A consistent pattern of slide effects in Illumina DNA methylation BeadChip array data.

Recent studies have identified thousands of associations between DNA methylation CpGs and complex diseases/traits, emphasizing the critical role of epigenetics in understanding disease aetiology and identifying biomarkers. However, association analyses based on methylation array data are susceptible to batch/slide effects, which can lead to inflated false positive rates or reduced statistical power We use multiple DNA methylation datasets based on the popular Illumina Infinium MethylationEPIC BeadChip array to describe consistent patterns and the joint distribution of slide effects across CpGs, confirming and extending previous results. The susceptible CpGs overlap with the Illumina Infinium HumanMethylation450 BeadChip array content.

Covariate adjustment of spirometric and smoking phenotypes: The potential of neural network models.

To increase power and minimize bias in statistical analyses, quantitative outcomes are often adjusted for precision and confounding variables using standard regression approaches. The outcome is modeled as a linear function of the precision variables and confounders; however, for many complex phenotypes, the assumptions of the linear regression models are not always met. As an alternative, we used neural networks for the modeling of complex phenotypes and covariate adjustments.

Machine Learning For Tuning, Selection, And Ensemble Of Multiple Risk Scores For Predicting Type 2 Diabetes.

Background: This study proposes the use of machine learning algorithms to improve the accuracy of type 2 diabetes predictions using non-invasive risk score systems.

Methods: We evaluated and compared the prediction accuracies of existing non-invasive risk score systems using the data from the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study). Two simple risk scores were established on the bases of logistic regression.

Statistical detection of geographic clusters of resistant Escherichia coli in a regional network with WHONET and SaTScan.

Background: While antimicrobial resistance threatens the prevention, treatment, and control of infectious diseases, systematic analysis of routine microbiology laboratory test results worldwide can alert new threats and promote timely response. This study explores statistical algorithms for recognizing geographic clustering of multi-resistant microbes within a healthcare network and monitoring the dissemination of new strains over time.

Methods: Escherichia coli antimicrobial susceptibility data from a three-year period stored in WHONET were analyzed across ten facilities in a healthcare network utilizing SaTScan's spatial multinomial model with two models for defining geographic proximity.

Geographic clusters in underimmunization and vaccine refusal.

Background And Objective: Parental refusal and delay of childhood vaccines has increased in recent years and is believed to cluster in some communities. Such clusters could pose public health risks and barriers to achieving immunization quality benchmarks. Our aims were to (1) describe geographic clusters of underimmunization and vaccine refusal, (2) compare clusters of underimmunization with different vaccines, and (3) evaluate whether vaccine refusal clusters may pose barriers to achieving high immunization rates.

Associations of early life risk factors with infant sleep duration.

Objective: Insufficient sleep in children is associated with adverse health effects. We examined the associations of early life risk factors with infant sleep duration.

Methods: We studied 1676 mother-infant pairs in a prebirth cohort study.

Asthma care quality for children with minority-serving providers.

Objective: To compare asthma care quality for children with and without minority-serving providers.

Design: Cross-sectional telephone survey of parents, linked with a mailed survey of their children's providers.

Setting: A Medicaid-predominant health plan and multispecialty provider group in Massachusetts.

Willingness to pay for a QALY based on community member and patient preferences for temporary health states associated with herpes zoster.

Background And Objectives: A clear sense of what society is willing to pay for a QALY could enhance the usefulness of cost-effectiveness analysis as a field. Scant information exists on willingness to pay (WTP) for a QALY based on direct elicitation of preferences from community members or patients. We had the opportunity to evaluate WTP per QALY using data from a survey on temporary health outcomes related to herpes zoster.

Predictive value of seizure ICD-9 codes for vaccine safety research.

Post-licensure vaccine safety studies often monitor for seizures using automated screening of ICD-9 codes. This study assessed the positive predictive value (PPV) of ICD-9 codes used to identify seizure visits in children aged 6 weeks to 23 months who were enrolled in seven managed care organizations during January 2000 to December 2005. ICD-9 codes were used to identify visits for seizures in the 0-30-day period following receipt of a pneumococcal vaccine.

INSIG2 is Associated with Lower Gain in Weight-for-Length Between Birth and Age 6 Months.

Researchers have described the association of a common DNA polymorphism, rs7566605, near INSIG2 (insulin-induced gene 2) with obesity in multiple independent populations that include subjects ages 11-60 years.1 To our knowledge, no studies have examined the association of this polymorphism with weight status during early childhood. We explored the association of the rs7566605 polymorphism with weight-for-length among 319 children at 6 months and 3 years participating in Project Viva, a pre-birth cohort study.

Repeatability of response to asthma medications.

Background: Pharmacogenetic studies of drug response in asthma assume that patients respond consistently to a treatment but that treatment response varies across patients; however, no formal studies have demonstrated this.

Objective: To determine the repeatability of commonly used outcomes for treatment response to asthma medications: bronchodilator response, FEV(1), and PC(20).

Methods: The Childhood Asthma Management Program was a multicenter clinical trial of children randomized to receiving budesonide, nedocromil, or placebo.

Short sleep duration in infancy and risk of childhood overweight.

Objective: To examine the extent to which infant sleep duration is associated with overweight at age 3 years.

Design: Longitudinal survey.

Setting: Multisite group practice in Massachusetts.

Racial/Ethnic variation in parent perceptions of asthma.

Objective: Black and Latino children with asthma have worse morbidity and receive less controller medication than their white peers. Scant information exists on racial/ethnic differences in parent perceptions of asthma. To compare parent perceptions among black, Latino, and white children with asthma in 4 domains: (1) expectations for functioning with asthma; (2) concerns about medications; (3) interactions with providers; and (4) competing family priorities.

Community and patient values for preventing herpes zoster.

Objectives: The US Advisory Committee on Immunization Practices has recently recommended a new vaccine against herpes zoster (shingles) for routine use in adults aged > or =60 years. However, estimates of the cost effectiveness of this vaccine vary widely, in part because of gaps in the data on the value of preventing herpes zoster. Our aims were to (i) generate comprehensive information on the value of preventing a range of outcomes of herpes zoster; (ii) compare these values among community members and patients with shingles and post-herpetic neuralgia (PHN); and (iii) identify clinical and demographic characteristics that explain the variation in these values.

Trends in childhood anemia in a Massachusetts Health Maintenance Organization, 1987-2001.

Context: An important indicator of nutritional status within a pediatric population is the anemia prevalence rate. Limited national data are available regarding trends in anemia prevalence among non-low-income children.

Objective: To determine the prevalence of anemia over time among children enrolled in a health maintenance organization (HMO).

To what extent is the protective effect of breastfeeding on future overweight explained by decreased maternal feeding restriction?

Objective: Previous studies have found that breastfeeding may protect infants against future overweight. One proposed mechanism is that breastfeeding, as opposed to bottle feeding, promotes maternal feeding styles that are less controlling and more responsive to infant cues of hunger and satiety, thereby allowing infants greater self-regulation of energy intake. The objective of this study was to determine the extent to which the protective effect of breastfeeding on future overweight is explained by decreased maternal feeding restriction.

The association of television and video viewing with fast food intake by preschool-age children.

Objective: To examine the extent to which television (TV) and video viewing is associated with consumption of fast food by preschool-age children.

Research Methods And Procedures: In a cross-sectional study of 240 parents of children ages 2.0 to 5.

Variation in hepatitis B immunization coverage rates associated with provider practices after the temporary suspension of the birth dose.

Background: In 1999, the American Academy of Pediatrics and U.S. Public Health Service recommended suspending the birth dose of hepatitis B vaccine due to concerns about potential mercury exposure.

Influenza vaccination among children with asthma in medicaid managed care.

Objective: To describe influenza vaccination rates and identify risk factors for missing vaccination among children with asthma in managed Medicaid.

Methods: As part of a longitudinal study of asthma care quality, parents of children aged 2-16 years with asthma enrolled in Medicaid managed care organizations in Massachusetts, Washington, and California were surveyed by telephone at baseline and 1 year. We evaluated influenza vaccination rates during the follow-up year.

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

Objective: To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families.

Data Source: The Household Component of the 2001 Medical Expenditure Panel Survey.

Study Design: Cross-sectional family-level analysis.

Breast cancer screening. Benefits, risks, and current controversies.

Mammography is the best tool available for screening for breast cancer. Although the data supporting clinical breast examination are not as strong, this procedure continues to be widely used in the United States. To maximize accuracy of results, women who undergo screening during their premenopausal years should attempt to schedule mammography during the follicular phase of the menstrual cycle.

Pertussis in adolescents and adults: should we vaccinate?

Background: The incidence of reported pertussis among adolescents, adults, and young infants has increased sharply over the past decade. Combined acellular pertussis vaccines for adolescents and adults are available in Canada, Australia, and Germany and may soon be considered for use in the United States.

Objective: To evaluate the potential health benefits, risks, and costs of a national pertussis vaccination program for adolescents and/or adults.

Overcoming economic barriers to the optimal use of vaccines.

Vaccines are among the most cost-effective interventions in health care, but economic factors may interfere with their optimal development and delivery in both industrialized and developing countries. For the United States, making the best use of available vaccines will require increasing the financing for vaccines via the public and private systems. For developing countries, innovative and promising approaches include pull mechanisms to establish predictable demand and push mechanisms such as targeted development programs.