Excess cumulative incidence estimation for matched cohort survival studies

2020 ◽  
Vol 39 (20) ◽  
pp. 2606-2620
Author(s):  
Cristina Boschini ◽  
Klaus K. Andersen ◽  
Hélène Jacqmin‐Gadda ◽  
Pierre Joly ◽  
Thomas H. Scheike
Keyword(s):  
Cumulative Incidence ◽  
Matched Cohort ◽  
Incidence Estimation ◽  
Survival Studies

Urinary Incontinence in Alzheimer’s Disease

2016 ◽  
Vol 32 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Hsiang-Ying Lee ◽  
Ching-Chia Li ◽  
Yung-Shun Juan ◽  
Yu-Han Chang ◽  
Hsin-Chih Yeh ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Urinary Incontinence ◽  
Cumulative Incidence ◽  
Statistical Significance ◽  
Annual Incidence ◽  
Study Cohort ◽  
Sample Population ◽  
Research Database ◽  
Matched Cohort

Objectives: Urinary incontinence (UI) is more prevalent in the elderly populations with dementia than without dementia, and Alzheimer’s disease (AD) is the most common cause of dementia. Urinary incontinence may complicate AD morbidity and mortality. Therefore, this study aimed to evaluate the prevalence and annual incidence and determine the risk possibility of UI, which is the main type of incontinence in patients with AD in Taiwan. Methods: A total of 933 patients with AD were included in the study cohort, and a total of 2799 patients without AD by 1:3 proportion compared to the study cohort were used as a matched cohort. All participants were selected from the National Health Insurance Research Database in 2000 sample population. We utilize Cox proportional hazard regression to evaluate the risk of UI and cumulative incidence ratio curve to analyze the cumulative incidence function. Prevalence and annual incidence rate are calculated in individual medication including rivastigmine, donepezil, galantamine, and memantine only being initiated in patients with AD. Results: The risk of UI is higher in AD cohort (hazard ratio: 1.54, 95% confidence interval: 1.13-2.09). The cumulative incidence ratio of UI event between AD cohort and matched cohort presents statistical significance ( P < .001). Annual incidence and prevalence of UI in patients with AD are 6.2% and 4.2%, respectively. Conclusion: The present results suggest that the risk of UI is higher in patients with AD than in the general population.

scholarly journals Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054098
Author(s):  
Jo-Hui Pan ◽  
Chih-Hung Cheng ◽  
Chao-Ling Wang ◽  
Chia-Yen Dai ◽  
Chau-Chyun Sheu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Cumulative Incidence ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Secondary Outcome ◽  
Matched Cohort ◽  
Cox Regression Analysis ◽  
Control Subjects

ObjectivesThis study was conducted to explore the association between pneumoconiosis and pneumothorax.DesignRetrospective cohort study.SettingNationwide population-based study using the Taiwan National Health Insurance Database.ParticipantsA total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).Primary and secondary outcome measuresThe incidence and the cumulative incidence of pneumothorax.ResultsBoth incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients.ConclusionsOur study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.

scholarly journals Improving SARS-CoV-2 cumulative incidence estimation through mixture modelling of antibody levels

2021 ◽  
Author(s):  
C. Bottomley ◽  
M. Otiende ◽  
S. Uyoga ◽  
K. Gallagher ◽  
E.W. Kagucia ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Antibody Level ◽  
Cumulative Incidence ◽  
Model Estimate ◽  
Mixture Modelling ◽  
Seroprevalence Data ◽  
Incidence Estimation ◽  
Using Data ◽  
Serological Data ◽  
Antibody Levels

AbstractAs countries decide on vaccination strategies and how to ease movement restrictions, estimates of cumulative incidence of SARS-CoV-2 infection are essential in quantifying the extent to which populations remain susceptible to COVID-19. Cumulative incidence is usually estimated from seroprevalence data, where seropositives are defined by an arbitrary threshold antibody level, and adjusted for sensitivity and specificity at that threshold. This does not account for antibody waning nor for lower antibody levels in asymptomatic or mildly symptomatic cases. Mixture modelling can estimate cumulative incidence from antibody-level distributions without requiring adjustment for sensitivity and specificity. To illustrate the bias in standard threshold-based seroprevalence estimates, we compared both approaches using data from several Kenyan serosurveys. Compared to the mixture model estimate, threshold analysis underestimated cumulative incidence by 31% (IQR: 11 to 41) on average. Until more discriminating assays are available, mixture modelling offers an approach to reduce bias in estimates of cumulative incidence.One-Sentence SummaryMixture models reduce biases inherent in the standard threshold-based analysis of SARS-CoV-2 serological data.

scholarly journals Acupuncture Treatment to Reduce the Risk of Dementia in Patients With Migraine: A Propensity Score–Matched Cohort Study

2021 ◽  
Author(s):  
Cheng-Hao Huang ◽  
Mei-Chen Lin ◽  
I-Ching Chou ◽  
Ching-Liang Hsieh
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Cumulative Incidence ◽  
Acupuncture Treatment ◽  
Research Database ◽  
Matched Cohort ◽  
Medication Usage ◽  
Urbanization Level ◽  
Matched Cohort Study ◽  
Incidence Of Dementia

Abstract BackgroundMigraine is a recurrent headache disease that has been identified as a risk factor for subsequent dementia. In Taiwan, some patients with migraine receive acupuncture treatment for other illnesses. Therefore, the association between the effects of acupuncture treatment and the risk of dementia in patients with migraine warrants investigation. The present study collected data from Taiwan’s National Health Insurance Research Database (NHIRD) to investigate the incidence of dementia in patients with migraine who did and did not concurrently receive acupuncture treatment.MethodsWe conducted a retrospective matched-cohort study that included 37,266 patients, selected from the NHIRD, who were newly diagnosed with migraine at some time between 2000 and 2012. The follow-up period ranged from the index date (the date when patients first received acupuncture after their migraine diagnosis) to dementia diagnosis, withdrawal from the insurance program, or December 31, 2013. A 1:1 propensity score method was used to match an equal number of patients (N = 11,280) in the acupuncture and nonacupuncture cohorts based on sex, age, migraine diagnosis year, index year, insurance amount, urbanization level, baseline comorbidities, and medication usage. We employed Cox proportional hazards models to evaluate the risk of dementia. The cumulative incidence of dementia in both cohorts was estimated using the Kaplan–Meier method, and the difference was assessed through a log-rank test.ResultsPatients with migraine who received acupuncture treatment were found to have a lower risk of dementia (adjusted hazard ratio [aHR] = 0.48, 95% CI = 0.40–0.57) than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, urbanization level, baseline comorbidities, and medication usage. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the nonacupuncture cohort (log-rank test, p < 0.001).ConclusionsThis propensity score–matched cohort study demonstrated an association between acupuncture treatment and dementia development in patients with migraine in Taiwan. The results suggest that acupuncture treatment significantly reduced the development of dementia in patients with migraine. However, future study is required to provide more empirical evidence.

Intracranial Hemorrhage in Patients with Primary Brain Tumors Treated with Therapeutic Enoxaparin: A Matched Cohort Study

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 142-142 ◽  
Author(s):  
Charlene Mantia ◽  
Erik Uhlmann ◽  
Maneka Puligandla ◽  
Donna S. Neuberg ◽  
Griffin M. Weber ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Brain Tumors ◽  
Intracranial Hemorrhage ◽  
Cumulative Incidence ◽  
Competing Risk ◽  
Matched Cohort ◽  
Intracranial Hemorrhages ◽  
Primary Brain Tumors ◽  
Therapeutic Anticoagulation

Abstract BACKGROUND Venous thromboembolism occurs in approximately 15-30% of individuals with primary brain tumors (e.g. glioblastoma, astrocytoma, and oligodendroglioma). Spontaneous intracranial hemorrhage (ICH) is also a frequent complication of primary brain tumors thus complicating the decision to administer therapeutic anticoagulation. Therapeutic anticoagulation does not appear to increase the risk of intracranial hemorrhage among patients with solid tumor brain metastases but whether anticoagulation is safe to administer to patients with primary brain tumors is less clear. The aim of this study was to determine the rate of intracranial hemorrhage associated with therapeutic enoxaparin for treatment of venous thromboembolism in patients with primary brain tumors compared to those patients with brain tumors not exposed to therapeutic anticoagulation. METHODS A 1:1 matched, cohort study was performed using a large hospital-based online medical record database (CQ2) linking ICD-9 codes with prescription medication records, cases were initially identified based on coding for primary brain tumors, venous thromboembolism, and prescription of enoxaparin. Matched controls were identified using a "round-robin" algorithm that ranked controls according to a scoring formula based on successful match for year of diagnosis, age, and gender. A blinded review of radiographic imaging was performed and intracranial hemorrhages were categorized as trace, measurable, and significant. Measurable intracranial hemorrhages were those defined as greater than 1 mL in volume and "significant" intracranial hemorrhages were defined as greater than 10 mL in volume, symptomatic (defined as focal neurologic deficit, headache, nausea, or change in cognitive function), or required surgical intervention. Time-to-event statistical analysis was performed using a competing risk analysis to account for death from any cause as an absorbing competing risk. Statistical comparison of event rates between cases and controls was performed using Fine and Gray competing risk regression. RESULTS A total of 100 patients with primary brain tumors were included in the study. The most common diagnosis was glioblastoma (85%), followed by anaplastic oligodendroglioma (8%), and anaplastic astrocytoma (7%). The two cohorts were well matched for age (60 years old), gender (65% male), and types of treatment received (99% radiation, 34% stereotactic radiosurgery, and 71% surgical resection). There was no statistical difference in the rate of measurable intracranial hemorrhage for the group of patients who received therapeutic enoxaparin at any point following the diagnosis of glioma compared to those who did not receive anticoagulation (subdistribution ratio hazard ratio 1.09, 95% CI 0.53-2.22). The 1-year cumulative incidence of measurable hemorrhage among those who were treated with enoxaparin was 23.6% compared with 20.0% in the control group (Gray's test P=0.48). The 1-year cumulative incidence of significant hemorrhage was 13.1% in those receiving enoxaparin compared with 6.0% in controls (sHR 1.45, 95% CI .47-4.65, P=0.68). The median survival was similar for the enoxaparin (1.56 years) and controls (1.63 years, Log rank P=0.81). CONCLUSION Intracranial hemorrhage is common in patients with primary brain tumors. In this matched cohort analysis utilizing a blinded radiologic review, the administration of therapeutic low molecular weight heparin did not significantly increase the risk of intracranial hemorrhage in the setting of glioma and venous thromboembolism. In patients with primary brain tumors, the diagnosis of venous thromboembolism treated with therapeutic enoxaparin did not impact overall survival. Disclosures Zwicker: Quercegen Pharma: Research Funding.

scholarly journals End-stage renal disease as a risk factor for epiglottitis: a population-based cohort study in Taiwan

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038683
Author(s):  
Yao-Te Tsai ◽  
Ming-Shao Tsai ◽  
Cheng-Ming Hsu ◽  
Ku-Hao Fang ◽  
Ethan I Huang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cumulative Incidence ◽  
Secondary Outcome ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Stage Renal Disease ◽  
End Stage

ObjectivesPatients with uremia are prone to infection; however, end-stage renal disease (ESRD) as a risk factor for acute epiglottitis warrants study. We investigated the risk of severe epiglottitis requiring hospitalisation in patients with ESRD.SettingWe conducted a retrospective matched cohort study by using the claims data of Taiwan’s National Health Insurance Research Database.ParticipantsWe identified an ESRD cohort with 87 908 patients newly diagnosed in 2000–2013 and underwent dialysis. The non-ESRD cohort comprised patients who had not received a diagnosis of ESRD, and they were matches to the ESRD cohort (1:1) by sex, age, residence urbanisation level, monthly income, and diabetes and hypertension status.Primary and secondary outcome measuresThe cumulative incidence of epiglottitis at the end of 2013 was analysed with Kaplan-Meier methods and log-rank tests. The HR of epiglottitis was calculated using the Cox proportional hazards model after adjustment for confounding factors.ResultsThe overall epiglottitis incidence rate was 94% greater in the ESRD cohort than in the non-ESRD cohort (10.3 vs 5.3 cases per 100 000 person-years, p=0.002), with an adjusted HR of 1.89 (95% CI: 1.23 to 2.91, p=0.004). In the log-rank analysis, compared with the non-ESRD group, the epiglottitis cumulative incidence was significantly higher in the ESRD group (p=0.003). Epiglottitis did not exhibit an association with higher rates of airway interventions, intensive care unit admissions or longer hospitalisation in patients with ESRD than in controls.ConclusionsThis nationwide matched cohort study indicated that ESRD patients should be monitored for the risk of severe epiglottitis requiring hospitalisation.

scholarly journals Impact of and Correction for Outcome Misclassification in Cumulative Incidence Estimation

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0137454 ◽  
Author(s):  
Giorgos Bakoyannis ◽  
Constantin T. Yiannoutsos
Keyword(s):  
Cumulative Incidence ◽  
Incidence Estimation
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