• Title/Summary/Keyword: odds ratios

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Application of Standardization for Causal Inference in Observational Studies: A Step-by-step Tutorial for Analysis Using R Software

  • Lee, Sangwon;Lee, Woojoo
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.2
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    • pp.116-124
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    • 2022
  • Epidemiological studies typically examine the causal effect of exposure on a health outcome. Standardization is one of the most straightforward methods for estimating causal estimands. However, compared to inverse probability weighting, there is a lack of user-centric explanations for implementing standardization to estimate causal estimands. This paper explains the standardization method using basic R functions only and how it is linked to the R package stdReg, which can be used to implement the same procedure. We provide a step-by-step tutorial for estimating causal risk differences, causal risk ratios, and causal odds ratios based on standardization. We also discuss how to carry out subgroup analysis in detail.

Paresthesia as the Prodrome of Stroke in Korean Women (일부 한국인 여성에서 뇌졸중 선행인자(先行因子)로서의 마목(麻木))

  • Bu, Song-Ah;Sun, Seung-Ho;Ko, Seong-Gyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.291-297
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    • 2007
  • Although Traditional Korean Medicine had always referred to Mamok(痲木: Paresthesia) as the prodrome of stroke for a long time, yet there were only few research papers on it. Hence, the purpose of this research is to explore the relationship between Mamok(痲木; Paresthesia) as the prodrome and an attack of stroke. Setting 509 Korean impatient women as the subject of research, 264 of the whole are stroke patients and 245 are non-stroke patients. Blood tests, questionnaires, and body measurements (height, weight, waist, hip) are performed to the subjects. Basic population traits, life-style, and past history are included in the contents of questionnaires. whether or not they have experience the numbness, description about the clinical characteristics of the symptom, the body parts which the symptom occurred, the onset of the symptom, and the incidences are examined in the category inquiring the numbness of the hand and foot. After adjusting for age, unilateral numbness was associated with significantly increased risk of stroke. When adjusted for other factors(Half of WHR, History of Hypertension and Diabetes mellitus, Cigarette smoking, Alcohol drinking, Education, Marital status, Regular exercise), the risk of stroke was positively associated with unilateral numbness.(Age Adjusted Odds Ratios=2.282(95%CI=1.107-4.705), Multivariate Odds Ratios=4.105(95% CI=1.233-13.671)) Whereas no significant association was observed in the onset and the incidence of unilateral numbness. This study suggest that preceding Mamok(痲木; paresthesia) before stroke attack is may be common prodrome symptoms of stroke. Prospective cohort study on the association between Mamok(痲木;Paresthesia) as the prodrome and an attack of stroke in Korean population will be necessary.

The Association between Smoking, Alcohol Intake, and Low-Salt Diet: Results from the 2008 Community Health Survey (흡연 및 음주행태와 저염식생활 실천과의 관련성: 2008년 지역사회건강조사 자료를 이용하여)

  • Chun, In-Ae;Park, Jong;Han, Mi-Ah;Choi, Seong-Woo;Ryu, So-Yeon
    • Journal of the Korean Dietetic Association
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    • v.19 no.3
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    • pp.223-235
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    • 2013
  • The purpose of this study was to identify the association between health-related behaviors including smoking, alcohol intake, and the practice of a low-salt diet using data from a Community Health Survey conducted in 2008. The study subjects were 129,151 persons (19 years and older) without cardiovascular diseases or diabetes mellitus diagnosis history. An index for evaluating low salinity was created by summing three low salinity-related questions (range: 0~3), and a low-salt diet was defined if the index of low salinity was 3. We examined the levels of smoking and alcohol intake according to the index of low salinity, and conducted multiple logistic regression analysis to examine the odds ratios of low-salt diet practice in relation to smoking and drinking behavior, adjusting for general characteristics. The smoking and drinking status significantly improved as the level of low salinity index increase. Adjusting for general characteristics, those with smoking, alcohol intake, or a combined habit of the two behaviors had significantly lower odds ratios for practice of a low-salt diet. In conclusion, smoking and drinking behavior were negatively associated with the practice of a low-salt diet. Based on these findings, it may be necessary to have comprehensive nutritional education programs that consider the multiple effects of smoking, drinking, and a low-salt diet.

Prostate Stem Cell Antigen Single Nucleotide Polymorphisms Influence Risk of Estrogen Receptor Negative Breast Cancer in Korean Females

  • Kim, Sook-Young;Yoo, Jae-Young;Shin, Ae-Sun;Kim, Yeon-Ju;Lee, Eun-Sook;Lee, Yeon-Su
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.41-48
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    • 2012
  • Introduction: Breast cancer is the second leading cancer in Korean women. To assess potential genetic associations between the prostate stem cell antigen (PSCA) gene in the chromosome 8q24 locus and breast cancer risk in Korean women, 13 SNPs were selected and associations with breast cancer risk were analyzed with reference to hormone receptor (HR) and menopausal status. Methods:We analyzed DNA extracted from buffy coat from 456 patients and 461 control samples, using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) based upon region-specific PCR followed by allelespecific single base primer extension reactions. Risks associated with PSCA genotypes and haplotypes were estimated with chi-square test (${\chi}^2$-test), and polytomous logistic regression models using odds ratios (OR) and 95% confidence intervals (CIs), by HR and menopausal status. Results: In case-control analysis, odds ratios (OR) of rs2294009, rs2294008, rs2978981, rs2920298, rs2976395, and rs2976396 were statistically significant only among women with estrogen receptor (ER) negative cancers, and those of rs2294008, rs2978981, rs2294010, rs2920298, rs2976394, rs10216533, and rs2976396 were statistically significant only in pre-menopausal women, and not in postmenopausal women. Risk with the TTGGCAA haplotype was significantly elevated in ER (-) status (OR= 1.48, 95% CI= 1.03~2.12, p<0.05). Especially risk of allele T of rs2294008 is significantly low in pre-menopausal breast cancer patients and AA genotype of rs2976395 in ER (-) status represents the increase of OR value. Conclusion: This report indicated for the first time that associations exist between PSCA SNPs and breast cancer susceptibility in Korean women, particularly those who are pre-menopausal with an estrogen receptor negative tumor status.

Factors Associated With Obstructive Pattern Spirometry In Shipyard Workers (조선소 근로자들의 폐쇄성 폐기능 저하와 관련된 요인)

  • Kim, Jahyun;Kim, Young Wook;Chae, Chang Ho;Son, Jun Seok;Kim, Chan Woo;Lee, Jun Ho;Park, Hyung Wook;Cho, Byung Mann
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.4
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    • pp.525-533
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    • 2015
  • Objectives: Alongside smoking, occupational exposure is an important risk factor for chronic obstructive pulmonary disease. The purpose of this study was to evaluate factors associated with occupational pulmonary function decline that can be used to create guidelines for the health management of shipyard workers Materials: This study analyzed spirometry from 10,597 male shipbuilding workers. Functional decline in spirometry was defined as FEV1/FVC <70% and logistic regression for work duration and occupational hazard exposure was performed Results: Among the subjects, 4.2% showed an obstructive pattern in pulmonary function. The odds ratios for hazard exposure were 1.67(indirect) and 3.54(direct), and for work duration 1.97(10-18 years), 2.29(19-27), and 5.02(28+). After adjusting for smoking and work-related factors, the odds ratios for work durations of over 10 years were 1.73(10-18 years), 1.99(19-27), and 4.09(28+), but for hazards exposure was 1.71(direct) alone after adjustment. Conclusions: Occupational COPD is insidious and chronic, and thus long-term hazard exposed(especially over 10 years) shipyard workers with functional decline in spirometry need to prevent and manage COPD. This study is important for establishing guidelines to manage hazard exposure among shipyard workers and prevent COPD.

Relationship Between Serum Concentrations of Organochlorine Pesticides and Metabolic Syndrome Among Non-Diabetic Adults

  • Park, Sun-Kyun;Son, Hyo-Kyung;Lee, Sung-Kook;Kang, Jung-Ho;Chang, Yoon-Seok;Jacobs, David R. Jr.;Lee, Duk-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.1-8
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    • 2010
  • Objectives: This study was performed to investigate if organochlorine pesticides (OCPs) were associated with metabolic syndrome and insulin resistance among non-diabetes. Methods: Among subjects who participated in a community-based health survey, 50 non-diabetic subjects with metabolic syndrome and 50 normal controls were selected. Insulin resistance was measured by the homeostasis model assessment (HOMA-IR). Eight OCPs were selected. Results: After adjusting for confounders except for body mass index (BMI), beta-hexachlorocyclohexane ($\beta$-HCH) and heptachlor epoxide were positively associated with metabolic syndrome. Odds ratios across tertiles of $\beta$-HCH and heptachlor epoxide were 1.0, 3.2 and 4.4, and 1.0, 4.0 and 6.0, respectively (p for trend = 0.01 and <0.01). After additional adjustment for body mass index (BMI), heptachlor epoxide still showed an increasing trend with adjusted odds ratios of 1.0, 4.1, and 4.6 (p for trend = 0.10). When the five components of metabolic syndrome (with the definition of high fasting glucose ($\geq$ 100 mg/dL) were separately analyzed, all components were positively, but not significantly, associated with heptachlor epoxide. As the serum concentration of heptachlor epoxide increased, HOMA-IR increased significantly in subjects with metabolic syndrome even after adjusting for BMI (p value <0.05 and <0.01). Conclusions: Despite the small sample size, this study suggests that the background exposure to some OCPs may be associated with metabolic syndrome.

Differences in Cancer Incidence among Predominantly Muslim and Buddhist Subpopulations in Songkhla

  • Sriplung, Hutcha;Bilheem, Surichai;Kuntipundee, Tirada;Geater, Sarayut Lucian
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9979-9983
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    • 2014
  • Background: The population of Songkhla, a province in Southern Thailand, can be divided into a predominantly Muslim subpopulation (PMSP, approximately 70% Muslim) and a predominantly Buddhist subpopulation (PBSP, around 14% Muslim). Objectives: This study was conducted to 1) describe the incidence of various cancers in both PMSP and PBSP, and 2) compare the incidence of various cancers between the two subpopulations. Materials and Methods: Cancer cases diagnosed between 1990 and 2010 were drawn from the database of Songkhla Cancer Registry. Population denominators were estimated from the 3 population censuses surveyed by the National Statistical Office of Thailand in 1990, 2000, and 2010. Results: The age-standardized incidence rates (ASR) of the 5 commonest male cancers among both subpopulations were calculated. In females, a lower incidence of cancers of the cervix and breast in PMSP compared to PBSP, with odds ratios of 0.54 (95% CI: 0.45-0.64) and 0.51 (95% CI: 0.43-0.60) respectively, was observed. In males, the incidence of cancers of the lung, liver, colon-rectum, and some other cancers were significantly different between the two populations in the past, but only prostate cancer showed a lower incidence among males in PMSP in recent years. Independent of sex and year of diagnosis, the incidence of lung, liver, NHL, and colorectal cancers was lower in MPSP compared to BPSP, with odds ratios of 0.75 (95% CI: 0.65-0.85), 0.74 (95% CI: 0.62-0.88), 0.74 (95% CI: 0.60-0.91), and 0.67 (95% CI: 0.56-0.78) respectively. Conclusions: The differences in incidence of some cancers and religionrelated culture between the two subpopulations need 2 sets of cancer-control plans and goals to fit the unique population context in deep Southern Thailand. This plan can be used in the 3 southernmost provinces of Thailand where the percentage of Muslims is over 85%.

Misclassification Adjustment of Family History of Breast Cancer in a Case-Control Study: a Bayesian Approach

  • Moradzadeh, Rahmatollah;Mansournia, Mohammad Ali;Baghfalaki, Taban;Ghiasvand, Reza;Noori-Daloii, Mohammad Reza;Holakouie-Naieni, Kourosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8221-8226
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    • 2016
  • Background: Misreporting self-reported family history may lead to biased estimations. We used Bayesian methods to adjust for exposure misclassification. Materials and Methods: A hospital-based case-control study was used to identify breast cancer risk factors among Iranian women. Three models were jointly considered; an outcome, an exposure and a measurement model. All models were fitted using Bayesian methods, run to achieve convergence. Results: Bayesian analysis in the model without misclassification showed that the odds ratios for the relationship between breast cancer and a family history in different prior distributions were 2.98 (95% CRI: 2.41, 3.71), 2.57 (95% CRI: 1.95, 3.41) and 2.53 (95% CRI: 1.93, 3.31). In the misclassified model, adjusted odds ratios for misclassification in the different situations were 2.64 (95% CRI: 2.02, 3.47), 2.64 (95% CRI: 2.02, 3.46), 1.60 (95% CRI: 1.07, 2.38), 1.61 (95% CRI: 1.07, 2.40), 1.57 (95% CRI: 1.05, 2.35), 1.58 (95% CRI: 1.06, 2.34) and 1.57 (95% CRI: 1.06, 2.33). Conclusions: It was concluded that self-reported family history may be misclassified in different scenarios. Due to the lack of validation studies in Iran, more attention to this matter in future research is suggested, especially while obtaining results in accordance with sensitivity and specificity values.

Gender Comparison Factors Influencing Regular Exercise Adherence in Patients with Coronary Artery Disease: Data from the 6th Korea National Health and Nutrition Examination Survey (2013~2015) (관상동맥질환자의 규칙적 운동이행 영향요인의 성별 비교: 국민건강영양조사 자료(2013~2015년) 활용)

  • Jin, Hyekyung;Kim, Minju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.25 no.2
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    • pp.134-145
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    • 2018
  • Purpose: The purpose of this study was to investigate gender related factors that influence regular exercise adherence in patients with coronary artery disease. Methods: This secondary analysis study used data from the 2013~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Three hundred and eighty patients over 20 years of age and having coronary artery disease were selected for this study. Measures included questions about regular exercise, general characteristics, health behaviors, and health status. Data were analyzed using descriptive analysis, Rao-Scott $x^2$ statistic, and multiple logistic regression analysis with the SPSS 21.0 program. Results: The results were as follows. Men did more regular exercise than women (58.8% vs 40.1%). The multivariate-adjusted Odds Ratios (OR) for regular exercise adherence in men were 2.93 (95% CI: 1.39~6.17) for non smokers and 3.06 (95% CI: 1.53~6.13) for men with 0 to 1 comorbidities. Women had a high odds ratios of 0.38 (95% CI: 0.18~0.82) for not using alcohol and 2.10 (95% CI: 1.03~4.29) for no back pain. Conclusion: To improve regular exercise adherence in patients with coronary artery disease, it is necessary to develop different approaches considering gender.

Evaluation of Nutritional Status of Vitamins and Minerals According to Consumption of Dietary Supplements in Korean Adults and the Elderly: Report Based on 2017 Korea National Health and Nutrition Examination Survey data (우리나라 성인 및 노인의 식이보충제 복용에 따른 비타민 및 무기질 영양상태 평가: 2017 국민건강영양조사 자료)

  • Kim, Ji-Myung
    • Korean Journal of Community Nutrition
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    • v.25 no.4
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    • pp.329-339
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    • 2020
  • Objectives: This study was undertaken to evaluate the intake of vitamins and minerals from dietary supplements (DSs) in Korean adults and elderly. Methods: Data for this study was generated from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). We analyzed 4,204 individuals aged 19 years and older (2,579 users and 1,625 non-users). The survey included 24-h recall questions on food and DS intakes, as well as questions on DS use over the past year. The nutrient DSs evaluated were calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C. Total nutrient intakes were obtained by combining nutrient intakes of foods and DSs consumed by each subject. Results: Most micronutrient intakes from food (except for thiamin) in adult users, and the four micronutrient intakes (iron, vitamin A, vitamin B2 and vitamin C) in elderly users, were significantly higher than values obtained in non-users. For total intake of nutrients and DSs, both adult and elderly users had a significantly higher intake than non-users. While proportions below Estimated Average Requirements for all micronutrients by adding respective DSs in users were significantly reduced in adults and elderly as compared to non-users, the proportions of above Tolerable Upper Intake Levels for calcium and vitamin A in adults, and vitamin A in elderly, were significantly increased. In the total subjects examined, consumption of DSs was associated with lower odds ratios of undernutrition of micronutrients, and with higher odds ratios of overnutrition of calcium, iron, and vitamin A, as compared to non-users of DSs. Conclusions: Although DSs consumption by adults and the elderly improves the micronutrient status, it also increases the risk of excessive intake of certain vitamins and minerals.