首页 > 最新文献

Epidemiology最新文献

英文 中文
The Population-level Effect of Adjuvant Therapies on Breast Cancer Recurrence: Application of the Trend-in-Trend Design. 辅助疗法对乳腺癌复发的人群效应:应用趋势中趋势设计。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-06 DOI: 10.1097/EDE.0000000000001753
Lindsay J Collin, Lance A Waller, Deirdre P Cronin-Fenton, Thomas P Ahern, Michael Goodman, Lauren E McCullough, Anders Kjærsgaard, Kirsten M Woolpert, Rebecca A Silliman, Peer M Christiansen, Bent Ejlertsen, Henrik Toft Sørensen, Timothy L Lash

Purpose: Breast cancer has an average 10-year relative survival reaching 84%. This favorable survival is due, in part, to the introduction of biomarker-guided therapies. We estimated the population-level effect of the introduction of two adjuvant therapies-tamoxifen and trastuzumab-on recurrence using the trend-in-trend pharmacoepidemiologic study design.

Methods: We ascertained data on women diagnosed with nonmetastatic breast cancer who were registered in the Danish Breast Cancer Group clinical database. We used the trend-in-trend design to estimate the population-level effect of the introduction of (1) tamoxifen for postmenopausal women with estrogen receptor (ER)-positive breast cancer in 1982, (2) tamoxifen for premenopausal women diagnosed with ER-positive breast cancer in 1999, and (3) trastuzumab for women <60 years diagnosed with human epidermal growth factor receptor 2-positive breast cancer in 2007.

Results: For the population-level effect of the introduction of tamoxifen among premenopausal women diagnosed with ER-positive breast cancer in 1999, the risk of recurrence decreased by nearly one-half (OR = 0.52), consistent with evidence from clinical trials; however, the estimate was imprecise (95% confidence interval [CI] = 0.25, 1.85). We observed an imprecise association between tamoxifen use and recurrence from the time it was introduced in 1982 (OR = 1.24 95% CI = 0.46, 5.11), inconsistent with prior knowledge from clinical trials. For the introduction of trastuzumab in 2007, the estimate was also consistent with trial evidence, though imprecise (OR = 0.51; 95% CI = 0.21, 22.4).

Conclusions: We demonstrated how novel pharmacoepidemiologic analytic designs can be used to evaluate the routine clinical care and effectiveness of therapeutic advancements in a population-based setting while considering some limitations of the approach.

目的:乳腺癌的 10 年平均相对生存率高达 84%。这种良好的生存率部分归功于生物标志物指导疗法的引入。我们采用趋势中趋势药物流行病学研究设计,估算了两种辅助疗法--他莫昔芬和曲妥珠单抗的引入对人群复发的影响:我们确定了丹麦乳腺癌小组临床数据库中登记的非转移性乳腺癌女性患者的数据。我们采用趋势中趋势的设计方法,估算了(1)1982 年对绝经后雌激素受体(ER)阳性乳腺癌妇女使用他莫昔芬、(2)1999 年对绝经前诊断为 ER 阳性乳腺癌的妇女使用他莫昔芬以及(3)对妇女使用曲妥珠单抗的人群效应:在 1999 年确诊为 ER 阳性乳腺癌的绝经前妇女中引入他莫昔芬的人群效应中,复发风险降低了近一半(OR = 0.52),这与临床试验的证据一致;然而,该估计值并不精确(95% 置信区间 [CI] = 0.25,1.85)。我们观察到,自1982年他莫昔芬问世以来,使用他莫昔芬与复发之间的关系并不精确(OR = 1.24 95% CI = 0.46, 5.11),这与之前临床试验的结果不一致。至于 2007 年引入的曲妥珠单抗,尽管不精确(OR = 0.51; 95% CI = 0.21, 22.4),但估计值也与试验证据一致:我们展示了如何利用新型药物流行病学分析设计来评估基于人群的常规临床护理和治疗进展的有效性,同时也考虑了该方法的一些局限性。
{"title":"The Population-level Effect of Adjuvant Therapies on Breast Cancer Recurrence: Application of the Trend-in-Trend Design.","authors":"Lindsay J Collin, Lance A Waller, Deirdre P Cronin-Fenton, Thomas P Ahern, Michael Goodman, Lauren E McCullough, Anders Kjærsgaard, Kirsten M Woolpert, Rebecca A Silliman, Peer M Christiansen, Bent Ejlertsen, Henrik Toft Sørensen, Timothy L Lash","doi":"10.1097/EDE.0000000000001753","DOIUrl":"10.1097/EDE.0000000000001753","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer has an average 10-year relative survival reaching 84%. This favorable survival is due, in part, to the introduction of biomarker-guided therapies. We estimated the population-level effect of the introduction of two adjuvant therapies-tamoxifen and trastuzumab-on recurrence using the trend-in-trend pharmacoepidemiologic study design.</p><p><strong>Methods: </strong>We ascertained data on women diagnosed with nonmetastatic breast cancer who were registered in the Danish Breast Cancer Group clinical database. We used the trend-in-trend design to estimate the population-level effect of the introduction of (1) tamoxifen for postmenopausal women with estrogen receptor (ER)-positive breast cancer in 1982, (2) tamoxifen for premenopausal women diagnosed with ER-positive breast cancer in 1999, and (3) trastuzumab for women <60 years diagnosed with human epidermal growth factor receptor 2-positive breast cancer in 2007.</p><p><strong>Results: </strong>For the population-level effect of the introduction of tamoxifen among premenopausal women diagnosed with ER-positive breast cancer in 1999, the risk of recurrence decreased by nearly one-half (OR = 0.52), consistent with evidence from clinical trials; however, the estimate was imprecise (95% confidence interval [CI] = 0.25, 1.85). We observed an imprecise association between tamoxifen use and recurrence from the time it was introduced in 1982 (OR = 1.24 95% CI = 0.46, 5.11), inconsistent with prior knowledge from clinical trials. For the introduction of trastuzumab in 2007, the estimate was also consistent with trial evidence, though imprecise (OR = 0.51; 95% CI = 0.21, 22.4).</p><p><strong>Conclusions: </strong>We demonstrated how novel pharmacoepidemiologic analytic designs can be used to evaluate the routine clinical care and effectiveness of therapeutic advancements in a population-based setting while considering some limitations of the approach.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining Spatial Epidemiology: A Systematic Review and Re-orientation. 定义空间流行病学:系统回顾与重新定位》。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI: 10.1097/EDE.0000000000001738
Christopher N Morrison, Christina F Mair, Lisa Bates, Dustin T Duncan, Charles C Branas, Brady R Bushover, Christina A Mehranbod, Ariana N Gobaud, Stephen Uong, Sarah Forrest, Leah Roberts, Andrew G Rundle

Background: Spatial epidemiology has emerged as an important subfield of epidemiology over the past quarter century. We trace the origins of spatial epidemiology and note that its emergence coincided with technological developments in spatial statistics and geography. We hypothesize that spatial epidemiology makes important contributions to descriptive epidemiology and analytic risk-factor studies but is not yet aligned with epidemiology's current focus on causal inference and intervention.

Methods: We conducted a systematic review of studies indexed in PubMed that used the term "spatial epidemiolog*" in the title, abstract, or keywords. Excluded articles were not written in English, examined disease in animals, or reported biologic pathogen distribution only. We coded the included papers into five categories (review, demonstration of method, descriptive, analytic, and intervention) and recorded the unit of analysis (i.e., individual vs. ecological). We additionally examined articles coded as analytic ecologic studies using scales for lexical content.

Results: A total of 482 articles met the inclusion criteria, including 76 reviews, 117 demonstrations of methods, 122 descriptive studies, 167 analytic studies, and 0 intervention studies. Demonstration studies were most common from 2006 to 2014, and analytic studies were most common after 2015. Among the analytic ecologic studies, those published in later years used more terms relevant to spatial statistics (incidence rate ratio =1.3; 95% confidence interval [CI] = 1.1, 1.5) and causal inference (incidence rate ratio =1.1; 95% CI = 1.1, 1.2).

Conclusions: Spatial epidemiology is an important and growing subfield of epidemiology. We suggest a re-orientation to help align its practice with the goals of contemporary epidemiology.

背景:过去四分之一世纪以来,空间流行病学已成为流行病学的一个重要分支领域。我们追溯了空间流行病学的起源,并注意到其出现与空间统计学和地理学的技术发展相吻合。我们假设,空间流行病学对描述性流行病学和风险因素分析研究做出了重要贡献,但尚未与流行病学目前关注的因果推断和干预相一致:我们对 PubMed 索引中标题、摘要或关键词中使用 "空间流行病学*"一词的研究进行了系统回顾。不包括非英文撰写、研究动物疾病或仅报告生物病原体分布的论文。我们将纳入的论文分为五类(综述、方法演示、描述性、分析性、干预性),并记录了分析单位(即个体与生态)。此外,我们还使用词法内容量表对编码为生态分析研究的论文进行了检查:共有 482 篇论文符合纳入标准,其中包括 76 篇综述、117 篇方法演示、122 篇描述性研究、167 篇分析性研究和 0 篇干预性研究。示范研究多见于 2006 年至 2014 年,分析研究多见于 2015 年之后。在分析性生态学研究中,后几年发表的研究使用了更多与空间统计学(IRR =1.3,95%CI:1.1,1.5)和因果推断(IRR =1.1,95%CI:1.1,1.2)相关的术语:空间流行病学是流行病学中一个重要且不断发展的子领域。我们建议对其重新定位,以帮助其实践与当代流行病学的目标保持一致。
{"title":"Defining Spatial Epidemiology: A Systematic Review and Re-orientation.","authors":"Christopher N Morrison, Christina F Mair, Lisa Bates, Dustin T Duncan, Charles C Branas, Brady R Bushover, Christina A Mehranbod, Ariana N Gobaud, Stephen Uong, Sarah Forrest, Leah Roberts, Andrew G Rundle","doi":"10.1097/EDE.0000000000001738","DOIUrl":"10.1097/EDE.0000000000001738","url":null,"abstract":"<p><strong>Background: </strong>Spatial epidemiology has emerged as an important subfield of epidemiology over the past quarter century. We trace the origins of spatial epidemiology and note that its emergence coincided with technological developments in spatial statistics and geography. We hypothesize that spatial epidemiology makes important contributions to descriptive epidemiology and analytic risk-factor studies but is not yet aligned with epidemiology's current focus on causal inference and intervention.</p><p><strong>Methods: </strong>We conducted a systematic review of studies indexed in PubMed that used the term \"spatial epidemiolog*\" in the title, abstract, or keywords. Excluded articles were not written in English, examined disease in animals, or reported biologic pathogen distribution only. We coded the included papers into five categories (review, demonstration of method, descriptive, analytic, and intervention) and recorded the unit of analysis (i.e., individual vs. ecological). We additionally examined articles coded as analytic ecologic studies using scales for lexical content.</p><p><strong>Results: </strong>A total of 482 articles met the inclusion criteria, including 76 reviews, 117 demonstrations of methods, 122 descriptive studies, 167 analytic studies, and 0 intervention studies. Demonstration studies were most common from 2006 to 2014, and analytic studies were most common after 2015. Among the analytic ecologic studies, those published in later years used more terms relevant to spatial statistics (incidence rate ratio =1.3; 95% confidence interval [CI] = 1.1, 1.5) and causal inference (incidence rate ratio =1.1; 95% CI = 1.1, 1.2).</p><p><strong>Conclusions: </strong>Spatial epidemiology is an important and growing subfield of epidemiology. We suggest a re-orientation to help align its practice with the goals of contemporary epidemiology.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Marco Piccininni, Winner of the 2024 Rothman Prize. Marco Piccininni,2024 年罗斯曼奖获得者。
IF 4.7 2区 医学 Q1 Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI: 10.1097/EDE.0000000000001748
{"title":"Marco Piccininni, Winner of the 2024 Rothman Prize.","authors":"","doi":"10.1097/EDE.0000000000001748","DOIUrl":"https://doi.org/10.1097/EDE.0000000000001748","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erratum: Average Causal Effect Estimation via Instrumental Variables: The No Simultaneous Heterogeneity Assumption. 勘误:通过工具变量估计平均因果效应:无同时异质性假设"。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-04-22 DOI: 10.1097/EDE.0000000000001729
{"title":"Erratum: Average Causal Effect Estimation via Instrumental Variables: The No Simultaneous Heterogeneity Assumption.","authors":"","doi":"10.1097/EDE.0000000000001729","DOIUrl":"10.1097/EDE.0000000000001729","url":null,"abstract":"","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of mRNA COVID-19 Vaccines as First Booster Doses in England: An Observational Study in OpenSAFELY-TPP. 英国 mRNA COVID-19 疫苗首次加强剂量的有效性:OpenSAFELY-TPP 观察性研究。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI: 10.1097/EDE.0000000000001747
Elsie M F Horne, William J Hulme, Edward P K Parker, Ruth H Keogh, Elizabeth J Williamson, Venexia M Walker, Tom M Palmer, Rachel Denholm, Rochelle Knight, Helen J Curtis, Alex J Walker, Colm D Andrews, Amir Mehrkar, Jessica Morley, Brian MacKenna, Sebastian C J Bacon, Ben Goldacre, Miguel A Hernán, Jonathan A C Sterne

Background: The UK delivered its first "booster" COVID-19 vaccine doses in September 2021, initially to individuals at high risk of severe disease, then to all adults. The BNT162b2 Pfizer-BioNTech vaccine was used initially, then also Moderna mRNA-1273.

Methods: With the approval of the National Health Service England, we used routine clinical data to estimate the effectiveness of boosting with BNT162b2 or mRNA-1273 compared with no boosting in eligible adults who had received two primary course vaccine doses. We matched each booster recipient with an unboosted control on factors relating to booster priority status and prior COVID-19 immunization. We adjusted for additional factors in Cox models, estimating hazard ratios up to 182 days (6 months) following booster dose. We estimated hazard ratios overall and within the following periods: 1-14, 15-42, 43-69, 70-97, 98-126, 127-152, and 155-182 days. Outcomes included a positive SARS-CoV-2 test, COVID-19 hospitalization, COVID-19 death, non-COVID-19 death, and fracture.

Results: We matched 8,198,643 booster recipients with unboosted controls. Adjusted hazard ratios over 6-month follow-up were: positive SARS-CoV-2 test 0.75 (0.74, 0.75); COVID-19 hospitalization 0.30 (0.29, 0.31); COVID-19 death 0.11 (0.10, 0.14); non-COVID-19 death 0.22 (0.21, 0.23); and fracture 0.77 (0.75, 0.78). Estimated effectiveness of booster vaccines against severe COVID-19-related outcomes peaked during the first 3 months following the booster dose. By 6 months, the cumulative incidence of positive SARS-CoV-2 test was higher in boosted than unboosted individuals.

Conclusions: We estimate that COVID-19 booster vaccination, compared with no booster vaccination, provided substantial protection against COVID-19 hospitalization and COVID-19 death but only limited protection against positive SARS-CoV-2 test. Lower rates of fracture in boosted than unboosted individuals may suggest unmeasured confounding. Observational studies should report estimated vaccine effectiveness against nontarget and negative control outcomes.

背景:英国于 2021 年 9 月首次接种 COVID-19 疫苗 "加强剂",最初接种对象为重症高危人群,随后接种对象为所有成年人。最初使用的是辉瑞生物技术公司的 BNT162b2 疫苗,后来又使用了 Moderna mRNA-1273:方法:经英格兰国民健康服务局批准,我们使用常规临床数据来估算接种 BNT162b2 或 mRNA-1273 与不接种 BNT162b2 或 mRNA-1273 的有效性比较。我们将每个强化接种者与未接受强化接种的对照组进行了匹配,匹配因素包括强化接种优先级和之前的 COVID-19 免疫接种。我们在 Cox 模型中对其他因素进行了调整,估计了强化剂接种后 182 天(6 个月)内的危险比。我们估算了总体的危险比,以及以下时间段内的危险比:1-14 天、15-42 天、43-69 天、70-97 天、98-126 天、127-152 天和 155-182 天。结果包括 SARS-CoV-2 检测呈阳性、COVID-19 住院、COVID-19 死亡、非 COVID-19 死亡和骨折:我们将 8,198,643 名接受强化治疗者与未接受强化治疗的对照组进行了配对。随访 6 个月的调整后危险比为:SARS-CoV-2 检测阳性 0.75(0.74,0.75);COVID-19 住院 0.30(0.29,0.31);COVID-19 死亡 0.11(0.10,0.14);非 COVID-19 死亡 0.22(0.21,0.23);骨折 0.77(0.75,0.78)。加强接种疫苗对 COVID-19 相关严重后果的估计效果在加强接种后的头 3 个月达到峰值。到 6 个月时,加强接种者的 SARS-CoV-2 检测阳性累积发生率高于未加强接种者:我们估计,接种 COVID-19 加强免疫疫苗比不接种加强免疫疫苗对 COVID-19 住院和 COVID-19 死亡有很大的保护作用,但对 SARS-CoV-2 检测阳性只有有限的保护作用。强化接种者的骨折发生率低于未强化接种者,这可能表明存在未测量的混杂因素。观察性研究应报告疫苗对非目标和阴性对照结果的估计效果。
{"title":"Effectiveness of mRNA COVID-19 Vaccines as First Booster Doses in England: An Observational Study in OpenSAFELY-TPP.","authors":"Elsie M F Horne, William J Hulme, Edward P K Parker, Ruth H Keogh, Elizabeth J Williamson, Venexia M Walker, Tom M Palmer, Rachel Denholm, Rochelle Knight, Helen J Curtis, Alex J Walker, Colm D Andrews, Amir Mehrkar, Jessica Morley, Brian MacKenna, Sebastian C J Bacon, Ben Goldacre, Miguel A Hernán, Jonathan A C Sterne","doi":"10.1097/EDE.0000000000001747","DOIUrl":"10.1097/EDE.0000000000001747","url":null,"abstract":"<p><strong>Background: </strong>The UK delivered its first \"booster\" COVID-19 vaccine doses in September 2021, initially to individuals at high risk of severe disease, then to all adults. The BNT162b2 Pfizer-BioNTech vaccine was used initially, then also Moderna mRNA-1273.</p><p><strong>Methods: </strong>With the approval of the National Health Service England, we used routine clinical data to estimate the effectiveness of boosting with BNT162b2 or mRNA-1273 compared with no boosting in eligible adults who had received two primary course vaccine doses. We matched each booster recipient with an unboosted control on factors relating to booster priority status and prior COVID-19 immunization. We adjusted for additional factors in Cox models, estimating hazard ratios up to 182 days (6 months) following booster dose. We estimated hazard ratios overall and within the following periods: 1-14, 15-42, 43-69, 70-97, 98-126, 127-152, and 155-182 days. Outcomes included a positive SARS-CoV-2 test, COVID-19 hospitalization, COVID-19 death, non-COVID-19 death, and fracture.</p><p><strong>Results: </strong>We matched 8,198,643 booster recipients with unboosted controls. Adjusted hazard ratios over 6-month follow-up were: positive SARS-CoV-2 test 0.75 (0.74, 0.75); COVID-19 hospitalization 0.30 (0.29, 0.31); COVID-19 death 0.11 (0.10, 0.14); non-COVID-19 death 0.22 (0.21, 0.23); and fracture 0.77 (0.75, 0.78). Estimated effectiveness of booster vaccines against severe COVID-19-related outcomes peaked during the first 3 months following the booster dose. By 6 months, the cumulative incidence of positive SARS-CoV-2 test was higher in boosted than unboosted individuals.</p><p><strong>Conclusions: </strong>We estimate that COVID-19 booster vaccination, compared with no booster vaccination, provided substantial protection against COVID-19 hospitalization and COVID-19 death but only limited protection against positive SARS-CoV-2 test. Lower rates of fracture in boosted than unboosted individuals may suggest unmeasured confounding. Observational studies should report estimated vaccine effectiveness against nontarget and negative control outcomes.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations of Local Cannabis Control Policies With Harmful Cannabis Exposures Reported to the California Poison Control System. 地方大麻管制政策与向加州毒物控制系统报告的有害大麻暴露的关联。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI: 10.1097/EDE.0000000000001737
Ellicott C Matthay, Leyla M Mousli, Chloe Sun, Justin Lewis, Laurie M Jacobs, Stuart Heard, Raymond Ho, Laura A Schmidt, Dorie E Apollonio

Background: Cannabis exposures reported to the California Poison Control System increased following the initiation of recreational cannabis sales on 1 January 2018 (i.e., "commercialization"). We evaluated whether local cannabis control policies adopted by 2021 were associated with shifts in harmful cannabis exposures.

Methods: Using cannabis control policies collected for all 539 California cities and counties in 2020-2021, we applied a differences-in-differences design with negative binomial regression to test the association of policies with harmful cannabis exposures reported to California Poison Control System (2011-2020), before and after commercialization. We considered three policy categories: bans on storefront recreational retail cannabis businesses, overall restrictiveness, and specific recommended provisions (restricting product types or potency, packaging and labeling restrictions, and server training requirements).

Results: Localities that ultimately banned storefront recreational retail cannabis businesses had fewer harmful cannabis exposures for children aged <13 years (rate ratio = 0.82; 95% confidence interval = 0.65, 1.02), but not for people aged >13 years (rate ratio = 0.97; 95% confidence interval = 0.85, 1.11). Of 167 localities ultimately permitting recreational cannabis sales, overall restrictiveness was not associated with harmful cannabis exposures among children aged <13 years, but for people aged >13 years, a 1-standard deviation increase in ultimate restrictiveness was associated with fewer harmful cannabis exposures (rate ratio = 0.93; 95% confidence interval = 0.86, 1.01). For recommended provisions, estimates were generally too imprecise to detect associations with harmful cannabis exposures.

Conclusion: Bans on storefront retail and other restrictive approaches to regulating recreational cannabis may be associated with fewer harmful cannabis exposures for some age groups following statewide commercialization.

背景:2018 年 1 月 1 日开始娱乐性大麻销售(即 "商业化")后,向加州毒物控制系统报告的大麻暴露有所增加。我们评估了 2021 年采取的地方大麻管制政策是否与有害大麻暴露的变化有关:利用 2020-2021 年收集的加利福尼亚州所有 539 个市县的大麻管制政策,我们采用负二项回归的差分设计来检验商业化前后政策与向加利福尼亚州毒物控制系统报告的有害大麻暴露(2011-2020 年)之间的关联。我们考虑了三个政策类别:禁止店面娱乐零售大麻业务、整体限制性和具体建议条款(限制产品类型或效力、包装和标签限制以及服务器培训要求):最终禁止店面休闲零售大麻业务的地方,13 岁儿童接触大麻的有害程度较低(比率 = 0.97;95% 置信区间 = 0.85,1.11)。在最终允许娱乐性大麻销售的 167 个地方中,总体限制性与 13 岁儿童接触有害大麻的情况无关,最终限制性每增加 1 个标准差,接触有害大麻的情况就会减少(比率 = 0.93;95% 置信区间 = 0.86,1.01)。对于建议的规定,估计值通常过于不精确,无法检测出与有害大麻暴露之间的关联:结论:禁止店面零售和采用其他限制性方法监管娱乐性大麻可能与全州范围商业化后某些年龄组的有害大麻暴露减少有关。
{"title":"Associations of Local Cannabis Control Policies With Harmful Cannabis Exposures Reported to the California Poison Control System.","authors":"Ellicott C Matthay, Leyla M Mousli, Chloe Sun, Justin Lewis, Laurie M Jacobs, Stuart Heard, Raymond Ho, Laura A Schmidt, Dorie E Apollonio","doi":"10.1097/EDE.0000000000001737","DOIUrl":"10.1097/EDE.0000000000001737","url":null,"abstract":"<p><strong>Background: </strong>Cannabis exposures reported to the California Poison Control System increased following the initiation of recreational cannabis sales on 1 January 2018 (i.e., \"commercialization\"). We evaluated whether local cannabis control policies adopted by 2021 were associated with shifts in harmful cannabis exposures.</p><p><strong>Methods: </strong>Using cannabis control policies collected for all 539 California cities and counties in 2020-2021, we applied a differences-in-differences design with negative binomial regression to test the association of policies with harmful cannabis exposures reported to California Poison Control System (2011-2020), before and after commercialization. We considered three policy categories: bans on storefront recreational retail cannabis businesses, overall restrictiveness, and specific recommended provisions (restricting product types or potency, packaging and labeling restrictions, and server training requirements).</p><p><strong>Results: </strong>Localities that ultimately banned storefront recreational retail cannabis businesses had fewer harmful cannabis exposures for children aged <13 years (rate ratio = 0.82; 95% confidence interval = 0.65, 1.02), but not for people aged >13 years (rate ratio = 0.97; 95% confidence interval = 0.85, 1.11). Of 167 localities ultimately permitting recreational cannabis sales, overall restrictiveness was not associated with harmful cannabis exposures among children aged <13 years, but for people aged >13 years, a 1-standard deviation increase in ultimate restrictiveness was associated with fewer harmful cannabis exposures (rate ratio = 0.93; 95% confidence interval = 0.86, 1.01). For recommended provisions, estimates were generally too imprecise to detect associations with harmful cannabis exposures.</p><p><strong>Conclusion: </strong>Bans on storefront retail and other restrictive approaches to regulating recreational cannabis may be associated with fewer harmful cannabis exposures for some age groups following statewide commercialization.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Efficient Approach to Nowcasting the Time-varying Reproduction Number. 预测时变繁殖数的有效方法
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-24 DOI: 10.1097/EDE.0000000000001744
Bryan Sumalinab, Oswaldo Gressani, Niel Hens, Christel Faes

Estimating the instantaneous reproduction number ( ) in near real time is crucial for monitoring and responding to epidemic outbreaks on a daily basis. However, such estimates often suffer from bias due to reporting delays inherent in surveillance systems. We propose a fast and flexible Bayesian methodology to overcome this challenge by estimating while taking into account reporting delays. Furthermore, the method naturally takes into account the uncertainty associated with the nowcasting of cases to get a valid uncertainty estimation of the nowcasted reproduction number. We evaluate the proposed methodology through a simulation study and apply it to COVID-19 incidence data in Belgium.

近乎实时地估算瞬时繁殖数()对于每天监测和应对流行病爆发至关重要。然而,由于监测系统固有的报告延迟,这种估计往往存在偏差。我们提出了一种快速灵活的贝叶斯方法,在考虑报告延迟的同时进行估算,从而克服这一难题。此外,该方法自然会考虑到与病例预报相关的不确定性,从而对预报的繁殖数量进行有效的不确定性估计。我们通过模拟研究对所提出的方法进行了评估,并将其应用于比利时 COVID-19 发病率数据。
{"title":"An Efficient Approach to Nowcasting the Time-varying Reproduction Number.","authors":"Bryan Sumalinab, Oswaldo Gressani, Niel Hens, Christel Faes","doi":"10.1097/EDE.0000000000001744","DOIUrl":"10.1097/EDE.0000000000001744","url":null,"abstract":"<p><p>Estimating the instantaneous reproduction number ( ) in near real time is crucial for monitoring and responding to epidemic outbreaks on a daily basis. However, such estimates often suffer from bias due to reporting delays inherent in surveillance systems. We propose a fast and flexible Bayesian methodology to overcome this challenge by estimating while taking into account reporting delays. Furthermore, the method naturally takes into account the uncertainty associated with the nowcasting of cases to get a valid uncertainty estimation of the nowcasted reproduction number. We evaluate the proposed methodology through a simulation study and apply it to COVID-19 incidence data in Belgium.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Direct and Spillover Effects of Intervention Packages in Network-randomized Studies. 在网络随机研究中评估一揽子干预措施的直接效应和溢出效应。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-06 DOI: 10.1097/EDE.0000000000001742
Ashley L Buchanan, Raúl U Hernández-Ramírez, Judith J Lok, Sten H Vermund, Samuel R Friedman, Laura Forastiere, Donna Spiegelman

Background: Intervention packages may result in a greater public health impact than single interventions. Understanding the separate impact of each component on the overall package effectiveness can improve intervention delivery.

Methods: We adapted an approach to evaluate the effects of a time-varying intervention package in a network-randomized study. In some network-randomized studies, only a subset of participants in exposed networks receive the intervention themselves. The spillover effect contrasts average potential outcomes if a person was not exposed to themselves under intervention in the network versus no intervention in a control network. We estimated the effects of components of the intervention package in HIV Prevention Trials Network 037, a Phase III network-randomized HIV prevention trial among people who inject drugs and their risk networks using marginal structural models to adjust for time-varying confounding. The index participant in an intervention network received a peer education intervention initially at baseline, then boosters at 6 and 12 months. All participants were followed to ascertain HIV risk behaviors.

Results: There were 560 participants with at least one follow-up visit, 48% of whom were randomized to the intervention, and 1,598 participant visits were observed. The spillover effect of the boosters in the presence of initial peer education training was a 39% rate reduction (rate ratio = 0.61; 95% confidence interval = 0.43, 0.87).

Conclusions: These methods will be useful for evaluating intervention packages in studies with network features.

背景:一揽子干预措施可能比单一干预措施对公众健康产生更大的影响。了解每个组成部分对一揽子干预措施整体效果的单独影响可以改进干预措施的实施:我们采用了一种方法,在网络随机研究中评估随时间变化的一揽子干预措施的效果。在一些网络随机研究中,只有暴露在网络中的一部分参与者本身会接受干预。溢出效应对比了在网络干预与对照网络无干预的情况下,如果一个人没有接触到自己可能产生的平均结果。我们使用边际结构模型来调整时变混杂因素,估算了第 037 号艾滋病预防试验网络(HIV Prevention Trials Network 037)中干预方案各组成部分的效果,这是一项在注射吸毒者及其风险网络中进行的第三阶段网络随机艾滋病预防试验。干预网络中的指数参与者最初在基线时接受同伴教育干预,然后在 6 个月和 12 个月时接受强化干预。对所有参与者进行跟踪调查,以确定其艾滋病风险行为:结果:共有 560 名参与者接受了至少一次随访,其中 48% 的参与者被随机分配接受干预,共观察到 1598 次随访。在初始同伴教育培训的基础上,助推器的溢出效应使感染率降低了 39%(比率 = 0.61;95% 置信区间 = 0.43,0.87):这些方法将有助于评估具有网络特征的研究中的一揽子干预措施。
{"title":"Assessing Direct and Spillover Effects of Intervention Packages in Network-randomized Studies.","authors":"Ashley L Buchanan, Raúl U Hernández-Ramírez, Judith J Lok, Sten H Vermund, Samuel R Friedman, Laura Forastiere, Donna Spiegelman","doi":"10.1097/EDE.0000000000001742","DOIUrl":"10.1097/EDE.0000000000001742","url":null,"abstract":"<p><strong>Background: </strong>Intervention packages may result in a greater public health impact than single interventions. Understanding the separate impact of each component on the overall package effectiveness can improve intervention delivery.</p><p><strong>Methods: </strong>We adapted an approach to evaluate the effects of a time-varying intervention package in a network-randomized study. In some network-randomized studies, only a subset of participants in exposed networks receive the intervention themselves. The spillover effect contrasts average potential outcomes if a person was not exposed to themselves under intervention in the network versus no intervention in a control network. We estimated the effects of components of the intervention package in HIV Prevention Trials Network 037, a Phase III network-randomized HIV prevention trial among people who inject drugs and their risk networks using marginal structural models to adjust for time-varying confounding. The index participant in an intervention network received a peer education intervention initially at baseline, then boosters at 6 and 12 months. All participants were followed to ascertain HIV risk behaviors.</p><p><strong>Results: </strong>There were 560 participants with at least one follow-up visit, 48% of whom were randomized to the intervention, and 1,598 participant visits were observed. The spillover effect of the boosters in the presence of initial peer education training was a 39% rate reduction (rate ratio = 0.61; 95% confidence interval = 0.43, 0.87).</p><p><strong>Conclusions: </strong>These methods will be useful for evaluating intervention packages in studies with network features.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States. ACCORD 试验参与者与美国中老年糖尿病患者的代表性比较。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-20 DOI: 10.1097/EDE.0000000000001746
Ryo Ikesu, Yingyan Wu, Scott C Zimmerman, Kosuke Inoue, Peter Buto, Melinda C Power, Catherine A Schaefer, M Maria Glymour, Elizabeth Rose Mayeda

Background: We evaluated whether participants in the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial represent US adults aged ≥40 with diabetes.

Methods: Using the nationally representative 2017-2020 prepandemic National Health and Nutrition Examination Survey data, we made operational definitions of ACCORD eligibility criteria. We calculated the percentage of individuals aged ≥40 with diabetes and HbA1c ≥ 6.0% or ≥ 7.5% who met operational ACCORD eligibility criteria.

Results: Applying survey sampling weights to 715 National Health and Nutrition Examination Survey participants aged ≥40 with diabetes and HbA1c ≥ 6.0% (representing 29,717,406 individuals), 12% (95% confidence interval [CI] = 8%, 18%) met the operational ACCORD eligibility criteria. Restricting to HbA1c ≥ 7.5%, 39% (95% CI = 28%, 51%) of respondents met the operational ACCORD eligibility criteria.

Conclusions: ACCORD represented a minority of US middle-aged and older adults with diabetes. Given the differential risk profile between ACCORD participants and the general population with diabetes, extrapolating the trial findings may not be appropriate.

背景:我们评估了具有里程碑意义的控制糖尿病心血管风险行动(ACCORD)试验的参与者是否代表了年龄≥40岁的美国成人糖尿病患者:利用具有全国代表性的 2017-2020 年大流行前全国健康与营养调查(NHANES)数据,我们对 ACCORD 的资格标准进行了操作性定义。我们计算了年龄≥40 岁、患有糖尿病且 HbA1c≥6.0% 或≥7.5%、符合 ACCORD 操作资格标准的个体所占的百分比:对 715 名年龄≥40 岁、患有糖尿病且 HbA1c ≥6.0% 的 NHANES 参与者(代表 29,717,406 人)应用调查抽样权重,12%(95% 置信区间 [CI]:8-18%)符合 ACCORD 操作资格标准。如果HbA1c≥7.5%,39%(95% 置信区间:28-51%)的受访者符合 ACCORD 标准:ACCORD 代表了少数美国中老年糖尿病患者。鉴于 ACCORD 参与者与普通糖尿病患者的风险状况不同,推断试验结果可能并不合适。
{"title":"Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States.","authors":"Ryo Ikesu, Yingyan Wu, Scott C Zimmerman, Kosuke Inoue, Peter Buto, Melinda C Power, Catherine A Schaefer, M Maria Glymour, Elizabeth Rose Mayeda","doi":"10.1097/EDE.0000000000001746","DOIUrl":"10.1097/EDE.0000000000001746","url":null,"abstract":"<p><strong>Background: </strong>We evaluated whether participants in the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial represent US adults aged ≥40 with diabetes.</p><p><strong>Methods: </strong>Using the nationally representative 2017-2020 prepandemic National Health and Nutrition Examination Survey data, we made operational definitions of ACCORD eligibility criteria. We calculated the percentage of individuals aged ≥40 with diabetes and HbA1c ≥ 6.0% or ≥ 7.5% who met operational ACCORD eligibility criteria.</p><p><strong>Results: </strong>Applying survey sampling weights to 715 National Health and Nutrition Examination Survey participants aged ≥40 with diabetes and HbA1c ≥ 6.0% (representing 29,717,406 individuals), 12% (95% confidence interval [CI] = 8%, 18%) met the operational ACCORD eligibility criteria. Restricting to HbA1c ≥ 7.5%, 39% (95% CI = 28%, 51%) of respondents met the operational ACCORD eligibility criteria.</p><p><strong>Conclusions: </strong>ACCORD represented a minority of US middle-aged and older adults with diabetes. Given the differential risk profile between ACCORD participants and the general population with diabetes, extrapolating the trial findings may not be appropriate.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Recall and Selection Biases on Modeling Cancer Risk From Mobile Phone Use: Results From a Case-Control Simulation Study. 回忆偏差和选择偏差对模拟使用手机致癌风险的影响:病例对照模拟研究的结果。
IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-05-20 DOI: 10.1097/EDE.0000000000001749
Liacine Bouaoun, Graham Byrnes, Susanna Lagorio, Maria Feychting, Abdellah Abou-Bakre, Rémi Béranger, Joachim Schüz

Background: The largest case-control study (Interphone study) investigating glioma risk related to mobile phone use showed a J-shaped relationship with reduced relative risks for moderate use and a 40% increased relative risk among the 10% heaviest regular mobile phone users, using a categorical risk model based on deciles of lifetime duration of use among ever regular users.

Methods: We conducted Monte Carlo simulations examining whether the reported estimates are compatible with an assumption of no effect of mobile phone use on glioma risk when the various forms of biases present in the Interphone study are accounted for. Four scenarios of sources of error in self-reported mobile phone use were considered, along with selection bias. Input parameters used for simulations were those obtained from Interphone validation studies on reporting accuracy and from using a nonresponse questionnaire.

Results: We found that the scenario simultaneously modeling systematic and random reporting errors produced a J-shaped relationship perfectly compatible with the observed relationship from the main Interphone study with a simulated spurious increased relative risk among heaviest users (odds ratio = 1.91) compared with never regular users. The main determinant for producing this J shape was higher reporting error variance in cases compared with controls, as observed in the validation studies. Selection bias contributed to the reduced risks as well.

Conclusions: Some uncertainty remains, but the evidence from the present simulation study shifts the overall assessment to making it less likely that heavy mobile phone use is causally related to an increased glioma risk.

研究背景最大的病例对照研究(Interphone研究)调查了与使用手机有关的胶质瘤风险,结果显示,使用手机的相对风险呈J形关系,中度使用手机的相对风险降低,而10%最频繁使用手机者的相对风险增加40%:我们进行了蒙特卡洛模拟,研究在考虑到 Interphone 研究中存在的各种偏差的情况下,报告的估计值是否与使用手机对胶质瘤风险没有影响的假设相符。在考虑选择偏差的同时,还考虑了自我报告手机使用情况的四种误差来源。模拟使用的输入参数是从 Interphone 关于报告准确性的验证研究和无应答问卷中获得的:我们发现,同时模拟系统报告误差和随机报告误差的方案产生了一种 J 型关系,与 Interphone 主要研究中观察到的关系完全吻合,与从不经常使用手机的人相比,最常使用手机的人的相对风险出现了模拟的虚假增加(OR = 1.91)。产生这种 "J "型关系的主要决定因素是,与验证研究中观察到的情况相比,病例的报告误差方差更大。选择偏差也是风险降低的原因之一:虽然仍存在一些不确定性,但本模拟研究提供的证据表明,总体评估结果显示,大量使用手机与胶质瘤风险增加之间存在因果关系的可能性较小。
{"title":"Effects of Recall and Selection Biases on Modeling Cancer Risk From Mobile Phone Use: Results From a Case-Control Simulation Study.","authors":"Liacine Bouaoun, Graham Byrnes, Susanna Lagorio, Maria Feychting, Abdellah Abou-Bakre, Rémi Béranger, Joachim Schüz","doi":"10.1097/EDE.0000000000001749","DOIUrl":"10.1097/EDE.0000000000001749","url":null,"abstract":"<p><strong>Background: </strong>The largest case-control study (Interphone study) investigating glioma risk related to mobile phone use showed a J-shaped relationship with reduced relative risks for moderate use and a 40% increased relative risk among the 10% heaviest regular mobile phone users, using a categorical risk model based on deciles of lifetime duration of use among ever regular users.</p><p><strong>Methods: </strong>We conducted Monte Carlo simulations examining whether the reported estimates are compatible with an assumption of no effect of mobile phone use on glioma risk when the various forms of biases present in the Interphone study are accounted for. Four scenarios of sources of error in self-reported mobile phone use were considered, along with selection bias. Input parameters used for simulations were those obtained from Interphone validation studies on reporting accuracy and from using a nonresponse questionnaire.</p><p><strong>Results: </strong>We found that the scenario simultaneously modeling systematic and random reporting errors produced a J-shaped relationship perfectly compatible with the observed relationship from the main Interphone study with a simulated spurious increased relative risk among heaviest users (odds ratio = 1.91) compared with never regular users. The main determinant for producing this J shape was higher reporting error variance in cases compared with controls, as observed in the validation studies. Selection bias contributed to the reduced risks as well.</p><p><strong>Conclusions: </strong>Some uncertainty remains, but the evidence from the present simulation study shifts the overall assessment to making it less likely that heavy mobile phone use is causally related to an increased glioma risk.</p>","PeriodicalId":11779,"journal":{"name":"Epidemiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Epidemiology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1