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Residential mobility during pregnancy and birth outcomes in the United States: The environmental influences on Child Health Outcomes (ECHO) Cohort (2010-2019). 美国怀孕期间的居住流动性和分娩结果:环境对儿童健康结果(ECHO)队列的影响(2010-2019)。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-17 DOI: 10.1016/j.annepidem.2026.01.008
Angela D'Adamo, Amii M Kress, Rima Habre, Nissa Towe-Goodman, Michael R Desjardins, Akram Alshawabkeh, Izzuddin M Aris, Carlos A Camargo, Kecia N Carroll, Andrea E Cassidy-Bushrow, Su H Chu, Yolaine Civil, Alexandrea L Craft, Lisa A Croen, Sean Deoni, Viren Dsa, Anne L Dunlop, Amy J Elliott, Assiamira Ferrara, Jody M Ganiban, Akhgar Ghassabian, Tina Hartert, Delma-Jean Watts, Margaret R Karagas, Catherine J Karr, Daphne Koinis-Mitchell, Michael Kramer, Cindy T McEvoy, Hooman Mirzakhani, Thomas G O'Connor, Wei Perng, Rebecca J Schmidt, Uzma Shah, Irene Tung, Rosalind J Wright, Emily A Knapp

Purpose: To examine factors associated with moving during pregnancy and impacts of assigning nSES at enrollment, delivery, or a time-weighted average on birth outcomes (birthweight, birthweight-for-gestational-age z-score, low birthweight, gestational age, small-for-gestational age, preterm birth).

Methods: We used data from the Environmental influences on Child Health Outcomes (ECHO) Cohort Study (2010-2019) with nSES data from the American Community Survey (ACS) matched by time and location to monthly residential histories. We used multivariable logistic models with Generalized Estimating Equations to identify factors associated with moving and quantify exposure misclassification in model estimates.

Results: Approximately 7 % of 15,376 participants moved at least once during pregnancy. Maternal age (OR: 0.97, 95 % CI: 0.95, 0.98) and other race vs. White (OR: 0.39, 95 % CI: 0.20, 0.80) were associated with lower odds of moving; lower neighborhood-level education (OR: 1.34, 95 % CI: 1.11, 1.62) and living in urban neighborhoods (OR: 3.03, 95 % CI: 1.39, 6.59) were associated with higher odds. Among movers, estimates between nSES and birth outcomes changed ≥ 16 % by address assignment; birthweight-for-gestational-age z-score was significant only when using nSES at delivery.

Conclusion: Sociodemographic and nSES characteristics are associated with moving during pregnancy; movers may experience exposure misclassification and underestimated effects on birth outcomes.

目的:研究与怀孕期间运动相关的因素,以及在入组、分娩或时间加权平均时分配nSES对出生结局(出生体重、出生体重/胎龄z得分、低出生体重、胎龄、小胎龄、早产)的影响。方法:我们使用来自2010-2019年环境对儿童健康结局(ECHO)队列研究的数据,以及来自美国社区调查(ACS)的nSES数据,这些数据按时间和地点与每月居住历史相匹配。我们使用具有广义估计方程的多变量逻辑模型来识别与移动相关的因素,并量化模型估计中的暴露误分类。结果:15,376名参与者中约有7%在怀孕期间至少搬家一次。母亲年龄(OR: 0.97, 95% CI: 0.95, 0.98)和其他种族(OR: 0.39, 95% CI: 0.20, 0.80)与较低的搬家几率相关;较低的社区教育水平(OR: 1.34, 95% CI: 1.11, 1.62)和居住在城市社区(OR: 3.03, 95% CI: 1.39, 6.59)与较高的几率相关。在迁居者中,nSES与出生结局之间的估计值因住址分配而变化≥16%;只有在分娩时使用nSES时,出生体重/胎龄z-score才有显著性。结论:社会人口学和nSES特征与妊娠期运动有关;搬运工可能会经历暴露错误分类和低估对出生结果的影响。
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引用次数: 0
Towards reliable feature interpretation in machine learning-based longevity prediction. 基于机器学习的寿命预测中可靠的特征解释。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-15 DOI: 10.1016/j.annepidem.2026.01.005
Souichi Oka, Yoshiki Takahashi, Yoshiyasu Takefuji
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引用次数: 0
Response to “Towards reliable feature interpretation in machine learning-based longevity prediction” 对“基于机器学习的寿命预测中可靠的特征解释”的回应
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-14 DOI: 10.1016/j.annepidem.2026.01.006
Dor Atias MD, MPH, Saar Ashri Bsc, Uri Goldbourt PhD, Yariv Gerber PhD, Uri Obolski PhD
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引用次数: 0
A multivariable model for improving the identification of cerebral palsy cases in administrative health data 提高行政卫生资料中脑瘫病例识别的多变量模型
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-13 DOI: 10.1016/j.annepidem.2026.01.004
Peter M. Socha , Maryam Oskoui , Jennifer A. Hutcheon , Sam Harper

Purpose

To improve the identification of cerebral palsy cases in administrative health data.

Methods

We included all children in a population-based cerebral palsy registry in Quebec, Canada, born from 1999 through 2002, and a sample of children without cerebral palsy. Population-based hospitalization and physician billing records through 2012 were obtained for all children. We used logistic regression to model the probability of cerebral palsy, using International Classification of Diseases codes for related diseases. We reported receiver operating characteristic (ROC) and precision-recall (PR) curves, and compared the accuracy to that of existing algorithms. We also reported the accuracy of cerebral palsy codes by age, data source, and gestational age at birth.

Results

The area under the ROC and PR curves of our model were 0.98 (95 % CI: 0.97–0.99) and 0.73 (95 % CI: 0.63–0.79), respectively. Cut-offs with a similar specificity to existing algorithms yielded sensitivities that were 1–14 %age-points higher. The sensitivity of cerebral palsy codes was higher (and the specificity was lower) with longer follow-up times since birth, when using both hospitalization and billing records, and among children born preterm.

Conclusions

Our model improved identification of cerebral palsy cases in administrative data, but residual misclassification remained.
目的提高行政卫生资料中脑瘫病例的识别水平。方法:我们纳入了加拿大魁北克省以人口为基础的脑瘫儿童登记处的所有儿童,这些儿童出生在1999年至2002年,并以非脑瘫儿童为样本。获得了截至2012年所有儿童的基于人口的住院和医生账单记录。我们使用逻辑回归对脑瘫的概率进行建模,使用国际疾病分类代码对相关疾病进行编码。我们报告了受试者工作特征(ROC)和精确召回率(PR)曲线,并与现有算法的准确性进行了比较。我们还报道了年龄、数据来源和出生时胎龄对脑瘫编码的准确性。结果模型的ROC曲线下面积为0.98(95 % CI: 0.97-0.99), PR曲线下面积为0.73(95 % CI: 0.63-0.79)。与现有算法具有相似特异性的截断值产生的敏感性高出1 - 14%的年龄点。脑瘫编码的敏感性较高(特异性较低),自出生以来随访时间较长,当使用住院和计费记录时,以及在早产儿童中。结论sour模型提高了行政资料对脑瘫病例的识别,但仍存在误分类现象。
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引用次数: 0
Is artificial intelligence a friend or foe to epidemiology? 人工智能是流行病学的朋友还是敌人?
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-12 DOI: 10.1016/j.annepidem.2026.01.003
Emaan Rashidi MHS , Madeline Brooks MPH , Ahmed Hassoon MD, MPH , Shruti Mehta PhD, MPH , Keri Althoff PhD, MPH , G. Caleb Alexander MD, MS
Epidemiology has long been central to public health, guiding our understanding of the distribution and determinants of disease. As the field has evolved—from John Snow’s cholera investigations to large-scale cohort studies and causal inference frameworks—it now faces a transformative juncture with the advent of artificial intelligence/machine learning (AI/ML). These technologies offer unprecedented opportunities to improve data measurement, inference, and population health insights, yet also pose methodological and ethical challenges. Anchored by the core epidemiologic domains of study population, measurement, and inference, we examine how epidemiologists can use AI/ML effectively. We consider the importance of careful population definition, informed sampling, and external validation to ensure generalizability and minimize bias when AI/ML is used. We also explore the need for rigorous assessment of data quality and model reliability, which strengthens the case for conceptual frameworks in guiding interpretation of scientific investigations. To realize AI/ML’s potential, epidemiology must adapt its training, invest in infrastructure, and promote interdisciplinary collaboration. Doing so will ensure that epidemiologic science remains robust, reproducible, and relevant in a rapidly evolving informational landscape. This moment calls for a strategic integration of AI/ML into the fabric of epidemiologic practice and training to advance both science and public health.
流行病学长期以来一直是公共卫生的核心,指导我们理解疾病的分布和决定因素。随着该领域的发展——从约翰·斯诺的霍乱调查到大规模队列研究和因果推理框架——随着人工智能/机器学习(AI/ML)的出现,它现在面临着一个变革性的转折。这些技术为改进数据测量、推断和人口健康见解提供了前所未有的机会,但也带来了方法学和伦理方面的挑战。以研究人群、测量和推断的核心流行病学领域为基础,我们研究了流行病学家如何有效地使用AI/ML。在使用AI/ML时,我们考虑了谨慎的总体定义、知情抽样和外部验证的重要性,以确保可泛化性和最小化偏差。我们还探讨了对数据质量和模型可靠性进行严格评估的必要性,这加强了指导科学调查解释的概念框架的案例。为了实现AI/ML的潜力,流行病学必须调整其培训,投资基础设施,并促进跨学科合作。这样做将确保流行病学在快速发展的信息环境中保持稳健、可复制和相关性。这一时刻要求将人工智能/机器学习战略整合到流行病学实践和培训的结构中,以促进科学和公共卫生。
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引用次数: 0
The association between paternal race and ethnicity and a spectrum of birth defects in a national case-control study 一项国家病例对照研究中父亲种族和民族与出生缺陷谱之间的关系。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-07 DOI: 10.1016/j.annepidem.2026.01.002
Omobola O. Oluwafemi , Laura E. Mitchell , Jenil R. Patel , Wendy N. Nembhard , Gary M. Shaw , Andrew F. Olshan , Han Chen , A.J. Agopian

Purpose

To estimate associations between paternal race and ethnicity and a spectrum of birth defects.

Methods

We analyzed data from the National Birth Defects Prevention Study for infants with birth defects and controls delivered between 1997–2011. Using unconditional logistic regression, we assessed associations between paternal race and ethnicity and 32 birth defects, before and after adjusting for maternal race and ethnicity and 14 other factors.

Results

Data from 33,455 fathers were analyzed (889 Asian/Pacific Islander [A/PI], 8394 Hispanic, 4139 non-Hispanic Black [NHB], and 20,033 non-Hispanic White [NHW]). Compared with NHW fathers, A/PI paternal race and ethnicity was significantly associated with 6/32 defects, Hispanic paternal ethnicity with 6/32 defects, and NHB paternal race and ethnicity with 7/32 defects, after adjustment. The strongest associations included A/PI and pulmonary valve stenosis (adjusted odds ratio [aOR] 0.36, 95 % CI 0.18–0.71), Hispanic and heterotaxy (aOR 2.53, 95 % CI 1.57–4.06), and NHB and gastroschisis (aOR 2.25, 95 % CI 1.62–3.12).

Conclusions

Paternal race and ethnicity were associated with heterotaxy, cleft lip with or without cleft palate, and spina bifida, independent of maternal race and ethnicity. These findings warrant replication and further investigation into biological, environmental, and social mechanisms that may underlie these associations.
目的:估计父亲种族和民族与出生缺陷谱之间的关系。方法:我们分析了1997-2011年出生缺陷和对照婴儿的国家出生缺陷预防研究数据。使用无条件逻辑回归,我们评估了父亲种族和民族与32个出生缺陷之间的关系,在调整母亲种族和民族以及14个其他因素之前和之后。结果:分析了33,455名父亲的数据(889名亚洲/太平洋岛民[A/PI], 8,394名西班牙裔,4,139名非西班牙裔黑人[NHB]和20,033名非西班牙裔白人[NHW])。与NHW父亲比较,A/PI父亲种族与6/32缺陷显著相关,西班牙裔父亲种族与6/32缺陷显著相关,NHB父亲种族与7/32缺陷显著相关。最强的相关性包括A/PI和肺动脉瓣狭窄(校正优势比[aOR] 0.36, 95% CI 0.18-0.71),西班牙裔和异位(aOR 2.53, 95% CI 1.57-4.06),以及NHB和胃裂(aOR 2.25, 95% CI 1.62-3.12)。结论:父亲的种族和民族与异位、唇裂伴或不伴腭裂、脊柱裂相关,与母亲的种族和民族无关。这些发现值得重复,并进一步研究这些关联背后的生物、环境和社会机制。
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引用次数: 0
The Abraham Lilienfeld Award of the American College of Epidemiology - From Paper to Pixels: The Digital Revolution in Women's Health Epidemiology, September 8, 2025 美国流行病学学院亚伯拉罕·利连菲尔德奖——从纸到像素:女性健康流行病学的数字革命,2025年9月8日
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-06 DOI: 10.1016/j.annepidem.2026.01.001
Michelle A. Williams ScD
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引用次数: 0
Mediation learning module: Pedersen et al (2025), Associations of early life body size and pubertal timing with breast density and postmenopausal breast cancer risk: A mediation analysis Pedersen et al .(2025),早期生活体型和青春期时间与乳腺密度和绝经后乳腺癌风险的关联:一个中介分析
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-01-01 DOI: 10.1016/j.annepidem.2025.10.021
Jeb Jones PhD, MPH, MS
Educational Engagement Modules (EEMs) are teaching materials for educators and students that facilitate a deeper understanding of key epidemiological methods and concepts. Each EEM poses a series of questions using a recently published paper in Annals to further understanding of a specific study design and to encourage critical thinking and careful evaluation. This EEM focuses on the use of mediation in a study exploring whether breast density mediates the relationship between early life characteristics and postmenopausal breast cancer: Pedersen DC, Hameiri-Bowen D, Aarestrup J, Jensen BW, Tjønneland A, Mellemkjær L, von Euler-Chelpin M, Vejborg I, Andersen ZJ, Baker JL. Associations of early life body size and pubertal timing with breast density and postmenopausal breast cancer risk: A mediation analysis. Ann Epidemiol. 2025 Feb;102:68–74. doi: 10.1016/j.annepidem.2025.01.004. Epub 2025 Jan 10. PMID: 39798680 [1].
教育参与模块(EEMs)是为教育工作者和学生提供的教材,有助于更深入地理解关键的流行病学方法和概念。每个EEM提出一系列问题,使用最近发表在《年鉴》上的一篇论文,以进一步理解特定的研究设计,并鼓励批判性思维和仔细评估。乳腺密度是否在早期生活特征与绝经后乳腺癌之间起中介作用的研究:Pedersen DC, Hameiri-Bowen D, Aarestrup J, Jensen BW, Tjønneland a, Mellemkjær L, von Euler-Chelpin M, Vejborg I, Andersen ZJ, Baker JL。早期生活体型和青春期时间与乳腺密度和绝经后乳腺癌风险的关联:一个中介分析。流行病学杂志。2025;102:68-74。doi: 10.1016 / j.annepidem.2025.01.004。Epub 2025年1月10日中国经济:39798680[1]。
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引用次数: 0
Improvements in stress and sleep following 24-months of Guaranteed Income, results from a randomized trial among Black women in Georgia 在24个月的保证收入后,压力和睡眠的改善,来自佐治亚州黑人妇女的随机试验结果。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-23 DOI: 10.1016/j.annepidem.2025.12.010
Kaitlyn Stanhope PhD , Quiana Lewis PhD, MPH , Laura Brugger PhD , Leah Hamilton PhD, MSW , Stephen Roll PhD , Latrice Rollins PhD, MSW , Naomi Zewde PhD

Objective

To estimate differences in mental distress, sleep quality, and sleep duration following twelve and twenty-four months of receipt of guaranteed income (GI) between program participants and a comparison group.

Methods

We conducted a community-engaged intervention study (In Her Hands) between 2022 and 2024 in Georgia, United States. Participants included self-identified Black women with income ≤ 200 % of the federal poverty level who participated in follow-up surveys (12-month participation rates: intervention: 40.8 %; control: 11.9 %). GI recipients were selected via lottery; comparison participants were those not selected at baseline who completed follow-up surveys. We measured mental distress using the Kessler-10 and sleep quality and duration via the Pittsburgh Sleep Quality Index at 12- and 24-months following enrollment. We fit linear regression models using generalized estimating equations, accounting for site, age, and wave to estimate differences and 95 % confidence intervals.

Results

We include 468 GI recipients and 374 controls (99.93 % Black; mean age 37.0 years, median annual income: $11,400). Following 12 and 24 months of GI receipt, GI recipients reported better sleep quality (24 month difference in PSQI score, −1.33 (-1.83, −0.82)) and lower mental distress (24 month K10 difference: −3.99 (-5.45, −2.52)) but not significant differences in sleep duration (24 month difference: 0.22 (-0.15, 0.60) compared to non-recipients.

Conclusions

At 12 and 24 months of GI, intervention participants reported higher sleep quality and lower mental distress compared to a comparison group.
目的:评估项目参与者和对照组在获得保证收入(GI) 12个月和24个月后的精神痛苦、睡眠质量和睡眠时间的差异。方法:我们于2022-2024年间在美国乔治亚州进行了一项社区参与的干预研究(In Her Hands)。参与者包括收入≤联邦贫困水平200%的自我认定的黑人妇女,她们参加了随访调查(12个月参与率:干预:40.8%;对照组:11.9%)。GI受助人以抽签方式选出;比较参与者是那些在基线时未被选中完成随访调查的人。在入组后的12个月和24个月,我们用凯斯勒-10量表测量了精神压力,用匹兹堡睡眠质量指数测量了睡眠质量和持续时间。我们使用广义估计方程拟合线性回归模型,考虑到地点、年龄和波浪来估计差异和95%置信区间。结果:我们纳入了468名GI受者和374名对照组(99.93%为黑人;平均年龄37.0岁,年收入中位数:11,400美元)。在接受GI治疗12个月和24个月后,GI接受者报告睡眠质量更好(PSQI评分24个月差异,-1.33(-1.83,-0.82)),精神压力更低(24个月K10差异:-3.99(-5.45,-2.52)),但睡眠时间差异不显著(24个月差异:0.22(-0.15,0.60))。结论:在GI的12个月和24个月,与对照组相比,干预参与者报告了更高的睡眠质量和更低的精神困扰。
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引用次数: 0
Impact of extensive health examination survey screening on quality of life, healthcare use, and mortality: A longitudinal matched cohort study 广泛健康检查筛查对生活质量、医疗保健使用和死亡率的影响:一项纵向匹配队列研究。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-19 DOI: 10.1016/j.annepidem.2025.12.008
Ingvild M. Rosenlund MD, PhD , Ellisiv B. Mathiesen Professor, MD, PhD , Unni Ringberg MD, PhD , Liv-Hege Johnsen MD, PhD , Tom Wilsgaard Professor, PhD , Jørgen Isaksen MD, PhD , Tor Ingebrigtsen Professor, MD, PhD

Purpose

Widespread use of diagnostic testing in asymptomatic individuals raises ethical concerns. We aimed to investigate whether participation in an extensive health examination survey is associated with psychosocial outcomes, healthcare use, and mortality.

Methods

This longitudinal matched cohort study included 461 participants who underwent comprehensive screening examinations as part of the population-based Tromsø7 Study, including electrocardiogram, carotid artery ultrasound, echocardiography, brain magnetic resonance imaging, and spirometry. Age- and sex-matched controls (n = 461) were drawn from Tromsø7 participants who only underwent limited basic measurements. Health-related quality of life, psychological distress, and health anxiety were assessed at baseline and after 5 years. Data on healthcare utilization and mortality were obtained from national registries.

Results

No significant differences were found in psychosocial outcomes. Healthcare use was largely similar, although screening participants had slightly fewer hospital admissions, 0.23 vs. 0.31 per person-year (95 % CI 0.19, 0.28 vs. 0.25, 0.38). Screening participants also had lower, but non-significant, risk of death compared with controls, hazard ratio 0.69 (95 % CI 0.47, 1.01).

Conclusion

Extensive health examination survey screening was not associated with psychosocial harms, healthcare use or statistically significant differences in mortality. Overall, the findings suggest that participation in such screening is safe.
目的:在无症状个体中广泛使用诊断测试引起了伦理问题。我们的目的是调查参与广泛的健康检查调查是否与心理社会结局、医疗保健使用和死亡率有关。方法:这项纵向匹配队列研究纳入了461名参与者,作为基于人群的Tromsø7研究的一部分,他们接受了全面的筛查检查,包括心电图、颈动脉超声、超声心动图、脑磁共振成像和肺活量测定。年龄和性别匹配的对照组(n=461)来自仅接受有限基本测量的Tromsø7参与者。在基线和5年后评估与健康相关的生活质量、心理困扰和健康焦虑。关于医疗保健利用和死亡率的数据来自国家登记处。结果:心理社会结局无显著差异。医疗保健使用大致相似,尽管筛查参与者的住院率略低,每人年0.23比0.31 (95% CI 0.19, 0.28比0.25,0.38)。与对照组相比,筛查参与者的死亡风险也较低,但不显著,风险比为0.69 (95% CI 0.47, 1.01)。结论:广泛的健康检查调查筛查与心理社会伤害、医疗保健使用或死亡率的统计学显著差异无关。总的来说,研究结果表明,参与这种筛查是安全的。
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引用次数: 0
期刊
Annals of Epidemiology
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