Dataset Information

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

ABSTRACT:

Background

The propensity score method has been underused in research concerning asthma epidemiology, which is useful for addressing covariate imbalance in observational studies.

Objective

To examine the impact of neighborhood environment on asthma incidence by applying the propensity score method.

Methods

The study was designed as a retrospective cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1979. Asthma status was previously determined by applying predetermined criteria. We applied the propensity score method to match children who lived in census tracts facing or not facing intersections with major highways or railroads. The propensity score of children living in a census tract facing intersections was formulated from a logistic regression model with 16 variables that may not be balanced between comparison groups. The Cox proportional hazard models were used in the matched samples to estimate hazard ratios of neighborhood environment and some other variables of interest and their corresponding 95% CIs.

Results

After matching with propensity scores, we found that children who lived in census tracts facing intersections with major highways or railroads had a higher risk of asthma (hazard ratios, 1.385-1.669 depending on the matching methods) compared with the matched counterparts who lived in census tracts not facing intersections with major highways or railroads.

Conclusion

Neighborhood environment may be an important risk factor in understanding the development of pediatric asthma. The propensity score method is a useful tool in addressing covariate imbalance and exploring for causal effect in studying asthma epidemiology.

SUBMITTER: Juhn YJ

PROVIDER: S-EPMC2962617 | biostudies-literature | 2010 Apr

REPOSITORIES: biostudies-literature

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Publications

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Juhn Young J YJ Qin Rui R Urm Sanghwa S Katusic Slavica S Vargas-Chanes Delfino D

The Journal of allergy and clinical immunology 20100317 4

<h4>Background</h4>The propensity score method has been underused in research concerning asthma epidemiology, which is useful for addressing covariate imbalance in observational studies.<h4>Objective</h4>To examine the impact of neighborhood environment on asthma incidence by applying the propensity score method.<h4>Methods</h4>The study was designed as a retrospective cohort study. Study subjects were all children born in Rochester, Minn, between 1976 and 1979. Asthma status was previously dete ...[more]

PMID: 20236695

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Project description:BackgroundThe impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain.ObjectiveOur study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension.MethodsA population-based propensity-score matched cohort study design was used based on the Ontario population from the Canadian Community Health Survey (2001-2010). Participants were adults ≥ 20 years of age who moved from a low-walkability neighborhood (defined as any neighborhood with a Walk Score < 90) to either a high- (Walk Score ≥ 90) or another low-walkability neighborhood. The incidence of hypertension was assessed by linking the cohort to administrative health databases using a validated algorithm. Propensity-score matched Cox proportional hazard models were used. Annual health examination was used as a control event.ResultsAmong the 1,057 propensity-score matched pairs there was a significantly lower risk of incident hypertension in the low to high vs. the low to low-walkability groups [hazard ratio = 0.46; 95% CI, 0.26, 0.81, p < 0.01]. The crude hypertension incidence rates were 18.0 per 1,000 person-years (95% CI: 11.6, 24.8) among the low- to low-walkability movers compared with 8.6 per 1,000 person-years (95% CI: 5.3, 12.7) among the low- to high-walkability movers (p < 0.001). There were no significant differences in the hazard of annual health examination between the two mover groups.ConclusionsMoving to a highly walkable neighborhood was associated with a significantly lower risk of incident hypertension. Future research should assess whether specific attributes of walkable neighborhoods (e.g., amenities, density, land-use mix) may be driving this relationship.CitationChiu M, Rezai MR, Maclagan LC, Austin PC, Shah BR, Redelmeier DA, Tu JV. 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-760; http://dx.doi.org/10.1289/ehp.1510425.

Project description:BackgroundThe diagnostic process is a key element of medicine but it is complex and prone to errors. Infectious diseases are one of the three categories of diseases in which diagnostic errors can be most harmful to patients. In this study we aimed to estimate the effect of initial misdiagnosis of the source of infection in patients with bacteraemia on 14 day mortality using propensity score methods to adjust for confounding.MethodsData from a previously described longitudinal cohort of patients diagnosed with monobacterial bloodstream infection (BSI) at the Leiden University Medical Centre (LUMC) between 2013 and 2015 were used. Propensity score matching and inversed probability of treatment weighting (IPTW) were applied to correct for confounding. The average treatment effect on the treated (ATT), which in this study was the average effect of initial misdiagnosis on the misdiagnosed (AEMM), was estimated. Methodological issues that were encountered when applying propensity score methods were addressed by performing additional sensitivity analyses. Sensitivity analyses consisted of varying caliper in propensity score matching and using different truncated weights in inversed probability of treatment weighting.ResultsData of 887 patients were included in the study. Propensity scores ranged between 0.015 and 0.999 and 80 patients (9.9%) had a propensity score > 0.95. In the matched analyses, 35 of the 171 misdiagnosed patients died within 14 days (20.5%), versus 10 of the 171 correctly diagnosed patients (5.8%), yielding a difference of 14.6% (7.6%; 21.6%). In the total group of patients, the observed percentage of patients with an incorrect initial diagnosis that died within 14 days was 19.8% while propensity score reweighting estimated that their probability of dying would have been 6.5%, if they had been correctly diagnosed (difference 13.3% (95% CI 6.9%;19.6%)). After adjustment for all variables that showed disbalance in the propensity score a difference of 13.7% (7.4%; 19.9%) was estimated. Sensitivity analyses yielded similar results. However, performing weighted analyses without truncation yielded unstable results.ConclusionThus, we observed a substantial increase of 14 day mortality in initially misdiagnosed patients. Furthermore, several patients received propensity scores extremely close to one and were almost sure to be initially misdiagnosed.

Dataset Information

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Background

Objective

Methods

Results

Conclusion

Publications

The influence of neighborhood environment on the incidence of childhood asthma: a propensity score approach.

Similar Datasets

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