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Academic performance and associated factors among female university students 女大学生的学习成绩及相关因素
Pub Date : 2024-11-07 DOI: 10.1016/j.gloepi.2024.100175
Tsiyon Birhanu Wube , Solomon Gebremichael Asgedom , Zelalem Mohammed Jemal , Lielt Gebreselassie Gebrekirstos

Background

Education serves as a vital instrument for empowering citizens to engage fully in the development process. However, various factors can impact the quality and competency of female students in higher education. In Ethiopian institutions, the proportion of female students is significantly lower than that of their male counterparts, highlighting the unique challenges faced by females that can hinder their academic success. Understanding these challenges and the factors influencing female academic performance is essential for enhancing educational outcomes and promoting greater equity in higher education.

Methods

An institutional-based cross-sectional study was conducted involving 633 female university students, supplemented by a qualitative approach. Participants were selected using a multistage sampling technique. Data were collected via a self-administered questionnaire, while qualitative data were gathered through key informant and in-depth interviews. Qualitative data were transcribed, labeled, and analyzed narratively through content analysis. Logistic regression analysis was employed to identify factors associated with academic performance.

Results

The study revealed that 11.85 % of female students (95 % CI: 9.43–14.62) experienced poor academic performance. Key factors influencing academic performance included alcohol consumption (AOR = 2.3, 95 % CI: 1.8–4.0), smoking (AOR = 2.9, 95 % CI: 1.1–7.4), working after school (AOR = 1.6, 95 % CI: 1.1–2.8), choice in preferred departments (AOR = 0.6, 95 % CI: 0.3–0.8), poor prior knowledge in English and basic science (AOR = 2.1, 95 % CI: 1.4–4.1), and insufficient parental support (AOR = 2.1, 95 % CI: 1.3–3.7).

Conclusion

The abstract effectively summarizes the key findings and offers relevant insights into the academic challenges faced by female students. More than one in ten female students encounters significant academic obstacles influenced by factors such as substance use, after-school employment, limited department choice, and inadequate foundational knowledge. Addressing these issues is crucial for improving academic performance and reinforcing support systems for female students, thereby providing a solid foundation for future studies in this area.
背景教育是增强公民全面参与发展进程能力的重要手段。然而,各种因素会影响高等教育中女生的质量和能力。在埃塞俄比亚的院校中,女生的比例明显低于男生,这凸显了女生所面临的独特挑战,这些挑战可能会阻碍她们在学业上取得成功。了解这些挑战和影响女生学业成绩的因素,对于提高教育成果和促进高等教育的公平性至关重要。方法:我们开展了一项以院校为基础的横断面研究,涉及 633 名女大学生,并辅以定性方法。采用多阶段抽样技术选取参与者。数据通过自填式问卷收集,定性数据则通过关键信息提供者和深度访谈收集。对定性数据进行了誊写、标记,并通过内容分析进行了叙述性分析。研究结果显示,11.85% 的女生(95% CI:9.43-14.62)学习成绩不佳。结论该摘要有效地总结了主要研究结果,并对女学生面临的学业挑战提出了相关见解。每十名女学生中就有一名以上在学业上遇到重大障碍,这些障碍受到药物使用、课后就业、院系选择有限以及基础知识不足等因素的影响。解决这些问题对于提高女学生的学业成绩和加强支持系统至关重要,从而为这一领域的未来研究奠定了坚实的基础。
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引用次数: 0
Exploring diseases burden in HIV population: Results from the CHAO (Comorbidities in HIV/AIDS outpatients) cross-sectional study in Kenya 探索艾滋病人群的疾病负担:肯尼亚 CHAO(艾滋病毒/艾滋病门诊患者合并症)横断面研究的结果
Pub Date : 2024-10-22 DOI: 10.1016/j.gloepi.2024.100174
Fausto Ciccacci , Benjamin Welu , Harrison Ndoi , Claudia Mosconi , Carolina De Santo , Mariachiara Carestia , Anna Maria Doro Altan , Joseph Murungi , Koome Muthuri , Mariagrazia Cicala , Giovanni Guidotti , Stefano Orlando

Background

Africa is the epicenter of the HIV epidemic, with over two-thirds of the global population living with HIV. It is also facing a dramatic increase in non-communicable diseases (NCDs) amidst its aging population. This necessitates a healthcare approach that addresses both infectious diseases and NCDs in HIV-positive individuals. In Kenya, with 1.4 million HIV-positive people, efforts include widespread ART access and integrating HIV services into the health system. Challenges remain in healthcare infrastructure, particularly in rural areas. The Comorbidities in HIV/AIDS Outpatients (CHAO) Project, funded by the Italian Cooperation Agency, aims to improve understanding and management of comorbidities in HIV patients, highlighting the need for cost-effective healthcare strategies to address this dual burden.

Methods

The CHAO (Comorbidities in HIV/AIDS Outpatients) project conducted a cross-sectional epidemiological study across 25 clinics in Meru County, Kenya. The study included comprehensive surveys and screenings for various comorbidities among HIV-positive patients receiving treatment, utilizing both clinical evaluations and laboratory tests to assess the prevalence of infectious diseases and NCDs.

Results

A total of 1051 HIV-positive individuals were included in the study: 75 % females, 25 % males, median age 47 years, the majority (96 %) on long-term ART, mostly Dolutegravir-based (95 %). 55.4 % had at least one comorbidity, with NCDs such as dyslipidemia (21.22 %) and hypertension (20.17 %) being the most prevalent. The study also noted significant occurrences of communicable diseases, including syphilis (5.23 %), hepatitis B (2.19 %), and hepatitis C (0.29 %). The prevalence of comorbidities varied with age, highlighting the impact of aging on disease burden.

Discussion

The high prevalence of comorbidities among HIV-positive patients in Meru County underscores the need for integrated healthcare strategies that address both infectious diseases and NCDs. The findings advocate for systematic screening and management of comorbidities within HIV care programs, emphasizing the need for holistic health approaches to improve outcomes for this population.
背景非洲是艾滋病毒疫情的中心,全球三分之二以上的人口感染了艾滋病毒。在人口老龄化的同时,非洲还面临着非传染性疾病 (NCD) 的急剧增加。因此,有必要采取一种医疗保健方法,同时解决艾滋病毒抗体阳性者的传染病和非传染性疾病问题。在拥有 140 万艾滋病毒抗体阳性者的肯尼亚,所做的努力包括普及抗逆转录病毒疗法,以及将艾滋病毒服务纳入卫生系统。医疗保健基础设施仍面临挑战,尤其是在农村地区。由意大利合作署资助的艾滋病毒/艾滋病门诊患者合并症(CHAO)项目旨在提高人们对艾滋病毒患者合并症的了解和管理,强调需要采取具有成本效益的医疗策略来解决这一双重负担。该研究包括对接受治疗的 HIV 阳性患者的各种合并症进行全面调查和筛查,利用临床评估和实验室检测来评估传染病和非传染性疾病的患病率:其中 75% 为女性,25% 为男性,年龄中位数为 47 岁,大多数人(96%)接受长期抗逆转录病毒疗法,大部分患者(95%)接受多鲁曲韦疗法。55.4%的患者至少患有一种合并症,其中以血脂异常(21.22%)和高血压(20.17%)等非传染性疾病最为常见。研究还注意到,梅毒(5.23%)、乙型肝炎(2.19%)和丙型肝炎(0.29%)等传染病的发病率也很高。并发症的患病率随年龄而变化,这凸显了老龄化对疾病负担的影响。讨论梅鲁县艾滋病毒阳性患者的并发症患病率很高,这凸显了同时应对传染病和非传染性疾病的综合医疗保健战略的必要性。研究结果提倡在艾滋病护理项目中对合并症进行系统筛查和管理,强调需要采用综合保健方法来改善这一人群的治疗效果。
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引用次数: 0
What constitutes valid evidence of causation? Gas stoves and childhood asthma revisited 什么是因果关系的有效证据?煤气灶与儿童哮喘再探讨
Pub Date : 2024-10-21 DOI: 10.1016/j.gloepi.2024.100173
Louis Anthony Cox Jr.
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引用次数: 0
Letter to the editor regarding: “Challenging unverified assumptions in causal claims: Do gas stoves increase risk of pediatric asthma?” 致编辑的信,内容涉及"质疑因果关系声明中未经核实的假设:燃气灶会增加小儿哮喘的风险吗?
Pub Date : 2024-10-19 DOI: 10.1016/j.gloepi.2024.100172
Kari C. Nadeau , Yannai Kashtan , Metta Nicholson , Colin J. Finnegan , Zutao Ouyang , Anchal Garg , Eric D. Lebel , Sebastian T. Rowland , Drew R. Michanowicz , Robert B. Jackson
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引用次数: 0
Identification of population multimorbidity patterns in 3.9 million patients from Bogota in 2018 2018年波哥大390万患者的人群多病模式识别
Pub Date : 2024-10-12 DOI: 10.1016/j.gloepi.2024.100171
Carolina Saavedra-Moreno , Rafael Hurtado , Nubia Velasco , Andrea Ramírez

Background

Multimorbidity has emerged as a challenge for health systems due to its association with adverse clinical outcomes. Given the limited information available on multimorbidity, particularly in low- and middle-income countries, this study characterizes multimorbidity patterns in the population of Bogotá, Colombia in 2018.

Methods

In a cross-sectional study, we analyzed 16 million medical consultation records from Bogotá reported in the National Service Delivery Records in 2018. Using network analysis, we quantified the prevalence of multimorbidity in the population and identified the most common associations between diagnoses, with data stratified by age, sex, and socioeconomic status.

Results

The study found that the prevalence of multimorbidity in the population was 44.2 %, increased with age, and was higher in women and in people affiliated to the contributory health scheme. Allergies and vasomotor rhinitis with asthma were common in young people. In women aged 19–39 years, obesity with hypothyroidism was common, while men in the same age group had obesity with dyslipidemia. In people aged 60 years and older, essential hypertension with dyslipidemia was the most common. In addition, some associations between diagnoses showed a higher association in people affiliated to the subsidized health scheme, with notable associations with trauma, especially in men.

Conclusion

Overall, the results provide valuable insights into multimorbidity in the population and highlight inequalities based on sociodemographic factors. Future research should investigate whether the lower prevalence of multimorbidity in vulnerable groups is related to biases in data collection or to underlying inequalities in healthcare access.
背景由于多病症与不良临床结果有关,多病症已成为卫生系统面临的一项挑战。鉴于有关多病症的信息有限,尤其是在中低收入国家,本研究描述了 2018 年哥伦比亚波哥大人口的多病症模式。方法在一项横断面研究中,我们分析了 2018 年国家服务提供记录中报告的波哥大 1600 万份医疗咨询记录。通过网络分析,我们量化了人口中多病的患病率,并确定了诊断之间最常见的关联,数据按年龄、性别和社会经济地位进行了分层。结果研究发现,人口中多病的患病率为 44.2%,随着年龄的增长而增加,女性和加入缴费医疗计划的人群患病率更高。过敏症和血管运动性鼻炎合并哮喘在年轻人中很常见。在 19-39 岁的女性中,肥胖伴甲状腺功能减退症很常见,而同一年龄段的男性则肥胖伴血脂异常。在 60 岁及以上的人群中,伴有血脂异常的原发性高血压最为常见。此外,一些诊断之间的关联显示,参加医疗补贴计划的人与创伤的关联度较高,尤其是男性。未来的研究应调查弱势群体的多病症发病率较低是否与数据收集中的偏差或医疗服务中的潜在不平等有关。
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引用次数: 0
Vitamin D deficiency in Ukraine: A multicentre cross-sectional study 乌克兰的维生素 D 缺乏症:多中心横断面研究
Pub Date : 2024-10-10 DOI: 10.1016/j.gloepi.2024.100170
Sofiia Shatylo , Volodymyr Bogomaz , Oleksii Babych

Background

Available epidemiological data on vitamin D status in the Ukrainian population are limited.

Objective

The aim of this study is to investigate the prevalence of vitamin D deficiency in Ukraine.

Methods

This multicentre cross-sectional study included a total of 11,462 participants: 1530 children with a median age 10 years, (IQR 6–14) and 56.21 % of them were female; 9932 adults with a median age of 36 years (IQR 26–48) and 78.72 % of them were female. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured once by chemiluminescent immunoassay (UniCel DxI 800 Access Immunoassay System, Beckman Coulter Inc., USA) in the period of January–December 2021 in Kyiv and Kyiv Oblast. The cut-offs were: vitamin D deficiency, <50 nmol/L; moderate deficiency, 25–<50 nmol/L; severe deficiency, <25 nmol/L; vitamin D insufficiency, 50–<75 nmol/L; vitamin D sufficiency, 75–<250 nmol/L; optimal concentration, 75–<125 nmol/L; increased levels, 125–<250 nmol/L; and toxicity, ≥250 nmol/L.

Results

The median 25(OH)D level was 65.4 nmol/L (IQR 49.5–85.6) among all participants, severe vitamin D deficiency was recorded in 2.9 % of participants (95 % CI: 2.6–3.2), moderate deficiency in 23 % (95 % CI: 22–24), and vitamin D insufficiency in 37 % (95 % CI: 36–38).
Prevalence of vitamin D deficiency in group 1–17 years was 23.5 % (95 % CI: 21–26). We did not find vitamin D deficiency in children aged 1–2 years; however toxic levels were recorded in 4.2 % of the children in this age group (95 % CI: 1.4–9.6). Among the adults (≥18 years old), prevalence of vitamin D deficiency was 26 % (95 % CI: 25–27).

Conclusion

Vitamin D deficiency and insufficiency are common in Ukraine.
背景有关乌克兰人口维生素 D 状态的流行病学数据十分有限。方法这项多中心横断面研究共纳入 11462 名参与者:1530 名儿童,中位年龄为 10 岁(IQR 6-14),其中 56.21% 为女性;9932 名成年人,中位年龄为 36 岁(IQR 26-48),其中 78.72% 为女性。2021 年 1 月至 12 月期间,在基辅和基辅州采用化学发光免疫测定法(UniCel DxI 800 Access Immunoassay System,美国贝克曼库尔特公司)对血清 25- 羟维生素 D(25(OH)D)水平进行了一次测定。临界值为:维生素 D 缺乏,50 nmol/L;中度缺乏,25-<50 nmol/L;严重缺乏,25 nmol/L;维生素 D 不足,50-<75 nmol/L;维生素 D 充足,75-<250 nmol/L;最佳浓度,75-<125 nmol/L;水平升高,125-<250 nmol/L;中毒,≥250 nmol/L。结果 所有参与者的 25(OH)D 水平中位数为 65.4 nmol/L(IQR 49.5-85.6),2.9% 的参与者严重缺乏维生素 D(95 % CI:2.6-3.2),23% 的参与者中度缺乏维生素 D(95 % CI:22-24),37% 的参与者维生素 D 不足(95 % CI:36-38)。我们在 1-2 岁儿童中未发现维生素 D 缺乏症,但该年龄组有 4.2% 的儿童(95% CI:1.4-9.6)出现维生素 D 中毒症状。在成年人(≥18 岁)中,维生素 D 缺乏症的发病率为 26 %(95 % CI:25-27)。
{"title":"Vitamin D deficiency in Ukraine: A multicentre cross-sectional study","authors":"Sofiia Shatylo ,&nbsp;Volodymyr Bogomaz ,&nbsp;Oleksii Babych","doi":"10.1016/j.gloepi.2024.100170","DOIUrl":"10.1016/j.gloepi.2024.100170","url":null,"abstract":"<div><h3>Background</h3><div>Available epidemiological data on vitamin D status in the Ukrainian population are limited.</div></div><div><h3>Objective</h3><div>The aim of this study is to investigate the prevalence of vitamin D deficiency in Ukraine.</div></div><div><h3>Methods</h3><div>This multicentre cross-sectional study included a total of 11,462 participants: 1530 children with a median age 10 years, (IQR 6–14) and 56.21 % of them were female; 9932 adults with a median age of 36 years (IQR 26–48) and 78.72 % of them were female. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured once by chemiluminescent immunoassay (UniCel DxI 800 Access Immunoassay System, Beckman Coulter Inc., USA) in the period of January–December 2021 in Kyiv and Kyiv Oblast. The cut-offs were: vitamin D deficiency, &lt;50 nmol/L; moderate deficiency, 25–&lt;50 nmol/L; severe deficiency, &lt;25 nmol/L; vitamin D insufficiency, 50–&lt;75 nmol/L; vitamin D sufficiency, 75–&lt;250 nmol/L; optimal concentration, 75–&lt;125 nmol/L; increased levels, 125–&lt;250 nmol/L; and toxicity, ≥250 nmol/L.</div></div><div><h3>Results</h3><div>The median 25(OH)D level was 65.4 nmol/L (IQR 49.5–85.6) among all participants, severe vitamin D deficiency was recorded in 2.9 % of participants (95 % CI: 2.6–3.2), moderate deficiency in 23 % (95 % CI: 22–24), and vitamin D insufficiency in 37 % (95 % CI: 36–38).</div><div>Prevalence of vitamin D deficiency in group 1–17 years was 23.5 % (95 % CI: 21–26). We did not find vitamin D deficiency in children aged 1–2 years; however toxic levels were recorded in 4.2 % of the children in this age group (95 % CI: 1.4–9.6). Among the adults (≥18 years old), prevalence of vitamin D deficiency was 26 % (95 % CI: 25–27).</div></div><div><h3>Conclusion</h3><div>Vitamin D deficiency and insufficiency are common in Ukraine.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modelling the factors associated with quality of life in women with osteoporosis: A cross-sectional study 骨质疏松症女性生活质量相关因素建模:横断面研究
Pub Date : 2024-10-09 DOI: 10.1016/j.gloepi.2024.100169
Rahmatollah Moradzadeh , Maryam Zamanian , Maliheh Taheri

Background

Considering the important factors contributing to different health-related quality of life (HRQoL) subscales is essential for implementing preventive measures to increase the HRQoL among women with osteoporosis. We here evaluated the variables related to the mental and physical HRQoL in a sample of Iranian osteoporotic women.

Methods

In this cross-sectional study, the participants included 111 women with osteoporosis in 2013. Physical and mental of HRQoL were measured by the ECOS-16 questionnaire. Other variables included BMD t-score (Osteoporosis was diagnosed based on bone mineral density (BMD) with BMD t-score < −2.5), age, body mass index, educational level, marital status, duration of the disease, history of bone fracture in the past year, the number of pregnancies, and weekly walking hours. Final regression coefficients were obtained based on the total effects of estimations (decompositions of effects into direct, indirect and total effects) by structural equation model (SEM) analysis.

Results

The mean scores of physical and mental domains of HRQoL were 54(21) and 54(25), respectively. The mean of BMD t-score was −3.2 (0.9). Based on the regression coefficients obtained in the SEM model, weekly walking hours(2.2), number of pregnancies (−1.2), and history of bone fracture in past year(−2.9) were the more important determinants of physical aspect of HRQoL than other included variables of this study. Furthermore, age over than 60 (−9.1), history of bone fracture in past year(−4.8), weekly walking hours(2.3), marital status(−5), and education level (3.9)influenced the mental aspect of HRQoL.

Conclusions

Social and life style factors tend to impact on physical and mental domains of HRQoL, a measure that is influenced by multiple factors among postmenopausal women. In this respect, these obtained factors should be considered for health planning to improve the physical and mental domains of HRQoL among postmenopausal women.
背景考虑导致不同健康相关生活质量(HRQoL)分量表的重要因素对于实施预防措施以提高骨质疏松症妇女的 HRQoL 至关重要。我们在此对伊朗骨质疏松症妇女样本中与精神和身体 HRQoL 相关的变量进行了评估。身体和精神方面的 HRQoL 通过 ECOS-16 问卷进行测量。其他变量包括 BMD t-score(诊断骨质疏松症的依据是 BMD t-score< -2.5)、年龄、体重指数、教育程度、婚姻状况、病程、过去一年的骨折史、怀孕次数和每周步行时间。通过结构方程模型(SEM)分析,根据估计的总效应(效应分解为直接效应、间接效应和总效应)得出最终回归系数。BMD t-得分的平均值为-3.2(0.9)。根据 SEM 模型得出的回归系数,与本研究中的其他变量相比,每周步行时间(2.2)、怀孕次数(-1.2)和过去一年的骨折史(-2.9)是决定身体方面 HRQoL 的更重要因素。此外,年龄超过 60 岁(-9.1)、过去一年有骨折史(-4.8)、每周步行时间(2.3)、婚姻状况(-5)和受教育程度(3.9)也影响了 HRQoL 的心理方面。因此,在制定健康计划时应考虑这些因素,以改善绝经后妇女的身体和精神方面的 HRQoL。
{"title":"Modelling the factors associated with quality of life in women with osteoporosis: A cross-sectional study","authors":"Rahmatollah Moradzadeh ,&nbsp;Maryam Zamanian ,&nbsp;Maliheh Taheri","doi":"10.1016/j.gloepi.2024.100169","DOIUrl":"10.1016/j.gloepi.2024.100169","url":null,"abstract":"<div><h3>Background</h3><div>Considering the important factors contributing to different health-related quality of life (HRQoL) subscales is essential for implementing preventive measures to increase the HRQoL among women with osteoporosis. We here evaluated the variables related to the mental and physical HRQoL in a sample of Iranian osteoporotic women.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, the participants included 111 women with osteoporosis in 2013. Physical and mental of HRQoL were measured by the ECOS-16 questionnaire. Other variables included BMD t-score (Osteoporosis was diagnosed based on bone mineral density (BMD) with BMD t-score &lt; −2.5), age, body mass index, educational level, marital status, duration of the disease, history of bone fracture in the past year, the number of pregnancies, and weekly walking hours. Final regression coefficients were obtained based on the total effects of estimations (decompositions of effects into direct, indirect and total effects) by structural equation model (SEM) analysis.</div></div><div><h3>Results</h3><div>The mean scores of physical and mental domains of HRQoL were 54(21) and 54(25), respectively. The mean of BMD t-score was −3.2 (0.9). Based on the regression coefficients obtained in the SEM model, weekly walking hours(2.2), number of pregnancies (−1.2), and history of bone fracture in past year(−2.9) were the more important determinants of physical aspect of HRQoL than other included variables of this study. Furthermore, age over than 60 (−9.1), history of bone fracture in past year(−4.8), weekly walking hours(2.3), marital status(−5), and education level (3.9)influenced the mental aspect of HRQoL.</div></div><div><h3>Conclusions</h3><div>Social and life style factors tend to impact on physical and mental domains of HRQoL, a measure that is influenced by multiple factors among postmenopausal women. In this respect, these obtained factors should be considered for health planning to improve the physical and mental domains of HRQoL among postmenopausal women.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing AI/ML approaches and classical regression for predictive modeling using large population health databases: Applications to COVID-19 case prediction 比较使用大型人口健康数据库进行预测建模的人工智能/ML 方法和经典回归方法:应用于 COVID-19 病例预测
Pub Date : 2024-10-04 DOI: 10.1016/j.gloepi.2024.100168
Lise M. Bjerre , Cayden Peixoto , Rawan Alkurd , Robert Talarico , Rami Abielmona

Background

Research comparing artificial intelligence and machine learning (AI/ML) methods with classical statistical methods applied to large population health databases is limited.

Objectives

This retrospective cohort study aimed to compare the predictive performance of AI/ML algorithms against conventional multivariate logistic regression models using linked health administrative data.

Methods

Using Ontario's population health databases, we created a cohort of residents of the city of Ottawa, Ontario, who underwent a PCR test for COVID-19 between March 10, 2020, and May 13, 2021. Using demographic, socio-economic and health data (including COVID-19 PCR test results and available, symptom data), we developed predictive models for the purpose of COVID-19 case identification using the following approaches: classical multivariate logistic regression (LR); deep neural network (DNN); random forest (RF); and gradient boosting trees (GBT). Model performance comparisons were made using the area under the curve (AUC) swarm plot for 10-fold cross-validation.

Results

The cohort consisted of n = 351,248 Ottawa residents tested for COVID-19 during the study period. Among whom, a total of n = 883,879 unique COVID-19 tests were performed (2.6 % positive test results). Inclusion of COVID-19 symptoms data in the analysis improved model performance and variable predictive value across all tested models (p < 0.0001), with the 10-fold cross-validation AUC increasing to near or over 0.7 in all models when symptoms data were included. In various pairwise comparisons, the GBT method had the highest predictive ability (AUC = 0.796 ± 0.017), significantly outperforming multivariate logistic regression and the other AI/ML approaches.

Conclusions

Conventional multivariate regression-based models are better than some and worse than other machine learning algorithms to provide good predictive accuracy in a moderate dataset with a reasonable number of features. However, whenever possible, the AI/ML GBT approach should be considered.
背景将人工智能和机器学习(AI/ML)方法与应用于大型人口健康数据库的传统统计方法进行比较的研究十分有限。方法我们利用安大略省的人口健康数据库,建立了一个安大略省渥太华市居民队列,这些居民在 2020 年 3 月 10 日至 2021 年 5 月 13 日期间接受了 COVID-19 PCR 检测。利用人口、社会经济和健康数据(包括 COVID-19 PCR 检测结果和可用的症状数据),我们开发了用于 COVID-19 病例识别的预测模型,采用的方法包括:经典多元逻辑回归 (LR)、深度神经网络 (DNN)、随机森林 (RF) 和梯度提升树 (GBT)。使用曲线下面积(AUC)群图对模型的性能进行比较,并进行 10 倍交叉验证。结果在研究期间,接受 COVID-19 检测的渥太华居民共有 n = 351,248 人。其中,共进行了 n = 883,879 次独特的 COVID-19 检测(2.6% 的检测结果为阳性)。在所有测试模型中,将 COVID-19 症状数据纳入分析可提高模型性能和可变预测值(p < 0.0001),纳入症状数据后,所有模型的 10 倍交叉验证 AUC 均接近或超过 0.7。在各种配对比较中,GBT 方法的预测能力最高(AUC = 0.796 ± 0.017),明显优于多元逻辑回归和其他人工智能/ML 方法。结论传统的基于多元回归的模型优于某些模型,而不如其他机器学习算法,能在具有合理特征数量的中等数据集中提供良好的预测准确性。不过,在可能的情况下,应考虑采用人工智能/ML GBT 方法。
{"title":"Comparing AI/ML approaches and classical regression for predictive modeling using large population health databases: Applications to COVID-19 case prediction","authors":"Lise M. Bjerre ,&nbsp;Cayden Peixoto ,&nbsp;Rawan Alkurd ,&nbsp;Robert Talarico ,&nbsp;Rami Abielmona","doi":"10.1016/j.gloepi.2024.100168","DOIUrl":"10.1016/j.gloepi.2024.100168","url":null,"abstract":"<div><h3>Background</h3><div>Research comparing artificial intelligence and machine learning (AI/ML) methods with classical statistical methods applied to large population health databases is limited.</div></div><div><h3>Objectives</h3><div>This retrospective cohort study aimed to compare the predictive performance of AI/ML algorithms against conventional multivariate logistic regression models using linked health administrative data.</div></div><div><h3>Methods</h3><div>Using Ontario's population health databases, we created a cohort of residents of the city of Ottawa, Ontario, who underwent a PCR test for COVID-19 between March 10, 2020, and May 13, 2021. Using demographic, socio-economic and health data (including COVID-19 PCR test results and available, symptom data), we developed predictive models for the purpose of COVID-19 case identification using the following approaches: classical multivariate logistic regression (LR); deep neural network (DNN); random forest (RF); and gradient boosting trees (GBT). Model performance comparisons were made using the area under the curve (AUC) swarm plot for 10-fold cross-validation.</div></div><div><h3>Results</h3><div>The cohort consisted of <em>n</em> = 351,248 Ottawa residents tested for COVID-19 during the study period. Among whom, a total of <em>n</em> = 883,879 unique COVID-19 tests were performed (2.6 % positive test results). Inclusion of COVID-19 symptoms data in the analysis improved model performance and variable predictive value across all tested models (<em>p</em> &lt; 0.0001), with the 10-fold cross-validation AUC increasing to near or over 0.7 in all models when symptoms data were included. In various pairwise comparisons, the GBT method had the highest predictive ability (AUC = 0.796 ± 0.017), significantly outperforming multivariate logistic regression and the other AI/ML approaches.</div></div><div><h3>Conclusions</h3><div>Conventional multivariate regression-based models are better than some and worse than other machine learning algorithms to provide good predictive accuracy in a moderate dataset with a reasonable number of features. However, whenever possible, the AI/ML GBT approach should be considered.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"8 ","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Estimating effects of aging and disease progression in current and former smokers using longitudinal models 利用纵向模型估算当前吸烟者和曾经吸烟者衰老和疾病进展的影响
Pub Date : 2024-09-29 DOI: 10.1016/j.gloepi.2024.100165
Matthew Strand , Surya Bhatt , Matthew Moll , David Baraghoshi

Objectives

To separate estimates of mean change in a health outcome into components of aging and disease progression for different severity groups of chronic obstructive pulmonary disease (COPD).

Study design and methods

A longitudinal model can be used to estimate mean change in a health outcome over time. Methods to separate this change into portions due to aging and disease progression are discussed, including conditions that allow for accurate estimation. Linear mixed models were used to estimate these changes for forced expiratory volume in 1 s (FEV1) for various COPD severity and smoking groups using a large cohort (COPDGene) followed for over 10 years.

Results

Based on an analysis of 4967 subjects, age-related loss in FEV1 was found to be about 1 % per year, consistent with published work. Excess average losses (those beyond natural aging) were significant for all severity groups (except nonsmokers), including those with smoking history but normal lung function. Subjects in higher severity groups tended to have less loss in FEV1, but more relative loss, compared to baseline averages. Losses in FEV1 that included both aging and disease progression ranged from 1 to 3 % over severity groups, with current smokers generally exhibiting greater mean losses in FEV1 than former smokers.

Discussion

Effects of disease progression separate from aging can be estimated in observational studies, although care should be taken in order to make sure assumptions involving this separation are reasonable for a given study. This article demonstrates methods to estimate such effects using temporal changes in lung function for subjects in the COPDGene study.
目的将慢性阻塞性肺病(COPD)不同严重程度组的健康结果平均变化估算值分为老化和疾病进展两部分。本文讨论了将这一变化分为老化和疾病进展两部分的方法,包括进行精确估算的条件。结果基于对 4967 名受试者的分析,发现与年龄相关的 FEV1 损失约为每年 1%,与已发表的研究结果一致。在所有严重程度组别(不吸烟者除外),包括有吸烟史但肺功能正常的受试者中,超额平均损失(自然衰老之外的损失)都很显著。与基线平均值相比,严重程度较高组别受试者的 FEV1 损失较少,但相对损失较多。包括衰老和疾病进展在内的 FEV1 损失在各严重程度组中从 1% 到 3% 不等,目前吸烟者的 FEV1 平均损失通常大于曾经吸烟者。讨论在观察性研究中可以估算出疾病进展与衰老分离的影响,但应注意确保涉及这种分离的假设对于特定研究是合理的。本文展示了利用 COPDGene 研究中受试者肺功能的时间变化来估计这种影响的方法。
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引用次数: 0
Improving the integration of epidemiological data into human health risk assessment: What risk assessors told us they want 更好地将流行病学数据纳入人类健康风险评估:风险评估员告诉我们他们想要什么
Pub Date : 2024-09-28 DOI: 10.1016/j.gloepi.2024.100167
Carl V. Phillips , Igor Burstyn , David J. Miller , Ali K. Hamade , Raghavendhran Avanasi , Denali Boon , Saumitra V. Rege , Sandrine E. Déglin
One of the practical contributions of epidemiology studies is to inform risk assessment and management to protect public health. However, there is a perception among some that environmental and occupational epidemiology is falling short of satisfying the needs of risk assessors. The specific reasons for this are not clearly understood. To help identify the points of dissatisfaction and possible areas for mutual learning, we conducted a survey of risk assessors, seeking their opinions of epidemiology research. We present a few quantitative measures and a thematic analysis of responses to open-ended questions. Survey results suggest that some risk assessors (with some adamant exceptions) believe that epidemiology has great potential to contribute to risk assessment but can be deficient in many ways. For example, respondents identified the lack of full disclosure of methods, deficiencies in exposure assessment, the absence of comprehensive uncertainty analyses, and the failure to investigate or explore thresholds of effects as some of the common shortcomings. These could be straightforward to address. Respondents also brought up a wide collection of more complicated and subtle concerns that could lead to further improvement of useful results. We identify areas where mutually-educating interdisciplinary dialogue seems particularly promising. Epidemiology research is expensive, and risk management decisions even more so; therefore, it is desirable for the risk assessment and epidemiologic communities to work toward making epidemiologic research more useful for informing decisions.
流行病学研究的实际贡献之一是为风险评估和管理提供信息,以保护公众健康。然而,一些人认为环境和职业流行病学不能满足风险评估者的需求。造成这种情况的具体原因尚不清楚。为了帮助找出不满意的地方以及相互学习的可能领域,我们对风险评估人员进行了一次调查,征求他们对流行病学研究的意见。我们提供了一些定量指标,并对开放式问题的回答进行了专题分析。调查结果表明,一些风险评估员(也有一些坚决的例外)认为流行病学对风险评估有很大的贡献潜力,但在很多方面可能存在不足。例如,受访者认为,缺乏对方法的充分披露、暴露评估中的缺陷、缺乏全面的不确定性分析,以及未能调查或探索影响的阈值,是一些常见的不足之处。这些都是可以直接解决的问题。受访者还提出了许多更复杂、更微妙的问题,这些问题可以进一步改进有用的结果。我们确定了一些领域,在这些领域中,相互教育的跨学科对话似乎特别有前景。流行病学研究耗资巨大,风险管理决策更是如此;因此,风险评估界和流行病学界应努力使流行病学研究更有助于为决策提供信息。
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Global Epidemiology
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