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Effects of self-reported health conditions and pesticide exposures on probability of follow-up in a prospective cohort study.

ABSTRACT: We investigated the potential for selection bias due to non-participation in the follow-up of a large prospective cohort study.Licensed pesticide applicators (52,395 private; 4,916 commercial) in the Agricultural Health Study provided demographic, health, and pesticide exposure information at enrollment (1993-1997) and in a 5-year follow-up telephone interview. Factors associated with non-participation in the follow-up were identified using multiple logistic regression. Potential for selection bias was evaluated by comparing exposure-disease associations between the entire cohort and the follow-up subset.Sixty-six percent of private and 60% of commercial applicators completed the follow-up interview. Private and commercial applicators who did not complete the follow-up reported at enrollment younger age, less education, lower body mass index, poorer health behaviors but fewer health conditions, and lower pesticide use. Estimates of exposure-disease associations calculated with and without non-participants did not indicate strong selection bias.Differences between non-participants and participants in the follow-up interview were generally small, and we did not find significant evidence of selection bias. However, the extent of bias may depend on the specific exposure and outcome under study.

SUBMITTER: Montgomery MP

PROVIDER: S-EPMC3184944 | biostudies-literature | 2010 May

REPOSITORIES: biostudies-literature

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Effects of self-reported health conditions and pesticide exposures on probability of follow-up in a prospective cohort study.

Montgomery Martha P MP Kamel Freya F Hoppin Jane A JA Beane Freeman Laura E LE Alavanja Michael C R MC Sandler Dale P DP

American journal of industrial medicine 20100501 5

<h4>Background</h4>We investigated the potential for selection bias due to non-participation in the follow-up of a large prospective cohort study.<h4>Methods</h4>Licensed pesticide applicators (52,395 private; 4,916 commercial) in the Agricultural Health Study provided demographic, health, and pesticide exposure information at enrollment (1993-1997) and in a 5-year follow-up telephone interview. Factors associated with non-participation in the follow-up were identified using multiple logistic re ...[more]

PMID: 20017198

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Project description:BackgroundOne of the most common reasons for poor medication adherence and associated treatment failure of triple therapy is adverse drug effect (ADEs) of medications.ObjectiveAssessment of ADEs and associated factors during H. pylori eradication therapy.MethodConsented H. pylori positive adult outpatients on standard triple therapy (proton pump inhibitor, amoxicillin and clarithromycin) were involved in this facility based follow up study from May 2016 to April 2018 at Bahir Dar city in Ethiopia. Pre-developed questionnaire and formats were used to collect sociodemographic, medical information, and patient practice data before, during, and after therapy. Bivariate and backward stepwise multivariate logistic regression was used to analyze data. P-value < 0.05 at 95%CI was considered as significant.ResultA total of 421 patients were involved in the study. Almost 80% of the patients were urban residents. Mean (±SD) age and body weight of patients were 30.63 (± 10.74) years and 56.79 (± 10.17) kg, respectively. ADE was reported from 26.1% of the patients and of all the reported ADEs, more than 85% was manifested with gastrointestinal symptoms which include gastrointestinal discomfort(39.1%), nausea (13.6%), constipation(12.7%), diarrhea(12.9%) and anorexia(10%). Determinants of self-reported ADEs among patients in the present study were body mass index above 25 (AOR: 2.55; 95%CI (1.21-5.38), p = 0.014), duration of acid-pepsin disorder more than 3weeks (AOR: 3.57; 95%CI (1.63-7.81), p = 0.001), pain feeling during long interval between meals (AOR: 2.14; 95%CI (1.19-3.84), p = 0.011), and residence in urban area (AOR: 1.95; 95% CI (1.04-3.67), p = 0.038).ConclusionSignificant proportion of patients reported ADEs which commonly manifested with gastrointestinal symptoms. Consideration of patients' body mass index, duration of the disorder, period of the day when patients feel pain, and patients' area of residence could help to reduce ADEs experienced during H. pylori eradication therapy.

Project description:BackgroundIdentifying the medical conditions that are associated with poor health is crucial to prioritize decisions for future research and organizing care. However, assessing the burden of disease in the general population is complex, lengthy, and expensive. Claims databases that include self-reported health status can be used to assess the impact of medical conditions on the health in a population.ObjectiveThis study aimed to identify medical conditions that are highly predictive of poor health status using claims databases.MethodsTo determine the medical conditions most highly predictive of poor health status, we used a retrospective cohort study using 2 US claims databases. Subjects were commercially insured patients. Health status was measured using a self-report health status response. All medical conditions were included in a least absolute shrinkage and selection operator regression model to assess which conditions were associated with poor versus excellent health.ResultsA total of 1,186,871 subjects were included; 61.64% (731,587/1,186,871) reported having excellent or very good health. The leading medical conditions associated with poor health were cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), sleep disorders, seizures, male reproductive tract infections, chronic obstructive pulmonary disease, cardiomyopathy, dementia, and headaches.ConclusionsUnderstanding the impact of disease in a commercially insured population is critical to identify subjects who may be at risk for reduced productivity and job loss. Claims database studies can measure the impact of medical conditions on the health status in a population and to assess changes overtime and could limit the need to collect prospective collection of information, which is slow and expensive, to assess disease burden. Leading medical conditions associated with poor health in a commercially insured population were the ones associated with high burden of disease such as cancer-related conditions, demyelinating disorders, diabetes, diabetic complications, psychiatric illnesses (mood disorders and schizophrenia), infections, chronic obstructive pulmonary disease, cardiomyopathy, and dementia. However, sleep disorders, seizures, male reproductive tract infections, and headaches were also part of the leading medical conditions associated with poor health that had not been identified before as being associated with poor health and deserve more attention.

Project description:ObjectivesTo examine multiple objective and self-reported measures of motor function for their associations with mortality.DesignProspective cohort study.SettingUK based Whitehall II cohort study, which recruited participants aged 35-55 years in 1985-88; motor function component was added at the 2007-09 wave.Participants6194 participants with motor function measures in 2007-09 (mean age 65.6, SD 5.9), 2012-13, and 2015-16.Main outcome measuresAll cause mortality between 2007 and 2019 in relation to objective measures (walking speed, grip strength, and timed chair rises) and self-reported measures (physical component summary score of the SF-36 and limitations in basic and instrumental activities of daily living (ADL)) of motor function.ResultsOne sex specific standard deviation poorer motor function in 2007-09 (cases/total, 610/5645) was associated with an increased mortality risk of 22% (95% confidence interval 12% to 33%) for walking speed, 15% (6% to 25%) for grip strength, 14% (7% to 23%) for timed chair rises, and 17% (8% to 26%) for physical component summary score over a mean 10.6 year follow-up. Having basic/instrumental ADL limitations was associated with a 30% (7% to 58%) increased mortality risk. These associations were progressively stronger when measures were drawn from 2012-13 (mean follow-up 6.8 years) and 2015-16 (mean follow-up 3.7 years). Analysis of trajectories showed poorer motor function in decedents (n=484) than survivors (n=6194) up to 10 years before death for timed chair rises (standardised difference 0.35, 95% confidence interval 0.12 to 0.59; equivalent to a 1.2 (men) and 1.3 (women) second difference), nine years for walking speed (0.21, 0.05 to 0.36; 5.5 (men) and 5.3 (women) cm/s difference), six years for grip strength (0.10, 0.01 to 0.20; 0.9 (men) and 0.6 (women) kg difference), seven years for physical component summary score (0.15, 0.05 to 0.25; 1.2 (men) and 1.6 (women) score difference), and four years for basic/instrumental ADL limitations (prevalence difference 2%, 0% to 4%). These differences increased in the period leading to death for timed chair rises, physical component summary score, and ADL limitations.ConclusionMotor function in early old age has a robust association with mortality, with evidence of terminal decline emerging early in measures of overall motor function (timed chair rises and physical component summary score) and late in basic/instrumental ADL limitations.

Dataset Information

Effects of self-reported health conditions and pesticide exposures on probability of follow-up in a prospective cohort study.

Publications

Effects of self-reported health conditions and pesticide exposures on probability of follow-up in a prospective cohort study.

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