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2. Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries:23 million person-years of observation

Author

Sun, L., Best, L. G., Cooper, C., Bakker, S. J.L., Kavousi, M., Meyer, H. E., Thompson, S. G., Hunt, K. J., Bom, M. T., Kraft, P., Psaty, B. M., de Boer, R., Trompet, S., Tilly, M., Ikram, M. A., Dorr, M., Can, G., Geleijnse, M., Sun, L., Best, L. G., Cooper, C., Bakker, S. J.L., Kavousi, M., Meyer, H. E., Thompson, S. G., Hunt, K. J., Bom, M. T., Kraft, P., Psaty, B. M., de Boer, R., Trompet, S., Tilly, M., Ikram, M. A., Dorr, M., Can, G., and Geleijnse, M.

Abstract

Background:The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. Methods:For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961–2007, median latest follow-up years 1980–2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU. Findings: For participants with diabetes, we observed a linear dose–response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43–2·97) when diagnosed at 30–39 years, 2·26 (2·08–2·45) at 40–49 years, 1·84 (1·72–1·97) at 50–59 years, 1·57 (1·47–1·67) at 60–69 years, and 1·39 (1·29–1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates

Published
2023

16. Element 98

Author

Thompson, S G, Street, K, Jr., Ghiorso, A, and Seaborg, G T

Published
1950

22. Individual‐patient meta‐analysis of three randomized trials comparing endovascular versus open repair for ruptured abdominal aortic aneurysm

Author

Sweeting, M. J., Balm, R., Desgranges, P., Ulug, P., Powell, J. T., Koelemay, M. J. W., Idu, M. M., Kox, C., Legemate, D. A., Huisman, L. C., Willems, M. C. M., Reekers, J. A., van Delden, O. M., van Lienden, K. P., Hoornweg, L. L., Reimerink, J. J., van Beek, S. C., Vahl, A. C., Leijdekkers, V. J., Bosma, J., Montauban van Swijndregt, A. D., de Vries, C., van der Hulst, V. P. M., Peringa, J., Blomjous, J. G. A. M., Visser, M. J. T., van der Heijden, F. H. W. M., Wisselink, W., Hoksbergen, A. W. J., Blankensteijn, J. D., Visser, M. T. J., Coveliers, H. M. E., Nederhoed, J. H., van den Berg, F. G., van der Meijs, B. B., van den Oever, M. L. P., Lely, R. J., Meijerink, M. R., Voorwinde, A., Ultee, J. M., van Nieuwenhuizen, R. C., Dwars, B. J., Nagy, T. O. M., Tolenaar, P., Wiersema, A. M., Lawson, J. A., van Aken, P. J., Stigter, A. A., van den Broek, T. A. A., Vos, G. A., Mulder, W., Strating, R. P., Nio, D., Akkersdijk, G. J. M., van der Elst, A., Exter, P.van, Becquemin, J.‐P., Allaire, E., Cochennec, F., Marzelle, J., Louis, N., Schneider, J., Majewski, M., Castier, Y., Leseche, G., Francis, F., Steinmetz, E., Berne, J.‐P., Favier, C., Haulon, S., Koussa, M., Azzaoui, R., Piervito, D., Alimi, Y., Boufi, M., Hartung, O., Cerquetta, P., Amabile, P., Piquet, P., Penard, J., Demasi, M., Alric, P., Canaud, L., Berthet, J.‐P., Julia, P., Fabiani, J.‐N., Alsac, J. M., Gouny, P., Badra, A., Braesco, J., Favre, J.‐P., Albertini, J.‐N., Martinez, R., Hassen‐Khodja, R., Batt, M., Jean, E., Sosa, M., Declemy, S., Destrieux‐Garnier, L., Lermusiaux, P., Feugier, P., Ashleigh, R., Gomes, M., Greenhalgh, R. M., Grieve, R., Hinchliffe, R., Sweeting, M., Thompson, M. M., Thompson, S. G., Cheshire, N. J., Boyle, J. R., Serracino‐Inglott, F., Smyth, J. V., Hinchliffe, R. J., Bell, R., Wilson, N., Bown, M., Dennis, M., Davis, M., Howell, S., Wyatt, M. G., Valenti, D., Bachoo, P., Walker, P., MacSweeney, S., Davies, J. N., Rittoo, D., Parvin, S. D., Yusuf, W., Nice, C., Chetter, I., Howard, A., Chong, P., Bhat, R., McLain, D., Gordon, A., Lane, I., Hobbs, S., Pillay, W., Rowlands, T., El‐Tahir, A., Asquith, J., Cavanagh, S., Dubois, L., Forbes, T. L., ACS - Amsterdam Cardiovascular Sciences, Surgery, 02 Surgical specialisms, Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, Other departments, and Oral and Maxillofacial Surgery

Subjects
medicine.medical_specialty, Aortic Rupture, Population, law.invention, Aneurysm, Randomized controlled trial, law, medicine, Humans, cardiovascular diseases, education, Randomized Controlled Trials as Topic, education.field_of_study, business.industry, Mortality rate, Hazard ratio, Endovascular Procedures, Odds ratio, Original Articles, medicine.disease, Abdominal aortic aneurysm, Surgery, Treatment Outcome, Meta-analysis, cardiovascular system, Original Article, business, Vascular Surgical Procedures, Aortic Aneurysm, Abdominal
Abstract

Background The benefits of endovascular repair of ruptured abdominal aortic aneurysm remain controversial, without any strong evidence about advantages in specific subgroups. Methods An individual‐patient data meta‐analysis of three recent randomized trials of endovascular versus open repair of abdominal aortic aneurysm was conducted according to a prespecified analysis plan, reporting on results to 90 days after the index event. Results The trials included a total of 836 patients. The mortality rate across the three trials was 31·3 per cent for patients randomized to endovascular repair/strategy and 34·0 per cent for those randomized to open repair at 30 days (pooled odds ratio 0·88, 95 per cent c.i. 0·66 to 1·18), and 34·3 and 38·0 per cent respectively at 90 days (pooled odds ratio 0·85, 0·64 to 1·13). There was no evidence of significant heterogeneity in the odds ratios between trials. Mean(s.d.) aneurysm diameter was 8·2(1·9) cm and the overall in‐hospital mortality rate was 34·8 per cent. There was no significant effect modification with age or Hardman index, but there was indication of an early benefit from an endovascular strategy for women. Discharge from the primary hospital was faster after endovascular repair (hazard ratio 1·24, 95 per cent c.i. 1·04 to 1·47). For open repair, 30‐day mortality diminished with increasing aneurysm neck length (adjusted odds ratio 0·69 (95 per cent c.i. 0·53 to 0·89) per 15 mm), but aortic diameter was not associated with mortality for either type of repair. Conclusion Survival to 90 days following an endovascular or open repair strategy is similar for all patients and for the restricted population anatomically suitable for endovascular repair. Women may benefit more from an endovascular strategy than men and patients are, on average, discharged sooner after endovascular repair., Strong evidence of equivalence

Published
2015

23. Risk thresholds for alcohol consumption:combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Author

Wood, A. M. (Angela M.), Kaptoge, S. (Stephen), Butterworth, A. S. (Adam S.), Willeit, P. (Peter), Warnakula, S. (Samantha), Bolton, T. (Thomas), Paige, E. (Ellie), Paul, D. S. (Dirk S.), Sweeting, M. (Michael), Burgess, S. (Stephen), Bell, S. (Steven), Astle, W. (William), Stevens, D. (David), Koulman, A. (Albert), Selmer, R. M. (Randi M.), Verschuren, W. M. (W. M. Monique), Sato, S. (Shinichi), Njolstad, I. (Inger), Woodward, M. (Mark), Salomaa, V. (Veikko), Nordestgaard, B. G. (Borge G.), Yeap, B. B. (Bu B.), Fletcher, A. (Astrid), Melander, O. (Olle), Kuller, L. H. (Lewis H.), Balkau, B. (Beverley), Marmot, M. (Michael), Koenig, W. (Wolfgang), Casiglia, E. (Edoardo), Cooper, C. (Cyrus), Arndt, V. (Volker), Franco, O. H. (Oscar H.), Wennberg, P. (Patrik), Gallacher, J. (John), de la Camara, A. G. (Agustin Gomez), Volzke, H. (Henry), Dahm, C. C. (Christina C.), Dale, C. E. (Caroline E.), Bergmann, M. M. (Manuela M.), Crespo, C. J. (Carlos J.), van der Schouw, Y. T. (Yvonne T.), Kaaks, R. (Rudolf), Simons, L. A. (Leon A.), Lagiou, P. (Pagona), Schoufour, J. D. (Josje D.), Boer, J. M. (Jolanda M. A.), Key, T. J. (Timothy J.), Rodriguez, B. (Beatriz), Moreno-Iribas, C. (Conchi), Davidson, K. W. (Karina W.), Taylor, J. O. (James O.), Sacerdote, C. (Carlotta), Wallace, R. B. (Robert B.), Quiros, J. R. (J. Ramon), Tumino, R. (Rosario), Blazer, D. G. (Dan G., II), Linneberg, A. (Allan), Daimon, M. (Makoto), Panico, S. (Salvatore), Howard, B. (Barbara), Skeie, G. (Guri), Strandberg, T. (Timo), Weiderpass, E. (Elisabete), Nietert, P. J. (Paul J.), Psaty, B. M. (Bruce M.), Kromhout, D. (Daan), Salamanca-Fernandez, E. (Elena), Kiechl, S. (Stefan), Krumholz, H. M. (Harlan M.), Grioni, S. (Sara), Palli, D. (Domenico), Huerta, J. M. (Jose M.), Price, J. (Jackie), Sundstrom, J. (Johan), Arriola, L. (Larraitz), Arima, H. (Hisatomi), Travis, R. C. (Ruth C.), Panagiotakos, D. B. (Demosthenes B.), Karakatsani, A. (Anna), Trichopoulou, A. (Antonia), Kuhn, T. (Tilman), Grobbee, D. E. (Diederick E.), Barrett-Connor, E. (Elizabeth), van Schoor, N. (Natasja), Boeing, H. (Heiner), Overvad, K. (Kim), Kauhanen, J. (Jussi), Wareham, N. (Nick), Langenberg, C. (Claudia), Forouhi, N. (Nita), Wennberg, M. (Maria), Despres, J.-P. (Jean-Pierre), Cushman, M. (Mary), Cooper, J. A. (Jackie A.), Rodriguez, C. J. (Carlos J.), Sakurai, M. (Masaru), Shaw, J. E. (Jonathan E.), Knuiman, M. (Matthew), Voortman, T. (Trudy), Meisinger, C. (Christa), Tjonneland, A. (Anne), Brenner, H. (Hermann), Palmieri, L. (Luigi), Dallongeville, J. (Jean), Brunner, E. J. (Eric J.), Assmann, G. (Gerd), Trevisan, M. (Maurizio), Gillum, R. F. (Richard F.), Ford, I. (Ian), Sattar, N. (Naveed), Lazo, M. (Mariana), Thompson, S. G. (Simon G.), Ferrari, P. (Pietro), Leon, D. A. (David A.), Smith, G. D. (George Davey), Peto, R. (Richard), Jackson, R. (Rod), Banks, E. (Emily), Di Angelantonio, E. (Emanuele), Danesh, J. (John), Wood, A. M. (Angela M.), Kaptoge, S. (Stephen), Butterworth, A. S. (Adam S.), Willeit, P. (Peter), Warnakula, S. (Samantha), Bolton, T. (Thomas), Paige, E. (Ellie), Paul, D. S. (Dirk S.), Sweeting, M. (Michael), Burgess, S. (Stephen), Bell, S. (Steven), Astle, W. (William), Stevens, D. (David), Koulman, A. (Albert), Selmer, R. M. (Randi M.), Verschuren, W. M. (W. M. Monique), Sato, S. (Shinichi), Njolstad, I. (Inger), Woodward, M. (Mark), Salomaa, V. (Veikko), Nordestgaard, B. G. (Borge G.), Yeap, B. B. (Bu B.), Fletcher, A. (Astrid), Melander, O. (Olle), Kuller, L. H. (Lewis H.), Balkau, B. (Beverley), Marmot, M. (Michael), Koenig, W. (Wolfgang), Casiglia, E. (Edoardo), Cooper, C. (Cyrus), Arndt, V. (Volker), Franco, O. H. (Oscar H.), Wennberg, P. (Patrik), Gallacher, J. (John), de la Camara, A. G. (Agustin Gomez), Volzke, H. (Henry), Dahm, C. C. (Christina C.), Dale, C. E. (Caroline E.), Bergmann, M. M. (Manuela M.), Crespo, C. J. (Carlos J.), van der Schouw, Y. T. (Yvonne T.), Kaaks, R. (Rudolf), Simons, L. A. (Leon A.), Lagiou, P. (Pagona), Schoufour, J. D. (Josje D.), Boer, J. M. (Jolanda M. A.), Key, T. J. (Timothy J.), Rodriguez, B. (Beatriz), Moreno-Iribas, C. (Conchi), Davidson, K. W. (Karina W.), Taylor, J. O. (James O.), Sacerdote, C. (Carlotta), Wallace, R. B. (Robert B.), Quiros, J. R. (J. Ramon), Tumino, R. (Rosario), Blazer, D. G. (Dan G., II), Linneberg, A. (Allan), Daimon, M. (Makoto), Panico, S. (Salvatore), Howard, B. (Barbara), Skeie, G. (Guri), Strandberg, T. (Timo), Weiderpass, E. (Elisabete), Nietert, P. J. (Paul J.), Psaty, B. M. (Bruce M.), Kromhout, D. (Daan), Salamanca-Fernandez, E. (Elena), Kiechl, S. (Stefan), Krumholz, H. M. (Harlan M.), Grioni, S. (Sara), Palli, D. (Domenico), Huerta, J. M. (Jose M.), Price, J. (Jackie), Sundstrom, J. (Johan), Arriola, L. (Larraitz), Arima, H. (Hisatomi), Travis, R. C. (Ruth C.), Panagiotakos, D. B. (Demosthenes B.), Karakatsani, A. (Anna), Trichopoulou, A. (Antonia), Kuhn, T. (Tilman), Grobbee, D. E. (Diederick E.), Barrett-Connor, E. (Elizabeth), van Schoor, N. (Natasja), Boeing, H. (Heiner), Overvad, K. (Kim), Kauhanen, J. (Jussi), Wareham, N. (Nick), Langenberg, C. (Claudia), Forouhi, N. (Nita), Wennberg, M. (Maria), Despres, J.-P. (Jean-Pierre), Cushman, M. (Mary), Cooper, J. A. (Jackie A.), Rodriguez, C. J. (Carlos J.), Sakurai, M. (Masaru), Shaw, J. E. (Jonathan E.), Knuiman, M. (Matthew), Voortman, T. (Trudy), Meisinger, C. (Christa), Tjonneland, A. (Anne), Brenner, H. (Hermann), Palmieri, L. (Luigi), Dallongeville, J. (Jean), Brunner, E. J. (Eric J.), Assmann, G. (Gerd), Trevisan, M. (Maurizio), Gillum, R. F. (Richard F.), Ford, I. (Ian), Sattar, N. (Naveed), Lazo, M. (Mariana), Thompson, S. G. (Simon G.), Ferrari, P. (Pietro), Leon, D. A. (David A.), Smith, G. D. (George Davey), Peto, R. (Richard), Jackson, R. (Rod), Banks, E. (Emily), Di Angelantonio, E. (Emanuele), and Danesh, J. (John)

Abstract

Background: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. Methods: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose–response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th–95th percentile 1·04–13·5]) from 71 011 participants from 37 studies. Findings: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality ris

Published
2018

33. Ischaemic Heart Disease And Cholesterol [with Reply]

Author

Bonneux, Luc, Barendregt, Jan J., Ravnskov, Uffe, Ramsay, L. E., Yeo, W. W., Jackson, P. R., Sheldon, Trevor A., Song, Fujian, Millo, Julian, Sudlow, C. L. M., MacLeod, M. R., Heady, J. A., Morris, J. N., Oliver, M. F., Vine, Donald L., Hastings, Glen E., Durrington, Paul N., Dugdale, Alan, Law, M. R., Wald, N. J., Wu, T., Hackshaw, A., Thompson, S. G., and Bailey, A.

Published
1994

35. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents

Author

Di Angelantonio, E., Bhupathiraju, S. N., Wormser, D., Gao, P., Kaptoge, S., de Gonzalez, A. B., Cairns, B. J., Huxley, R., Jackson, C. L., Joshy, G., Lewington, S., Manson, J. A. E., Murphy, N., Patel, A. V., Samet, J. M., Woodward, M., Zheng, W., Zhou, M., Bansal, N., Barricarte, A., Carter, B., Cerhan, J. R., Collins, R., Smith, G. D., Fang, X., Franco, O. H., Green, J., Halsey, J., Hildebrand, J. S., Ji Jung, K., Korda, R. J., McLerran, D. F., Moore, S. C., O'Keeffe, L. M., Paige, E., Ramond, A., Reeves, G. K., Rolland, B., Sacerdote, C., Sattar, N., Anopoulou, E. S., Stevens, J., Thun, M., Ueshima, H., Yang, L., Duk Yun, Y., Willeit, P., Banks, E., Beral, V., Chen, Z., Gapstur, S. M., Gunter, M. J., Hartge, P., Jee, S. H., Lam, T. H., Peto, R., Potter, J. D., Willett, W. C., Thompson, S. G., Danesh, J., Hu, F. B., Di Angelantonio, E., Bhupathiraju, S. N., Wormser, D., Gao, P., Kaptoge, S., de Gonzalez, A. B., Cairns, B. J., Huxley, R., Jackson, C. L., Joshy, G., Lewington, S., Manson, J. A. E., Murphy, N., Patel, A. V., Samet, J. M., Woodward, M., Zheng, W., Zhou, M., Bansal, N., Barricarte, A., Carter, B., Cerhan, J. R., Collins, R., Smith, G. D., Fang, X., Franco, O. H., Green, J., Halsey, J., Hildebrand, J. S., Ji Jung, K., Korda, R. J., McLerran, D. F., Moore, S. C., O'Keeffe, L. M., Paige, E., Ramond, A., Reeves, G. K., Rolland, B., Sacerdote, C., Sattar, N., Anopoulou, E. S., Stevens, J., Thun, M., Ueshima, H., Yang, L., Duk Yun, Y., Willeit, P., Banks, E., Beral, V., Chen, Z., Gapstur, S. M., Gunter, M. J., Hartge, P., Jee, S. H., Lam, T. H., Peto, R., Potter, J. D., Willett, W. C., Thompson, S. G., Danesh, J., and Hu, F. B.

Abstract

© 2016 The Author(s). This is an Open Access article under the CC-BY license Background Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up. Methods Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4–14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5–<25·0 kg/m 2 . Findings All-cause mortality was minimal at 20·0–25·0 kg/m 2 (HR 1·00, 95% CI 0·98–1·02 for BMI 20·0–<22·5 kg/m 2 ; 1·00, 0·99–1·01 for BMI 22·5–<25·0 kg/m 2 ), and increased significantly both just below this range (1·13, 1·09–1·17 for BMI 18·5–<20·0 kg/m 2 ; 1·51, 1·43–1·59 for BMI 15·0–<18·5) and throughout the overweight range (1·07, 1·07–1·08 for BMI 25·0–<27·5 kg/m 2 ; 1·20, 1·18–1·22 for BMI 27·5–<30·0 kg/m 2 ). The HR for obesity grade 1 (BMI 30·0–<35·0 kg/m 2 ) was 1·45, 95% CI 1·41–1·48; the HR for obesity grade 2 (35·0–<40·0 kg/m 2 ) was 1·94, 1·87–2·01; and the HR for obesity grade 3 (40·0&ndash

Published
2016

36. A framework for quantifying net benefits of alternative prognostic models

Author

Rapsomaniki, E., White, I. R., Wood, A. M., Thompson, S. G., Tipping, R. W., Ford, C. E., Simpson, L. M., Folsom, A. R., Chambless, L. E., Panagiotakos, D. B., Pitsavos, C., Chrysohoou, C., Stefanadis, C., Knuiman, M., Whincup, P. H., Wannamethee, S. G., Morris, R. W., Kiechl, S., Willeit, J., Oberhollenzer, F., Mayr, A., Wald, N., Lawlor, D. A., Yarnell, J. W., Gallacher, J., Casiglia, E., Tikhonoff, V., Nietert, P. J., Sutherland, S. E., Bachman, D. L., Keil, J. E., Cushman, M., Tracy, R., Tybjaerg-Hansen, A., Nordestgaard, B. G., Frikke-Schmidt, R., Giampaoli, S., Palmieri, L., Panico, S., Vanuzzo, D., Pilotto, L., Gomez de la Camara, A., Gomez Gerique, J. A., Simons, L., Mccallum, J., Friedlander, Y., Lee, A. J., Taylor, J., Guralnik, J. M., Wallace, R., Blazer, D. G., Khaw, K. -T., Schottker, B., Muller, H., Rothenbacher, D., Jansson, J. -H., Wennberg, P., Nissinen, A., Donfrancesco, C., Salomaa, V., Harald, K., Jousilahti, P., Vartiainen, E., Woodward, M., D'Agostino Sr, R. B., Wolf, P. A., Vasan, R. S., Pencina, M. J., Bladbjerg, E. -M., Jorgensen, T., Moller, L., Jespersen, J., Dankner, R., Chetrit, A., Lubin, F., Rosengren, A., Lappas, G., Eriksson, H., Bjorkelund, C., Lissner, L., Bengtsson, C., Nagel, D., Kiyohara, Y., Arima, H., Doi, Y., Ninomiya, T., Rodriguez, B., Dekker, J. M., Nijpels, G., Stehouwer, C. D. A., Iso, H., Kitamura, A., Yamagishi, K., Noda, H., Goldbourt, U., Kauhanen, J., Salonen, J. T., Cooper, J. A., Verschuren, W. M. M., Blokstra, A., Shea, S., Doring, A., Meisinger, C., Bueno-de-Mesquita, H. B., Kuller, L. H., Grandits, G., Gillum, R. F., Mussolino, M., Bauer, K. A., Kirkland, S., Shaffer, J., Korin, M. R., Sato, S., Amouyel, P., Arveiler, D., Evans, A., Ferrieres, J., Schulte, H., Assmann, G., Westendorp, R. G., Buckley, B. M., Packard, C. J., Sattar, N., Cantin, B., Despres, J. -P., Dagenais, G. R., Barrett-Connor, E., Wingard, D. L., Bettencourt, R., Gudnason, V., Aspelund, T., Sigurdsson, G., Thorsson, B., Witteman, J., Kardys, I., Tiemeier, H., Hofman, A., Tunstall-Pedoe, H., Tavendale, R., Lowe, G. D. O., Howard, B. V., Zhang, Y., Best, L., Umans, J., Ben-Shlomo, Y., Davey-Smith, G., Njolstad, I., Wilsgaard, T., Ingelsson, E., Lind, L., Giedraitis, V., Lannfelt, L., Gaziano, J. M., Stampfer, M., Ridker, P., Wassertheil-Smoller, S., Manson, J. E., Marmot, M., Clarke, R., Fletcher, A., Brunner, E., Shipley, M., Buring, J., Shepherd, J., Cobbe, S. M., Ford, I., Robertson, M., Marin Ibanez, A., Feskens, E. J. M., Kromhout, D., Interne Geneeskunde, and RS: CARIM School for Cardiovascular Diseases

Subjects
Nutrition and Disease, Epidemiology, Cost effectiveness, Cost-Benefit Analysis, cardiovascular-disease, Kaplan-Meier Estimate, 01 natural sciences, Health informatics, 010104 statistics & probability, 0302 clinical medicine, cardiovascular disease, Voeding en Ziekte, Econometrics, Medicine, 030212 general & internal medicine, Research Articles, competing risks, validation, Framingham Risk Score, Cost–benefit analysis, coronary heart-disease, Discriminant Analysis, cohort, Prognosis, 3. Good health, Cardiovascular Diseases, Meta-analysis, Risk assessment, metaanalysis, Statistics and Probability, reclassification, Context (language use), risk score, Risk Assessment, screening strategies, statins, 03 medical and health sciences, Meta-Analysis as Topic, Humans, 0101 mathematics, cost-effectiveness, Proportional Hazards Models, VLAG, business.industry, Proportional hazards model, Cardiovascular disease, Competing risks, Cost-effectiveness, Net benefit, Screening strategies, Epidemiologic Research Design, predictive ability, R1, meta-analysis, roc curve, business, net benefit
Abstract

New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context. We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit) of the treatment decisions they support, assuming a set of predetermined clinical treatment guidelines. The change in net benefit is more clinically interpretable than changes in traditional measures and can be used in full health economic evaluations of prognostic models used for screening and allocating risk reduction interventions. We extend previous work in this area by quantifying net benefits in life years, thus linking prognostic performance to health economic measures; by taking full account of the occurrence of events over time; and by considering estimation and cross-validation in a multiple-study setting. The method is illustrated in the context of cardiovascular disease risk prediction using an individual participant data meta-analysis. We estimate the number of cardiovascular-disease-free life years gained when statin treatment is allocated based on a risk prediction model with five established risk factors instead of a model with just age, gender and region. We explore methodological issues associated with the multistudy design and show that cost-effectiveness comparisons based on the proposed methodology are robust against a range of modelling assumptions, including adjusting for competing risks. Copyright © 2011 John Wiley & Sons, Ltd.

Published
2012
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38. Inflammatory markers and extent and progression of early atherosclerosis : Pooled analysis of individual participant data from 20 prospective studies of the PROG-IMT collaboration

Author

Willeit, P., Thompson, S. G., Agewall, S., Bergstrom, G., Bickel, H., Catapano, A. L., Chien, K. L., de Groot, E., Empana, J. P., Etgen, T., Franco, O. H., Iglseder, B., Johnsen, S. H., Kavousi, M., Lind, Lars, Liu, J., Mathiesen, E. B., Norata, G. D., Olsen, M. H., Papagianni, A., Poppert, H., Price, J. F., Sacco, R. L., Yanez, D. N., Zhao, D., Schminke, U., Buelbuel, A., Polak, J. F., Sitzer, M., Hofman, A., Grigore, L., Doerr, M., Su, T. C., Ducimetiere, P., Xie, W., Ronkainen, K., Kiechl, S., Rundek, T., Robertson, C., Fagerberg, B., Bokemark, L., Steinmetz, H., Ikram, M. A., Voelzke, H., Lin, H. J., Plichart, M., Tuomainen, T. P., Desvarieux, M., McLachlan, S., Schmidt, C., Kauhanen, J., Willeit, J., Lorenz, M. W., Sander, D., Willeit, P., Thompson, S. G., Agewall, S., Bergstrom, G., Bickel, H., Catapano, A. L., Chien, K. L., de Groot, E., Empana, J. P., Etgen, T., Franco, O. H., Iglseder, B., Johnsen, S. H., Kavousi, M., Lind, Lars, Liu, J., Mathiesen, E. B., Norata, G. D., Olsen, M. H., Papagianni, A., Poppert, H., Price, J. F., Sacco, R. L., Yanez, D. N., Zhao, D., Schminke, U., Buelbuel, A., Polak, J. F., Sitzer, M., Hofman, A., Grigore, L., Doerr, M., Su, T. C., Ducimetiere, P., Xie, W., Ronkainen, K., Kiechl, S., Rundek, T., Robertson, C., Fagerberg, B., Bokemark, L., Steinmetz, H., Ikram, M. A., Voelzke, H., Lin, H. J., Plichart, M., Tuomainen, T. P., Desvarieux, M., McLachlan, S., Schmidt, C., Kauhanen, J., Willeit, J., Lorenz, M. W., and Sander, D.

Published
2014

39. Bayesian methods for meta-analysis of causal relationships estimated using genetic instrumental variables

Author

Burgess, Stephen, Thompson, Simon G, Andrews, G, Samani, N J, Hall, A, Whincup, P, Morris, R, Lawlor, D A, Davey Smith, G, Timpson, N, Ebrahim, S, Ben-Shlomo, Y, Brown, M, Ricketts, S, Sandhu, M, Reiner, A, Psaty, B, Lange, L, Cushman, M, Hung, J, Thompson, P, Beilby, J, Warrington, N, Palmer, L J, Nordestgaard, B G, Tybjaerg-Hansen, A, Zacho, J, Wu, C, Lowe, G, Tzoulaki, I, Kumari, M, Yamamoto, J F, Chiodini, B, Franzosi, M, Hankey, G J, Jamrozik, K, Palmer, L, Rimm, E, Pai, J, Heckbert, S, Bis, J, Anand, S, Engert, J, Collins, R, Clarke, R, Melander, O, Berglund, G, Ladenvall, P, Johansson, L, Jansson, Jan-Håkan, Hallmans, Göran, Hingorani, A, Humphries, S, Manson, J, Watkins, H, Hopewell, J, Saleheen, D, Frossard, R, Danesh, J, Sattar, N, Robertson, M, Shepherd, J, Schaefer, E, Hofman, A, Witteman, J C M, Kardys, I, de Faire, U, Bennet, A, Ford, I, Packard, C, Lawlor, Debbie A, Davey Smith, George, Casas, J P, Smeeth, L, Wensley, F, Bowden, J, Burgess, S, Di Angelantonio, E, Gao, P, Shah, T, Thompson, S G, Verzilli, C, Walker, M, Whittaker, J, Burgess, Stephen, Thompson, Simon G, Andrews, G, Samani, N J, Hall, A, Whincup, P, Morris, R, Lawlor, D A, Davey Smith, G, Timpson, N, Ebrahim, S, Ben-Shlomo, Y, Brown, M, Ricketts, S, Sandhu, M, Reiner, A, Psaty, B, Lange, L, Cushman, M, Hung, J, Thompson, P, Beilby, J, Warrington, N, Palmer, L J, Nordestgaard, B G, Tybjaerg-Hansen, A, Zacho, J, Wu, C, Lowe, G, Tzoulaki, I, Kumari, M, Yamamoto, J F, Chiodini, B, Franzosi, M, Hankey, G J, Jamrozik, K, Palmer, L, Rimm, E, Pai, J, Heckbert, S, Bis, J, Anand, S, Engert, J, Collins, R, Clarke, R, Melander, O, Berglund, G, Ladenvall, P, Johansson, L, Jansson, Jan-Håkan, Hallmans, Göran, Hingorani, A, Humphries, S, Manson, J, Watkins, H, Hopewell, J, Saleheen, D, Frossard, R, Danesh, J, Sattar, N, Robertson, M, Shepherd, J, Schaefer, E, Hofman, A, Witteman, J C M, Kardys, I, de Faire, U, Bennet, A, Ford, I, Packard, C, Lawlor, Debbie A, Davey Smith, George, Casas, J P, Smeeth, L, Wensley, F, Bowden, J, Burgess, S, Di Angelantonio, E, Gao, P, Shah, T, Thompson, S G, Verzilli, C, Walker, M, and Whittaker, J

Abstract

Genetic markers can be used as instrumental variables, in an analogous way to randomization in a clinical trial, to estimate the causal relationship between a phenotype and an outcome variable. Our purpose is to extend the existing methods for such Mendelian randomization studies to the context of multiple genetic markers measured in multiple studies, based on the analysis of individual participant data. First, for a single genetic marker in one study, we show that the usual ratio of coefficients approach can be reformulated as a regression with heterogeneous error in the explanatory variable. This can be implemented using a Bayesian approach, which is next extended to include multiple genetic markers. We then propose a hierarchical model for undertaking a meta-analysis of multiple studies, in which it is not necessary that the same genetic markers are measured in each study. This provides an overall estimate of the causal relationship between the phenotype and the outcome, and an assessment of its heterogeneity across studies. As an example, we estimate the causal relationship of blood concentrations of C-reactive protein on fibrinogen levels using data from 11 studies. These methods provide a flexible framework for efficient estimation of causal relationships derived from multiple studies. Issues discussed include weak instrument bias, analysis of binary outcome data such as disease risk, missing genetic data, and the use of haplotypes.

Published
2010
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40. Readiness for lifestyle advice: self-assessments of coronary risk prior to screening in the British family heart study. Family Heart Study Group

Author

Marteau, T M, Kinmonth, A L, Pyke, S, and Thompson, S G

Subjects
Adult, Male, Risk Factors, Humans, Mass Screening, Coronary Disease, Female, Middle Aged, Attitude to Health, Life Style, Research Article
Abstract

BACKGROUND. Where health professionals and patients hold similar views of a problem, health outcomes may be better. AIM. The aims of this paper were to document how attenders at primary care cardiovascular screening clinics perceived their risks of coronary heart disease prior to screening; the degree of similarity between perceived level of risk and an epidemiologically derived risk score; and the relative importance assigned to individual risk factors by subjects compared with those assigned by the risk score. METHOD: These issues were investigated in 3725 middle aged men and women who accepted an invitation to attend health screening as part of the British family heart study. RESULTS. Overall, there was a tendency for subjects to be optimistic (37%) rather than pessimistic (21%) when judging their risk of coronary heart disease. Nevertheless, there were strong significant associations between perceived risk and the levels of individual risk factors, particularly personal and family medical history and body mass index. There was also a strong association with the overall risk score though a large minority (31%) held views of their risk of coronary heart disease that were quite different from those based upon the epidemiologically derived index of risk. Respondents accorded greater importance to smoking and parental death from coronary heart disease and less importance to cholesterol level and blood pressure than did the risk score. CONCLUSION. Possible explanations for the observed disagreement are over-optimism or the relative importance given to individual risk factors. The relationships between patients' perceptions of risk and the epidemiological indices likely to be espoused by health professionals are important in understanding the difficulties in communication that might arise in offering lifestyle advice after screening for cardiovascular risk.

Published
1995

44. Palladium profiles in titanium treated by high-intensity plasma pulses

Author

Werner, Z., Piekoszewski, J., Szymczyk, W., Bonilla, F. A., Ong, T. S., Skeldon, P., Thompson, S. G., Zielinski, E., Chmielewski, A., Grötzschel, R., Werner, Z., Piekoszewski, J., Szymczyk, W., Bonilla, F. A., Ong, T. S., Skeldon, P., Thompson, S. G., Zielinski, E., Chmielewski, A., and Grötzschel, R.

Published
2002

45. Turning the Pump Handle: Evolving Methods for Integrating the Evidence on Gene-Disease Association

Author

Higgins, J. P. T., primary, Little, J., additional, Ioannidis, J. P. A., additional, Bray, M. S., additional, Manolio, T. A., additional, Smeeth, L., additional, Sterne, J. A., additional, Anagnostelis, B., additional, Butterworth, A. S., additional, Danesh, J., additional, Dezateux, C., additional, Gallacher, J. E., additional, Gwinn, M., additional, Lewis, S. J., additional, Minelli, C., additional, Pharoah, P. D., additional, Salanti, G., additional, Sanderson, S., additional, Smith, L. A., additional, Taioli, E., additional, Thompson, J. R., additional, Thompson, S. G., additional, Walker, N., additional, Zimmern, R. L., additional, and Khoury, M. J., additional

Published
2007
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