1.Data science in large cohort studies.
Chinese Journal of Epidemiology 2019;40(1):1-4
Large cohort study gained its popularity in biomedical research and demonstrated its application in exploring disease etiology and pathogenesis, improving the prognosis of disease, as well as reducing the burden of diseases. Data science is an interdisciplinary field that uses scientific methods from computer science and statistics to extract insights or knowledge from data in a specific domain. The results from the combination of the two would provide new evidence for developing the strategies and measures on disease prevention and control. This review included a brief introduction of data science, descriptions on characteristics of large cohort data according to the development of the study design, and application of data science at each stage of a large cohort study, as well as prospected the application of data science in the future large cohort studies.
Cohort Studies
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Data Science
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Interdisciplinary Studies
2.Determination of normative bone mineral density values in Filipino women.
Bermudez Charito C ; Tan-Ong Millicent Y ; Torralba Tito P ; Saavedra-Sue Celle ; Navarra Sandra V ; Mercado-Asis Leilan ; Llamado Lyndon Q ; Dy Sarah H ; Yu Julie L
Philippine Journal of Internal Medicine 2013;51(1):42-46
OBJECTIVE: To obtain reference values of bone mineral density (BMD) for Filipino women in order to make a population-specific diagnosis of osteoporosis.
SETTING: Osteoporosis Unit, Joint and Bone Center, Section of Rheumatology and Clinical Immunology, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
PARTICIPANTS: 442 healthy Filipino women volunteers recruited from the outpatient department, Rheumatology and Clinical Immunology Clinic of the University of Santo Tomas Hospital and from within the University of Santo Tomas campus. Subjects with known underlying illness or conditions or intake of drugs that predispose to osteoporosis were excluded from the study.
INTERVENTION: Bone mineral density (BMD) measurements, expressed in grams per square centimenter of the lumbar spine, non-dominant femur and non-dominant forearm were done in 442 consecutive healthy Filipino women using the LUNAR DPX-IQ machine.
RESULTS: Means and standard deviations of BMD measurements at each site were calculated using Kwikstat software Version 3.6, Release 7. Results were grouped in decades to serve as reference per decade.
CONCLUSION: BMD of these 442 healthy Filipino women may serve as an initial reference guide for the diagnosis of osteoporosis in Filipino women.
Human ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Osteoporosis ; Femur ; Forearm ; Chronic Pain ; Delivery Of Health Care ; Bone Density ; Body Mass Index
3.Interpretation for the group standards in data management for large population-based cohorts.
C Q YU ; Y N LIU ; J LYU ; Z BIAN ; Y L TAN ; Y GUO ; H J TANG ; X YANG ; L M LI
Chinese Journal of Epidemiology 2019;40(1):17-19
Precision medicine became the key strategy in development priority of science and technology in China. The large population-based cohorts become valuable resources in preventing and treating major diseases in the population, which can contribute scientific evidence for personalized treatment and precise prevention. The fundamental question of the achievements above, therefore, is how to construct a large population-based cohort in a standardized way. The Chinese Preventive Medicine Association co-ordinated experienced researchers from Peking University and other well-known institutes to write up two group standards Technical specification of data processing for large population-based cohort study (T/CPMA 001-2018) and Technical specification of data security for large population-based cohort study (T/CPMA 002-2018), on data management. The standards are drafted with principles of emphasizing their scientific, normative, feasible, and generalizable nature. In these two standards, the key principles are proposed, and technical specifications are recommended in data standardization, cleansing, quality control, data integration, data privacy protection, and database security and stability management in large cohort studies. The standards aim to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence, to improve domestic scientific research level and the international influence, and to support decision-making and practice of disease prevention and control.
China
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Cohort Studies
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Delivery of Health Care
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Humans
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Population Surveillance
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Quality Control
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Reference Standards
4.Introduction on 'assessing the risk of bias of individual studies' in systematic review of health-care intervention programs revised by the Agency for Healthcare Research and Quality.
J C YANG ; Z R YANG ; S Q YU ; S Y ZHAN ; F SUN
Chinese Journal of Epidemiology 2019;40(1):106-111
This paper summarizes the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions revised by the Agency for Healthcare Research and Quality (AHRQ) and introduces how to use Revman software make risk of bias graph or risk of bias summary. AHRQ tool can be used to evaluate following study designs: RCTs, cohort study, case-control study (including nested case-control), case series study and cross-sectional study. The tool evaluates the risk of bias of individual studies from selection bias, performance bias, attrition bias, detection bias and reporting bias. Each of the bias domains contains different items, and each item is available for the assessment of one or more study designs. It is worth noting that the appropriate items should be selected for evaluation different study designs instead of using all items to directly assess the risk of bias. AHRQ tool can be used to evaluate risk of bias individual studies when systematic reviews of health care interventions is including different study designs. Moreover, the tool items are relatively easy to understand and the assessment process is not complicated. AHRQ recommends the use of high, medium and low risk classification methods to assess the overall risk of bias of individual studies. However, AHRQ gives no recommendations on how to determine the overall bias grade. It is expected that future research will give corresponding recommendations.
Bias
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Evidence-Based Medicine/standards*
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Health Services Research
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Systematic Reviews as Topic
5.The correlation between No. 6 and No. 14v lymph node metastasis and the value of dissecting these lymph nodes in radical gastrectomy.
Q C YANG ; H K ZHOU ; C YUE ; W D WANG ; R Q GAO ; Z C MO ; P P JI ; J P WEI ; X S YANG ; P F YU ; X H LI ; G JI
Chinese Journal of Gastrointestinal Surgery 2023;26(1):38-43
Radical gastrectomy with D2 lymphadenectomy has been widely performed as the standard surgery for patients with gastric cancer in major medical centers in China and abroad. However, the exact extent of lymph node dissection is still controversial. In the latest version of the Japanese Gastric Cancer Treatment Guidelines, No. 14v lymph nodes (along the root of the superior mesenteric vein) are again defined as loco-regional lymph nodes, and it is clarified that distal gastric cancer presenting with infra-pyloric regional lymph node (No.6) metastasis is recommended for D2+ superior mesenteric vein (No. 14v) lymph node dissection. To explore the relevance and clinical significance of No.6 and No.14v lymphadenectomy in radical gastric cancer surgery, a review of the national and international literature revealed that No.6 lymph node metastasis was associated with No.14v lymph node metastasis, that No.6 lymph node status was a valid predictor of No.14v lymph node negative status and false negative rate, and that for gastric cancer patients with No. 14v lymph node negative and No.6 lymph node positive, the dissection of No.14v lymph node may also have some significance. The addition of No. 14v lymph node dissection in radical gastrectomy is safe, but it is more important to distinguish the patients who can benefit from it. Professor Liang Han of Tianjin Medical University Cancer Hospital is currently leading a multicenter, large-sample, prospective clinical trial (NCT02272894) in China, which is expected to provide higher level evidence for the clinical significance of lymph node dissection in No.14v.
Humans
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Stomach Neoplasms/pathology*
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Lymphatic Metastasis/pathology*
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Prospective Studies
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Retrospective Studies
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Lymph Nodes/pathology*
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Lymph Node Excision
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Gastrectomy
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Multicenter Studies as Topic
6.Effect of family environment in childhood and adolescence on mental health in adulthood.
Y N LIU ; F X GAN ; C Q YU ; W J GAO ; J LYU ; Z C PANG ; L M CONG ; H WANG ; X P WU ; W H CAO ; L M LI
Chinese Journal of Epidemiology 2018;39(5):600-603
Objective: To explore the relationship of family environment in childhood and adolescence and mental health in adulthood. Methods: A total of 791 subjects aged ≥25 years were selected through the Chinese National Twin Registry (CNTR). The short-form of Family Environment Scale-Chinese Version (FES-CV) was used to evaluate the family environment during childhood and adolescence in three dimensions: relationship, system maintenance and personal growth. The mental health status in adulthood was assessed with the Chinese version of 6-item Kessler Psychological Distress Scale (K6). The generalized linear mixed model was used to examine their relationship. Results: About 4.6% of the subjects reported general or worse mental health status. Compared with the subjects with good mental status, statistical difference was observed only in parenting way among twins (living together or not). After adjusting the potential confounders, such as age, sex, zygosity, education and lifestyle (smoking, drinking and physical activity), good family relationship and system maintenance had a positive effect on mental health, with the OR (95%CI) of 0.66 (0.51-0.87) and 0.70 (0.50-0.98) respectively. Furthermore, parenting way did not modify the effect of family environment on mental health status in adulthood (interaction: P>0.05). In each scale, scores of cohesion and organization were positively correlated with mental health, while the score of conflict was negatively correlated with the mental health. Conclusion: Good family relationship and system maintenance in childhood and adolescence had a positive impact on mental health in adulthood.
Adolescent
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Adult
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Child
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China
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Family Relations
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Female
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Humans
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Interpersonal Relations
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Male
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Mental Health
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Parenting
7.Association between central obesity and risk for heart disease in adults in China: a prospective study.
Y TIAN ; S C YANG ; C Q YU ; Y GUO ; Z BIAN ; Y L TAN ; P PEI ; J S CHEN ; Z M CHEN ; J LYU ; L M LI
Chinese Journal of Epidemiology 2018;39(9):1172-1178
Objective: To understand the association between central obesity, assessed by waist circumference, and the risks for ischemic heart disease (IHD), major coronary event (MCE), and IHD death. Methods: After excluding participants with heart disease, stroke, cancer, COPD, and diabetes at baseline survey, we included a total of 428 595 participants from the China Kadoorie Biobank for the analysis. The baseline survey was conducted from June 2004 to July 2008. We used Cox proportional hazards model to estimate the hazard ratio (HR) and 95%CI. Results: During an average 9.1 years of follow-up (3 803 637 person-years), we documented 26 900 incident cases of IHD, 4 320 cases of MCE, and 2 787 of deaths from IHD. After adjustment for possible confounders and BMI, central obesity was found to be associated with increased risks for IHD, MCE, and IHD death. The adjusted HRs (for the participants who had waist circumference of 85.0-89.9 cm in men and 80.0-84.9 cm in women were 1.13 (95%CI: 1.09-1.17) for IHD, 1.15 (95%CI: 1.05-1.26) for MCE and 1.11 (95%CI: 0.98-1.24) for IHD death. The respective HRs for those central obese participants (men ≥90.0 cm, women ≥85.0 cm) were 1.29 (95%CI: 1.24-1.34), 1.30 (95%CI: 1.17-1.44) and 1.32 (95%CI: 1.16-1.51). Further stratification analysis according to BMI showed that the risks for incident IHD, MCE, and IHD death increased along with the increase of waist circumference even in the participants with normal weight. Conclusion: This large-scale prospective study revealed that central obesity was an independent risk factor for IHD in adults in China, and the risk of IHD would increase with the increase of waist circumference.
Adult
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Asian People/statistics & numerical data*
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Body Mass Index
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China/epidemiology*
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Female
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Heart Diseases/ethnology*
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Humans
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Male
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Obesity
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Obesity, Abdominal/epidemiology*
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Overweight/epidemiology*
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Proportional Hazards Models
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Prospective Studies
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Risk Factors
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Waist Circumference
8.Epidemiological characteristics of household fuel use in 10 areas of China.
J C LI ; M WU ; C Q YU ; J LYU ; Y GUO ; Z BIAN ; Y L TAN ; P PEI ; J S CHEN ; Z M CHEN ; W H CAO ; L M LI
Chinese Journal of Epidemiology 2018;39(11):1426-1431
Objective: To describe the characteristics of cooking and heating fuel use in participants from the China Kadoorie Biobank (CKB) study. Methods: The CKB study recruited 512 891 adults from 10 areas in China during 2004-2008. Information on cooking fuel and heating fuel was collected using a questionnaire in baseline survey. The proportions of various fuels used in different areas, in different populations, and at different time points were calculated and compared. Results: Overall, 52.1% participants used solid fuel for cooking or heating. Rural areas had higher prevalence of solid fuel use than urban areas. The percentage of participants using solid fuel for cooking was 36.1% (coal 20.1%, wood/charcoal 16.0%); The percentage of participants using solid fuel for heating was 36.7% (coal 22.7%, wood/charcoal 14.0%). The prevalence of solid fuel use and the fuel type mainly used varied widely across 10 areas. The proportion of clean fuel use was lower in less-educated and lower-income people. Household coal and wood/charcoal use showed a declining trend, which was more remarkable in urban areas. Conclusion: There are still a large number of rural residents and people with low income relying on solid fuel in China, which is a serious public health concern.
Adult
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Air Pollution, Indoor
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China
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Coal
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Cooking
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Family Characteristics
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Humans
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Rural Population/statistics & numerical data*
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Urban Population/statistics & numerical data*
9.SRF-rearranged cellular perivascular myoid tumor: a clinicopathological analysis of two cases.
T C YIN ; M Y SHAO ; M SUN ; L ZHAO ; Q Y LAO ; Q L YAO ; Q M BAI ; L YU ; X Y ZHOU ; J WANG
Chinese Journal of Pathology 2024;53(1):64-70
Objective: To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of SRF-rearranged cellular perivascular myoid tumor. Methods: Two cases of SRF-rearranged cellular perivascular myoid tumor diagnosed in the Department of Pathology, Fudan University Shanghai Cancer Center from October 2021 to March 2022 were collected. Immunohistochemical staining, fluorescence in-situ hybridization (FISH) and next-generation sequencing (NGS) were performed, and the literature was reviewed. Results: Case 1, a 3-month-old boy presented with a painless tumor of the scalp, measuring about 2 cm in diameter. Case 2, a 3-year-old girl complained with a painless tumor of the knee, measuring approximately 1.5 cm in diameter. Microscopically, the tumor had a clear boundary and showed multinodular growth. The tumor was mainly composed of spindle cells arranged in long intersecting fascicles associated with thin, slit-like or branching ectatic vessels, focally forming hemangiopericytoma-like appearance. The tumor cells were abundant, but there was no obvious atypia. Mitotic figures (3-4/10 HPF) were noted. H-caldesmon and SMA were positive in both cases. Case 1 showed diffuse and strong positivity for Desmin, and focally for CKpan. Ki-67 proliferation index was 20% and 30%, respectively. FISH displayed NCOA2 gene translocation in case 1 and the RELA gene translocation in case 2. NGS detected the SRF-NCOA2 gene fusion in case 1 and the SRF-RELA gene fusion in case 2. Both patients underwent local excisions. During the follow-up of 5-14 months, case 1 had no local recurrence, while case 2 developed local recurrence 1 year post operatively. Conclusions: SRF-rearranged cellular perivascular myoid tumor is a novel variant of perivascular cell tumor, which tends to occur in children and adolescents. The tumor forms a broad morphologic spectrum ranging from a pericytic pattern to a myoid pattern, and include hybrid tumors with a mixture of pericytic and myoid patterns. Due to its diffuse hypercellularity and increased mitotic figures and smooth muscle-like immunophenotype, the tumor is easy to be misdiagnosed as myogenic sarcomas. The tumor usually pursues a benign clinical course and rare cases may locally recur.
Child, Preschool
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Female
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Humans
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Infant
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Male
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Biomarkers, Tumor/analysis*
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Calmodulin-Binding Proteins
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China
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Hemangiopericytoma/pathology*
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Sarcoma/pathology*
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Soft Tissue Neoplasms/pathology*
10.Family history and risk of coronary heart disease.
J H SI ; R R MENG ; C Q YU ; Y GUO ; Z BIAN ; Y L TAN ; P PEI ; J S CHEN ; Z M CHEN ; J LYU ; L M LI
Chinese Journal of Epidemiology 2018;39(2):173-178
Objective: To evaluate the association of family history with risk of major coronary events (MCE) and ischemic heart disease (IHD). Methods: After excluding participants with heart disease, stroke or cancer at baseline survey, a total of 485 784 participants from the China Kadoorie Biobank, who had no missing data on critical variables, were included in the analysis. Cox regression analysis was used to estimate the hazard ratios (HR) and 95% CI. Subgroup analyses were performed according to the baseline characteristics. Results: During a median of 7.2 years of follow-up, we documented 3 934 incident cases of MCE and 24 537 cases of IHD. In multivariable-adjusted models, family history was significantly associated with risk of MCE and IHD. The adjusted HRs (95%CI) were 1.41 (1.19-1.65) and 1.25 (1.18-1.33), respectively. History of disease among siblings was more strongly associated with early-onset MCE than parental history (HR=2.97, 95%CI: 1.80-4.88). Moreover, the association of family history with MCE and IHD was stronger in persons who were overweight or obesive, and the association between family history and MEC was stronger in smokers. Conclusion: This large-scale, prospective study indicated that family history was an independent risk factor for MCE and IHD in China. The intervention targeting major known lifestyle risk factors and the management of chronic diseases should be strengthened for Chinese population, especially for the individuals with family history were at high risk.
Asian People/statistics & numerical data*
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China/epidemiology*
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Coronary Disease/genetics*
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Humans
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Incidence
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Myocardial Ischemia/genetics*
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Overweight/ethnology*
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Proportional Hazards Models
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Prospective Studies
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Risk Assessment
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Risk Factors
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Smoking/ethnology*