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Biomedical subjects

E E Logue

Publications and source records attributed to E E Logue.

4 recordsLinked to original sources

Modeling heart disease mortality with census tract rates and social class mixtures.

The relationship between social class and 1980 heart disease (HD) mortality in eight urban U.S. counties was examined by regressing age and sex adjusted census tract specific HD rates (N = 1211) on tract social class characteristics. The regression model indicated that lower middle class residents experienced a HD mortality rate 1.9 (95% CI = 1.3, 2.8) times the rate in the upper middle/middle class, while the working poor experienced a HD rate 4.4 (95% CI = 3.5, 5.7) times the rate in the referent class. Similar class effects were seen for both black and nonblack residents. The crude race effect (1.3 with 95% CI = 1.2, 1.4) was explainable by the concentration of blacks in the lower classes. The methods illustrate the ecologic regression of mixtures of mortality rates on mixtures of exposure in the presence of random tract effects which eliminates some of the problems associated with small denominators or zero rates in some tracts.

Coronary Disease

Hyperacute T-wave criteria using computer ECG analysis.

Hyperacute T waves (HATWs) have been described as tall-amplitude, primary T-wave abnormalities sometimes seen in the early phases of transmural myocardial infarction. Despite numerous human and animal studies addressing the presence and significance of HATWs, there are no widely held, reliable ECG criteria for their accurate identification. Using a specially designed computer program on a Hewlett-Packard Realm ECG analysis system, we screened 13,393 adult ECGs to identify those having T-wave amplitudes greater than accepted standards (limb leads, greater than 0.5 mV; precordial leads, greater than 1.0 mV). Patients with other known causes of primary and secondary tall T waves were excluded from the study sample. Patients with tall-amplitude T-waves who then developed clinically verifiable myocardial infarction were labeled the HATW group. The HATW group (21) represented 4.1% of the tall T wave group (513) and 0.16% of the entire sample. The remaining patients, who did not meet HATW criteria, were called the early repolarization variant (ERV) group (51). Both groups underwent comparative computer morphology analysis. Nine parameters were statistically significant in discriminating HATWs from early repolarization variants. A combination of J-point position/T-wave amplitude of more than 25%, T-wave amplitude/QRS amplitude of more than 75%, J-point position of more than 0.30 mV, and age of more than 45 years predicted HATWs from a control group with a specificity of 98.0% and a sensitivity of 61.9% and with positive and negative predictive values of 92.9% and 86.2%, respectively. We conclude that HATWs have characterizable discriminating ECG morphology as determined by computer ECG analysis compared with a control group.

Electrocardiography

Life-table methods for detecting age-risk factor interactions in long-term follow-up studies.

Methodological investigation has suggested that age-risk factor interactions should be more evident in age of experience life tables than in follow-up time tables due to the mixing of ages of experience over follow-up time in groups defined by age at initial examination. To illustrate the two approaches, age modification of the effect of total cholesterol on ischemic heart disease mortality in two long-term follow-up studies was investigated. Follow-up time life table analysis of 116 deaths over 20 years in one study was more consistent with a uniform relative risk due to cholesterol, while age of experience life table analysis was more consistent with a monotonic negative age interaction. In a second follow-up study (160 deaths over 24 years), there was no evidence of a monotonic negative age-cholesterol interaction by either method. It was concluded that age-specific life table analysis should be used when age-risk factor interactions are considered, but that both approaches yield almost identical results in absence of age interaction. The identification of the more appropriate life-table analysis should be ultimately guided by the nature of the age or time phenomena of scientific interest.

Actuarial Analysis

Symptom reports and mortality in an occupational cohort.

The relationship between baseline symptom reports and subsequent mortality over a 24-year period was examined in a group of 1,224 white male nonsupervisory paper workers. Symptom reports were measured via the Cornell Medical Index, and the vital status of each participant was ascertained by reviewing company personnel records and death certificates. Analyses based on proportional hazards models suggest that symptom reports are predictive of mortality (RR = 1.24; P = .0002), independent of the participant's age and biologic risk status at intake. Analyses based upon age-specific and age-standardized mortality ratios confirm that the paper workers were subject to a "healthy worker effect" (standardized mortality ratio [SMR] = 0.66), and that the healthy worker effect is attenuated (SMR = 0.77) among those participants reporting ten or more symptoms at the beginning of the follow-up period.

Adult