Pub Date : 2025-02-11DOI: 10.1016/j.gloepi.2025.100187
Lawrence L. Kupper , Sandra L. Martin
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Pub Date : 2025-02-08DOI: 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。
{"title":"All are not created equal: Method descriptions in an epidemiology publication differ among media summaries – A case study comparison","authors":"Lilianne Samad, J.E. Reed","doi":"10.1016/j.gloepi.2025.100188","DOIUrl":"10.1016/j.gloepi.2025.100188","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420221","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}
Pub Date : 2025-01-22DOI: 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.
{"title":"On the current and future potential of simulations based on directed acyclic graphs","authors":"Lutz P. Breitling , Anca D. Dragomir , Chongyang Duan , George Luta","doi":"10.1016/j.gloepi.2025.100186","DOIUrl":"10.1016/j.gloepi.2025.100186","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100420","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}
Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease.
Methods
A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review.
Results
Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit.
Conclusions
This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.
目的儿童多系统炎症综合征(multi - system inflammatory syndrome of childhood, MIS-C)是新发现的与COVID-19相关的儿童疾病。目的是描述74例诊断为这种疾病的患者的临床病程。方法对约旦5家主要医院进行多中心回顾性研究。收集了确诊感染SARS-CoV-2的住院儿童或与确诊病例密切接触的儿童的数据。共有74例患者被诊断为misc。临床,实验室,放射学和治疗资料收集回顾性图表审查。结果患者出现发热、腹痛、缺氧等症状。心脏方面的发现较少,不包括冠状动脉的发现。治疗主要是皮质类固醇和IVIG。本组病例均无死亡,但发生严重疾病,部分患者被送入儿科重症监护病房。结论本研究描述了约旦misc病例的流行病学、临床过程、处理和结局。这一发现与全球其他地区的情况一致。表现的严重程度有很大的差别。腹痛多见,部分患儿被误诊为外科急腹症。
{"title":"Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, clinical characteristics: A multi-center observational study from Jordan","authors":"Marwan Shalabi , Salam Ghanem , Iyad Al-Ammouri , Amirah Daher , Enas Al-zayadneh , Alaa Alsmadi , Mais Ayyoub , Samah Abughanam , Mariam Jabr , Montaha Al-Iede","doi":"10.1016/j.gloepi.2025.100185","DOIUrl":"10.1016/j.gloepi.2025.100185","url":null,"abstract":"<div><h3>Objective</h3><div>Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease.</div></div><div><h3>Methods</h3><div>A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review.</div></div><div><h3>Results</h3><div>Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit.</div></div><div><h3>Conclusions</h3><div>This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157041","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}
Pub Date : 2025-01-09DOI: 10.1016/j.gloepi.2025.100184
Kalpana Singh , George V. Joy , Asma Al Bulushi , Albara Mohammad Ali Alomari , Kamaruddeen Mannethodi , Jibin Kunjavara , Nesiya Hassan , Zeinab Idris , Mohd Abdel Daem Mohd Yassin , Badriya Al Lenjawi
Background
Multimorbidity in adult patients puts them at a considerable risk of not taking their medications as prescribed. It is well known that patients with chronic conditions with self-management help is an excellent way to improve medication compliance. The impact of the medication self-management intervention in adult patients with multimorbidity is not well known, yet. This paper presents the protocol to assess the efficacy of a nurse-led medication self-management intervention in enhancing medication adherence and health outcomes for adult patients with multimorbidity.
Methods
The Standard Protocol Items: Guidelines for Interventional Trials 2013 statement is followed by the study protocol. This study is a two-arm, single centre, open label, randomized controlled trial. Adult patients with multimorbidity will be recruited from National Cancer Center Research, QATAR. A total of 100 participants will be randomly assigned to either standard care alone or standard care along with the medication self-management intervention. Clinical nursing specialists will deliver the intervention. Three in-person education sessions and two weekly phone conversations for follow-up are part of the 6-week intervention. Participants in the control group continue to receive all aspects of the standard care provided by healthcare professionals, including consultations regarding patients' diseases and treatments, management of chronic conditions, prescription of medications, referrals to hospital specialists, health education, and management of chronic conditions.
The 8-item mo-risky-8 Medication Adherence Scale was used to measure medication adherence as the primary outcome. Secondary outcomes include medication self-management capacity (medication knowledge, medication beliefs, and medication self-efficacy), treatment experiences (medication treatment satisfaction and treatment burden), and depressive symptoms. All outcomes will be assessed at baseline, immediately post-intervention, and at 3-month post-intervention.
Discussion
This study will offer proof of the merits of a nurse-delivered medication self-management intervention for adult patients with multimorbidity and adherence issues. If the study findings are helpful in enhancing patient adherence and health outcomes, it is anticipated that they will offer healthcare professionals evidence-based self-management support tools for routine chronic condition management.
Trial registration: The trial is registered at clinicaltrial.org (NCT05645653;9Dec2022).
{"title":"Nurse-led medication self-management intervention in the improvement of medication adherence in adult patients with multi-morbidity: A Protocol for a Feasibility Randomized controlled trial","authors":"Kalpana Singh , George V. Joy , Asma Al Bulushi , Albara Mohammad Ali Alomari , Kamaruddeen Mannethodi , Jibin Kunjavara , Nesiya Hassan , Zeinab Idris , Mohd Abdel Daem Mohd Yassin , Badriya Al Lenjawi","doi":"10.1016/j.gloepi.2025.100184","DOIUrl":"10.1016/j.gloepi.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity in adult patients puts them at a considerable risk of not taking their medications as prescribed. It is well known that patients with chronic conditions with self-management help is an excellent way to improve medication compliance. The impact of the medication self-management intervention in adult patients with multimorbidity is not well known, yet. This paper presents the protocol to assess the efficacy of a nurse-led medication self-management intervention in enhancing medication adherence and health outcomes for adult patients with multimorbidity.</div></div><div><h3>Methods</h3><div>The Standard Protocol Items: Guidelines for Interventional Trials 2013 statement is followed by the study protocol. This study is a two-arm, single centre, open label, randomized controlled trial. Adult patients with multimorbidity will be recruited from National Cancer Center Research, QATAR. A total of 100 participants will be randomly assigned to either standard care alone or standard care along with the medication self-management intervention. Clinical nursing specialists will deliver the intervention. Three in-person education sessions and two weekly phone conversations for follow-up are part of the 6-week intervention. Participants in the control group continue to receive all aspects of the standard care provided by healthcare professionals, including consultations regarding patients' diseases and treatments, management of chronic conditions, prescription of medications, referrals to hospital specialists, health education, and management of chronic conditions.</div><div>The 8-item mo-risky-8 Medication Adherence Scale was used to measure medication adherence as the primary outcome. Secondary outcomes include medication self-management capacity (medication knowledge, medication beliefs, and medication self-efficacy), treatment experiences (medication treatment satisfaction and treatment burden), and depressive symptoms. All outcomes will be assessed at baseline, immediately post-intervention, and at 3-month post-intervention.</div></div><div><h3>Discussion</h3><div>This study will offer proof of the merits of a nurse-delivered medication self-management intervention for adult patients with multimorbidity and adherence issues. If the study findings are helpful in enhancing patient adherence and health outcomes, it is anticipated that they will offer healthcare professionals evidence-based self-management support tools for routine chronic condition management.</div><div><strong>Trial registration:</strong> The trial is registered at <span><span>clinicaltrial.org</span><svg><path></path></svg></span> (<span><span>NCT05645653</span><svg><path></path></svg></span>;9Dec2022).</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081411","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}
Pub Date : 2025-01-06DOI: 10.1016/j.gloepi.2025.100183
Daniel M. Mwanga , Isaac C. Kipchirchir , George O. Muhua , Charles R. Newton , Damazo T. Kadengye
Background
Attrition is a challenge in parameter estimation in both longitudinal and multi-stage cross-sectional studies. Here, we examine utility of machine learning to predict attrition and identify associated factors in a two-stage population-based epilepsy prevalence study in Nairobi.
Methods
All individuals in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) (Korogocho and Viwandani) were screened for epilepsy in two stages. Attrition was defined as probable epilepsy cases identified at stage-I but who did not attend stage-II (neurologist assessment). Categorical variables were one-hot encoded, class imbalance was addressed using synthetic minority over-sampling technique (SMOTE) and numeric variables were scaled and centered. The dataset was split into training and testing sets (7:3 ratio), and seven machine learning models, including the ensemble Super Learner, were trained. Hyperparameters were tuned using 10-fold cross-validation, and model performance evaluated using metrics like Area under the curve (AUC), accuracy, Brier score and F1 score over 500 bootstrap samples of the test data.
Results
Random forest (AUC = 0.98, accuracy = 0.95, Brier score = 0.06, and F1 = 0.94), extreme gradient boost (XGB) (AUC = 0.96, accuracy = 0.91, Brier score = 0.08, F1 = 0.90) and support vector machine (SVM) (AUC = 0.93, accuracy = 0.93, Brier score = 0.07, F1 = 0.92) were the best performing models (base learners). Ensemble Super Learner had similarly high performance. Important predictors of attrition included proximity to industrial areas, male gender, employment, education, smaller households, and a history of complex partial seizures.
Conclusion
These findings can aid researchers plan targeted mobilization for scheduled clinical appointments to improve follow-up rates. These findings will inform development of a web-based algorithm to predict attrition risk and aid in targeted follow-up efforts in similar studies.
{"title":"Modeling the determinants of attrition in a two-stage epilepsy prevalence survey in Nairobi using machine learning","authors":"Daniel M. Mwanga , Isaac C. Kipchirchir , George O. Muhua , Charles R. Newton , Damazo T. Kadengye","doi":"10.1016/j.gloepi.2025.100183","DOIUrl":"10.1016/j.gloepi.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>Attrition is a challenge in parameter estimation in both longitudinal and multi-stage cross-sectional studies. Here, we examine utility of machine learning to predict attrition and identify associated factors in a two-stage population-based epilepsy prevalence study in Nairobi.</div></div><div><h3>Methods</h3><div>All individuals in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) (Korogocho and Viwandani) were screened for epilepsy in two stages. Attrition was defined as probable epilepsy cases identified at stage-I but who did not attend stage-II (neurologist assessment). Categorical variables were one-hot encoded, class imbalance was addressed using synthetic minority over-sampling technique (SMOTE) and numeric variables were scaled and centered. The dataset was split into training and testing sets (7:3 ratio), and seven machine learning models, including the ensemble Super Learner, were trained. Hyperparameters were tuned using 10-fold cross-validation, and model performance evaluated using metrics like Area under the curve (AUC), accuracy, Brier score and F1 score over 500 bootstrap samples of the test data.</div></div><div><h3>Results</h3><div>Random forest (AUC = 0.98, accuracy = 0.95, Brier score = 0.06, and F1 = 0.94), extreme gradient boost (XGB) (AUC = 0.96, accuracy = 0.91, Brier score = 0.08, F1 = 0.90) and support vector machine (SVM) (AUC = 0.93, accuracy = 0.93, Brier score = 0.07, F1 = 0.92) were the best performing models (base learners). Ensemble Super Learner had similarly high performance. Important predictors of attrition included proximity to industrial areas, male gender, employment, education, smaller households, and a history of complex partial seizures.</div></div><div><h3>Conclusion</h3><div>These findings can aid researchers plan targeted mobilization for scheduled clinical appointments to improve follow-up rates. These findings will inform development of a web-based algorithm to predict attrition risk and aid in targeted follow-up efforts in similar studies.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100421","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}