High-quality Epidemiological Research Research Articles

Exploring postgraduate epidemiology competencies: Preparing our students for a post-COVID world

ObjectiveThis research sought consensus from both experts and graduates on postgraduate epidemiology competencies. MethodsIn 2021, a two-round online survey using a modified Delphi method was undertaken exploring competencies across six domains. Focus groups were conducted with recent postgraduate epidemiology graduates to assess their viewpoints on learning experiences and employability. ResultsForty-one experts participated in the first Delphi round. Nineteen factors reached consensus (>70% agreement) for importance and feasibility after two survey rounds in the following domains: general epidemiologic methods/concepts (n=8/13), advanced analytic/statistical skills (n=2/7), applied epidemiology/specialised fields (n=1/4), professional/transferrable skills (n=5/14), general public health knowledge/skills (n=2/4), independent research and work-integrated learning (n=1/3). Nine graduates participated in focus groups. A main theme was the substantial value gained in undertaking a dissertation, acknowledging its benefit for applying research skills and for networking opportunities. ConclusionsTo ensure that high-quality epidemiological research and practice continues, we need consensus on the set of essential skills required of graduating students. Implications for Public HealthCompetencies for postgraduate epidemiology students require periodic review to safeguard a workforce that can meet emerging challenges and work across academia, research, policy, and practice.

Environmental substances associated with Alzheimer's disease – A scoping review

Abstract Background Dementia is an overarching term for memory-affecting and progressive diseases interfering with cognitive abilities, behaviour and daily living of persons affected. Deterioration of cognitive function influences the processes of memory, thinking, orientation, comprehension, learning and language capacity as well as judgement. Alzheimer's disease (AD) is the most common form of dementia, prevalent in approximately 50-70% of the dementia cases. In 2015, there were 47 million people affected by dementia worldwide, and the figure was estimated to increase to 75 million by 2030 and to 132 million by 2050. Genetics, environmental factors and lifestyle patterns are risk factors for developing AD. Methods In the framework of the “European Human Biomonitoring Initiative” (HBM4EU, https://www.hbm4eu.eu/), a set of 18 substances or substance groups were prioritized for investigation. For each of these, a scoping document was developed, summarizing current knowledge and policy-related knowledge gaps. This work presents a scoping review of chemical substances, which may be associated with AD, based on the HBM4EU scoping documents and relevant recent scientific literature. Results Exposure to pesticides is possibly a risk factor for AD. Exposure to mercury is possibly associated with AD development, but results are inconsistent. Though results on cadmium and arsenic and AD are conflicting, they are possibly associated with the risk of disease. The evidence regarding lead is weak. Harmful exposures to these substances in Europe were mostly connected to occupational settings. Conclusions Although there is tentative evidence on exposure to environmental substances and risk for AD, more research is needed. Some evidence is inconsistent and there is a lack of extensive human studies. Attention should be paid to certain occupations, such as farmers exposed to pesticides and workers exposed to heavy metals, since these substances may be linked to increased disease rates of AD. Key messages Exposure to pesticides, mercury, cadmium and arsenic may adversely affect cognitive abilities and contribute to risk of AD. High-quality epidemiological research is needed to confirm the findings. Because adverse environmental chemical exposures affect both workers in certain occupations and general public, protecting humans from the chemical hazards is an essential public health issue.

1263Exploring postgraduate epidemiology competencies in the Australian context

Abstract Background In response to emerging challenges faced by epidemiologists, it is timely to ensure that university teaching aligns with the competencies required in professional practice. Therefore, the field requires a regular evaluation of the educational competencies being covered. The aim of this research was to seek consensus from both students and experts on postgraduate epidemiology competencies relevant to the Australian context. Methods A two-round online survey using a modified Delphi method was used to establish expert consensus on postgraduate epidemiology competencies. Focus groups were also conducted with recent graduates who completed a postgraduate epidemiology course to assess their viewpoints on learning experiences and employability. Results In total, 41 experts participated in the first Delphi round. A total of 19/40 factors (general epidemiologic methods/concepts) reached consensus in the first round for importance (high/most important by > 70% of participants). Seventeen factors also reached consensus in terms of feasibility (usually/always/very feasible by > 70% of participants). Further results from the second Delphi round focusing on advanced analysis skills, applied fields and professional/transferrable skills will be available for presentation at the Conference. One main theme emerging from the graduate focus groups was the substantial value gained in undertaking a dissertation, acknowledging its benefit for applying research skills and for networking opportunities. Conclusions Competencies for postgraduate epidemiology students require periodic review to safeguard a workforce that can meet emerging challenges. Key messages To ensure that high quality epidemiological research and practice continues we need consensus on the set of essential skills required of graduating students.

Recurrent Traumatic Brain Injury Surveillance Using Administrative Health Data: A Bayesian Latent Class Analysis.

Background: The initial injury burden from incident TBI is significantly amplified by recurrent TBI (rTBI). Unfortunately, research assessing the accuracy to conduct rTBI surveillance is not available. Accurate surveillance information on recurrent injuries is needed to justify the allocation of resources to rTBI prevention and to conduct high quality epidemiological research on interventions that mitigate this injury burden. This study evaluates the accuracy of administrative health data (AHD) surveillance case definitions for rTBI and estimates the 1-year rTBI incidence adjusted for measurement error.Methods: A 25% random sample of AHD for Montreal residents from 2000 to 2014 was used in this study. Four widely used TBI surveillance case definitions, based on the International Classification of Disease and on radiological exams of the head, were applied to ascertain suspected rTBI cases. Bayesian latent class models were used to estimate the accuracy of each case definition and the 1-year rTBI measurement-error-adjusted incidence without relying on a gold standard rTBI definition that does not exist, across children (<18 years), adults (18-64 years), and elderly (> =65 years).Results: The adjusted 1-year rTBI incidence was 4.48 (95% CrI 3.42, 6.20) per 100 person-years across all age groups, as opposed to a crude estimate of 8.03 (95% CrI 7.86, 8.21) per 100 person-years. Patients with higher severity index TBI had a significantly higher incidence of rTBI compared to patients with lower severity index TBI. The case definition that identified patients undergoing a radiological examination of the head in the context of any traumatic injury was the most sensitive across children [0.46 (95% CrI 0.33, 0.61)], adults [0.79 (95% CrI 0.64, 0.94)], and elderly [0.87 (95% CrI 0.78, 0.95)]. The most specific case definition was the discharge abstract database in children [0.99 (95% CrI 0.99, 1.00)], and emergency room visits claims in adults/elderly [0.99 (95% CrI 0.99, 0.99)]. Median time to rTBI was the shortest in adults (75 days) and the longest in children (120 days).Conclusion: Conducting accurate surveillance and valid epidemiological research for rTBI using AHD is feasible when measurement error is accounted for.

A Roadmap for conducting psychosocial research in epidemiological studies: perspectives of cohort study principal investigators

BackgroundPsychosocial adversity disproportionately affects racial/ethnic and socioeconomic minorities in the USA, and therefore understanding the mechanisms through which psychosocial stress and resilience influence human health can provide meaningful insights into...

RETRACTED: How many bereaved people hallucinate about their loved one? A systematic review and meta-analysis of bereavement hallucinations

Bereavement hallucinations (BHs) entail a perception of a deceased in any sense modality or as a quasi-sensory sense of presence. BHs are an associated feature of the proposed Persistent Complex Bereavement Disorder (PCBD) in DSM-5. The goals of this review are to estimate the prevalence of BHs, identify possible moderators, and review the methodological status of this research field. A systematic literature search was conducted through the databases PubMed, PsycINFO, and CINAHL. Studies systematically assessing the prevalence of BHs of a relative or friend were included. Twenty-one eligible studies were identified and 8 meta-analyses of BHs in different sense modalities were conducted. The prevalence of having one or more BHs was estimated to be 56.6% (95% CI 49.9-63.2), and the estimated prevalence of BHs in specific sense modalities ranged within 7.0-39.7%. Meta-regression analyses revealed associations to age and conjugal bereavement, but results are tentative and dependent on the type of BH in question. The included studies were methodologically heterogeneous. Limitations included the lack of a valid measure of BHs and low sample generalizability. This first systematic review and meta-analysis of BHs suggests that more than half of the bereaved people experience some kind of BH. However, there are considerable methodological limitations in the research of BHs, which is of pertinent interest as BHs have been linked to the development of a future diagnosis of clinically impairing grief. A valid measure of BHs needs to be developed and used in high-quality epidemiological research using population-based designs.

How to write high-quality epidemiological research paper Ⅵ. Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut)

Concerns have been raised about the reporting quality in nutritional epidemiology. Therefore, strengthening the reporting of observational studies in epidemiology-nutritional epidemiology (STROBE-nut) has been proposed by extending the STROBE statement to include additional recommendations on issues related to nutritional epidemiology and dietary assessment, aiming to provide more specific guidelines on how to report observational research in the field. This paper presents a brief introduction to STROBE-nut and also an explanation of the key points in the additional items, with an example illustrating the application of the checklist.

A review of the public health impacts of unconventional natural gas development.

The public health impact of hydraulic fracturing remains a high profile and controversial issue. While there has been a recent surge of published papers, it remains an under-researched area despite being possibly the most substantive change in energy production since the advent of the fossil fuel economy. We review the evidence of effects in five public health domains with a particular focus on the UK: exposure, health, socio-economic, climate change and seismicity. While the latter would seem not to be of significance for the UK, we conclude that serious gaps in our understanding of the other potential impacts persist together with some concerning signals in the literature and legitimate uncertainties derived from first principles. There is a fundamental requirement for high-quality epidemiological research incorporating real exposure measures, improved understanding of methane leakage throughout the process, and a rigorous analysis of the UK social and economic impacts. In the absence of such intelligence, we consider it prudent to incentivise further research and delay any proposed developments in the UK. Recognising the political realities of the planning and permitting process, we make a series of recommendations to protect public health in the event of hydraulic fracturing being approved in the UK.

Validity of a hospital-based obstetric register using medical records as reference.

BackgroundData from hospital-based registers and medical records offer valuable sources of information for clinical and epidemiological research purposes. However, conducting high-quality epidemiological research requires valid and complete data sources.ObjectiveTo assess completeness and validity of a hospital-based clinical register – the Obstetric Database – using a national register and medical records as references.MethodsWe assessed completeness of a hospital-based clinical register – the Obstetric Database – by linking data from all women registered in the Obstetric Database as having given birth in 2013 to the National Patient Register with coverage of all births in 2013. Validity of eleven selected indicators from the Obstetric Database was assessed using medical records as a golden standard. Using a random sample of 250 medical records, we calculated proportion of agreement, sensitivity, specificity, and positive and negative predictive values for each indicator. Two assessors independently reviewed medical records and inter-rater reliability was calculated as proportion of agreement and Cohen’s κ coefficient.ResultsWe found 100% completeness of the Obstetric Database when compared to the Danish National Patient Register. Except for one delivery all 6,717 deliveries were present in both registers. Proportion of agreement between the Obstetric Database and medical records ranged from 91.1% to 99.6% for the eleven indicators. The validity measures ranged from 0.70 to 1.00 indicating high validity of the Obstetric Database. κ coefficients from the inter-rater reliability ranged from 0.71 to 1.00.ConclusionCompleteness and validity of the Obstetric Database were found acceptable when using the National Patient Register and medical records as golden standards. The Obstetric Database therefore offers a valuable source for examining clinical, administrative, and research questions.

How to write high-quality epidemiological research paper V. Guidelines for Transparent Reporting of Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION statement)

[导读]医院感染已成为增加医疗负担的重要原因.随着医院感染问题日趋严重,越来越多的研究者开展相关领域的研究,以期为医院感染防控工作提供参考和建议.然而相关研究的报告质量参差不齐,限制了这些研究结果的理解和进一步利用.本文介绍“医院感染暴发报告和干预研究的透明报告规范”(Guidelines for Transparent Reporting of Outbreak Reports and Intervention Studies of Nosocomial Infection,ORION statement),并解读报告规范中一些重要的条目。

How to write high-quality epidemiological research paper IV. Strengthening the reporting of immune genome studies statement-introduction and explanation

现代高通量的人类白细胞抗原和杀伤细胞免疫球蛋白样受体分型技术产生了大量的免疫基因组学数据,对组织相容性和免疫相关的疾病关联研究带来深刻影响.而免疫基因组学数据的高度多态性为不同数据集的信息合成带来了独特的方法学和计算挑战.“加强免疫基因组学研究报告规范”(Strengthening the Reporting of Immunogenomic Studies statemen,STREIS)以STREGA为基础进行了扩展,专门说明免疫基因组学数据的相关问题,以加强研究的透明化报告和一致性解释.本文旨在介绍STREIS清单并对扩展条目进行解读。

How to write high-quality epidemiological research paper III. Reporting recommendations for Tumor Marker Prognostic Studies(REMARK)-introduction and explanation

尽管肿瘤标志物的研究已历经多年且产出颇丰,但真正能够应用到临床者却很少.其中不规范、不全面的报告严重影响了研究质量及结果评估,在一定程度上制约了肿瘤标志物的发展及应用.本文旨在介绍肿瘤标志物预后研究报告规范(Reporting Recommendations for Tumor Marker Prognostic Studies,REMARK)的清单内容,并对一些重要条目进行说明及解读。

How to write high-quality epidemiological research paper I. Statement of genetic risk prediction studies (GRIPS) -introduction and explanation

[导读]随着遗传流行病学的兴起,复杂疾病的遗传风险预测日益得到关注.近年来,遗传风险预测研究层出不穷,但其在报告的质量和完整性方面存在很大差别.对该类研究结果的正确评价有赖于规范、准确的报告.本文介绍加强遗传风险预测研究报告质量声明(Genetic RiskPrediction Studies,GRIPS)的清单内容,并对其中一些重要条目做详细说明。

Thirty years on from Alma-Ata: Where have we come from? Where are we going?

The 2008 William Pickles Lecture coincided with a number of important anniversaries: 60 years since Pickles published his landmark monograph ‘ Epidemiology in Country Practice ’;1 40 years since Pat Byrne gave the first William Pickles Lecture at the Royal College of General Practitioners; and 30 years since the publication of the Alma-Ata Declaration.2 In my lecture, I cover four themes. First, whatever happened to what is sometimes depicted as the idyllic life of the William Pickles-style country GP? Second, whatever happened to Alma-Ata? Third, what — more generally — do these changes represent? And finally, what (if anything) can we salvage from our nostalgic memories of old-fashioned general practice that will help us in our contemporary role as primary care practitioners? William Pickles was a GP in the glorious setting of Wensleydale in the Yorkshire Dales from 1922 until the mid 1960s. He demonstrated that high-quality epidemiological research can be achieved if family doctors think hard about their practice, pursue their clinical and scientific hunches, and keep meticulous records.1 His intimate knowledge of the local rural community and its ways; his simple hand-drawn epidemiological charts; and his ruthless hunting down of the social contacts of people with contagious diseases, equipped him to make significant contributions to the science of epidemiology — including documenting the incubation period of measles, influenza, hepatitis A, and dysentery, as well as helping to establish the link between chickenpox and shingles. Wensleydale in the early 20th century was a quintessentially English farming community. It was by no means affluent but it was close-knit, hard-working, and focused almost exclusively on the core business of growing crops, tending livestock, and getting products to market. Records suggest that the family doctor was a unique and respected member of such rural communities, who tended to suffer …

Is it possible to carry out high-quality epidemiological research in psychiatry with limited resources?

This review covers the epidemiological research from developing countries to identify the scope of research in the various aspects of epidemiology and the strengths of research. The period covered is June 2004 to June 2005. The literature survey used searches of Medline, key psychiatric journals and personal correspondence with leading psychiatric researchers from developing countries. There is a new interest in epidemiological studies in developing countries. These studies have been driven by three factors, namely international collaboration; specific situations like disasters, terrorism and severe acute respiratory syndrome; and international attention to specific topics like maternal depression. There is limited long-term research on specific conditions. There are a number of leads suggesting local social-cultural factors contribute to the distribution of psychiatric problems. Child psychiatry continues to be low in priority. There is also lack of research in areas such as personality disorders and organic psychiatric disorders. It is possible to carry out high quality epidemiological research in developing countries. Such research has provided new insights into the distribution, causation, course and outcome of mental disorders. There is need for greater attention to the development of epidemiological assessment tools to suit local conditions. Specific centers/institutions developing long-term research interests on specific subjects would be valuable for future efforts. There is also need to widen the conditions to be studied.