American Journal of Epidemiology

No abstract text is available yet for this article.

Variable selection in regression models is a particularly important issue in epidemiology, where one usually encounters observational studies. In contrast to randomized trials or experiments, confounding is often not controlled by the study design, but has to be accounted for by suitable statistical methods. For instance, when risk factors should be identified with unconfounded effect estimates, multivariable regression techniques can help to adjust for confounders. We investigated the current practice of variable selection in four major epidemiological journals in 2019 and found that the majority of articles used subject-matter knowledge to determine a priori the set of included variables...

Black women in the U.S. have the highest incidence of hypertensive disorders of pregnancy (HDP) and are disproportionately burdened by its adverse sequalae compared to women of all racial and ethnic groups. Segregation, a key driver of structural racism for Black families, can provide critical information to understanding these disparities. We examined the association between racial and economic segregation at two points and incident HDP using intergenerationally linked birth records of 45,204 Black California-born primiparous mothers (born 1982-1997) and their infants (born 1997-2011), with HDP ascertained from hospital discharge records...

The Korean Social Life, Health, and Aging Project (KSHAP) was a multidisciplinary prospective study conducted in South Korea that measured various health biomarkers from blood, hair, and brain MRIs, and examined their associations with sociocentric (global) social network data of older adults in two entire villages (or Cohorts). Cohort K included participants aged 60 or older, and Cohort L included participants aged 65 or older. We performed a baseline survey involving 814 of the 860 individuals (94.7% response rate) in Cohort K in 2012 and 947 of the 1,043 individuals (90...

Conventional propensity score methods encounter challenges when unmeasured confounding is present, as it becomes impossible to accurately estimate the gold-standard propensity score when certain confounders are unavailable. Propensity score calibration (PSC) addresses this issue by constructing a surrogate for the gold-standard propensity score under the surrogacy assumption. This assumption posits that the error-prone propensity score, based on observed confounders, is independent of the outcome when conditioned on the gold-standard propensity score and the exposure...

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Research on neighborhoods and health typically measures neighborhood context at a single point in time. However, neighborhood exposures accumulate over the life course, influenced by both residential mobility and neighborhood change, with potential implications for estimating the impact of neighborhoods on health. Commercial databases offer fine-grained longitudinal residential address data that can enrich life course spatial epidemiology research and validated methods for re-constructing residential histories from these databases are needed...

Transmissible infections such as those caused by SARS-CoV-2 spread according to who contacts whom. Therefore, many epidemic models incorporate contact patterns through contact matrices. Contact matrices can be generated from social contact survey data. However, the resulting matrices are often imbalanced, such that the total number of contacts reported by group A with group B do not match those reported by group B with group A. We examine the theoretical influence of imbalanced contact matrices on the estimated basic reproduction number (R0)...

Estimates of excess mortality can provide insight into direct and indirect impacts of the COVID-19 pandemic beyond deaths specifically attributed to COVID-19. We analyzed death certificate data from Baltimore City, Maryland from March 1, 2020 to March 31, 2021 and found that 1,725 individuals (95% confidence interval, 1,495-1,954) died in excess of what was expected from all-cause mortality trends in 2016-2019. 1,050 (61%) excess deaths were attributed to COVID-19. Observed mortality was 23-32% higher than expected among individuals aged 50 years and older...

A goal of evidence synthesis for trials of complex interventions is to inform the design or implementation of novel versions of complex interventions by predicting expected outcomes with each intervention version. Conventional aggregate data meta-analyses of studies comparing complex interventions have limited ability to provide such information. We argue that evidence synthesis for trials of complex interventions should forgo aspirations of estimating causal effects and instead model the response surface of study results to (i) summarize the available evidence and (ii) predict the outcomes of future studies or practice in target populations and settings of interest...

This study explores natural direct and joint natural indirect effects (JNIE) of prenatal opioid exposure on neurodevelopmental disorders (NDDs) in children mediated through pregnancy complications, major and minor congenital malformations, and adverse neonatal outcomes, using Medicaid claims linked to vital statistics in Rhode Island, United States, 2008-2018. A Bayesian mediation analysis with elastic net shrinkage prior was developed to estimate mean time to NDD diagnosis ratio using posterior mean and 95$\%$ credible intervals (CIs) from Markov chain Monte Carlo algorithms...

Postnatal mental health is often assessed using self-assessment questionnaires in epidemiological research. Differences in response style, influenced by language, culture and experience, may mean that the same response may not have the same meaning in different settings. These differences need to be identified and accounted for in cross-cultural comparisons. We describe the development and application of anchoring vignettes to investigate the cross-cultural functioning of the Edinburgh Postnatal Depression Scale (EPDS) in urban community samples in India (n = 828) and the UK (n = 549), alongside a UK calibration sample (n = 226)...

We used design principles of target trial methodology to emulate the effect of sustained adherence to the Dietary Approach to Stop Hypertension (DASH) diet on the 22-year risk of heart failure. Women and men aged 45-83 years without previous heart failure who answered questionnaires in 1997 from the Swedish Mammography Cohort and the Cohort of Swedish Men were eligible. Follow-up questionnaires were sent in 2008-2009. Incidence of heart failure was ascertained using the Swedish Patient Register updated until 31 December 2019...

We estimate changes in life expectancy between 2019 and 2021 in the United States (total population and separately for five racial-ethnic groups) and 20 high-income peer countries. For each country's total population, we decompose the 2019-2020 and 2020-2021 changes in life expectancy by age. For U.S. populations, we also decompose the changes in life expectancy by age and COVID-19 deaths. U.S. life expectancy decreases in 2020 (1.86 years) and 2021 (0.55 years) exceeded mean changes in peer countries (0.39-year decrease and 0...

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We developed and validated a claims-based algorithm that classifies patients into obesity categories. Using Medicare (2007-2017) and Medicaid (2000-2014) claims data linked to two electronic health records (EHR) systems in Boston, Massachusetts, United States, we identified a cohort of patients with an EHR-based BMI measurement. We used regularized regression to select from 137 variables and built generalized linear models to classify patients with BMI≥25, BMI≥30 and BMI≥40. We developed the prediction model using EHR system-1 (training set) and validated it in EHR system-2 (validation set)...

This paper compares location data from a dedicated Global Positioning Systems (GPS) device with location data from smartphones. Data from the INTerventions, Equity, and Action in Cities Team (INTERACT), a study examining urban form changes on health in Victoria, Vancouver, Saskatoon, and Montreal, were used. A total of 337 participants contributed data from the Ethica Data smartphone app and the SenseDoc dedicated GPS. Participants recorded an average total of 14,781 Ethica locations (SD=19,353) and 197,167 SenseDoc locations (SD=111,868)...

We advocate and expand upon a previously described monitoring strategy for efficient and robust estimation of disease prevalence and case numbers within closed and enumerated populations such as schools, workplaces, or retirement communities. The proposed design relies largely on voluntary testing, notoriously biased (e.g., in the case of COVID-19) due to non-representative sampling. The approach yields unbiased and comparatively precise estimates with no assumptions about factors underlying selection of individuals for voluntary testing, building on the strength of what can be a small random sampling component...

Rapid point-of-care tests that diagnose gonococcal infections and identify susceptibility to antibiotics enable individualized treatment. This could improve patient outcomes and slow the emergence and spread of resistance. However, little is known about the long-term impact of such diagnostics on the burden of gonorrhea and the effective lifespan of antibiotics. We used a mathematical model of gonorrhea transmission among men who have sex with men in the US to project the annual rate of reported gonorrhea cases and the effective lifespan of ceftriaxone, the recommended antibiotic for the first-line treatment of gonorrhea, as well as two previously recommended antibiotics, ciprofloxacin and tetracycline, when a rapid drug susceptibility test (DST) that reports susceptibility to ciprofloxacin and tetracycline is available...

We assessed the risk of SARS-CoV-2 acquisition from household and community exposure according to age, family ties, socioeconomic and living conditions using serological data from the nationwide population-based EpiCov cohort (ORCHESTRA collaboration). A history of SARS-CoV-2 infection was defined by a positive Euroimmun Anti-SARS-CoV-2 ELISA IgG result in November-December 2020. We applied stochastic chain binomial models fitted to the final distribution of infections in households to data from 17,983 individuals >6 years enrolled from 8,165 households...