Global Epidemiology最新文献_第6页

Prevalence and characteristics of tobacco use among adults in Kazakhstan: A cross-sectional National Survey 哈萨克斯坦成年人烟草使用的流行率和特征：一项横断面全国调查

Global Epidemiology

Pub Date : 2025-03-06 DOI: 10.1016/j.gloepi.2025.100194

Anel Ibrayeva , Marat Shoranov , Rassulbek Aipov , Adil Katarbayev , Shynar Tanabayeva , Ildar Fakhradiyev

Background

Smoking remains a major public health concern worldwide, contributing significantly to morbidity and mortality. Despite the implementation of tobacco control measures, smoking prevalence in Kazakhstan remains high. This study aims to assess the prevalence, demographic characteristics, and regional variations in smoking habits among adults in Kazakhstan.

Methods

A cross-sectional national survey was conducted from October 2021 to May 2022, covering all 17 regions of Kazakhstan. A total of 6720 adults aged 18–69 years participated, selected using a weighted multistage cluster sampling method. Data were collected through structured interviews based on the WHO STEPwise approach. Smoking status, tobacco consumption patterns, and smoking cessation attempts were analyzed. The results were reported as means with 95 % confidence intervals (CI).

Findings

The overall smoking prevalence was 19.1 %. Smoking was significantly more common among men (30.3 %) than women (7.9 %). The highest smoking prevalence was observed in the 30–44 age group (44.2 %) and among private-sector employees (53.2 %). Regional differences were notable, with the lowest smoking prevalence in Atyrau (9.2 %) and the highest in Pavlodar (30.4 %). Among current smokers, 89.1 % smoked daily, with an average of 11.8 cigarettes per day (95 % CI: 11.4–12.2). Only 36.7 % of smokers who visited healthcare professionals in the past year received advice to quit. Additionally, 42.8 % attempted to quit smoking in the past 12 months. Passive smoking exposure was common, with 26.8 % of women and 22.3 % of men exposed at home, and 30.2 % of men and 14.4 % of women exposed at work. The prevalence of smokeless tobacco use was low (1 %).

Interpretation

Smoking remains prevalent among adults in Kazakhstan, with significant differences by gender, age, occupation, and region. The high prevalence of daily smoking and the low frequency of smoking cessation advice from healthcare professionals indicate the need for stronger tobacco control policies, targeted public health campaigns, and enhanced smoking cessation support programs. These findings provide a basis for future research and policy-making efforts aimed at reducing tobacco consumption and its associated health risks.

吸烟仍然是世界范围内一个主要的公共卫生问题，在很大程度上导致发病率和死亡率。尽管实施了烟草控制措施，哈萨克斯坦的吸烟率仍然很高。本研究旨在评估哈萨克斯坦成年人吸烟习惯的患病率、人口统计学特征和区域差异。方法于2021年10月至2022年5月对哈萨克斯坦所有17个地区进行全国性横断面调查。采用加权多阶段整群抽样的方法，对6720名18-69岁的成年人进行了调查。数据是根据世卫组织STEPwise方法通过结构化访谈收集的。分析吸烟状况、烟草消费模式和戒烟尝试。结果以95%置信区间（CI）的平均值报告。总体吸烟率为19.1%。吸烟在男性中的比例（30.3%）明显高于女性（7.9%）。吸烟率最高的是30-44岁年龄组（44.2%）和私营部门雇员（53.2%）。地区差异显著，吸烟率最低的是阿特劳（9.2%），最高的是巴甫洛达尔（30.4%）。在目前的吸烟者中，89.1%每天吸烟，平均每天11.8支烟（95% CI: 11.4-12.2）。在过去的一年中，只有36.7%的吸烟者去看过医疗保健专业人员，他们得到了戒烟的建议。此外，42.8%的人在过去12个月内曾尝试戒烟。被动吸烟暴露很常见，26.8%的女性和22.3%的男性在家中暴露，30.2%的男性和14.4%的女性在工作中暴露。无烟烟草使用的流行率很低（1%）。吸烟在哈萨克斯坦成年人中仍然很普遍，在性别、年龄、职业和地区之间存在显著差异。日常吸烟的高流行率和来自卫生保健专业人员的戒烟建议的低频率表明需要加强烟草控制政策，有针对性的公共卫生运动和加强戒烟支持计划。这些发现为今后旨在减少烟草消费及其相关健康风险的研究和决策工作提供了基础。

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引用次数: 0

An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots 母乳喂养障碍和促进因素综述：分析全球研究趋势和热点

Global Epidemiology

Pub Date : 2025-03-06 DOI: 10.1016/j.gloepi.2025.100192

Agustín Ramiro Miranda , Paula Eugenia Barral , Ana Veronica Scotta , Mariela Valentina Cortez , Elio Andrés Soria

Breastfeeding is the most cost-effective intervention for reducing infant morbidity and mortality, offering benefits for infants and mothers. Despite extensive promotion, global adherence remains below 50 %, resulting in significant clinical, economic, and environmental impacts. Thus, this overview of reviews aims to synthesize barriers and facilitators of breastfeeding, analyze research trends, and identify gaps to guide future research. A comprehensive literature search was conducted, including systematic reviews that examine these factors. The search covered seven electronic data repositories. The methodological quality was assessed using the Risk of Bias in Systematic Reviews tool. Bibliometric analysis focused on identifying top journals, authors, and countries, assessing their impact, and exploring trends over time. Findings were classified and analyzed thematically through line-by-line coding, theme description, and analytical formulation. A total of 123 reviews were included, mostly of high quality and published in top journals. Key trends comprised a growing focus on psychosocial and cultural factors, increased representation from low- and middle-income countries, and improved methodological rigor. However, geographical representation remains biased towards high-income countries, and some breastfeeding outcomes need further exploration. Thematic analysis revealed four categories: Therapeutic and care interventions; Support networks and education; Maternal-infant health issues; and Societal and environmental context. In conclusion, this overview of reviews identifies barriers and facilitators of breastfeeding and emphasizes the need for more inclusive research and tailored support. Addressing gaps in evidence for enhancing healthcare systems and policies can improve breastfeeding practices and outcomes worldwide.

母乳喂养是降低婴儿发病率和死亡率的最具成本效益的干预措施，对婴儿和母亲都有好处。尽管进行了广泛推广，但全球依从性仍低于50%，造成了重大的临床、经济和环境影响。因此，本综述旨在综合母乳喂养的障碍和促进因素，分析研究趋势，并确定差距，以指导未来的研究。进行了全面的文献检索，包括检查这些因素的系统综述。搜索范围包括七个电子数据库。使用系统评价中的偏倚风险工具评估方法学质量。文献计量分析侧重于识别顶级期刊、作者和国家，评估其影响，并探索随时间变化的趋势。通过逐行编码、主题描述和分析公式，对研究结果进行分类和分析。共有123篇综述被纳入，其中大部分是高质量的，发表在顶级期刊上。主要趋势包括越来越重视社会心理和文化因素，增加来自低收入和中等收入国家的代表性，以及改进方法的严谨性。然而，地域代表性仍然偏向于高收入国家，一些母乳喂养结果需要进一步探索。专题分析揭示了四个类别：治疗和护理干预；支持网络和教育；母婴保健问题；以及社会和环境背景。总之，本综述确定了母乳喂养的障碍和促进因素，并强调需要开展更具包容性的研究和量身定制的支持。解决加强卫生保健系统和政策的证据差距可以改善全世界的母乳喂养做法和结果。

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引用次数: 0

Reproductive health services utilization and associated factors among university youth students in Ethiopia: A mixed-methods study 埃塞俄比亚大学生生殖健康服务利用及其相关因素：一项混合方法研究

Global Epidemiology

Pub Date : 2025-03-06 DOI: 10.1016/j.gloepi.2025.100195

Tsiyon Birhanu Wube , Solomon Gebremichael Asgedom , Dawit Gebregziabher Abrha , Lielt Gebreselassie Gebrekirstos

Background

Reproductive health services utilization among youth university students is essential for their sexual and reproductive well-being. Despite growing awareness, students often face barriers—cultural, social, and economic—that limit their access to these services. Understanding service utilization patterns and associated factors is crucial for addressing unmet needs, such as limited access to family planning, maternal care, and sexual health services, as well as the lack of resources and awareness, which affect the quality of care and access to services. The study investigated the utilization of the services among youth university students, aiming to provide insights for targeted interventions and enhanced service delivery.

Methods

We conducted an institutional-based cross-sectional study with 768 youth university students, using a mixed-methods approach. Participants were selected via a multistage sampling technique. Data were collected through a self-administered questionnaire, supplemented by key informant interviews and in-depth interviews. Quantitative analysis was performed using SPSS version 25, and qualitative data were transcribed and analyzed narratively through content analysis. Logistic regression was employed to identify associations with service utilization.

Results

The study found that the prevalence of adequate reproductive health service utilization rate was 42.5 % (95 % CI: 38.81 % - 46.20 %), which is comparable to similar studies conducted in other low- and middle-income countries. Key factors included open discussions about reproductive health (AOR = 4.1, 95 % CI: 2.14–7.16), positive attitudes towards services (AOR = 6.03, 95 % CI: 3.72–9.75), and perceived HIV risk (AOR = 4.32, 95 % CI: 2.39–7.77).

Conclusion

Utilization of reproductive health services is relatively low, with only 42.5 % reporting usage. Key factors influencing utilization include open discussions, positive attitudes towards services, and perceived HIV risk. Addressing barriers through inclusive, youth-friendly interventions such as peer education programs could significantly improve outcomes.

青年大学生利用生殖健康服务对其性健康和生殖健康至关重要。尽管越来越多的人意识到这一点，但学生们经常面临文化、社会和经济方面的障碍，这些障碍限制了他们获得这些服务。了解服务利用模式和相关因素对于解决未满足的需求至关重要，例如获得计划生育、孕产妇保健和性健康服务的机会有限，以及缺乏资源和认识，这些都影响到护理质量和获得服务的机会。本研究调查了大学生服务的使用情况，旨在为有针对性的干预和加强服务提供提供见解。方法采用混合方法对768名青年大学生进行了基于机构的横断面研究。参与者通过多阶段抽样技术选择。数据通过自我管理的问卷收集，辅以关键信息提供者访谈和深度访谈。定量分析采用SPSS version 25进行，定性数据通过内容分析进行转录和叙述性分析。采用逻辑回归来确定与服务利用率的关联。结果研究发现，生殖健康服务使用率为42.5% (95% CI: 38.81% - 46.20%)，与其他中低收入国家进行的类似研究相当。关键因素包括对生殖健康的公开讨论（AOR = 4.1, 95% CI: 2.14-7.16）、对服务的积极态度（AOR = 6.03, 95% CI: 3.72-9.75）和感知到的艾滋病毒风险（AOR = 4.32, 95% CI: 2.39-7.77）。结论我国生殖健康服务使用率较低，使用率仅为42.5%。影响利用的关键因素包括公开讨论、对服务的积极态度和认识到的艾滋病毒风险。通过同伴教育项目等包容的、对青年友好的干预措施来解决障碍，可以显著改善结果。

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引用次数: 0

Time-varying confounders in association between general and central obesity and coronary heart disease: Longitudinal targeted maximum likelihood estimation on atherosclerosis risk in communities study 全身性和中枢性肥胖与冠心病之间的时变混杂因素：社区研究中动脉粥样硬化风险的纵向目标最大似然估计

Global Epidemiology

Pub Date : 2025-03-06 DOI: 10.1016/j.gloepi.2025.100193

Hossein Mozafar Saadati PhD , Niloufar Taherpour MSc , Seyed Saeed Hashemi Nazari MD, MPH, PhD

Aim

This study examines the association between general and central obesity and the risk of cardiovascular diseases, utilizing the Targeted Maximum Likelihood Estimator (TMLE) method to account for time-varying covariates and also we compares the findings with those derived from conventional regression methods in the Atherosclerosis Risk in Communities (ARIC) cohort study.

Methods

We considered 15,792 participants 45–75 years of age registered in the Atherosclerosis Risk in Communities study, visit 1 and followed to visit 4. General obesity defined as body mass index and central obesity defined as Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Body Shape Index (BSI) and Body Roundness Index (BRI). The effect of obesity on Coronary Heart Disease (CHD) was estimated and compared by Longitudinal Targeted Maximum Likelihood Estimation (LTMLE) and generalized linear model.

Results

The effects of BMI, adjusted for baseline and time-varying confounders, was 1.15 (95 %CI =1.00, 1.34). About the gender groups, the effect of BMI for males and females was 1.17 (95 %CI =0.97,1.40) and 1.19 (95 %CI =0.94,1.52), respectively. Considering age groups, the effect of BMI was 1.21 (95 %CI =0.95, 1.53) and 1.13 (95 %CI = 0.93, 1.36) for age ≤ 54 years and age > 54 years, respectively. With regards to central obesity, the BSI and WC were shown the strongest effects, respectively. Among females and age group≤54 years, WHtR was associated with a higher incidence of CHD.

Conclusions

According to the results, the appropriate index for obesity varies based on gender and age. Knowledge about this difference will help to experts to implement appropriate interventions.

目的：本研究利用目标最大似然估计（Targeted Maximum Likelihood Estimator， TMLE）方法来解释时变协变量，并将结果与社区动脉粥样硬化风险（ARIC）队列研究中传统回归方法得出的结果进行比较，探讨了一般肥胖和中心性肥胖与心血管疾病风险之间的关系。方法：我们纳入了15792名年龄在45-75岁之间的社区动脉粥样硬化风险研究的参与者，随访随访至随访4。一般肥胖定义为体重指数，中心性肥胖定义为腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、体型指数（BSI）和身体圆度指数（BRI）。采用纵向目标最大似然估计（LTMLE）和广义线性模型估计和比较肥胖对冠心病（CHD）的影响。结果经基线和时变混杂因素调整后，BMI的影响为1.15 （95% CI =1.00, 1.34）。在性别分组中，BMI对男性和女性的影响分别为1.17 （95% CI =0.97,1.40）和1.19 （95% CI =0.94,1.52）。从年龄组来看，BMI对年龄≤54岁和年龄>的影响分别为1.21 （95% CI =0.95, 1.53）和1.13 (95% CI = 0.93, 1.36)；分别是54年。对于中心性肥胖，体重指数和腰围分别表现出最强的影响。在女性和年龄≤54岁的人群中，WHtR与较高的冠心病发病率相关。结论根据研究结果，肥胖的适宜指标因性别和年龄而异。了解这种差异将有助于专家实施适当的干预措施。

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引用次数: 0

Epidemiology of adult asthma within the Hungarian population between 2009 and 2019 – A retrospective financial database analysis 2009年至2019年匈牙利人群中成人哮喘的流行病学-回顾性财务数据库分析

Global Epidemiology

Pub Date : 2025-03-06 DOI: 10.1016/j.gloepi.2025.100191

B. Sánta , A. Keglevich , T. Kovács , B. Engi , A. Südi , E. Noémi , L. Tamási

Background

Asthma is the most common chronic obstructive respiratory disease and is a considerable burden on the patients, caregivers and healthcare providers. However, data on epidemiology, healthcare expenditures, inhalation medication usage and comorbidities are scarce on a country-wide level.

Methods

A retrospective analysis was performed on the Hungarian National Health Insurance Fund's financial database. All patients who had filled at least one prescription for asthma maintenance therapy between 2009-’19 had been enrolled. Prevalence for each year was assessed, based on prescriptions filled for asthma annually. Incidence was assessed only for 2011–’19. Frequency of exacerbations and their costs were calculated.

Results

Through the study period 439,977 patients filled at least one prescription for asthma maintenance therapy. The number of patients having at least one prescription in 12 months increased by 20.34 % (from 132,292 to 159,225 patients). Between 2011–’19 an average of 20,742.1 new patients used asthma maintenance medications. Between 2009 and ‘19 an average of 4308 patients were hospitalized due to asthma, on an average 5129 times. Healthcare expenditure on hospitalizations and outpatient treatment of asthmatics increased by 28.05 %.

Conclusion

Through our study period a substantial increase in patient numbers and overall expenditure was seen. Number and frequency of exacerbations however decreased over the years.

背景：哮喘是最常见的慢性阻塞性呼吸系统疾病，对患者、护理人员和医疗保健提供者来说是一个相当大的负担。然而，在全国范围内，关于流行病学、医疗支出、吸入性药物使用和合并症的数据很少。方法对匈牙利国家健康保险基金财务数据库进行回顾性分析。所有在2009年至2019年期间至少服用过一种哮喘维持治疗处方的患者都被纳入研究。根据每年开具的哮喘处方，评估了每年的患病率。发病率仅评估了2011 - 19年。计算恶化频率及其成本。结果在整个研究期间，439,977名患者至少服用了一种哮喘维持治疗处方。在12个月内至少有一个处方的患者数量增加了20.34%（从132,292例增加到159,225例）。2011年至2019年间，平均有20,742.1名新患者使用哮喘维持药物。2009年至1919年间，平均4308名患者因哮喘住院，平均5129次。用于哮喘患者住院和门诊治疗的医疗保健支出增加了28.05%。结论在我们的研究期间，患者人数和总费用均有显著增加。然而，病情恶化的次数和频率逐年下降。

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引用次数: 0

Generalized anxiety disorder and associated factors among Sudanese adolescents during the Sudan Army conflict: A cross sectional study 苏丹军队冲突期间苏丹青少年的广泛性焦虑障碍及其相关因素：一项横断面研究

Global Epidemiology

Pub Date : 2025-02-16 DOI: 10.1016/j.gloepi.2025.100190

Mohammed Haydar Awad , Maram Elmutasim , Maeen Mohieldin Mohamed , Lina Hemmeda

Background

Anxiety is the state of being worried and uneasy about anything that happens either now or in the future. It is unclear what exactly causes generalized anxiety disorder (GAD). According to some research, a variety of variables, including heredity, differences in brain chemistry, and environmental influences, could be involved. After the Sudanese army battle began in 2023, the purpose of this study was to determine the prevalence of generalized anxiety disorder among Sudanese teenagers.

Methods

A cross-sectional, community-based study was carried out among all Sudanese adolescents between 13 and 18 years old who were living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Generalized Anxiety Disorder-7 checklist for the assessment of GAD symptoms. The questionnaire was translated into Arabic by expert translators, and its validity and reliability were confirmed. Data were analyzed and presented in the form of descriptive and inferential statistics.

Results

Among the 855 participants, the mean age was 16.5 years, 66.8 % were female, and 50.8 % had generalized anxiety disorder. There was a significant positive relationship between GAD and age, sex, current residency, and traumatic events exposure. With participants aged 17–18 years old having 82 % higher odds of experiencing GAD in comparison with the reference age group (OR = 1.8 (95 % CI [1.2, 2.7])). Furthermore, females were found to have 92 % higher odds for GAD as compared with men (OR = 1.9 (95 % CI [1.4, 2.6])). Whereas internally displaced participants showed 205 % higher odds of GAD in comparison to those who had not been in a war zone (OR = 3.1 (95 % CI [2.11, 4.4])). In addition, experiencing a traumatic event during the war increases the odds of having GAD by 126 % in comparison to those who did not experience it (OR = 2.3 (95 % CI [1.7, 3.1])).

Conclusion

GAD was highly prevalent among the Sudanese adolescents included in the present study. The findings will help the government to provide proper mental health interventions for affected people.

焦虑是对现在或未来发生的任何事情感到担心和不安的状态。目前还不清楚究竟是什么导致了广泛性焦虑症（GAD）。根据一些研究，包括遗传、脑化学差异和环境影响在内的各种变量都可能涉及其中。在苏丹军队于2023年开始战斗后，本研究的目的是确定苏丹青少年中广泛性焦虑症的患病率。方法对冲突开始时居住在苏丹的所有13至18岁的苏丹青少年进行了一项以社区为基础的横断面研究，在父母（如有必要）的指导下使用自填问卷。问卷改编自广泛性焦虑障碍-7检查表，用于评估广泛性焦虑症的症状。通过专家翻译将问卷翻译成阿拉伯文，验证问卷的效度和信度。数据以描述性和推理统计的形式进行分析和呈现。结果855名参与者的平均年龄为16.5岁，66.8%为女性，50.8%患有广泛性焦虑症。GAD与年龄、性别、当前居住地和创伤性事件暴露之间存在显著的正相关。与参考年龄组相比，17-18岁的参与者患广泛性焦虑症的几率高出82% （OR = 1.8 (95% CI[1.2, 2.7])）。此外，女性患广泛性焦虑症的几率比男性高92% （OR = 1.9 (95% CI[1.4, 2.6])）。然而，国内流离失所的参与者与没有在战区的参与者相比，GAD的几率高出205% （OR = 3.1 (95% CI[2.11, 4.4])）。此外，与没有经历创伤性事件的人相比，在战争期间经历创伤性事件的人患广泛性焦虑症的几率增加了126% （OR = 2.3 (95% CI[1.7, 3.1])）。结论ad在本研究的苏丹青少年中非常普遍。研究结果将有助于政府为受影响的人提供适当的心理健康干预。

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引用次数: 0

Trends, prevalence, and determinants of unfavorable tuberculosis treatment outcomes among adult patients in Northeast Ethiopia: The race to achieve a 90 % treatment success rate by 2025 埃塞俄比亚东北部成年患者结核病治疗结果不利的趋势、流行率和决定因素：到2025年实现90%治疗成功率的竞赛

Global Epidemiology

Pub Date : 2025-02-15 DOI: 10.1016/j.gloepi.2025.100189

Tegene Atamenta Kitaw , Amsalu Baylie , Addisu Getie , Ribka Nigatu Haile

Background

Tuberculosis (TB) continues to be a significant public health issue, especially in developing nations like Ethiopia. The country aims to reach a 90 % treatment success rate for TB by 2025. However, there is a considerable lack of recent data on treatment outcomes in the region. Current data on treatment outcomes and their determinants are crucial for guiding early interventions and aligning efforts with national goals and the End TB Strategy. Understanding the current state of TB treatment outcomes and influencing factors is vital for implementing effective interventions and measuring progress toward the target.

Methods

A four-year retrospective study (2019–2022) was conducted. From 323 patient files, 312 were eligible to be included in the final analysis, resulting in a response rate of 96.6 %. Data collection utilized a structured checklist, and analysis was performed with STATA version 18. The Mann-Kendall trend test was used to detect trends in TB incidence. Multicollinearity was checked using variance inflation factors (VIFs). A logistic regression model identified determinants of treatment outcomes.

Results

The study revealed that 84.94 % of participants achieved favorable treatment outcomes, while 15.06 % had unfavorable outcomes. A decreasing trend in unfavorable outcomes was noted, from 18.84 % in 2019 to 10.71 % in 2022 (Kendall's tau (τ) = −0.0686). Determinants of unfavorable outcomes included older age (AOR: 3.59, 95 % CI: 1.23–10.56), HIV positivity (AOR: 5.43, 95 % CI: 1.65–10.83), and smear-negative pulmonary TB (AOR: 3.82, 95 % CI: 1.39–10.45).

Conclusion

The overall treatment success rate of 84.94 % is below the global target of >90 % for 2025. Tailored treatment strategies for older patients and those co-infected with HIV are recommended. Additionally, improving TB diagnostic capabilities is essential for early intervention and achieving better outcomes.

结核病（TB）仍然是一个重大的公共卫生问题，特别是在埃塞俄比亚等发展中国家。该国的目标是到2025年达到90%的结核病治疗成功率。然而，关于该地区治疗结果的近期数据相当缺乏。目前关于治疗结果及其决定因素的数据对于指导早期干预和使努力与国家目标和终止结核病战略保持一致至关重要。了解结核病治疗结果的现状和影响因素对于实施有效干预措施和衡量实现这一目标的进展至关重要。方法采用4年回顾性研究（2019-2022年）。从323例患者档案中，312例符合纳入最终分析的条件，有效率为96.6%。数据收集使用结构化检查表，并使用STATA版本18进行分析。使用Mann-Kendall趋势检验来检测结核病发病率的趋势。使用方差膨胀因子（VIFs）检查多重共线性。逻辑回归模型确定了治疗结果的决定因素。结果84.94%的参与者获得了良好的治疗结果，15.06%的参与者获得了不良的治疗结果。不利结果呈下降趋势，从2019年的18.84%降至2022年的10.71% （Kendall τ (τ) = - 0.0686）。不良结局的决定因素包括年龄较大（AOR: 3.59, 95% CI: 1.23-10.56）、HIV阳性（AOR: 5.43, 95% CI: 1.65-10.83）和涂片阴性肺结核（AOR: 3.82, 95% CI: 1.39-10.45）。结论总治疗成功率为84.94%，低于2025年90%的全球目标。建议为老年患者和合并感染艾滋病毒的患者提供量身定制的治疗策略。此外，提高结核病诊断能力对于早期干预和取得更好的结果至关重要。

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引用次数: 0

Commentary on the commentary “On measurement error, PSA doubling time, and prostate cancer” 《关于测量误差、PSA倍增时间与前列腺癌》一文评注

Global Epidemiology

Pub Date : 2025-02-11 DOI: 10.1016/j.gloepi.2025.100187

Lawrence L. Kupper , Sandra L. Martin

引用次数: 0

All are not created equal: Method descriptions in an epidemiology publication differ among media summaries – A case study comparison 并非人人平等：流行病学出版物中的方法描述在媒体摘要中有所不同-案例研究比较

Global Epidemiology

Pub Date : 2025-02-08 DOI: 10.1016/j.gloepi.2025.100188

Lilianne Samad, J.E. Reed

It is common to see mass media headlines about health-related topics in traditional and online news outlets, as well as on social media platforms. What a consumer might not realize is that often these headlines are a distillation of results reported in epidemiologic publications. Journalists make decisions about what information to include and exclude, hopefully without compromising the main conclusions. In this exercise, sixty-three media articles that summarized one peer-reviewed journal publication (Zhang et al., 2021) describing results from a cohort study on coffee and tea consumption and risk of stroke and dementia were compared to determine the consistency of details among them. The most heterogeneity was observed in whether articles compared results with other literature. There was some variation in inclusion of a measure of frequency within the study population, and in details describing measurement of exposure. However, most of the articles were consistent in either including or excluding other methodological details in the main text. The results of the present comparison have implications for readers, researchers, and journalists. Readers must know that media summaries of peer reviewed studies are just that – summaries. It is likely that some information from the original source is not represented by the article, and that additional information might be necessary to craft an informed opinion on a given topic.

在传统和在线新闻媒体以及社交媒体平台上，经常看到有关健康主题的大众媒体头条。消费者可能没有意识到的是，这些标题通常是流行病学出版物报道的结果的精华。记者们会在不影响主要结论的前提下，决定哪些信息应该包括，哪些信息应该排除。在这个练习中，63篇媒体文章总结了一篇同行评议的期刊出版物（Zhang et al., 2021），描述了一项关于咖啡和茶消费与中风和痴呆风险的队列研究的结果，并进行了比较，以确定其中细节的一致性。在文章是否与其他文献比较结果时，观察到最大的异质性。在纳入研究人群的频率测量和描述暴露测量的细节方面存在一些差异。但是，大多数条款在包括或排除正文中的其他方法细节方面是一致的。目前比较的结果对读者、研究人员和记者都有启示意义。读者必须知道，媒体对同行评议研究的总结只是总结而已。很可能来自原始来源的一些信息没有在文章中表现出来，并且可能需要额外的信息来形成对给定主题的知情意见。

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引用次数: 0

On the current and future potential of simulations based on directed acyclic graphs 基于有向无环图的模拟的当前和未来潜力

Global Epidemiology

Pub Date : 2025-01-22 DOI: 10.1016/j.gloepi.2025.100186

Lutz P. Breitling , Anca D. Dragomir , Chongyang Duan , George Luta

Real-world data are playing an increasingly important role in regulatory decision making. Adequately addressing bias is of paramount importance in this context. Structural representations of bias using directed acyclic graphs (DAGs) provide a unified approach to conceptualize bias, distinguish between different types of bias, and identify ways to address bias. DAG-based data simulation further enhances the scope of this approach. Recently, DAGs have been used to demonstrate how missing eligibility information can compromise emulated target trial analysis, a cutting edge approach to estimate treatment effects using real-world data. The importance of simulation for methodological research has received substantial recognition in the past few years, and others have argued that simulating data based on DAGs can be especially helpful for understanding various epidemiological concepts. In the present work, we present two concrete examples of how simulations based on DAGs can be used to gain insights into issues commonly encountered in real-world analytics, i.e., regression modelling to address confounding bias, and the potential extent of selection bias. Increasing accessibility and extending the simulation algorithms of existing software to include longitudinal and time-to-event data are identified as priorities for further development. With such extensions, simulations based on DAGs would be an even more powerful tool to advance our understanding of the rapidly growing toolbox of real-world analytics.

现实世界的数据在监管决策中发挥着越来越重要的作用。在这种情况下，充分解决偏见是至关重要的。使用有向无环图（dag）的偏差结构表示提供了一种统一的方法来概念化偏差，区分不同类型的偏差，并确定解决偏差的方法。基于dag的数据模拟进一步增强了这种方法的范围。最近，dag被用来证明缺失的资格信息如何影响模拟靶试验分析，这是一种利用真实世界数据估计治疗效果的前沿方法。在过去几年中，模拟对方法学研究的重要性已经得到了广泛的认可，其他人认为基于dag的模拟数据对理解各种流行病学概念特别有帮助。在目前的工作中，我们提出了两个具体的例子，说明如何使用基于dag的模拟来深入了解现实世界分析中常见的问题，即回归建模来解决混淆偏差，以及选择偏差的潜在程度。增加可访问性和扩展现有软件的模拟算法以包括纵向和事件时间数据被确定为进一步开发的优先事项。有了这样的扩展，基于dag的模拟将成为一个更强大的工具，促进我们对快速增长的现实世界分析工具箱的理解。

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引用次数: 0