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Cohort profile: the provincial opioid agonist treatment cohort in Ontario, Canada.
Eur J Epidemiol
January 2025
Health Sciences North Research Institute, Sudbury, ON, Canada.
Background: Opioid Agonist Treatment (OAT) is the most effective intervention for opioid use disorder (OUD), but retention has decreased due to increasingly potent drugs like fentanyl. This cohort can be used retrospectively to observe trends in service utilization, healthcare integration, healthcare costs and patient outcomes. It also facilitates the design of observational studies to mimic a prospective design.
View Article and Find Full Text PDFVeno-venous extracorporeal membrane oxygenation (VV-ECMO) for acute poisonings in United States: a retrospective analysis of the Extracorporeal Life Support Organization Registry.
Clin Toxicol (Phila)
January 2025
Pediatric Intensive Care Unit, Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Introduction: Veno-arterial extracorporeal membrane oxygenation is frequently considered and implemented to help manage patients with cardiogenic shock from acute poisoning. However, utilization of veno-venous extracorporeal membrane oxygenation in acutely poisoned patients is largely unknown.
Method: We conducted a retrospective study analyzing the epidemiologic, clinical characteristics and survival of acutely poisoned patients placed on veno-venous extracorporeal membrane oxygenation using the Extracorporeal Life Support Organization registry.
Four targets: an enhanced framework for guiding causal inference from observational data.
Int J Epidemiol
December 2024
Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, United States.
Observational studies play an increasingly important role in estimating causal effects of a treatment or an exposure, especially with the growing availability of routinely collected real-world data. To facilitate drawing causal inference from observational data, we introduce a conceptual framework centered around "four targets"-target estimand, target population, target trial, and target validity. We illustrate the utility of our proposed "four targets" framework with the example of buprenorphine dosing for treating opioid use disorder, explaining the rationale and process for employing the framework to guide causal thinking from observational data.
View Article and Find Full Text PDFThe U.S. opioid epidemic is an extraordinary public health crisis that started in 1990 and significantly accelerated in the last decade.
View Article and Find Full Text PDFUnderstanding the opioid syndemic in North Carolina: A novel approach to modeling and identifying factors.
Biostatistics
December 2024
Department of Statistical Sciences, College of Arts and Sciences, Wake Forest University, 127 Manchester Hall, Winston-Salem, NC, 27109, United States.
The opioid epidemic is a significant public health challenge in North Carolina, but limited data restrict our understanding of its complexity. Examining trends and relationships among different outcomes believed to reflect opioid misuse provides an alternative perspective to understand the opioid epidemic. We use a Bayesian dynamic spatial factor model to capture the interrelated dynamics within six different county-level outcomes, such as illicit opioid overdose deaths, emergency department visits related to drug overdose, treatment counts for opioid use disorder, patients receiving prescriptions for buprenorphine, and newly diagnosed cases of acute and chronic hepatitis C virus and human immunodeficiency virus.
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