Current Epidemiology Reports

Purpose of review: Electronic health records (EHRs) contain valuable data for identifying health outcomes, but these data also present numerous challenges when creating computable phenotyping algorithms. Machine learning methods could help with some of these challenges. In this review, we discuss four common scenarios that researchers may find helpful for thinking critically about when and for what tasks machine learning may be used to identify health outcomes from EHR data. Recent findings: We first consider the conditions in which machine learning may be especially useful with respect to two dimensions of a health outcome: 1) the characteristics of its diagnostic criteria, and 2) the format in which its diagnostic data are usually stored within EHR systems...

Purpose of review: The obesity epidemic is a global health crisis of staggering proportion. Excess body weight is a major risk factor for the development of cardiovascular disease (CVD). We review temporal trends in obesity rates, pertinent pathophysiology to understand mechanisms of disease, and treatment strategies in the context of reducing cardiovascular risk. Recent findings: The prevalence of obesity is increasing in recent decades and is driven by a complex interplay of economic, environmental, and biological factors...

Purpose of review: Many of the diseases and dysfunctions described in the paradigm of the developmental origins of health and disease have been studied in relation to prenatal nutrition or environmental toxicant exposures. Here, we selectively review the current research on four exposures-two nutritional and two environmental-that have recently emerged as prenatal risk factors for long-term health outcomes. Recent findings: Recent studies have provided strong evidence that prenatal exposure to (1) excessive intake of sugar-sweetened beverages, (2) unhealthy dietary patterns, (3) perfluoroalkyl substances, and (4) fine particulate matter, may increase risk of adverse health outcomes, such as obesity, cardiometabolic dysfunction, and allergy/asthma...

Purpose of review: Pharmacoepidemiologic studies employing large databases are critical to evaluating the effectiveness and safety of drug exposures in large and diverse populations. Because treatment is not randomized, researchers must select a relevant comparison group for the treatment of interest. The comparator group can consist of individuals initiating: (1) a similarly indicated treatment (active comparator), (2) a treatment used for a different indication (inactive comparator) or (3) no particular treatment (non-initiators)...

Purpose of review: We review recent examples of data analysis with the g-formula, a powerful tool for analyzing longitudinal data and survival analysis. Specifically, we focus on the common choices of time scale and review inferential issues that may arise. Recent findings: Researchers are increasingly engaged with questions that require time scales subject to left-truncation and right-censoring. The assumptions necessary for allowing right-censoring are well defined in the literature, whereas similar assumptions for left-truncation are not well defined...

Purpose of this review: This review provides a summary of statistical approaches that researchers can use to study environmental exposure mixtures. Two primary considerations are the form of the research question and the statistical tools best suited to address that question. Because the choice of statistical tools is not rigid, we make recommendations about when each tool may be most useful. Recent Findings: When dimensionality is relatively low, some statistical tools yield easily interpretable estimates of effect (e...

Purpose of the Review: In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions...

Purpose of review: Our goal was to assess current literature and knowledge on associations between characteristics (mean, variability, extremes) of ambient temperatures and human health. We were motivated by concerns that climate change, which operates on a time frame of decades or longer, may influence not only shorter-term associations between weather and health (daily/weekly) but also have enduring implications for population health. We reviewed papers published between 2010 and 2017 on the health effects of longer-term (3 weeks to years) exposures to ambient temperature...

Purpose of review: The setting of competing risks in which there is an event that precludes the event of interest from occurring is prevalent in epidemiological research. Unless studying all-cause mortality, any study following up individuals is subject to having a competing risk should individuals die during time period that the study covers. While there are prior papers discussing the need for competing risk methods in epidemiologic research, we are not aware of any review that discusses issues of missing data in a competing risk setting...

Purpose of review: Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities. Recent findings: Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically-disadvantaged and racially/ethnically diverse populations...

Purpose of Review: Diabetes mellitus is a top contributor to the global burden of mortality and disability in adults. There has also been a slow, but steady rise in prediabetes and type 2 diabetes in youth. The current review summarizes recent findings regarding the impact of increased exposure to air pollutants on the type 2 diabetes epidemic. Recent Findings: Human and animal studies provide strong evidence that exposure to ambient and traffic-related air pollutants such as particulate matter (PM), nitrogen dioxide (NO2 ), and nitrogen oxides (NOx ) play an important role in metabolic dysfunction and type 2 diabetes etiology...

Purpose of Review: Breast cancer is the most common cancer diagnosed among US women. Air pollution is a pervasive mixture of chemicals containing carcinogenic compounds and chemicals with endocrine disrupting properties. In the present review, we examine the epidemiologic evidence regarding the association between air pollution measures and breast cancer risk. Recent Findings: We identified seventeen studies evaluating the risk of breast cancer associated with air pollution...

Purpose of review: In this paper, we summarize prior studies that have used Mendelian Randomization (MR) methods to study the effects of exposures, lifestyle factors, physical traits, and/or biomarkers on cancer risk in humans. Many such risk factors have been associated with cancer risk in observational studies, and the MR approach can be used to provide evidence as to whether these associations represent causal relationships. MR methods require a risk factor of interest to have known genetic determinants that can be used as proxies for the risk factor (i...

Purpose of Review: Sleep is important for overall health and well-being. Insufficient sleep and sleep disorders are highly prevalent among adults and children and therefore a public health burden, particularly because poor sleep is associated with adverse health outcomes. Emerging evidence has demonstrated that environmental factors at the household- and neighborhood-level can alter healthy sleep. This paper will (1) review recent literature on the environmental determinants of sleep among adults as well as children and adolescents; and (2) discuss the opportunities and challenges for advancing research on the environment and sleep...

Purpose of Review: Syphilis continues to cause morbidity and mortality worldwide. While syphilis infection is easily identifiable and treatable, rates of syphilis infection continue to increase among select populations in high-income countries and remain at endemic levels in low- and middle-income counties. Recent findings: World Health Organization recommended strategies have led to the dual elimination of mother-to-child transmission of syphilis and HIV in several countries, however outbreaks among select populations need to be adequately addressed...

Purpose of the Review: As the science of the microbiome advances, social epidemiologists can contribute to understanding how the broader social environment shapes the microbiome over the life course. This review summarizes current research and describes potential mechanisms of the social epidemiology of the microbiome. Recent Findings: Most existing literature linking the social environment and the microbiome comes from animal models, focused on the impact of social interactions and psychosocial stress...

Purpose of Review: This paper discusses the current issues in the development of foetal charts and is informed by a scoping review of studies constructing charts between 2012 and 2018. Recent Findings: The scoping review of 20 articles revealed that there is still a lack of consensus on how foetal charts should be constructed and whether an international chart that can be applied across populations is feasible. Many of these charts are in clinical use today and directly affect the identification of at risk newborns that require treatment and nutritional strategies...

Purpose of Review: The purpose of this review is to provide an overview of the published studies that have been used to generate evidence on the safety of medicine use when only medication dispensing data are available. Recent Findings: Medication dispensing databases are increasingly available for research on large populations, particularly in countries that provide universal coverage for medicines. These data are often used for drug utilisation studies to identify inappropriate medicine use at the population level that may be associated with known safety issues...

Purpose of Review: Atrial fibrillation (AF) and dementia are both prevalent diseases in aging societies, which exert a great economic burden worldwide. Although a handful of epidemiologic studies have indicated that AF is independently associated with faster cognitive decline and a higher risk of dementia, there is still a lack of comprehensive understanding of the observed association. In this review, we summarize evidence from major epidemiologic studies concerning AF-related cognitive decline and dementia, the potential mechanisms underlying their association, and the cognitive benefits of treatment options...

Purpose of Review: Instrumental variable (IV) methods continue to be applied to questions ranging from genetic to social epidemiology. In the epidemiologic literature, discussion of whether the assumptions underlying IV analyses hold is often limited to only certain assumptions and even then, arguments are mostly made using subject matter knowledge. To complement subject matter knowledge, there exist a variety of falsification strategies and other tools for weighing the plausibility of the assumptions underlying IV analyses...