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Computerized registration of epidemiological data from intraoral radiographs.

Software was developed for graphic registration of epidemiological dental data from intraoral radiographs. The measured variables included marginal bone level in relation to tooth and root length as well as proximal caries and restoration areas. Caries and peridontitis progress nowadays slowly in large populations. Registration methods must, therefore, offer high precision. The hard and software were first tested. After that the method's reliability or precision was studied. The precision of measuring marginal bone level as a per cent of total tooth or root length was found to vary between 0.3-4.3. The corresponding precision of measuring a caries area in relation to the whole crown area was 1.4%. Precision was also divided into its components and analysed in more detail. All registered tooth variables except the angle between the proximal marginal bone and the root surface gave satisfactory results indicating good reliability.

Adult↗

Collection of occupational epidemiologic data: the use of surrogate respondents to provide occupational histories.

When information about subjects in a study is unavailable from other sources, surrogate respondents, such as family members, have provided information about the subject. This chapter focuses on the quality of occupational histories provided by surrogates. The author addresses the issues of (1) nonresponse of the surrogate, (2) surrogate-subject and surrogate-record agreement, and (3) the impact of misclassification on estimates of relative risk.

Bias↗

Ecological and epidemiological data on Hantavirus in bank vole populations in Belgium.

Epidemiological and ecological data of a Hantavirus infected bank vole population were collected using live-trapping methods. A close association between the distribution of HV-infected bank voles and wet habitat types was found. Several seroconversions were observed during the life of individual bank voles. All seroconversions occurred within the wet habitat types and only after a certain age was reached. Survival of HV-infected bank voles did not differ from not-infected animals. In the laboratory passive antibody transfer was observed from antibody-positive females to their offspring.

Age Factors↗

Aetiology of burn injuries in childhood in Casablanca, Morocco: epidemiological data and preventive aspects.

A retrospective epidemiological study is reported concerning burn injuries in 775 children hospitalized at the unit of burn care of Casablanca between 1985 and 1993. The mean age was 3 years and 8 months; 69.9 per cent of the patients were below 5 years old. The male to female ratio was 1.43 to 1.0. The most common agents were scalding liquids (69.1 per cent) followed by flames (15.2 per cent). The authors underline through this report that preventive measures depend closely on the regional, environmental and sociocultural specificity.

Adolescent↗

Spina bifida: epidemiological data from a pilot study.

The epidemiology of spina bifida has great geographical variation. A small unselected group of patients were registered as part of a pilot project on infantile hydrocephalus. Twenty-two patients, born 1963-69 in Vejle county, Denmark were identified, giving an incidence of 0.77 per 1000 births. The mothers had 26 pregnancies prior to the spina bifida children; 14 of these had resulted in normal viable infants (54%). Seven of the patients had other congenital malformations, unrelated to the neural tube defect. All unoperated patients died. Four of 10 operated children were alive at age 7-12 years, three of them without handicap.

Abnormalities, Multiple↗

The collection and interpretation of epidemiological data about the cardiovascular risks associated with the use of steroid contraceptives.

A variety of epidemiological approaches have been used to assess the safety of steroid contraceptives. Each study design has its own strengths and weaknesses, especially with respect to susceptibility to bias and confounding. Randomized controlled trials provide the strongest evidence of a cause and effect relationship, but the low incidence of cardiovascular disease in women of reproductive age precludes the use of this study design to examine these clinical endpoints. Consequently, observational cohort and case-control studies have provided the most useful clinical information about the main cardiovascular effects of steroid contraceptives. Data from epidemiological research need to be interpreted carefully taking into consideration which of the potential biases or sources of confounding are likely to have affected a particular study, and what effect these may have on any inferences from the study. Additional factors that need to be considered before deciding whether a causal relationship exists include evidence that the exposure preceded the disease, the strength of association, consistency of findings with other studies, presence of dose gradients, and agreement with animal or laboratory research. Even if a casual link is thought to be plausible, the public health implications may be minimal; absolute (attributable) risks are required in order to assess these. An understanding of these epidemiological issues will enable clinicians to advise their clients whether steroid contraceptives alter the risk of cardiovascular disease and, if so, the clinical significance of such changes.

Cardiovascular Diseases↗

Econometric approaches to epidemiologic data: relating endogeneity and unobserved heterogeneity to confounding.

The concepts of endogeneity and unobserved heterogeneity are well-known among econometricians. However, these issues are rarely addressed in epidemiologic studies. This paper explores these two concepts, their relationship to each other, and the implications for analysis in epidemiologic studies. An endogenous variable is defined as a predictor variable which is partly determined by factors within the model itself, while unobserved heterogeneity is conceptualized as a vector of missing variables acting through the error term. Under certain assumptions, the simultaneous existence of an endogenous variable and unobserved heterogeneity is shown to act in a manner analogous to confounding. Specifically, this occurs due to an association between the error term in the equation and the endogenous predictor variable. The accepted econometric solution to this problem is to replace the endogenous variable with an 'instrumental variable' which is not correlated with the error term and thus not susceptible to confounding. The validity of these concepts and of the proposed solution are discussed.

Confounding Factors, Epidemiologic↗

Statistical modeling of epidemiologic data.

The application of statistical modeling to epidemiology may help suggest a form for the mechanism of exposure action. But distinguishing between the entertained biological models is often difficult due to both inadequacies in epidemiologic studies and inaccuracies in the verbal specifications of the hypothesized interaction mechanisms. For example, the independent and interactive effects of asbestos and smoking on the production of lung cancer have not yet been fully established. In the present communication an analysis of illustrative data from a hypothetical case-compeer study was attempted with the estimation of rate ratios and the use of a log-linear model fitting technique. These analyses allow a parametric representation of the testable models. For adequate material they might provide tentative insight as to whether the data would conform more closely to an additive model than to a multiplicative one or to some other advocated pattern of action.

Asbestosis↗

Epidemiological data on anorexia nervosa in Japan.

An epidemiological survey on anorexia nervosa was performed in Japanese hospitals in 1985 and 1992 using a questionnaire. The reported number of patients with anorexia nervosa was 2391 from 732 institutions. From these data, the total number of anorexia nervosa patients treated in 1985 in Japanese hospitals was estimated to be about 3500-4500. In 1992, the reported number of patients with AN was 2247. The total number of AN patients treated in 1992 was estimated to be about 4500-4600, which is a little higher than that in 1985 (3500-4500). The prevalence was 3.6-4.5 per 100000 among the general population, 6.3-9.7 per 10(5) among the female population, and 25.2-30.7 per 10(5) among the 13-29 year-old female population.

Adolescent↗

Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies. The DECODE-study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis of Diagnostic Criteria in Europe.

AIMS/HYPOTHESIS: The World Health Organisation Consultation recommended new diagnostic criteria for diabetes mellitus including: lowering of the diagnostic fasting plasma glucose to 7.0 mmol/l and introduction of a new category: impaired fasting glycaemia. The diagnostic 2-h glucose concentrations for diabetes and for impaired glucose tolerance were unchanged. This study identifies fasting plasma glucose concentrations predicting a diabetic 2-h plasma glucose of 11.1 mmol/l or more, analyses the sensitivity and specificity of different screening strategies for diabetes and describes the cardiovascular risk profile in people with impaired fasting glycaemia. METHODS: European population based studies (n = 17) or large, representative samples of employees (n = 3) with both fasting and 2-h post load glucose concentrations following 75-g oral glucose tolerance tests were included (18,918 men and 10,190 women). The Iceland study (8881 men and 9407 women) is presented separately as a 50-g glucose load was used. RESULTS: The fasting plasma glucose predicting a 2-h plasma glucose of 11.1 mmol/l or more with optimal sensitivity and specificity was a) 5.8 mmol/l in women and 6.4 mmol/l in men; b) independent of age; c) increased with obesity. Fasting plasma glucose of 7.0/7.8 mmol/l or more predicted a diabetic 2-h plasma glucose with sensitivities of 49.0/29.8% and specificities of 98.2/99.7%, respectively. CONCLUSION/INTERPRETATION: If fasting glucose is used alone, the 31% of diabetic subjects with a non-diabetic fasting glucose but a diabetic 2-h glucose, will not be diagnosed; impaired fasting glycaemia and impaired glucose tolerance do not identify the same people; the risk profile of people with impaired fasting glycaemia depends on 2-h glucose concentrations. Obesity is the main confounder in the association between fasting and 2-h glucose.

Adult↗