Most prior work in quantitative approaches to generalizability and transportability emphasizes extending causal effect estimates from randomized trials to target populations. Extending findings from observational studies is also of scientific interest, and identifiability assumptions and estimation methods differ from randomized settings when there is selection on both the exposure and exposure-outcome mediators in combination with exposure-outcome confounders (and both confounders and mediators can modify exposure-outcome effects). We argue that this causal structure is common in observational studies, particularly in the field of life course epidemiology, for example, when extending estimates of the effect of an early-life exposure on a later-life outcome from a cohort enrolled in midlife or late life. We describe identifiability assumptions and identification using observed data in such settings, highlighting differences from work extending findings from randomized trials. We describe statistical methods, including weighting, outcome modeling, and doubly robust approaches, to estimate potential outcome means and average treatment effects in the target population and illustrate performance of the methods in a simulation study. We show that in the presence of selection into the study sample on both exposure and confounders, estimators must be able to address confounding in the target population. When there is also selection on mediators of the exposure-outcome relationship, estimators need to be able to use different sets of variables to account for selection (including the mediator), and confounding. We discuss conceptual implications of our results as well as highlight unresolved practical questions for applied work to extend findings from observational studies to target populations.
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http://dx.doi.org/10.1097/EDE.0000000000001780 | DOI Listing |
BMC Psychiatry
December 2024
Suzhou Guangji Hospital, Suzhou, Jiangsu Province, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China.
Background: In observational studies, frailty has been strongly associated with mental disorders. However, the mechanisms underlying the association between frailty and mental disorders remain unclear.
Methods: We conducted a two-sample Mendelian randomization (MR) study to assess the causal relationship between frailty, as measured by the frailty index (FI), and ten common mental disorders.
J Healthc Qual Res
December 2024
Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Introduction And Objectives: The principle of patient autonomy in the participation and incorporation of their health data in research projects is a legal and deontological obligation that must be fulfilled. The aim of this study was to know the degree of compliance and adequacy of informed consent in clinical research projects in a university hospital.
Material And Methods: Through this cross-sectional study, the adequacy of the way patient data are obtained in the research projects presented to the Research Committee of a university hospital was analyzed.
Zhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of Gastrointestinal Endoscopy, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou510655, China Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University,Guangzhou510655, China.
To examine follow-up data of different subgroups in order to further evaluate the performance and practical value of community colorectal cancer screening by detection of stool methylation syndecan-2 gene (m) among residents of Shipai Town, Dongguan City. This was an observational study. From May 2021 to February 2022, the Shipai Town government of Dongguan City completed screening for colorectal cancer by detection of stool m in 10,708 residents from 18 villages who had met the initial screening criteria and been selected using whole population sampling.
View Article and Find Full Text PDFAm Heart J
December 2024
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Background: Percutaneous coronary intervention of severely calcified lesions is limited by inadequate stent expansion and poor clinical outcomes. Over the past decade, several devices and techniques have been developed for calcium modification and lesion preparation. Intravascular lithotripsy (IVL) is a novel tool in this context.
View Article and Find Full Text PDFIndian Heart J
December 2024
Jacobi Medical Center/North Central Bronx, Albert Einstein College of Medicine, NYC Health and Hospitals, 3424 Kossuth Avenue, Bronx, New York, 10467.
Aim: The present study aims to investigate the outcomes of Percutaneous coronary intervention (PCI) in patients with Rheumatoid arthritis (RA).
Methods: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 15 September 2023. All statistical analyses were conducted using Review Manager 5.
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