The case-crossover design for studying sudden events.
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ABSTRACT:
SUBMITTER: Lewer D
PROVIDER: S-EPMC9978680 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
Publications
The case-crossover design for studying sudden events.
Lewer Dan D Petersen Irene I Maclure Malcolm M
BMJ medicine 20220531 1
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Project description:CONTEXT:Exogenous testosterone administration may affect blood clotting, polycythaemia, and may increase atherosclerosis, though any association with cardiovascular events is unclear. While the literature is inconclusive, some studies have suggested testosterone use may increase short-term risk of cardiovascular events and stroke, and injection testosterone may convey higher risks than other dosage forms. OBJECTIVE:We sought to evaluate the short-term cardiovascular risk of receiving injection testosterone. DESIGN:We conducted a case-crossover analysis comparing injection testosterone exposure in the 7 days prior to an outcome event to referent windows in the past to estimate the acute association of cardiovascular outcomes with the receipt of testosterone injections. PATIENTS:We identified adult male testosterone users hospitalized with myocardial infarction (MI), stroke or a composite of MI, stroke or unstable angina in US commercial claims (2000-2013) or Medicare (2007-2010) databases. MEASUREMENTS:We identified testosterone use for the patients from pharmacy dispensing claims or in-office procedure codes in the insurance billing data. RESULTS:We identified 2898 commercially insured men with events and recent testosterone use, and 339 from Medicare. Injected testosterone was associated with an increased risk of adverse events (composite outcome of myocardial infarction, stroke or unstable angina) in the immediate postinjection period for the older, Medicare population only: commercial insurance, odds ratios (OR) = 0.98 (95% confidence intervals [CI]: 0.86-1.12); Medicare, OR = 1.45 (1.07, 1.98). This association was either greatly attenuated or not present when evaluating receipt of any testosterone dosage forms (injection, gel, patch, implant): commercial insurance, OR = 1.01 (0.92, 1.11); Medicare, OR = 1.26 (95% CI: 0.98-1.63). CONCLUSIONS:Testosterone injections were uniquely associated with short-term risk of acute cardio- and cerebrovascular events in older adult men following injection receipt.
| S-EPMC5903996 | biostudies-literature
Project description:Sudden infant death syndrome (SIDS) is an occasional cause of unexpected mortality in infancy. While various etiological factors have been hypothesized, air pollution has been consistently presented as an environmental factor. In this study, we aimed to estimate the risk of SIDS in relation to exposure to air pollution and the effects of its modifying factors. A mortality dataset with supplementary infant mortality survey data from Statistics Korea was used and combined the concentration of ambient air pollution data from AirKorea based on the date of death and residential addresses of the SIDS cases. Odds ratios (ORs) were estimated according to birthweight, gestational age, maternal age, and infant age using a time-stratified case-crossover study design. The risk of exposure to particulate matter of less than 10 μm in diameter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide was estimated. The number of deaths due to SIDS was 454 (253 males and 201 females). The OR per 27.8 µg/m3 increment of PM10 was 1.14 (95% confidence interval [CI]: 1.03-1.25) and that per 215.8 ppb of CO was 1.20 (95% CI: 1.03-1.40) in all infants. In females, an increase in NO2 and CO levels was associated with a higher risk of SIDS in low-birthweight and preterm infants. The OR per 15.7 ppb increment in NO2 was highest among preterm infants, with a value of 5.12 (95% CI: 1.27-20.63), and low-birthweight individuals, with a value of 4.11 (95% CI: 1.74-9.72), at a moving average of 0 to 3 days. In males, however, no significant association was found. In the present study, exposure to air pollution was associated with an increased risk of SIDS. This association was more evident in susceptible infants with a low-birthweight or in cases of preterm birth.
| S-EPMC6765778 | biostudies-literature
Project description:With a case-crossover design, a case's exposure during a risk period is compared to the case's exposures at referent periods. The selection of referents for this self-controlled design is determined by the referent selection strategy (RSS). Previous research mainly focused on systematic bias associated with the RSS. We additionally focused on how RSS determines the number of referents per risk, sensitivity to overdispersion and time-varying confounding.We illustrated the consequences of different RSS using a simulation study informed by data on meteorological variables and Legionnaires' disease. By randomising the events and exposure time series, we explored statistical power associated with time-stratified and fixed bidirectional RSS and their susceptibility to systematic bias and confounding bias. In addition, we investigated how a high number of events on the same date (e.g. outbreaks) affected coefficient estimation. As illustrated by our work, referent selection alone can be insufficient to control for a time-varying confounding bias. In contrast to systematic bias, confounding bias can be hard to detect. We studied potential solutions: varying the model parameters and link-function, outlier-removal and aggregating the input-data over smaller areas. Our simulation study offers a framework for researchers looking to detect and to avoid bias in case-crossover studies.
| S-EPMC7374809 | biostudies-literature
Project description:In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records. The location and timing of CSO events were obtained from the Metropolitan Sewer District (MSD) of Greater Cincinnati. ED visits with a residential address within 500m of a CSO site were used in a case-control crossover study with two bi-directional control periods. Conditional logistic regression models were used to estimate the risk of an ED visit associated with a CSO event at lag periods of 0 to 7days. Statistically significant elevated risks for GI-related ED visits was observed two (OR: 1.16 [95% CI 1.04,1.30]) days after CSO events. CSO events were not significantly associated with asthma- or SSTI-related ED visits, but show similar trends. Our findings suggest an increased risk for GI-related ED visits following CSO events among children who reside near CSO sites.
| S-EPMC5818157 | biostudies-literature
Project description:PurposeIn this case-crossover study, we investigated the odds of having a labor/delivery with cardiovascular event (i.e., ischemic heart disease, stroke, heart failure, cardiac arrest/failure, and other or unspecified cardiovascular events) associated with acute exposure to common air pollutants.MethodsWe selected 680 women with singleton pregnancy and cardiovascular events at labor/delivery from 12 U.S. clinical sites (2002-2008). Exposures to six criteria air pollutants, six particulate constituents, and 26 air toxics were obtained using modified Community Multiscale Air Quality models. Conditional logistic regression models calculated the odds ratio (OR) and 95% confidence intervals (CI) comparing exposures during the day of delivery, the week before delivery, and each of the days of the week before delivery to two control periods before and after.ResultsAn interquartile range increase in particulate matter (PM) ≤2.5 microns and nitric oxide exposures during the week before delivery was associated with an 11% (OR 1.11, 95% CI: 1.01-1.23) and 21% (OR 1.21, 95% CI: 1.04-1.42) increased cardiovascular events odds, respectively. These pollutants, sulfur dioxide, carbon monoxide, PM ≤ 10 microns, and some PM constituents showed associations with event odds for days 0, 1, 5, and 6 before delivery. Inverse associations were observed for O3 and some PM constituents as well as air toxics.ConclusionsCardiovascular events at labor/delivery merit more attention in relation to air pollution.
| S-EPMC5533083 | biostudies-literature
Project description:ObjectiveTo test a priori hypothesis of an association between season-specific cold spells and sudden cardiac death (SCD).MethodsWe conducted a case-crossover study of 3614 autopsy-verified cases of SCD in the Province of Oulu, Finland (1998-2011). Cold spell was statistically defined by applying an individual frequency distribution of daily temperatures at the home address during the hazard period (7 days preceding death) and 50 reference periods (same calendar days of other years) for each case using the home coordinates. Conditional logistic regression was applied to estimate ORs for the association between the occurrence of cold spells and the risk of SCD after controlling for temporal trends.ResultsThe risk of SCD was associated with a preceding cold spell (OR 1.33; 95% CI 1.00, 1.78). A greater number of cold days preceding death increased the risk of SCD approximately 19% per day (OR 1.19; 95% CI 1.07 to 1.32). The association was strongest during autumn (OR 2.51; 95% CI 1.27 to 4.96) and winter (OR 1.70; 95% CI 1.13 to 2.55) and lowest during summer (OR 0.42; 95% CI 0.15 to 1.18) and spring (OR 0.89; 95% CI 0.45 to 1.79). The association was stronger for ischaemic (OR 1.55; 95% CI 1.12 to 2.13) than for non-ischaemic SCD (OR 0.68; 95% CI 0.32 to 1.45) verified by medicolegal autopsy.ConclusionsOur results indicate that there is an association between cold spells and SCD, that this association is strongest during autumn, when the weather event is prolonged, and with cases suffering ischaemic SCD. These findings are subsumed with potential prevention via weather forecasting, medical advice and protective behaviour.
| S-EPMC5695410 | biostudies-literature
Project description:In case-control research where there are multiple case groups, standard analyses fail to make use of all available information. Multiple events case-control (MECC) studies provide a new approach to sampling from a cohort and are useful when it is desired to study multiple types of events in the cohort. In this design, subjects in the cohort who develop any event of interest are sampled, as well as a fraction of the remaining subjects. We show that a simple case-control analysis of data arising from MECC studies is biased and develop three general estimating-equation-based approaches to analyzing data from these studies. We conduct simulation studies to compare the efficiency of the various MECC analyses with each other and with the corresponding conventional analyses. It is shown that the gain in efficiency by using the new design is substantial in many situations. We demonstrate the application of our approach to a nested case-control study of the effect of oral sodium phosphate use on chronic kidney injury with multiple case definitions.
| S-EPMC2980800 | biostudies-literature
Project description:Sudden Death in the Young Case Registry
| PRJNA942023 | ENA
Project description:Sudden Death in the Young Case Registry
| PRJNA942024 | ENA
Project description:Antipsychotics have been linked to prolongation of the QT interval. However, little is known about the risk of ventricular arrhythmia (VA) and/or sudden cardiac death (SCD) associated with individual antipsychotic drug use. This study was designed to investigate the association between specific antipsychotic drugs and the risk of VA and/or SCD. We conducted a case-crossover study using a nation-wide population-based sample obtained from Taiwan's National Health Insurance Research Database. A total of 17 718 patients with incident VA and/or SCD were enrolled. Conditional logistic regression models were applied to examine the effects of antipsychotic drug use on the risk of VA/SCD during various case and control time windows of 7, 14, and 28 days. The effect of the potency of a human ether-à-go-go-related gene (hERG) potassium channel blockade was also assessed. Antipsychotic drug use was associated with a 1.53-fold increased risk of VA and/or SCD. Antipsychotic drugs with increased risk included clothiapine, haloperidol, prochlorperazine, thioridazine, olanzapine, quetiapine, risperidone, and sulpiride. The association was significantly higher among those with short-term use. Antipsychotics with a high potency of the hERG potassium channel blockade had the highest risk of VA and/or SCD. Use of antipsychotic drugs is associated with an increased risk of VA and/or SCD. Careful evaluations of the risks and benefits of antipsychotic treatment are highly recommended.
| S-EPMC4345877 | biostudies-literature