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The Centennial of the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health: A Century of Epidemiologic Discovery and Education.

ABSTRACT: The Department of Epidemiology at Johns Hopkins School of Hygiene and Public Health was founded in 1919, with Wade Hampton Frost as inaugural chair. In our Centennial Year, we review how our research and educational programs have changed. Early years focused on doctoral education in epidemiology and some limited undergraduate training for practice. Foundational work on concepts and methods linked to the infectious diseases of the day made major contributions to study designs and analytical methodologies, largely still in use. With the epidemiologic transition from infectious to chronic disease, new methods were developed. The Department of Chronic Diseases merged with the Department of Epidemiology in 1970, under the leadership of Abraham Lilienfeld. Leon Gordis became chair in 1975, and multiple educational tracks were developed. Genetic epidemiology began in 1979, followed by advances in infectious disease epidemiology spurred by the human immunodeficiency virus/acquired immune deficiency syndrome epidemic. Collaborations with the Department of Medicine led to development of the Welch Center for Prevention, Epidemiology, and Clinical Research in 1989. Between 1994 and 2008, the department experienced rapid growth in faculty and students. A new methods curriculum was instituted for upper-level epidemiologic training in 2006. Today's research projects are increasingly collaborative, taking advantage of new technologies and methods of data collection, responding to "big data" analysis challenges. In our second century, the department continues to address issues of disease etiology and epidemiologic practice.

SUBMITTER: Celentano DD

PROVIDER: S-EPMC7306280 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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The Centennial of the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health: A Century of Epidemiologic Discovery and Education.

Celentano David D DD Platz Elizabeth E Mehta Shruti H SH

American journal of epidemiology 20191201 12

The Department of Epidemiology at Johns Hopkins School of Hygiene and Public Health was founded in 1919, with Wade Hampton Frost as inaugural chair. In our Centennial Year, we review how our research and educational programs have changed. Early years focused on doctoral education in epidemiology and some limited undergraduate training for practice. Foundational work on concepts and methods linked to the infectious diseases of the day made major contributions to study designs and analytical metho ...[more]

PMID: 31509178

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Project description:PurposeThe use of radiation therapy (RT) in consolidating oligometastatic prostate cancer (OPCa) is a rapidly evolving treatment paradigm. We review our institutional experience using metastasis-directed therapy in the definitive management of men with OPCa.Methods and materialsPatients with OPCa treated with definitive RT were included. The Kaplan-Meier method and multivariable Cox regression analysis were performed to assess biochemical progression-free survival (bPFS) and time to next intervention. Cumulative incidence functions were used to calculate rates of local failure. Toxicity was assessed using Common Terminology Criteria for Adverse Events (version 4).ResultsThis study analyzed 156 patients with OPCa and 354 metastatic lesions with median follow-up of 24.6 months. Of 150 patients with toxicity data, 53 (35%) experienced acute grade 1 toxicity, 8 (5%) had grade 2, and none had grade 3 toxicity. Only 13 patients (9%) had late toxicities. At 24 months, the cumulative incidence of local failure was 7.4%. Median bPFS for the entire cohort was 12.9 months and 52% at 1 year. On multivariable analysis, factors associated with prolonged bPFS were peri-RT androgen deprivation therapy (ADT), lower gross tumor volume, and hormone-sensitive (HS) OPCa. Median time to next intervention, including repeat RT, was 21.6 months. Median bPFS for men with HS prostate cancer was 17.2 months compared with 7.2 months in men with castrate-resistant OPCa (P < .0001), and cumulative incidence of local failure at 24 months was lower with HS OPCa (4.8% vs 12.1%; P = .034). We analyzed 28 men with HS OPCa treated with a course of peri-RT ADT (median, 4.3 months) with recovery of testosterone. At a median follow-up of 33.5 months, 20 patients had not developed bPFS, median bPFS had not been reached, and 24-month bPFS was 77%.ConclusionsMetastasis-directed therapy can be effective across a wide range of OPCa subtypes, but with differential efficacy. Further study is warranted to investigate the use of RT across the wide range of patients with OPCa.

Project description:PurposeFall prevention is a safety goal in many hospitals. The performance of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) in older inpatients is largely unknown. We aimed to assess the JHFRAT performance in a large sample of Dutch older inpatients, including its trend over time.MethodsWe used an Electronic Health Records (EHR) dataset with hospitalized patients (≥ 70), admitted for ≥ 24 h between 2016 and 2021. Inpatient falls were extracted from structured and free-text data. We assessed the association between JHFRAT and falls using logistic regression. For test accuracy, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Discrimination was measured by the AUC. For calibration, we plotted the predicted fall probability with the actual probability of falls. For time-related effects, we calculated the AUC per 6 months (using data of patients admitted during the 6 months' time interval) and plotted these different AUC values over time. Furthermore, we compared the model (JHFRAT and falls) with and without adjusting for seasonal influenza, COVID-19, spring, summer, fall or winter periods.ResultsData included 17,263 admissions with at least 1 JHFRAT measurement, a median age of 76 and a percentage female of 47%. The in-hospital fall prevalence was 2.5%. JHFRAT [OR = 1.11 (1.03-1.20)] and its subcategories were significantly associated with falls. For medium/high risk of falls (JHFRAT > 5), sensitivity was 73%, specificity 51%, PPV 4% and NPV 99%. The overall AUC was 0.67, varying over time between 0.62 and 0.71 (for 6 months' time intervals). Seasonal influenza did affect the association between JHFRAT and falls. COVID-19, spring, summer, fall or winter did not affect the association.ConclusionsOur results show an association between JHFRAT and falls, a low discrimination by JHFRAT for older inpatients and over-prediction in the calibration. Improvements in the fall-risk assessment are warranted to improve efficiency.

Dataset Information

The Centennial of the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health: A Century of Epidemiologic Discovery and Education.

Publications

The Centennial of the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health: A Century of Epidemiologic Discovery and Education.

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