Use and misuse of population attributable fractions.

Rockhill, Beverly; Newman, Beth; Weinberg, Clarice R.

doi:10.2105/ajph.88.1.15

Cited by 1,453 publications

(1,303 citation statements)

References 31 publications

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“…Furthermore, the prevalence of both depression and LBP concurrently is high, and the increased risk of LBP observed in our review can have substantial implications. If we apply our summary OR to the worldwide prevalence of depression, we can estimate the population proportional attributable risk as the following: prevalence of depression 3 (OR 2 1)/(1 1 prevalence of depression) 3 (OR 2 1) (45), where the OR, in this example, is the OR from our overall pooling results. Considering a 12-month prevalence of depression of 6% (46), the population attributable risk would be 3.4%.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Pinheiro

Ferreira

Refshauge

et al. 2015

Arthritis Care & Research

159

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Objective. To investigate the contribution of symptoms of depression to future episodes of low back pain (LBP). Methods. A search was conducted of AMED, CINAHL, Embase, Health and Society (H&S), LILACS, MEDLINE, PsycINFO, Scopus, and Web of Science databases. We included cohort studies investigating the effect of symptoms of depression on the development of new episodes of LBP, either lifetime incidence or a recurrent episode, in a population free of LBP at baseline. We accepted the original study's definition for a new episode of LBP, and for classifying patients as LBP-free at study entry. Two independent investigators extracted data and assessed methodological quality. Meta-analyses with random effects were used to pool risk estimates. Results. We included 19 studies, with 11 incorporated in the meta-analyses. Overall pooled results showed that symptoms of depression increased the risk of developing LBP (odds ratio [OR] 1.59, 95% confidence interval [95% CI] 1.26-2.01). The risk was similar in studies that used the diagnostic interview method (OR 1.66, 95% CI 1.14-2.42) and in studies using selfreport screening questionnaires (OR 1.68, 95% CI 1.05-2.70). No statistically significant relationship was observed when we pooled studies that employed nonspecific screening questionnaires (OR 1.17, 95% CI 0.48-2.87). Three studies provided results in incremental categories of symptoms of depression and the pooled OR for the most severe level of depression (OR 2.51, 95% CI 1.58-3.99) was higher than for the lowest level (OR 1.51, 95% CI 0.89-2.56). Conclusion. Individuals with symptoms of depression have an increased risk of developing an episode of LBP in the future, with the risk being higher in patients with more severe levels of depression.

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Section: Discussionmentioning

confidence: 99%

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Pinheiro

Ferreira

Refshauge

et al. 2015

Arthritis Care & Research

159

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“…1 Second, the methods we used to calculate aggregate healthcare expenditures associated with excess body weight are widely accepted, 12,14,15,20,23 but those methods are more appropriately applied to incidentFnot prevalentFconditions and assume no confounding of the exposure-outcome relationship. 24 In this analysis, the obesity-expenditure relationship may be confounded by unmeasured health conditions (eg physical disability). Further research is needed to establish an unbiased method of calculating estimates of obesity-attributable expenditures, accounting for the complex causal relationships between body weight and chronic medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Impact of morbid obesity on medical expenditures in adults

2005

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CONTEXT: Morbid obesity (body mass index (BMI) Z40 kg/m 2 ) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. OBJECTIVE: To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. MAIN OUTCOME MEASURES: Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. RESULTS: When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. CONCLUSIONS: The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly obese adults.

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“…We compared the prevalence of each AV category between the 5 identified trajectories in analyses adjusted for age, sex, race, and center. To determine the population attributable risk for AV dysfunction (sclerosis or stenosis) associated with low percentage attained CVHS (<50%, <60%, <70%, or <80%), we used the prevalence among cases and the odds ratio estimate to calculate the percentage population attributable risk using the following formulation23: population attributable risk%=pd i ×[RR i −1/RR i ], where pd i is the proportion of total cases in the population arising from the i th exposure category and RR i is the adjusted risk ratio for the i th exposure category. A 2‐sided P value of <0.05 was considered significant.…”

Section: Methodsmentioning

confidence: 99%

Ideal Cardiovascular Health and the Prevalence and Severity of Aortic Stenosis in Elderly Patients

Sengeløv

Cheng

Biering‐Sørensen

et al. 2018

JAHA

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BackgroundThe relationship between ideal cardiovascular health reflected in the cardiovascular health score (CVHS) and valvular heart disease is not known. The purpose of this study was to determine the association of CVHS attainment through midlife to late life with aortic stenosis prevalence and severity in late life.Methods and ResultsThe following 6 ideal cardiovascular health metrics were assessed in ARIC (Atherosclerosis Risk in Communities) Study participants at 5 examination visits between 1987 and 2013 (visits 1–4 in 1987–1998 and visit 5 in 2011–2013): smoking, body mass index, total cholesterol, blood pressure, physical activity, and blood glucose. Percentage attained CVHS was calculated in 6034 participants as the sum of CVHS at each visit/the maximum possible score. Aortic stenosis was assessed by echocardiography at visit 5 on the basis of the peak aortic valve velocity. Aortic stenosis was categorized sclerosis, mild stenosis, and moderate‐to‐severe stenosis. Mean age was 76±5 years, 42% were men, and 22% were black. Mean percentage attained CVHS was 63±14%, and the prevalence of aortic stenosis stages were 15.9% for sclerosis, 4.3% for mild stenosis, and 0.7% for moderate‐to‐severe stenosis. Worse percentage attained CVHS was associated with higher prevalence of aortic sclerosis (P<0.001 for trend), mild stenosis (P<0.001), and moderate‐to‐severe stenosis (P=0.002), adjusting for age, sex, and race.ConclusionsGreater attainment of ideal cardiovascular health in midlife to late life is associated with a lower prevalence of aortic sclerosis and stenosis in late life in a large cohort of older adults.

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Use and misuse of population attributable fractions.

Cited by 1,453 publications

References 31 publications

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Impact of morbid obesity on medical expenditures in adults

Ideal Cardiovascular Health and the Prevalence and Severity of Aortic Stenosis in Elderly Patients

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