Papillomavirus Transmission Rates Between Heterosexual Partners: A Bayesian Reanalysis of the HITCH Cohort
Conclusion: Our updated analysis supports previous research suggesting higher women-to-men than men-to-women HPV transmission rates and a protective effect of condoms in heterosexual partnerships. Our results also suggest that crude incidence rates underestimate HPV transmission rates due to interval-censoring. See video abstract at http://links.lww.com/EDE/B794. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Infectious Diseases Source Type: research

Incorporating Information on Control Diseases Across Space and Time to Improve Estimation of the Population-level Impact of Vaccines
Conclusions: When synthetic control struggles to identify important prevaccine associations due to noise in control time series, users can aggregate controls over time or space to generate more robust estimates of the vaccine impact. DLMs automate this process without requiring prespecification of the aggregation level. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Infectious Diseases Source Type: research

Immunologic and Epidemiologic Drivers of Norovirus Transmission in Daycare and School Outbreaks
Conclusions: The epidemiology of norovirus outbreaks in daycare and school settings cannot be well described by a simple transmission model in which all individuals start as fully susceptible. More studies on how best to design interventions which leverage population immunity and encourage more rigorous individual exclusion may improve venue-level control measures. See video abstract at http://links.lww.com/EDE/B795. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Infectious Diseases Source Type: research

Mediating to Opportunity: The Challenges of Translating Mediation Estimands into Policy Recommendations
No abstract available (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Psychosocial Epidemiology Source Type: research

Helped into Harm: Mediation of a Housing Voucher Intervention on Mental Health and Substance Use in Boys
Conclusions: This evidence suggests that, even though the intervention had the desired effects on neighborhood poverty and the school environment, these “positives” ultimately negatively impacted the long-term mental health and behaviors of boys. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Psychosocial Epidemiology Source Type: research

Trends from 2008 to 2018 in Electricity-dependent Durable Medical Equipment Rentals and Sociodemographic Disparities
Background: Duration and number of power outages have increased over time, partly fueled by climate change, putting users of electricity-dependent durable medical equipment (hereafter, “durable medical equipment”) at particular risk of adverse health outcomes. Given health disparities in the United States, we assessed trends in durable medical equipment rental prevalence and individual- and area-level sociodemographic inequalities. Methods: Using Kaiser Permanente South California electronic health record data, we identified durable medical equipment renters. We calculated annual prevalence of equipm...
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Environmental Epidemiology Source Type: research

Tropical Cyclone Exposures and Risks of Emergency Medicare Hospital Admission for Cardiorespiratory Diseases in 175 Urban United States Counties, 1999–2010
Conclusions: In this study, tropical cyclone exposures were associated with a short-term increase in cardiorespiratory hospitalization risk among the elderly, based on a multi-year/multi-site investigation of US Medicare beneficiaries ≥65 years. (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Environmental Epidemiology Source Type: research

In Memoriam: George R. Seage III, 1957–2021
No abstract available (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Remembrance Source Type: research

Thanks to Our Reviewers
No abstract available (Source: Epidemiology)
Source: Epidemiology - April 9, 2021 Category: Epidemiology Tags: Appreciation Source Type: research

Erratum: A graphical description of partial exchangeability
No abstract available (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Erratum Source Type: research

A Graphical Description of Partial Exchangeability
No abstract available (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Letters Source Type: research

ppmHR: A Privacy-protecting Tool to Fit Inverse Probability Weighted Cox Models in Multisite Studies
No abstract available (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Letters Source Type: research

The Serpent of Their Agonies: Exploitation as Structural Determinant of Mental Illness
Conclusions: Exploitation is associated with mental illness. Focusing on exploitation rather than its consequences (e.g., socioeconomic status), shifts attention to a structural process that may be a more appropriate explanatory mechanism, and a more pragmatic intervention target, for mental illness. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Spatiotemporal Trends in Opioid Overdose Deaths by Race for Counties in Ohio
Conclusions: County-level opioid overdose death rates increased faster for Blacks than Whites during the study. By 2018, death rates were comparable for Blacks and Whites in many counties. The opioid epidemic spans racial groups in Ohio and trends indicate that overdose is a growing problem among Blacks. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

The Target Trial: A Powerful Device Beyond Well-defined Interventions
No abstract available (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Commentary Source Type: research

Meaningful Causal Decompositions in Health Equity Research: Definition, Identification, and Estimation Through a Weighting Framework
This article addresses these concerns by explicitly considering what covariates the outcome disparity and hypothetical intervention adjust for (so-called allowable covariates) and the equity value judgments these choices convey, drawing from the bioethics, biostatistics, epidemiology, and health services research literatures. From this discussion, we generalize decomposition estimands and formulae to incorporate allowable covariate sets (and thereby reflect equity choices) while still allowing for adjustment of non-allowable covariates needed to satisfy causal assumptions. For these general formulae, we provide weighting-b...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Validation of ICD-10 Codes for Gestational and Pregestational Diabetes During Pregnancy in a Large, Public Hospital
Conclusions: In a large public hospital, ICD-10 codes accurately identified cases of pregestational and gestational diabetes with low numbers of false positives. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Validation Study Source Type: research

A Pharmacoepidemiologic Approach to Evaluate Real-world Effectiveness of Hormonal Contraceptives in the Presence of Drug–drug Interactions
Conclusions: OCs in combination with antiepileptic drugs that interact with metabolic enzymes were associated with increased contraceptive failure rates. Measurement of conception in claims data had adequate accuracy to uncover a strong drug–drug interaction, offering promise for broader application in comparative effectiveness studies on hormonal contraceptives to inform clinical and regulatory decisionmaking. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

A Prospective Ultrasound Study of Plasma Polychlorinated Biphenyl Concentrations and Incidence of Uterine Leiomyomata
Conclusions: In this cohort of reproductive-aged Black women, plasma PCB concentrations typical of the contemporary general population were not appreciably associated with higher risk of fibroids. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Gestational Weight Gain and Long-term Maternal Obesity Risk: A Multiple-Bias Analysis
Conclusions: The inference of a positive association between excessive gestational weight gain and mid-life obesity is robust to methods accounting for selection and misclassification bias. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Male Preconception Marijuana Use and Spontaneous Abortion: A Prospective Cohort Study
Background: Male marijuana use has increased steadily over the last decade, but its effect on risk of spontaneous abortion to our knowledge has not been studied. Methods: We analyzed data from Pregnancy Study Online, a North American prospective cohort study of pregnancy planners (2013–2019). During the preconception period, male and female participants completed baseline questionnaires on demographics, medical history, and behavioral factors, including marijuana use. Female participants identified pregnancy losses on bimonthly follow-up questionnaires and questionnaires completed in early and late pregnan...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Addressing Competing Risks When Assessing the Impact of Health Services Interventions on Hospital Length of Stay
Conclusions: Treating length of stay as time to discharge allows for estimation of risk of being discharged alive at specific days after admission while accounting for competing risk of death. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Clinical Trial Emulation by Matching Time-dependent Propensity Scores: The Example of Estimating Impact of Kidney Transplantation
Conclusions: Our study has estimated the life expectancy gain due to kidney transplantation. It confirms transplantation as the best treatment for end-stage renal disease. Furthermore, we demonstrated that this simple method should also be considered for estimating marginal effects of time-dependent exposures. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Insights into the Cross-world Independence Assumption of Causal Mediation Analysis
Causal mediation analysis is a useful tool for epidemiologic research, but it has been criticized for relying on a “cross-world” independence assumption that counterfactual outcome and mediator values are independent even in causal worlds where the exposure assignments for the outcome and mediator differ. This assumption is empirically difficult to verify and problematic to justify based on background knowledge. In the present article, we aim to assist the applied researcher in understanding this assumption. Synthesizing what is known about the cross-world independence assumption, we discuss the relationship be...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Review Article Source Type: research

Incremental Propensity Score Effects for Time-fixed Exposures
When causal inference is of primary interest, a range of target parameters can be chosen to define the causal effect, such as average treatment effects (ATEs). However, ATEs may not always align with the research question at hand. Furthermore, the assumptions needed to interpret estimates as ATEs, such as exchangeability, consistency, and positivity, are often not met. Here, we present the incremental propensity score (PS) approach to quantify the effect of shifting each person’s exposure propensity by some predetermined amount. Compared with the ATE, incremental PS may better reflect the impact of certain policy int...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

To Adjust or Not to Adjust? When a “Confounder” Is Only Measured After Exposure
Advice regarding the analysis of observational studies of exposure effects usually is against adjustment for factors that occur after the exposure, as they may be caused by the exposure (or mediate the effect of exposure on outcome), so potentially leading to collider stratification bias. However, such factors could also be caused by unmeasured confounding factors, in which case adjusting for them will also remove some of the bias due to confounding. We derive expressions for collider stratification bias when conditioning and confounding bias when not conditioning on the mediator, in the presence of unmeasured confounding ...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Representativeness Is Not Representative: Addressing Major Inferential Threats in the UK Biobank and Other Big Data Repositories
No abstract available (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Commentary Source Type: research

Is Cohort Representativeness Passé? Poststratified Associations of Lifestyle Risk Factors with Mortality in the UK Biobank
Conclusions: Lack of representativeness may distort the associations of alcohol with CVD mortality, and may underestimate health hazards among those with cumulatively the least healthy lifestyles. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Inference of Naturally Acquired Immunity Using a Self-matched Negative-Control Design
Host adaptive immune responses may protect against infection or disease when a pathogen is repeatedly encountered. The hazard ratio of infection or disease, given previous infection, is typically sought to estimate the strength of protective immunity. However, variation in individual exposure or susceptibility to infection may introduce frailty bias, whereby a tendency for infections to recur among individuals with greater risk confounds the causal association between previous infection and susceptibility. We introduce a self-matched “case-only” inference method to control for unmeasured individual heterogeneit...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Bounding the Accuracy of Diagnostic Tests, With Application to COVID-19 Antibody Tests
Tests used to diagnose illness commonly have imperfect accuracy, with some false-positive and negative results. For risk assessment and clinical decisions, predictive values are of interest. Positive predictive value (PPV) is the chance that a member of a relevant population who tests positive has been ill. Negative predictive value (NPV) is the chance that someone who tests negative has not been ill. The medical literature regularly reports sensitivity and specificity. Sensitivity is the chance that an ill person receives a positive test result. Specificity is the chance that a nonill person receives a negative result. Kn...
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Original Article Source Type: research

Estimating the Unknown: Greater Racial and Ethnic Disparities in COVID-19 Burden After Accounting for Missing Race and Ethnicity Data
Conclusions: These results highlight that complete case analyses may underestimate absolute disparities in notification rates. Complete reporting of race/ethnicity information is necessary for health equity. When data are missing, quantitative bias analysis methods may improve estimates of racial/ethnic disparities in the COVID-19 burden. (Source: Epidemiology)
Source: Epidemiology - February 4, 2021 Category: Epidemiology Tags: Brief Report Source Type: research

Investigation of Concomitant Use of Alzheimer’s Disease Drugs with Sulfonylureas and Serious Hypoglycemia
No abstract available (Source: Epidemiology)
Source: Epidemiology - December 1, 2020 Category: Epidemiology Tags: Letters Source Type: research

The Authors Respond
No abstract available (Source: Epidemiology)
Source: Epidemiology - December 1, 2020 Category: Epidemiology Tags: Letters Source Type: research

The Quest for Timely Insights into COVID-19 Should not Come at the Cost of Scientific Rigor
No abstract available (Source: Epidemiology)
Source: Epidemiology - December 1, 2020 Category: Epidemiology Tags: Letters Source Type: research

Comment on Williamson et al. (OpenSAFELY): The Table 2 Fallacy in a Study of COVID-19 Mortality Risk Factors
No abstract available (Source: Epidemiology)
Source: Epidemiology - December 1, 2020 Category: Epidemiology Tags: Letters Source Type: research

On My Lived Experience As an Epidemiologist in 2020
No abstract available (Source: Epidemiology)
Source: Epidemiology - December 1, 2020 Category: Epidemiology Tags: Special Sections Source Type: research