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Find video protocols related to scientific articles indexed in Pubmed.
Maximum linkage space-time permutation scan statistics for disease outbreak detection.
Int J Health Geogr
PUBLISHED: 03-29-2014
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In disease surveillance, the prospective space-time permutation scan statistic is commonly used for the early detection of disease outbreaks. The scanning window that defines potential clusters of diseases is cylindrical in shape, which does not allow incorporating into the cluster shape potential factors that can contribute to the spread of the disease, such as information about roads, landscape, among others. Furthermore, the cylinder scanning window assumes that the spatial extent of the cluster does not change in time. Alternatively, a dynamic space-time cluster may indicate the potential spread of the disease through time. For instance, the cluster may decrease over time indicating that the spread of the disease is vanishing.
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Minimizing signal detection time in postmarket sequential analysis: balancing positive predictive value and sensitivity.
Pharmacoepidemiol Drug Saf
PUBLISHED: 02-28-2014
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Outcome misclassification in retrospective epidemiologic analyses has been well-studied, but little is known about such misclassification with respect to sequential statistical analysis during surveillance of medical product-associated risks, a planned capability of the US Food and Drug Administration's Sentinel System.
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Absence of associations between influenza vaccines and increased risks of seizures, Guillain-Barré syndrome, encephalitis, or anaphylaxis in the 2012-2013 season.
Pharmacoepidemiol Drug Saf
PUBLISHED: 02-04-2014
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We conducted weekly surveillance for pre-specified adverse events following receipt of the 2012-2013 influenza vaccines in the Vaccine Safety Datalink (VSD).
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Relative risk estimates from spatial and space-time scan statistics: are they biased?
Stat Med
PUBLISHED: 02-02-2014
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The purely spatial and space-time scan statistics have been successfully used by many scientists to detect and evaluate geographical disease clusters. Although the scan statistic has high power in correctly identifying a cluster, no study has considered the estimates of the cluster relative risk in the detected cluster. In this paper, we evaluate whether there is any bias on these estimated relative risks. Intuitively, one may expect that the estimated relative risks has upward bias, because the scan statistic cherry picks high rate areas to include in the cluster. We show that this intuition is correct for clusters with low statistical power, but with medium to high power, the bias becomes negligible. The same behavior is not observed for the prospective space-time scan statistic, where there is an increasing conservative downward bias of the relative risk as the power to detect the cluster increases.
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Intussusception risk after rotavirus vaccination in U.S. infants.
N. Engl. J. Med.
PUBLISHED: 01-14-2014
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International postlicensure studies have identified an increased risk of intussusception after vaccination with the second-generation rotavirus vaccines RotaTeq (RV5, a pentavalent vaccine) and Rotarix (RV1, a monovalent vaccine). We studied this association among infants in the United States.
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Automated influenza-like illness reporting--an efficient adjunct to traditional sentinel surveillance.
Public Health Rep
PUBLISHED: 01-02-2014
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We compared an electronic health record-based influenza-like illness (ILI) surveillance system with manual sentinel surveillance and virologic data to evaluate the utility of the automated system for routine ILI surveillance.
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Laboratory-Based Prospective Surveillance for Community Outbreaks of Shigella spp. in Argentina.
PLoS Negl Trop Dis
PUBLISHED: 12-01-2013
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To implement effective control measures, timely outbreak detection is essential. Shigella is the most common cause of bacterial diarrhea in Argentina. Highly resistant clones of Shigella have emerged, and outbreaks have been recognized in closed settings and in whole communities. We hereby report our experience with an evolving, integrated, laboratory-based, near real-time surveillance system operating in six contiguous provinces of Argentina during April 2009 to March 2012.
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Medical product safety surveillance: how many databases to use?
Epidemiology
PUBLISHED: 07-23-2013
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Large linked database networks, like the US Food and Drug Administrations Sentinel System, are being built for medical product surveillance. One use of these networks is for "near real-time" sequential database surveillance of prespecified medical product-adverse event pairs, which may result in a "safety signal" when a statistical excess risk is detected. Sequential database surveillance requires the investigator to manage surveillance in both information time (ie, how sample size accrues) and calendar time. Calendar time is important because people external to the surveillance population may be affected by the speed with which a safety signal is detected or ruled out. Optimal design and analysis aspects of sequential database surveillance are not well developed, but are gaining in importance as observational database networks grow. Using information time concepts, we show how to calculate sample sizes when performing sequential database surveillance, illustrating the relationships between statistical power, the time to detect a signal, and the maximum sample size for various true effect sizes. Then, using a vaccine example, we demonstrate a four-step planning process that allows investigators to translate information time into calendar time. Given the calendar time for surveillance, the process focuses on choosing observational database configurations consistent with the investigators preferences for timeliness and statistical power. Although the planning process emphasizes sample size considerations, the influence of secondary database attributes such as delay times, measurement error, and cost are also discussed. Appropriate planning allows the most efficient use of public health dollars dedicated to medical product surveillance efforts.
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Confounding adjustment in comparative effectiveness research conducted within distributed research networks.
Med Care
PUBLISHED: 06-12-2013
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A distributed research network (DRN) of electronic health care databases, in which data reside behind the firewall of each data partner, can support a wide range of comparative effectiveness research (CER) activities. An essential component of a fully functional DRN is the capability to perform robust statistical analyses to produce valid, actionable evidence without compromising patient privacy, data security, or proprietary interests.
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Detection of spatial variations in temporal trends with a quadratic function.
Stat Methods Med Res
PUBLISHED: 04-25-2013
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Methods for the assessment of spatial variations in temporal trends (SVTT) are important tools for disease surveillance, which can help governments to formulate programs to prevent diseases, and measure the progress, impact, and efficacy of preventive efforts already in operation. The linear SVTT method is designed to detect areas with unusual different disease linear trends. In some situations, however, its estimation trend procedure can lead to wrong conclusions. In this article, the quadratic SVTT method is proposed as alternative of the linear SVTT method. The quadratic method provides better estimates of the real trends, and increases the power of detection in situations where the linear SVTT method fails. A performance comparison between the linear and quadratic methods is provided to help illustrate their respective properties. The quadratic method is applied to detect unusual different cervical cancer trends in white women in the United States, over the period 1969 to 1995.
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Drug Adverse Event Detection in Health Plan Data Using the Gamma Poisson Shrinker and Comparison to the Tree-based Scan Statistic.
Pharmaceutics
PUBLISHED: 03-01-2013
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Background: Drug adverse event (AE) signal detection using the Gamma Poisson Shrinker (GPS) is commonly applied in spontaneous reporting. AE signal detection using large observational health plan databases can expand medication safety surveillance. Methods: Using data from nine health plans, we conducted a pilot study to evaluate the implementation and findings of the GPS approach for two antifungal drugs, terbinafine and itraconazole, and two diabetes drugs, pioglitazone and rosiglitazone. We evaluated 1676 diagnosis codes grouped into 183 different clinical concepts and four levels of granularity. Several signaling thresholds were assessed. GPS results were compared to findings from a companion study using the identical analytic dataset but an alternative statistical method-the tree-based scan statistic (TreeScan). Results: We identified 71 statistical signals across two signaling thresholds and two methods, including closely-related signals of overlapping diagnosis definitions. Initial review found that most signals represented known adverse drug reactions or confounding. About 31% of signals met the highest signaling threshold. Conclusions: The GPS method was successfully applied to observational health plan data in a distributed data environment as a drug safety data mining method. There was substantial concordance between the GPS and TreeScan approaches. Key method implementation decisions relate to defining exposures and outcomes and informed choice of signaling thresholds.
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Drug safety data mining with a tree-based scan statistic.
Pharmacoepidemiol Drug Saf
PUBLISHED: 01-08-2013
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In post-marketing drug safety surveillance, data mining can potentially detect rare but serious adverse events. Assessing an entire collection of drug-event pairs is traditionally performed on a predefined level of granularity. It is unknown a priori whether a drug causes a very specific or a set of related adverse events, such as mitral valve disorders, all valve disorders, or different types of heart disease. This methodological paper evaluates the tree-based scan statistic data mining method to enhance drug safety surveillance.
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Near real-time adverse drug reaction surveillance within population-based health networks: methodology considerations for data accrual.
Pharmacoepidemiol Drug Saf
PUBLISHED: 01-02-2013
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This study describes practical considerations for implementation of near real-time medical product safety surveillance in a distributed health data network.
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Guillain-Barré Syndrome, Influenza Vaccination, and Antecedent Respiratory and Gastrointestinal Infections: A Case-Centered Analysis in the Vaccine Safety Datalink, 2009-2011.
PLoS ONE
PUBLISHED: 01-01-2013
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Guillain-Barré Syndrome (GBS) can be triggered by gastrointestinal or respiratory infections, including influenza. During the 2009 influenza A (H1N1) pandemic in the United States, monovalent inactivated influenza vaccine (MIV) availability coincided with high rates of wildtype influenza infections. Several prior studies suggested an elevated GBS risk following MIV, but adjustment for antecedent infection was limited.
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Herpes zoster and postherpetic neuralgia surveillance using structured electronic data.
Mayo Clin. Proc.
PUBLISHED: 10-13-2011
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To develop electronic algorithms for rapid, automated surveillance for herpes zoster and postherpetic neuralgia (PHN) using codified electronic health data.
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Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink.
Vaccine
PUBLISHED: 07-27-2011
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In 7 large managed care organizations (MCOs), we performed a post-licensure safety assessment of quadrivalent human papillomavirus vaccine (HPV4) among 9-26 year-old female vaccine recipients between August 2006 and October 2009.
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New approaches to estimating national rates of invasive pneumococcal disease.
Am. J. Epidemiol.
PUBLISHED: 05-26-2011
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National infectious disease incidence rates are often estimated by standardizing locally derived rates using national-level age and race distributions. Data on other factors potentially associated with incidence are often not available in the form of patient-level covariates. Including characteristics of patients area of residence may improve the accuracy of national estimates. The authors used data from the Centers for Disease Control and Preventions Active Bacterial Core Surveillance program (2004-2005), adjusted for census-based variables, to estimate the national incidence of invasive pneumococcal disease (IPD). The authors tested Poisson and negative binomial models in a cross-validation procedure to select variables best predicting the incidence of IPD in each county. Including census-level information on race and educational attainment improved the fit of both Poisson and negative binomial models beyond that achieved by adjusting for other census variables or by adjusting for an individuals race and age alone. The Poisson model with census-based predictors led to a national estimate of IPD of 16.0 cases per 100,000 persons as compared with 13.5 per 100,000 persons using an individuals age and race alone. Accuracy of, and confidence intervals for, these estimates can only be determined by obtaining data from other randomly selected US counties. However, incorporating census-derived characteristics should be considered when estimating national incidence of IPD and other diseases.
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Near real-time vaccine safety surveillance with partially accrued data.
Pharmacoepidemiol Drug Saf
PUBLISHED: 05-04-2011
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The Vaccine Safety Datalink (VSD) Project conducts near real-time vaccine safety surveillance using sequential analytic methods. Timely surveillance is critical in identifying potential safety problems and preventing additional exposure before most vaccines are administered. For vaccines that are administered during a short period, such as influenza vaccines, timeliness can be improved by undertaking analyses while risk windows following vaccination are ongoing and by accommodating predictable and unpredictable data accrual delays. We describe practical solutions to these challenges, which were adopted by the VSD Project during pandemic and seasonal influenza vaccine safety surveillance in 2009/2010.
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Active surveillance for adverse events: the experience of the Vaccine Safety Datalink project.
Pediatrics
PUBLISHED: 04-18-2011
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To describe the Vaccine Safety Datalink (VSD) projects experience with population-based, active surveillance for vaccine safety and draw lessons that may be useful for similar efforts.
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H1N1 and seasonal influenza vaccine safety in the vaccine safety datalink project.
Am J Prev Med
PUBLISHED: 03-09-2011
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The emergence of pandemic H1N1 influenza virus in early 2009 prompted the rapid licensure and use of H1N1 monovalent inactivated (MIV) and live, attenuated (LAMV) vaccines separate from seasonal trivalent inactivated (TIV) and live, attenuated (LAIV) influenza vaccines. A robust influenza immunization program in the U.S. requires ongoing monitoring of potential adverse events associated with vaccination.
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Timely detection of localized excess influenza activity in Northern California across patient care, prescription, and laboratory data.
Stat Med
PUBLISHED: 02-12-2011
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Timely detection of clusters of localized influenza activity in excess of background seasonal levels could improve situational awareness for public health officials and health systems. However, no single data type may capture influenza activity with optimal sensitivity, specificity, and timeliness, and it is unknown which data types could be most useful for surveillance. We compared the performance of 10 types of electronic clinical data for timely detection of influenza clusters throughout the 2007/08 influenza season in northern California. Kaiser Permanente Northern California generated zip code-specific daily episode counts for: influenza-like illness (ILI) diagnoses in ambulatory care (AC) and emergency departments (ED), both with and without regard to fever; hospital admissions and discharges for pneumonia and influenza; antiviral drugs dispensed (Rx); influenza laboratory tests ordered (Tests); and tests positive for influenza type A (FluA) and type B (FluB). Four credible events of localized excess illness were identified. Prospective surveillance was mimicked within each data stream using a space-time permutation scan statistic, analyzing only data available as of each day, to evaluate the ability and timeliness to detect the credible events. AC without fever and Tests signaled during all four events and, along with Rx, had the most timely signals. FluA had less timely signals. ED, hospitalizations, and FluB did not signal reliably. When fever was included in the ILI definition, signals were either delayed or missed. Although limited to one health plan, location, and year, these results can inform the choice of data streams for public health surveillance of influenza.
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A spatial scan statistic for multinomial data.
Stat Med
PUBLISHED: 08-04-2010
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As a geographical cluster detection analysis tool, the spatial scan statistic has been developed for different types of data such as Bernoulli, Poisson, ordinal, exponential and normal. Another interesting data type is multinomial. For example, one may want to find clusters where the disease-type distribution is statistically significantly different from the rest of the study region when there are different types of disease. In this paper, we propose a spatial scan statistic for such data, which is useful for geographical cluster detection analysis for categorical data without any intrinsic order information. The proposed method is applied to meningitis data consisting of five different disease categories to identify areas with distinct disease-type patterns in two counties in the U.K. The performance of the method is evaluated through a simulation study.
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Gumbel based p-value approximations for spatial scan statistics.
Int J Health Geogr
PUBLISHED: 07-12-2010
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The spatial and space-time scan statistics are commonly applied for the detection of geographical disease clusters. Monte Carlo hypothesis testing is typically used to test whether the geographical clusters are statistically significant as there is no known way to calculate the null distribution analytically. In Monte Carlo hypothesis testing, simulated random data are generated multiple times under the null hypothesis, and the p-value is r/(R + 1), where R is the number of simulated random replicates of the data and r is the rank of the test statistic from the real data compared to the same test statistics calculated from each of the random data sets. A drawback to this powerful technique is that each additional digit of p-value precision requires ten times as many replicated datasets, and the additional processing can lead to excessive run times.
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Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures.
Pediatrics
PUBLISHED: 06-29-2010
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In February 2008, we alerted the Advisory Committee on Immunization Practices to preliminary evidence of a twofold increased risk of febrile seizures after the combination measles-mumps-rubella-varicella (MMRV) vaccine when compared with separate measles-mumps-rubella (MMR) and varicella vaccines. Now with data on twice as many vaccine recipients, our goal was to reexamine seizure risk after MMRV vaccine.
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Evaluating real-time syndromic surveillance signals from ambulatory care data in four states.
Public Health Rep
PUBLISHED: 04-21-2010
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We evaluated a real-time ambulatory care-based syndromic surveillance system in four metropolitan areas of the United States.
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Automated detection of infectious disease outbreaks in hospitals: a retrospective cohort study.
PLoS Med.
PUBLISHED: 01-21-2010
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Detection of outbreaks of hospital-acquired infections is often based on simple rules, such as the occurrence of three new cases of a single pathogen in two weeks on the same ward. These rules typically focus on only a few pathogens, and they do not account for the pathogens underlying prevalence, the normal random variation in rates, and clusters that may occur beyond a single ward, such as those associated with specialty services. Ideally, outbreak detection programs should evaluate many pathogens, using a wide array of data sources.
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Using imputation to provide location information for nongeocoded addresses.
PLoS ONE
PUBLISHED: 01-07-2010
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The importance of geography as a source of variation in health research continues to receive sustained attention in the literature. The inclusion of geographic information in such research often begins by adding data to a map which is predicated by some knowledge of location. A precise level of spatial information is conventionally achieved through geocoding, the geographic information system (GIS) process of translating mailing address information to coordinates on a map. The geocoding process is not without its limitations, though, since there is always a percentage of addresses which cannot be converted successfully (nongeocodable). This raises concerns regarding bias since traditionally the practice has been to exclude nongeocoded data records from analysis.
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Near real-time surveillance for influenza vaccine safety: proof-of-concept in the Vaccine Safety Datalink Project.
Am. J. Epidemiol.
PUBLISHED: 12-04-2009
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The emergence of pandemic H1N1 influenza in 2009 has prompted public health responses, including production and licensure of new influenza A (H1N1) 2009 monovalent vaccines. Safety monitoring is a critical component of vaccination programs. As proof-of-concept, the authors mimicked near real-time prospective surveillance for prespecified neurologic and allergic adverse events among enrollees in 8 medical care organizations (the Vaccine Safety Datalink Project) who received seasonal trivalent inactivated influenza vaccine during the 2005/06-2007/08 influenza seasons. In self-controlled case series analysis, the risk of adverse events in a prespecified exposure period following vaccination was compared with the risk in 1 control period for the same individual either before or after vaccination. In difference-in-difference analysis, the relative risk in exposed versus control periods each season was compared with the relative risk in previous seasons since 2000/01. The authors used Poisson-based analysis to compare the risk of Guillain-Barré syndrome following vaccination in each season with that in previous seasons. Maximized sequential probability ratio tests were used to adjust for repeated analyses on weekly data. With administration of 1,195,552 doses to children under age 18 years and 4,773,956 doses to adults, no elevated risk of adverse events was identified. Near real-time surveillance for selected adverse events can be implemented prospectively to rapidly assess seasonal and pandemic influenza vaccine safety.
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Active influenza vaccine safety surveillance: potential within a healthcare claims environment.
Med Care
PUBLISHED: 09-30-2009
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Rapid safety assessment of novel vaccines, especially those targeted against pandemic influenza, is a public health priority.
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A scan statistic for continuous data based on the normal probability model.
Int J Health Geogr
PUBLISHED: 07-30-2009
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Temporal, spatial and space-time scan statistics are commonly used to detect and evaluate the statistical significance of temporal and/or geographical disease clusters, without any prior assumptions on the location, time period or size of those clusters. Scan statistics are mostly used for count data, such as disease incidence or mortality. Sometimes there is an interest in looking for clusters with respect to a continuous variable, such as lead levels in children or low birth weight. For such continuous data, we present a scan statistic where the likelihood is calculated using the the normal probability model. It may also be used for other distributions, while still maintaining the correct alpha level. In an application of the new method, we look for geographical clusters of low birth weight in New York City.
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Evaluation of the performance of tests for spatial randomness on prostate cancer data.
Int J Health Geogr
PUBLISHED: 07-03-2009
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Spatial global clustering tests can be used to evaluate the geographical distribution of health outcomes. The power of several of these tests has been evaluated and compared using simulated data, but their performance using real unadjusted data and data adjusted for individual- and area-level covariates has not been reported previously.We evaluated data on prostate cancer histologic tumor grade and stage of disease at diagnosis for incident cases of prostate cancer reported to the Maryland Cancer Registry during 1992-1997. We analyzed unadjusted data as well as expected counts from models that were adjusted for individual-level covariates (race, age and year of diagnosis) and area-level covariates (census block group median household income and a county-level socioeconomic index). We chose 3 spatial clustering tests that are commonly used to evaluate the geographic distribution of disease: Cuzick-Edwards k-NN (k-Nearest Neighbors) test, Morans I and Tangos MEET (Maximized Excess Events Test).
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New vaccines against otitis media: projected benefits and cost-effectiveness.
Pediatrics
PUBLISHED: 06-02-2009
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New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed.
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An assessment of the safety of adolescent and adult tetanus-diphtheria-acellular pertussis (Tdap) vaccine, using active surveillance for adverse events in the Vaccine Safety Datalink.
Vaccine
PUBLISHED: 04-08-2009
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Using a new sequential analytic method, the safety of tetanus-diphtheria-acellular pertussis (Tdap) vaccine was monitored weekly among subjects aged 10-64 years during 2005-2008. Encephalopathy-encephalitis-meningitis, paralytic syndromes, seizures, cranial nerve disorders, and Guillain-Barré syndrome were selected as outcomes based on previous reports and biologic plausibility. The risk following Tdap was not significantly higher than the risk after Td. Statistical power was sufficient to detect a relative risk of 4-5 for Guillain-Barré syndrome and 1.5-2 for the other outcomes. This study provides reassurance that Tdap is similar in safety to Td regarding the outcomes studied and supports the viability of sequential analysis for post-licensure vaccine safety monitoring.
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Dementia care consultation for family caregivers: collaborative model linking an Alzheimers association chapter with primary care physicians.
Aging Ment Health
PUBLISHED: 04-07-2009
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The primary objective is to report on the efficacy of an individualized dementia care consultation intervention for family caregivers of patients with diagnosed dementia living in the community. The secondary objective is to present evidence on the intervention process to inform the feasibility and sustainability of the model featuring collaboration between primary care physicians and a voluntary sector organization.
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Telephone triage service data for detection of influenza-like illness.
PLoS ONE
PUBLISHED: 03-13-2009
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Surveillance for influenza and influenza-like illness (ILI) is important for guiding public health prevention programs to mitigate the morbidity and mortality caused by influenza, including pandemic influenza. Nontraditional sources of data for influenza and ILI surveillance are of interest to public health authorities if their validity can be established.
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Early adverse drug event signal detection within population-based health networks using sequential methods: key methodologic considerations.
Pharmacoepidemiol Drug Saf
PUBLISHED: 01-17-2009
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Active surveillance of population-based health networks may improve the timeliness of detection of adverse events (AEs). Our objective was to expand our previous signal detection work by investigating the effect on signal detection of alternative study specifications.
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Influence of spatial resolution on space-time disease cluster detection.
PLoS ONE
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Utilizing highly precise spatial resolutions within disease outbreak detection, such as the patients address, is most desirable as this provides the actual residential location of the infected individual(s). However, this level of precision is not always readily available or only available for purchase, and when utilized, increases the risk of exposing protected health information. Aggregating data to less precise scales (e.g., ZIP code or county centroids) may mitigate this risk but at the expense of potentially masking smaller isolated high risk areas.
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Risk of confirmed Guillain-Barre syndrome following receipt of monovalent inactivated influenza A (H1N1) and seasonal influenza vaccines in the Vaccine Safety Datalink Project, 2009-2010.
Am. J. Epidemiol.
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An increased risk of Guillain-Barré syndrome (GBS) following administration of the 1976 swine influenza vaccine led to a heightened focus on GBS when monovalent vaccines against a novel influenza A (H1N1) virus of swine origin were introduced in 2009. GBS cases following receipt of monovalent inactivated (MIV) and seasonal trivalent inactivated (TIV) influenza vaccines in the Vaccine Safety Datalink Project in 2009-2010 were identified in electronic data and confirmed by medical record review. Within 1-42 days following vaccination, 9 cases were confirmed in MIV recipients (1.48 million doses), and 8 cases were confirmed in TIV-only recipients who did not also receive MIV during 2009-2010 (1.72 million doses). Five cases following MIV and 1 case following TIV-only had an antecedent respiratory infection, a known GBS risk factor; furthermore, unlike TIV, MIV administration was concurrent with heightened influenza activity. In a self-controlled risk interval analysis comparing GBS onset within 1-42 days following MIV with GBS onset 43-127 days following MIV, the risk difference was 5.0 cases per million doses (95% confidence interval: 0.5, 9.5). No statistically significant increased GBS risk was found within 1-42 days following TIV-only vaccination versus 43-84 days following vaccination (risk difference = 1.1 cases per million doses, 95% confidence interval: -3.1, 5.4). Further evaluation to assess GBS risk following both vaccination and respiratory infection is warranted.
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Surveillance for adverse events following receipt of pandemic 2009 H1N1 vaccine in the Post-Licensure Rapid Immunization Safety Monitoring (PRISM) System, 2009-2010.
Am. J. Epidemiol.
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The Post-Licensure Rapid Immunization Safety Monitoring (PRISM) system is a cohort-based active surveillance network initiated by the US Department of Health and Human Services to supplement preexisting and other vaccine safety monitoring systems in tracking the safety of monovalent pandemic 2009 H1N1 influenza vaccine in the United States during 2009-2010. PRISM investigators conducted retrospective analysis to determine whether 2009 H1N1 vaccination was associated with increased risk of any of 14 prespecified outcomes. Five health insurance and associated companies with 38 million members and 9 state/city immunization registries contributed records on more than 2.6 million doses of 2009 H1N1 vaccine. Data on outcomes came from insurance claims. Complementary designs (self-controlled risk interval, case-centered, and current-vs.-historical comparison) were used to optimize control for confounding and statistical power. The self-controlled risk interval analysis of chart-confirmed Guillain-Barré syndrome found an elevated but not statistically significant incidence rate ratio following receipt of inactivated 2009 H1N1 vaccine (incidence rate ratio = 2.50, 95% confidence interval: 0.42, 15.0) and no cases following live attenuated 2009 H1N1 vaccine. The study did not control for infection prior to Guillain-Barré syndrome, which may have been a confounder. The risks of other health outcomes of interest were generally not significantly elevated after 2009 H1N1 vaccination.
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Gastrointestinal disease outbreak detection using multiple data streams from electronic medical records.
Foodborne Pathog. Dis.
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Passive reporting and laboratory testing delays may limit gastrointestinal (GI) disease outbreak detection. Healthcare systems routinely collect clinical data in electronic medical records (EMRs) that could be used for surveillance. This studys primary objective was to identify data streams from EMRs that may perform well for GI outbreak detection.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.