scholarly journals 1168Are there non-linear alcohol–health relationships?: Review of observational studies employing enhanced causal methods

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rachel Visontay ◽  
Matthew Sunderland ◽  
Tim Slade ◽  
Jack Wilson ◽  
Louise Mewton
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Health Outcomes ◽  
Causal Inference ◽  
Observational Studies ◽  
Consumption Pattern ◽  
Non Linear ◽  
Functional Forms

Abstract Focus of Presentation Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. While enhanced methods for data analysis (e.g. G-methods) and alternative observational designs (e.g. Mendelian Randomisation) have been developed, they are not commonly applied to alcohol–health research. This presentation will report on a systematic review of observational studies that employ improved approaches to mitigate confounding in characterising alcohol–long-term health relationships (PROSPERO registration: CRD42020185861). Findings MEDLINE, PsycINFO, Embase and SCOPUS were searched in May 2020, yielding 16 published manuscripts reporting on cancer, diabetes, dementia, mental health, cardiovascular health, mortality, HIV seroconversion, and musculoskeletal health. Study findings were qualitatively synthesised. A variety of functional forms were found, including reverse J/J-shaped relationships for prostate cancer and related mortality, dementia risk, mental health, and certain lipids. However, most outcomes were only evaluated by a single study, and few studies provided information on the role of alcohol consumption pattern. Conclusions/Implications More research employing enhanced causal inference methods is urgently required to accurately characterise alcohol–long-term health relationships. Those studies that have been conducted find a variety of linear and non-linear functional forms, with results tending to be discrepant even within specific health outcomes. Key messages A systematic review found that those studies of alcohol–long-term health relationships employing enhanced causal methods are too few and inconsistent to establish whether non-linear alcohol–health relationships exist.

scholarly journals Are there non-linear relationships between alcohol consumption and long-term health?: a systematic review of observational studies employing approaches to improve causal inference

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachel Visontay ◽  
Matthew Sunderland ◽  
Tim Slade ◽  
Jack Wilson ◽  
Louise Mewton
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Health Outcomes ◽  
Causal Inference ◽  
Observational Studies ◽  
Consumption Pattern ◽  
Human Populations ◽  
Non Linear ◽  
Functional Forms

Abstract Background Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. This review aimed to identify all observational studies employing improved approaches to mitigate confounding in characterizing alcohol–long-term health relationships, and to qualitatively synthesize their findings. Methods Eligible studies met the above description, were longitudinal (with pre-defined exceptions), discretized alcohol consumption, and were conducted with human populations. MEDLINE, PsycINFO, Embase and SCOPUS were searched in May 2020, yielding 16 published manuscripts reporting on cancer, diabetes, dementia, mental health, cardiovascular health, mortality, HIV seroconversion, and musculoskeletal health. Risk of bias of cohort studies was evaluated using the Newcastle-Ottawa Scale, and a recently developed tool was used for Mendelian Randomization studies. Results A variety of functional forms were found, including reverse J/J-shaped relationships for prostate cancer and related mortality, dementia risk, mental health, and certain lipids. However, most outcomes were only evaluated by a single study, and few studies provided information on the role of alcohol consumption pattern. Conclusions More research employing enhanced causal inference methods is urgently required to accurately characterize alcohol–long-term health relationships. Those studies that have been conducted find a variety of linear and non-linear functional forms, with results tending to be discrepant even within specific health outcomes. Trial registration PROSPERO registration number CRD42020185861.

scholarly journals Are there non-linear relationships between alcohol consumption and long-term health? Protocol for a systematic review of observational studies employing approaches to improve causal inference

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043985
Author(s):  
Rachel Visontay ◽  
Matthew Sunderland ◽  
Tim Slade ◽  
Jack Wilson ◽  
Louise Mewton
Keyword(s):  
Systematic Review ◽  
Alcohol Consumption ◽  
Health Outcomes ◽  
Causal Inference ◽  
Study Design ◽  
Observational Studies ◽  
Alcohol Exposure ◽  
Non Linear ◽  
The Relationship

IntroductionThere is a substantial literature finding that moderate alcohol consumption is protective against certain health conditions. However, more recent research has highlighted the possibility that these findings are methodological artefacts, caused by confounding and other biases. While modern analytical and study design approaches can mitigate confounding and thus enhance causal inference in observational studies, they are not routinely applied in research assessing the relationship between alcohol use and long-term health outcomes. The purpose of this systematic review is to identify observational studies that employ these analytical/design-based approaches in assessing whether relationships between alcohol consumption and health outcomes are non-linear. This review seeks to evaluate, on a per-outcome basis, what these studies find the strength and form of the relationship between alcohol consumption and health to be.Methods and analysisElectronic databases (MEDLINE, PsycINFO, Embase and SCOPUS) were searched in May 2020. Study selection will comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles will be screened against eligibility criteria intended to capture studies using observational data to assess the relationship between varying levels of alcohol exposure and any long-term health outcome (actual or surrogate), and that have employed at least one of the prespecified approaches to enhancing causal inference. Risk of bias of included articles will be assessed using study design-specific tools. A narrative synthesis of the results is planned.Ethics and disseminationFormal ethics approval is not required given there will be no primary data collection. The results of the study will be disseminated through published manuscripts, conferences and seminar presentations.PROSPERO registration numberCRD42020185861.

scholarly journals Are there non-linear relationships between alcohol consumption and long-term health?: Protocol for a systematic review of observational studies employing approaches to improve causal inference

2020 ◽  
Author(s):  
Rachel Visontay ◽  
Matthew Sunderland ◽  
Tim Slade ◽  
Jack Wilson ◽  
Louise Mewton
Keyword(s):  
Systematic Review ◽  
Alcohol Consumption ◽  
Health Outcomes ◽  
Causal Inference ◽  
Study Design ◽  
Observational Studies ◽  
Alcohol Exposure ◽  
Non Linear ◽  
The Relationship

Introduction: There is a substantial literature finding that moderate alcohol consumption is protective against certain health conditions. However, more recent research has highlighted the possibility that these findings are methodological artefacts, caused by confounding and other biases. While modern analytical and study design approaches can enhance causal inference in observational studies, they are not routinely applied in research assessing the relationship between alcohol use and long-term health outcomes. The purpose of this systematic review is to identify observational studies that employ these analytical/design-based approaches in assessing whether relationships between alcohol consumption and health outcomes are non-linear. This review seeks to evaluate, on a per-outcome basis, what these studies find the strength and form of the relationship between alcohol consumption and health to be.Methods and analysis: Electronic databases (MEDLINE, PsycINFO, Embase and SCOPUS) were searched in May 2020. Study selection will comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles will be screened against eligibility criteria intended to capture studies using observational data to assess the relationship between varying levels of alcohol exposure and any long-term health outcome (actual or surrogate), and that have employed at least one of the pre-specified approaches to enhancing causal inference. Risk of bias of included articles will be assessed using study design-specific tools. A narrative synthesis of the results is planned.

scholarly journals Are there non-linear relationships between alcohol consumption and long-term health?: A systematic review of observational studies employing approaches to improve causal inference

2021 ◽  
Author(s):  
Rachel Visontay ◽  
Matthew Sunderland ◽  
Tim Slade ◽  
Jack Wilson ◽  
Louise Mewton
Keyword(s):  
Mental Health ◽  
Alcohol Consumption ◽  
Causal Inference ◽  
Observational Studies ◽  
Cardiovascular Health ◽  
Consumption Pattern ◽  
Human Populations ◽  
Linear Relationships ◽  
Hiv Seroconversion

Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. This review aimed to identify all observational studies employing improved approaches to mitigate confounding in characterizing alcohol–long-term health relationships, and to qualitatively synthesize their findings (PROSPERO registration: CRD42020185861). Eligible studies met the above description, were longitudinal (with pre-defined exceptions), discretized alcohol consumption, and were conducted with human populations. MEDLINE, PsycINFO, Embase and SCOPUS were searched in May 2020, yielding 16 published manuscripts reporting on cancer, diabetes, dementia, mental health, cardiovascular health, mortality, HIV seroconversion, and musculoskeletal health. Risk of bias of cohort studies was evaluated using the Newcastle Ottawa Scale, and a recently developed tool was used for Mendelian Randomization studies. A variety of functional forms were found, including reverse J/J-shaped relationships for prostate cancer and related mortality, dementia risk, mental health, and certain lipids. However, most outcomes were only evaluated by a single study, and few studies provided information on the role of alcohol consumption pattern. More research employing enhanced causal inference methods is urgently required to accurately characterize alcohol–long term health relationships.

Abortion and long-term mental health outcomes: a systematic review of the evidence

Contraception ◽  
2008 ◽  
Vol 78 (6) ◽  
pp. 436-450 ◽  
Author(s):  
Vignetta E. Charles ◽  
Chelsea B. Polis ◽  
Srinivas K. Sridhara ◽  
Robert W. Blum
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Outcomes ◽  
Mental Health Outcomes

scholarly journals The Health Impact of Electronic Nicotine Delivery Systems: A Systematic Review

2020 ◽  
Author(s):  
C Hajat ◽  
E Stein ◽  
S Shantikumar ◽  
R Niaura ◽  
P Ferrara ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Lung Function ◽  
Health Outcomes ◽  
Health Impact ◽  
Assessment Tools ◽  
Hypertensive Patients ◽  
Increased Risk

AbstractIntroductionThe objective of this systematic review was to identify, report and critically appraise studies that have reported health outcomes from use of ENDS.MethodsWe conducted a systematic review of all published literature on the health impact of ENDS products from 1st January 2015 until February 1, 2020, following the PRISMA protocol, including across the databases, PubMed, Embase, Scopus and Google Scholar. Medical subject headings were used in the execution of PubMed searches.A category for the level of evidence was assigned blindly using the Centres for Evidence Based Medicine framework. A similar approach was adopted to evaluate methodological quality of each study utilizing the National Institutes for Health (NIH) Quality Assessment Tools.ResultsThe database search identified 755 studies and a further 265 were identified from other sources and reference reviews of which 37 studies met the eligibility criteria.The majority of studies were of low strength for levels of evidence including 24 (65%) cross-sectional, 1(2.7%) case-control and six (16%) case studies. There were four (11%) cohort studies and only one (2.7%) RCT. There was only one (2.7%) meta-analysis or pooled study of observational study designs; there were no pooled results of randomized controlled trials. Of 37 studies, eight (22%) studies reported on benefits, two (2%) studies were neutral, reporting on both harm and benefits, the remaining 27 (73%) reported only on harms. The quality ratings were poor (20, 54%), fair (9, 24%) and good (8, 22%).In our review ENDS use has not been shown to be causative for any CVD outcomes and has been shown to be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of COPD, with no evidence of long-term deterioration in lung function. There was a suggestion of short-term reductions in respiratory function in asthmatics, but no increased risk of asthma in ENDS users who were never smokers. Mental Health, cancer and mortality have not been adequately studied to form any consensus with regards to health outcomes from ENDS use.ConclusionOur review suggests that the majority of studies on the use of ENDS products reported on negative health impacts with few reporting on health outcomes from switching from cigarettes to e-cigarettes. The strength of evidence and quality of the published studies overall is poor.Our review has demonstrated that ENDS use is not causative for any harmful CVD outcomes and may be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of COPD, with no evidence of increased risk of asthma, long-term respiratory harm or deterioration in lung function. Other health outcomes such as mental health, cancer and mortality have not been adequately studied to form a consensus. However, the findings of our review did not negate the consensus held by many that ENDS use is safer than the risks posed from smoking cigarettes.Overall, our review found the research on ENDS use is not yet adequate to provide quantitative estimates about health risks. Consequently, the current body of evidence is inadequate for informing policy around tobacco harm reduction.

scholarly journals Relationship between Green and Blue Spaces with Mental and Physical Health: A Systematic Review of Longitudinal Observational Studies

2021 ◽  
Vol 18 (17) ◽  
pp. 9010
Author(s):  
Mariya Geneshka ◽  
Peter Coventry ◽  
Joana Cruz ◽  
Simon Gilbody
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Outcomes ◽  
Physical Health ◽  
Observational Studies ◽  
Green Space ◽  
Health Conditions ◽  
Longitudinal Observational Studies ◽  
The Relationship ◽  
Mental And Physical Health

There is growing interest in the ways natural environments influence the development and progression of long-term health conditions. Vegetation and water bodies, also known as green and blue spaces, have the potential to affect health and behaviour through the provision of aesthetic spaces for relaxation, socialisation and physical activity. While research has previously assessed how green and blue spaces affect mental and physical wellbeing, little is known about the relationship between these exposures and health outcomes over time. This systematic review summarised the published evidence from longitudinal observational studies on the relationship between exposure to green and blue space with mental and physical health in adults. Included health outcomes were common mental health conditions, severe mental health conditions and noncommunicable diseases (NCDs). An online bibliographic search of six databases was completed in July 2020. After title, abstract and full-text screening, 44 eligible studies were included in the analysis. Depression, diabetes and obesity were the health conditions most frequently studied in longitudinal relationships. The majority of exposures included indicators of green space availability and urban green space accessibility. Few studies addressed the relationship between blue space and health. The narrative synthesis pointed towards mixed evidence of a protective relationship between exposure to green space and health. There was high heterogeneity in exposure measures and adjustment for confounding between studies. Future policy and research should seek a standardised approach towards measuring green and blue space exposures and employ theoretical grounds for confounder adjustment.

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