“In 2017, approximately 47,600 individuals in the US died from an opioid overdose, and morbidity and mortality from the opioid epidemic continues to accrue. [..] To fully estimate the epidemic’s scope and the impact of interventions to address it, it is essential to consider differences in individuals using prescription opioids vs heroin or illicit fentanyl, the increased risk of second overdose in people who have experienced an initial overdose, and the evolving time-dependent nature of the epidemic. Despite the contributions of prior models of the epidemic, most have not incorporated these elements, nor have they accounted for the more than … Read More
All posts in Epidemiology
“[Abstract methods] we searched PubMed and Web of Science from inception to March 12, 2020, and included interventions that: successfully targeted any of nine prespecified potentially modifiable risk factors (hypertension, diabetes, hearing loss, obesity, physical inactivity, social isolation, depression, cigarette smoking, and less childhood education); had robust evidence that the intervention improved risk or risk behaviour; and are feasible to enact in an adult population. We established when in the life course each intervention would be delivered. We calculated dementia incidence reduction from annual incidence of dementia in people with each risk factor, and population attributable fraction for each risk, … Read More
“[Abstract] Objectives: To evaluate the effectiveness of conventional treatments for localised prostate cancer (active monitoring, radical prostatectomy and radical radiotherapy) in men aged 50–69 years. Design: A prospective, multicentre prostate-specific antigen testing programme followed by a randomised trial of treatment, with a comprehensive cohort follow-up. Setting: Prostate-specific antigen testing in primary care and treatment in nine urology departments in the UK. Participants: Between 2001 and 2009, 228,966 men aged 50–69 years received an invitation to attend an appointment for information about the Prostate testing for cancer and Treatment (ProtecT) study and a prostate-specific antigen test; 82,429 men were tested, 2664 … Read More
“In the United States, Medicare beneficiaries represent 70% to 80% of all patients hospitalized with heart failure (HF) each year. The Medicare population has also experienced substantial changes in the epidemiology of HF, with progressively fewer Medicare beneficiaries being diagnosed as having HF each year over the last decade after several decades of increasing incidence. However, the epidemiological mechanisms underlying the observed decline in the incidence of HF are not well understood. [..] We used a national 5% sample of all fee-for-service Medicare beneficiaries with no prior HF followed up from 2011 to 2016, accessing data on all of the … Read More
“On February 4, 2020, the U.S. secretary of health and human services declared that emergency use of diagnostics for SARS-CoV-2 was justified, triggering emergency authority for the Food and Drug Administration (FDA) to grant an emergency use authorization (EUA) for a device if it reasonably believes that it may be effective, rather than waiting to grant full approval when it has reasonable assurance that the device is safe and effective. This mechanism expedites access to accurate diagnostic tests during emergencies, when information gaps and false results may adversely affect patient care and public health decision making. The EUA process enabled … Read More
“An estimated 19,416 individuals died of a drug overdose in the United States in the first 3 months of 2020 compared with 16,682 in the same 3-month period in 2019, according to preliminary data released last week by the US Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics. The agency also estimates that 75,500 overdose deaths occurred in the 12-month period between March 2019 and March 2020, an increase of approximately 10%. If this increased rate for drug overdose deaths holds, the United States is on track to reach a new all-time record for overdose fatalities … Read More
“The US Centers for Disease Control and Prevention has recognised public health programmes that reduced deaths from coronary heart disease and stroke and prevented deaths from smoking as two of the greatest public health achievements of the 20th century, both championed by robust evidence connecting these risks to reductions in healthy life expectancy. [..] To our knowledge, no study links a comprehensive set of modifiable risk factors to health-care spending by condition. [..] To address this research gap, we estimated US health-care spending attributable to 84 modifiable risk factors in 2016, with the latest data available. We included behavioural risks, … Read More
“Annually, about 10 million people develop TB, and an estimated 1.5 million die from their disease, which makes it the leading infectious killer worldwide, even in the time of COVID-19. [..] Key factors can significantly increase an individual’s risk. In particular, 2.3 million cases of TB were worldwide attributable to undernutrition in 2018: That’s one in five cases. By comparison, 1.2 million cases were attributable to HIV and 0.8 million cases to diabetes—risk factors that receive considerably more attention and funding. Undernutrition blunts the function of the immune system and increases the risk for TB so much so that it … Read More
“Described as the “greatest global challenge for health and social care in the 21st century,” dementia is a debilitating disease that affects about 50 million individuals worldwide, a number projected to triple by 2050. Given the limited efficacy of current dementia treatments, society stands to benefit tremendously from public health prevention strategies. Hearing loss (HL) has been recently shown to be a treatable risk factor for dementia. [..] Clinicians may be tempted to use the known independent association between HL and cognition to justify HL treatment (eg, hearing aids) to prevent age-related cognitive deficits. While appropriate management of HL is … Read More