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Meta-analysis with zero-event studies:a comparative study with application to COVID-19 data

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Military Medical Research 2022年第1期9卷 126-137页

作者： Jia-Jin Wei En-Xuan Lin Jian-Dong Shi Ke Yang Zong-Liang Hu Xian-Tao Zeng Tie-Jun Tong department of Mathematics Hong Kong Baptist UniversityHong KongChina Shenzhen Research Institute of Big Data ShenzhenChina College of Mathematics and Statistics Shenzhen UniversityShenzhenChina Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhanChina.

Background:Meta-analysis is a statistical method to synthesize evidence from a number of independent studies,including those from clinical studies with binary outcomes.In practice,when there are zero events in one or both groups,it may cause statistical problems in the subsequent analysis.Methods:In this paper,by considering the Relative risk as the effect size,we conduct a comparative study that consists of four continuity correction methods and another state-of-the-art method without the continuity correction,namely the generalized linear mixed models(GLMMs).To further advance the literature,we also introduce a new method of the continuity correction for estimating the Relative risk.Results:From the simulation studies,the new method performs well in terms of mean squared error when there are few studies.In contrast,the generalized linear mixed model performs the best when the number of studies is large.In addition,by reanalyzing recent coronavirus disease 2019(COVID-19)data,it is evident that the double-zero-event studies impact the estimate of the mean effect size.Conclusions:We recommend the new method to handle the zero-event studies when there are few studies in a meta-analysis,or instead use the GLMM when the number of studies is large.The double-zero-event studies may be informative,and so we suggest not excluding them.

关键词： Continuity correction Coronavirus disease 2019 data Meta-analysis Relative risk Zero-event studies

Transmission and mortality risk assessment of severe fever with thrombocytopenia syndrome in China:results from 11-years’study

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Infectious Diseases of Poverty 2022年第5期11卷 30-40页

作者： Qiulan Chen Dong Yang Yanping Zhang Mantong Zhu Ning Chen Zainawudong Yushan Key Laboratory of Surveillance and Early-Warning on Infectious Diseases Chinese Center for Disease Control and PreventionBeijingChina Changsha Center for Disease Control and Prevention ChangshaChina School of Public Health Guangxi Medical UniversityNanningChina Chinese Center for Disease Control and Prevention Changbai RoadChangpingBeijing 102206China.

Background: The transmission and fatal risk of severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease first discovered in China in 2009, still needed further quantification. This research aimed to analyze the SFTS clusters and assess the transmission and mortality risk for SFTS.Methods: Both epidemiological investigation and case reports regarding SFTS clusters in China during 2011-2021 were obtained from the Public Health Emergency Information Management System of the Chinese Center for Disease Control and Prevention Information System. The transmission risk was evaluated by using the secondary attack rate (SAR) and Relative risk (RR). Mortality risk factors were analyzed using a logistic regression model.Results: There were 35 SFTS clusters during 2011-2021 involving 118 patients with a fatality rate of 22.0%. The number of clusters annually increased seasonally from April to September. The clusters mainly occurred in Anhui (16 clusters) and Shandong provinces (8 clusters). The SAR through contact with blood or bloody fluids was much higher than that through contact with non-bloody fluids (50.6% vs 3.0%;χ^(2) = 210.97,P risk factors were a long interval from onset to diagnosis [odds ratio (OR)= 1.385), 95%CI: 1.083-1.772,P= 0.009) and advanced age (OR: 1.095, 95%CI: 1.031-1.163,P= 0.01).Conclusions: The SFTS clusters showed a high mortality rate and resulted in a high SAR. Contact with a bleeding corpse was associated with a higher infection risk, compared with contacting the blood from living patients. It is important to promote early detection and appropriate case management of patients with SFTS, as well as improved handling of their corpses,

关键词： Severe fever with thrombocytopenia syndrome Cluster Human-to-human transmission Transmission risk Secondary attack rate Blood contact Relative risk Epidemiological characteristics Mortality China

Study on the correlation between ambient environment-meteorological factors and the number of visits of acute otitis media,Lanzhou,China

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Journal of Otology 2020年第3期15卷 86-94页

作者： Haiyue Tian Baicheng Xu Xinlan Wang Jinyan Wang Cuiping Zhong From the Department of Otolaryngology Head and Neck Surgery The 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA333 Binhenan RoadQilihe DistrictLanzhouGansu Province730050China From the Department of OtolaryngologyeHead and Neck Surgery Second Affiliated Hospital of Lanzhou UniversityNo.82CuiyingmenChengguan DistrictLanzhouGansu Province730030China From the School of Atmospheric Sciences Lanzhou UniversityNo.222Tianshuinan RoadChengguan DistrictLanzhouGansu Province730000China

To investigate the correlation between environmental-meteorological factors and daily visits for acute otitis media(AOM)in Lanzhou,China.Methods:Data were collected in 2014e2016 by the Departments of Otolaryngology-Head and Neck Surgery at two hospitals in Lanzhou.Relevant information,including age,sex and visiting time,was collected.Environmental data included air quality index,PM10,PM2.5,O3,CO,NO2 and SO2,and meteorological data included daily average temperature(T,C),daily mean atmospheric pressure(AP,hPa),daily average relative humidity(RH,%)and daily mean wind speed(W,m/s).The SPSS22.0 software was used to generate Spearman correlation coefficients in descriptive statistical analysis,and the R3.5.0 software was used to calculate Relative risk(RR)and to obtain exposure-response curves.The relationship between meteorological-environmental parameters and daily AOM visits was summarized.Results:Correlations were identified between daily AOM visits and CO,O3,SO2,CO,NO2,PM2.5 and PM10 levels.NO2,SO2,CO,AP,RH and T levels significantly correlated with daily AOM visits with a lag exposure-response pattern.The effects of CO,NO2,SO2 and AP on daily AOM visits were significantly stronger compared to other factors(P<0.01).O3,W,T and RH were negatively correlated with daily AOM visits.The highest RR lagged by 3e4 days.Conclusions:The number of daily AOM visits appeared to be correlated with short-term exposure to mixed air pollutants and meteorological factors from 2014 through 2016 in Lanzhou.

关键词： Acute otitis media Air pollution and meteolofical factors Non-parametric generalized additive model Relative risk Exposure-response curve

Retrospective Analysis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in 88 Chinese Patients

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Chinese Medical Journal 2017年第9期130卷 1062-1068页

作者： Li Wang Xue-Ling Mei Department of Dermatology Allergy and Clinical Immunology Centre Beijing Friendship Hospital Capital Medical University Beijing 100050 China

Background： Stevens-Johnson syndrome （SJS） and toxic epidennal necrolysis （TEN） are life-threatening diseases with high mortality rates. This study was designed to analyze the pathogenic factors, clinical manifestations, complications, treatment, and prognosis of SJS/TEN and to explore the differences between surviving and deceased patients. Methods： SJS/TEN patients admitted to Beijing Friendship Hospital from January 2006 to December 2015 were included in the study. Patients＇ data were retrospectively analyzed. Comparative studies were performed on the survival group and the deceased group, and Fisher＇s exact probability test was used for statistical analysis. Results： Among the 88 patients included, 40 （45.5%） were male with a mean age of 45 - 18 years. Forty-eight （54.5%） had SJS, 34 （38.6%） had SJS/TEN, and 6 （6.8%） had TEN. Fifty-three （60.2%） cases were caused by medications, mainly antibiotics （n = 24） followed by traditional Chinese medicines 97 - 7）. Forty-two cases （47.7%） developed visceral damage. Eighty-two patients improved or recovered and were discharged from hospital, and six patients died. Comparative studies on the survival group and the deceased group showed that the presence of malignant tumor （Z2 = 27.969, P 〈 0.001）, connective tissue diseases （x^2 - 9.187, P = 0.002）, previous abnormal liver/kidney functions （x^2 = 6.006, P = 0.014）, heart rate 〉100 times/rain （x^2 = 6.347, P = 0.012）, detached skin area 〉20% （x^2 = 5.594, P = 0.018）, concurrent mucosal involvement at the mouth, eyes, and external genitals （Z2 = 4.945, P = 0.026）, subsequent accompanying liver/kidney damage （x^ = 11.839, P = 0.001, and x^2 = 36.302, P 〈 0.00 l, respectively）, and SCORTEN score 〉2 （x^2 = 37.148, P 〈 0.001 ） increased the risk of death. Conclusions： SJS/TEN is mainly caused by medications, and nearly half of patients develop visceral damage. Multiple factors increase the mortality risk.

关键词： Mortality Relative risk Stevens-Johnson Syndrome Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Toxic Epidernlal Necrolysis

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

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World Journal of Gastroenterology 2020年第44期26卷 6993-7004页

作者： Flora Maria Lorenzo Fortes Ney Boa Sorte Victor D Mariano Laila D Andrade Fernanda A Oliveira Monique CA Santos Claudia Ivanilda N dos Santos Catharina A Passos Mila P Pacheco Valdiana C Surlo Neogelia P de Almeida Jaciane AM Fontes Andrea M Pimentel Raquel Rocha Genoile Oliveira Santana Pharmaceutical Sciences Pos-graduation Program State University of BahiaSalvadorBA 40460-120Brazil Outpatient Gastroenterology Unit General Hospital Roberto SantosSalvadorBA 40286-901Brazil Life Sciences Department State University of BahiaSalvadorBA 41150-000Brazil Department of Medicine FTC UniversitySalvadorBA 41741-590Brazil Department of Sciences of Nutrition School of NutritionFederal University of BahiaSalvadorBA 41701-035Brazil

BACKGROUND There has been an increase in cases of inflammatory bowel disease(IBD)in recent years.There is also greater access and availability of immunosuppressive and biological agents,which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing.Tuberculosis(TB)remains a public health problem,and it has a high incidence in several countries.Therefore,knowledge of the risk of developing TB in patients with IBD is important.AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.METHODS A standard questionnaire included demographic variables,clinical aspects of IBD disease,history of active TB during treatment,active TB characteristics and evolution,initial screening and results and time from the start of anti-tumor necrosis factor alpha(TNFα)to TB development.RESULTS Azathioprine,anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence.The TNFα blockers increased the Relative risk of developing active TB compared to other treatments.All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB.After adjustment for sex,age,type of IBD and latent TB,anti-TNFα with azathioprine increased the Relative risk to 17.8 times more than conventional treatment.Late TB,which was diagnosed 3 mo after the start of anti-TNFα,was the most frequent.CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America.This risk was increased when anti-TNFα was combined with azathioprine.The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

关键词： Inflammatory bowel disease Therapy Tumor necrosis factor alpha Relative risk Tuberculosis Latent tuberculosis

Disease risks of Childhood Obesity in China

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Biomedical and Environmental Sciences 2005年第6期18卷 401-410页

作者： YAN-PING LI XIAO-GUANG YANG FENG-YING ZHAI JIAN-HUA PIAO WEN-HUA ZHAO JIAN ZHANG GUAN-SHENG MA National Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention 29 Nanwei Road Beijing 100050 China

Objective To estimate the Relative risks of dyslipidemia, hypertension, diabetes mellitus, and metabolic syndromes among overweight and obese Chinese children compared with their normal weight counterparts. Methods Overweight and obesity were defined by age- and sex-specific BMI classification reference for Chinese children and adolescents. Pediatric metabolic syndrome （MetS） and each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia for adults was applied as well. General linear model factor analysis and chi-square test were used to compare the difference in metabolic indicators among normal weight, overweight, and obese groups. Multiple logistic regression analysis was performed to estimate the odds ratio of metabolic abnormalities between obesity, overweight, and normal weight children, after adjustment for living area, family economic level, age, sex, and daily exercise time and TV watching time, as well as different dietary indices in the model. Results Significant increases in blood lipids, glucose, and blood pressure were found among overweight and obese children as compared with their counterparts with normal weight. By applying WGOC-recommended BMI classification, the risks for hypertriglyceridemia, low HDL and dyslipidemia among overweight children were 1.9, 1.4, and 1.5 times, and was 3.3, 1.5, and 1.8 times among obese groups compared to their counterparts with normal weight after adjustment for age, sex, region, socioeconomic status, physical activity, and dietary intakes. The overweight and obese children （15-17.9 years） had a high-risk of developing hypertension, which was 2.3 and 2.9 times higher than their counterparts with normal weight. Above 90% obese adolescents had abdominal obesity, while less than 1% normal weight ones had abdominal obesity. No obese adolescents were free from any risk factors for MetS, while 36.9% of normal weight adolescents were from the risk factors. 83.3% obese boys and all obese girls had metabolic

关键词： Chinese obese children Metabolic syndrome （MetS） Hypertension Lipids Relative risk

Smoking increases risk of tooth loss: A meta-analysis of the literature

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World Journal of Meta-Analysis 2013年第1期1卷 16-26页

作者： Fumihito Sato Masashi Sawamura Miki Ojima Keiko Tanaka Takashi Hanioka Hideo Tanaka Keitaro Matsuo Division of Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Aichi 464-8618 Japan Department of Preventive Dentistry Graduate School of Dentistry Osaka University Suita Osaka 565-0871 Japan Department of Public Health Faculty of Medicine Fukuoka University Fukuoka 814-0180 Japan Department of Preventive and Public Health Dentistry Fukuoka Dental College Fukuoka 814-0193 Japan Department of Epidemiology Nagoya University Graduate School of Medicine Nagoya Aichi 464-8601 Japan

AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P risk of tooth loss.CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.

关键词： Meta-analysis Oral health Relative risk Smoking Tooth loss

A Cohort Model for Ash Mortality risk Due to Potential Emerald Ash Borer Infestation

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Open Journal of Biophysics 2016年第2期6卷 38-51页

作者： Samuel G. Jenkins Peter G. Oduor Larry Kotchman Michael Kangas GIS Coordinator Moorhead Public Service Moorhead MN USA Department of Geosciences North Dakota State University Fargo ND USA State Forester North Dakota Forest Service Bottineau ND USA Nursery & State Forest Team Leader North Dakota State University Fargo ND USA

Emerald ash borer (Agrilus planipennis Fairmaire) (Coleoptera: Buprestidae) is a phloem-feeding beetle native to Asia that is causing widespread mortality of ash trees in eastern North America. In this study, we quantify ash mortality risk associated with potential anthropogenic-induced introduction of Emerald Ash Borer (EAB) in North Dakota. The cohort model is calibrated with data from Ohio using weighting across factors—proximity to existing ash stands, campgrounds, roads and rails—to get a more accurate assessment of overall ash mortality risk. These factors are known to be associated with introduction of EAB to unaffected areas. Two protocols, a) “detection trees” and b) EAB traps are utilized to investigate EAB presence. Ash mortality risk maps such as the ones produced here may guide the placement of traps. Although North Dakota regions of high density ash tree stands are few, the resulting relative ash mortality risk map displays: a) very high risk areas around the Turtle Mountains and Theodore Roosevelt National Park and b) regions of high Relative risk along the main riparian corridors. The applicability of risk maps such as the one developed may aid in assessing areas that may require significant monitoring.

关键词： Exposure Pathway Relative risk EAB risk Model

Assessment of Radon Concentrations inside Residential Buildings and Estimation of the Dose in the City of Kaya, Burkina Faso

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Open Journal of Applied Sciences 2023年第7期13卷 1066-1078页

作者： Wend-Yam Appolinaire Elola Telado Luc Bambara Ali Doumounia Nièssan Kohio Soumaila Ouédraogo François Zougmore Laboratoire de matériaux et Environnement Université Joseph Ki-Zerbo Burkina Faso Institut des Sciences et de Technologie Ecole Normale Supérieure Burkina Faso

Colorless, incessant radon gas is notably the second most important cause of lung cancer after smoking in smokers and the first cause in non-smokers. Having little effect in the atmosphere, radon gas accumulates in confined spaces. Therefore, the determination of radon concentrations inside residential buildings is very important to improve the health of the inhabitants. The objective of this research is to measure the concentration of radon in indoor air in residential areas of the city of Kaya and to assess the absorbed dose, the effective dose and the Relative risk of lung cancer. In this study, the CORENTIUM AIR THINGS digital radon detector is used to determine the radon concentration in twenty-one houses in Kaya. The CORENTIUM AIR THINGS digital radon detector has been placed in each residential building for a minimum period of one week and the concentration values are read every 24 hours. This research revealed that the average concentration of radon was 28.47 Bq/m3 in the residential areas of Kaya. The radon concentration in a house has been found to exceed 100 Bq/m3, which is the level authorized by the World Health Organization (WHO). In the long term, the absorbed dose varies from 0.118 mSv to 4.975 mSv and the effective dose is between 0.229 mSv and 12.002 mSv. In the short term, the absorbed dose varies between 0.095 mSv to 5.001 mSv and the effective dose is between 0.283 mSv to 11.935 mSv. The mean lung cancer Relative risk (CPRR) from indoor exposure was 1.026. There is a need to raise awareness among the population of the city of Kaya on this issue and to take measures to reduce radon in homes when the concentrations are above the limit recommended by the WHO.

关键词： Radon Concentration Dose Relative risk Lung Cancer