Abstract:
OBJECTIVES:The aim was to construct and validate algorithms for osteoporosis case ascertainment from administrative databases and to estimate the population prevalence of osteoporosis for these algorithms. STUDY DESIGN AND SETTING:Artificial neural networks, classification trees, and logistic regression were applied to hospital, physician, and pharmacy data from Manitoba, Canada. Discriminative performance and calibration (i.e., error) were compared for algorithms defined from different sets of diagnosis, prescription drug, comorbidity, and demographic variables. Algorithms were validated against a regional bone mineral density testing program. RESULTS:Discriminative performance and calibration were poorer and sensitivity was generally lower for algorithms based on diagnosis codes alone than for algorithms based on an expanded set of data features that included osteoporosis prescriptions and age. Validation measures were similar for neural networks and classification trees, but prevalence estimates were lower for the former model. CONCLUSION:Multiple features of administrative data generally resulted in improved sensitivity of osteoporosis case-detection algorithm without loss of specificity. However, prevalence estimates using an expanded set of features were still slightly lower than estimates from a population-based study with primary data collection. The classification methods developed in this study can be extended to other chronic diseases for which there may be multiple markers in administrative data.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Lix LM,Yogendran MS,Leslie WD,Shaw SY,Baumgartner R,Bowman C,Metge C,Gumel A,Hux J,James RCdoi
10.1016/j.jclinepi.2008.02.002subject
Has Abstractpub_date
2008-12-01 00:00:00pages
1250-1260issue
12eissn
0895-4356issn
1878-5921pii
S0895-4356(08)00050-4journal_volume
61pub_type
杂志文章abstract::We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90075-k
更新日期:1991-01-01 00:00:00
abstract::Scotland has one of the highest mortality rates from coronary heart disease for both men and women. However within Scotland there are major geographical differences in the mortality rates, exemplified by the differences between the two largest Scottish cities. Glasgow on the west has a much higher mortality rate for c...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(90)90033-l
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Mendelian randomization is a popular technique for assessing and estimating the causal effects of risk factors. If genetic variants which are instrumental variables for a risk factor are shown to be additionally associated with a disease outcome, then the risk factor is a cause of the disease. However, in man...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.08.001
更新日期:2016-01-01 00:00:00
abstract::Although CHF has been considered a risk factor for venous thromboembolism, this has not been directly studied. We hypothesized that congestive heart failure would increase the risk of venous thromboembolism in an outpatient population, and that this risk would increase as patients' ventricular function worsened. We co...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00373-5
更新日期:2001-08-01 00:00:00
abstract::Cancer mortality from 1986 to 1992 was examined in a cohort of 4419 individuals who had been residing in an area of the municipality of Reggio Emilia, northern Italy, where tap water with unusually high selenium content was accidentally supplied. Mortality for all cancers was not significantly different, both in males...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(95)00014-u
更新日期:1995-09-01 00:00:00
abstract::The similarity in meaning assigned to response choice labels from the SF-36 Health Survey (SF-36) was evaluated across countries. Convenience samples of judges (range, 10 to 117; median = 48) from 13 countries rated translations of response choice labels, using a variation of the Thurstone method of equal appearing in...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00084-5
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to investigate the effect of number of studies in a meta-analysis on the detection of publication bias using P value-driven methods. METHODS:The proportion of meta-analyses detected by Egger's, Harbord's, Peters', and Begg's tests to have asymmetry suggestive of publication bias wer...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.11.011
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Statistical interaction between a single, instantaneous exposure and attained age (age during follow-up; attained age = age at exposure + time since exposure) is used in risk analyses to assess potential effect modification by unmeasured factors correlated with age. However, the impact of such interaction on ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.10.004
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The impact of disease on population health is most commonly estimated by the population attributable fraction (PAF), or less commonly by the excess risk, an alternative measure that estimates the absolute risk of disease in the population that can be ascribed to the exposure. Using chronic airflow obstructio...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.10.020
更新日期:2018-01-01 00:00:00
abstract:UNLABELLED:To systematically investigate location bias of controlled clinical trials in complementary/alternative medicine (CAM). METHODS:Literature searches were performed to identify systematic reviews and meta-analyses, which were used to retrieve controlled clinical trials. Trials were categorised by whether they ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(99)00220-6
更新日期:2000-05-01 00:00:00
abstract::Information concerning people's relative preferences for health care outcomes is usually obtained using questionnaires which ask subjects to imagine health states of various kinds. When using illness- or treatment-specific states, elaborate descriptions of patients' quality of life may adequately convey to the rater a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90083-y
更新日期:1992-03-01 00:00:00
abstract::The purpose of this study was to relate the 1-year risk of death and development of acute myocardial infarction among diabetics with acute chest pain to whether they had a history of hypertension or not. All patients with a history of diabetes mellitus who, during 21 months, were admitted to the Emergency Room in Sahl...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90174-0
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:To evaluate whether noninferiority trials are designed to adequately preserve the historical treatment effect of their active comparators. STUDY DESIGN AND SETTING:We reviewed 162 noninferiority trials published in high-impact medical journals. We assessed whether trials were designed to ensure that interve...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2019.03.003
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To examine if commonly recommended assumptions for multivariable logistic regression are addressed in two major epidemiological journals. METHODS:Ninety-nine articles from the Journal of Clinical Epidemiology and the American Journal of Epidemiology were surveyed for 10 criteria: six dealing w...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2003.05.003
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVES:To recommend methodological standards in the prevention and handling of missing data for primary patient-centered outcomes research (PCOR). STUDY DESIGN AND SETTING:We searched National Library of Medicine Bookshelf and Catalog as well as regulatory agencies' and organizations' Web sites in January 2012 for...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2013.08.013
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:Cochrane acute respiratory infections (ARIs) group conducts systematic reviews of the evidence for treatment and prevention of ARIs. We report the results of a prioritization project, aiming to identify highest priority systematic review topics. STUDY DESIGN/SETTING:The project consisted of two phases. Phase...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.05.016
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Asymptomatic peripheral arterial occlusive disease (PAOD) is a common atherosclerotic disorder among the elderly population. Scarce data are available on the risk of nonfatal and fatal cardiovascular diseases in these subjects. We investigated cardiovascular morbidity and mortality of asymptomatic PAOD subjec...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2003.09.003
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:Optimism bias refers to unwarranted belief in the efficacy of new therapies. We assessed the impact of optimism bias on a proportion of trials that did not answer their research question successfully and explored whether poor accrual or optimism bias is responsible for inconclusive results. STUDY DESIGN:Syst...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.09.007
更新日期:2011-06-01 00:00:00
abstract::A key component in the evaluation of efficacy of a vaccine to protect against disease caused by an antigenically diverse infectious pathogen in a preventative vaccine trial is assessing how vaccine-induced protection depends on genotypic and phenotypic variations of the exposing pathogen. This assessment is made by co...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/s0895-4356(00)00258-4
更新日期:2001-01-01 00:00:00
abstract::Trialists argue about the usefulness of stratified randomization. For investigators designing trials and readers who use them, the argument has created uncertainty regarding the importance of stratification. In this paper, we review stratified randomization to summarize its purpose, indications, accomplishments, and a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/s0895-4356(98)00138-3
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate how frequently complex interventions are shown to be superior to routine care in general practice-based cluster-randomized controlled studies (c-RCTs) and to explore whether potential differences explain results that come out in favor of a complex intervention. STUDY DE...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2017.10.010
更新日期:2018-02-01 00:00:00
abstract::This paper focuses on the appropriateness of outcome measures to evaluate trauma care. The preventable death rate (PDR), based on the study of deceased patients only, has been the traditional measure of the impact of trauma care on improving the survival of patients with severe trauma. Another measure frequently used ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(90)90125-9
更新日期:1990-01-01 00:00:00
abstract::Sarcoidosis is a chronic granulomatous disorder of unknown cause, characterized by activation of T-lymphocytes and macrophages. A Case Control Etiologic Study of Sarcoidosis (ACCESS) is a multicenter study designed to determine the etiology of sarcoidosis. The study organization includes 10 Clinical Centers, a Clinica...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0895-4356(99)00142-0
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:To illustrate and discuss current and proposed new concepts of effect size (ES) quantification and significance, with a focus on statistical and clinical/subjective interpretation and supported by empirical examples. STUDY DESIGN AND SETTINGS:Different methods for determining minimal clinically important dif...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.11.016
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. STUDY DESIGN AND SETTING:A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and h...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2007.02.002
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In 1981, toxic oil syndrome (TOS) appeared in Spain, affecting more than 20,000 persons and causing over 2500 deaths to date. Previous studies have addressed mortality only by gender and age. We analyzed possible prognostic factors in the survival of the cohort. METHODS:The study period was 1 ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(03)00119-7
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is a promising prognostic tool for future work disability outcomes. Rasch analysis was conducted to examine the psychometric performance of the RA-WIS in work-related upper limb disorders. STUDY DESIGN AND SETTING:Eligible injured workers (n=396) a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2011.02.002
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:In multisite human immunodeficiency virus (HIV) observational cohorts, clustering of observations often occurs within sites. Ignoring clustering may lead to "Simpson's paradox" (SP) where the trend observed in the aggregated data is reversed when the groups are separated. This study aimed to investigate the ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2016.01.030
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To study whether the methodological change from parent to index subject as questionnaire respondent affected the prevalence estimates and risk factor patterns for allergic diseases in a longitudinal study. STUDY DESIGN AND SETTING:A prospective study of asthma and allergic diseases among children was begun ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2009.08.017
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The use of then-test (retrospective pre-test) scores has frequently been proposed as a solution to potential confounding of change scores because of response shift, as it is assumed that then-test and post-test responses are provided from the same perspective. However, this assumption has not been formally te...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2009.01.021
更新日期:2009-11-01 00:00:00