Interrupted time series analyses to assess the impact of alcohol control policy on socioeconomic inequalities in mortality in Lithuania: a study protocol

IntroductionAlcohol use is a major risk factor for mortality. Previous studies suggest that the alcohol-attributable mortality burden is higher in lower socioeconomic strata. This project will test the hypothesis that the 2017 increase of alcohol excise taxes linked to lower all-cause mortality rates in previous analyses will reduce socioeconomic mortality inequalities.Methods and analysisData on all causes of deaths will be obtained from Statistics Lithuania. Record linkage will be implemented using personal identifiers combining data from (1) the 2011 whole-population census, (2) death records between 1 March 2011 (census date) and 31 December 2019, and (3) emigration records, for individuals aged 40–70 years. The analyses will be performed separately for all-cause and for alcohol-attributable deaths. Monthly age-standardised mortality rates will be calculated by sex, education and three measures of socioeconomic status (SES). Inequalities in mortality will be assessed using absolute and relative indicators between low and high SES groups. We will perform interrupted time series analyses, and test the impact of the 2017 rise in alcohol excise taxation using generalised additive mixed models. In these models, we will control for secular trends for economic development.Ethics and disseminationThis work is part of project grant 1R01AA028224-01 by the National Institute on Alcohol Abuse and Alcoholism. It has been granted research ethics approval 050/2020 by Centre for Addiction and Mental Health Research Ethics Board on 17 April 2020, renewed on 30 March 2021. The time series of mortality inequalities as well as the statistical code will be made publicly available, allowing other researchers to adapt the proposed method to other jurisdictions.

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Interrupted time series analyses to assess the impact of alcohol control policy on socioeconomic inequalities in mortality in Lithuania: a study protocol

10.1101/2021.05.10.21256944 ◽

2021 ◽

Author(s):

Jakob Manthey ◽

Domantas Jasilionis ◽

Huan Jiang ◽

Olga Mesceriakova-Veliuliene ◽

Janina Petkeviciene ◽

...

Keyword(s):

Time Series ◽

Research Ethics ◽

Interrupted Time Series ◽

Mortality Rates ◽

Attributable Mortality ◽

Population Census ◽

Combining Data ◽

Time Series Analyses ◽

Inequalities In Mortality ◽

The Impact

Introduction Alcohol use is a major risk factor for mortality. Previous studies suggest that the alcohol-attributable mortality burden is higher in lower socioeconomic strata. This project will test the hypothesis, that the 2017 increase of alcohol excise taxes for beer and wine, which was linked to lower all-cause mortality rates in previous analyses, will reduce socioeconomic mortality inequalities. Methods and analysis Data on all causes of deaths will be obtained from Statistics Lithuania. Record linkage will be implemented using personal identifiers combining data from 1) the 2011 whole-population census, 2) death records between March 1, 2011 (census date) and December 31, 2019, and 3) emigration records, for individuals aged 30 to 70 years. The analyses will be performed separately for all-cause and for alcohol-attributable deaths. Monthly age-standardized mortality rates will be calculated by sex, education, and three measures of socioeconomic status. Inequalities in mortality will be assessed using absolute and relative indicators between low and high SES groups. We will perform interrupted time series analyses, and test the impact of the 2017 rise in alcohol excise taxation using generalized additive mixed models. In these models, we will control for secular trends for economic development. Ethics and dissemination This work is part of project grant 1R01AA028224-01 by the National Institute on Alcohol Abuse and Alcoholism. It has been granted research ethics approval 050/2020 by CAMH Research Ethics Board on April 17, 2020, renewed on March 30, 2021.

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Changes in antibiotic usage and susceptibility in nosocomial Enterobacteriaceae and Pseudomonas isolates following the introduction of ertapenem to hospital formulary

Epidemiology and Infection ◽

10.1017/s0950268811000082 ◽

2011 ◽

Vol 140 (1) ◽

pp. 115-125 ◽

Cited By ~ 5

Author(s):

C. J. GRABER ◽

C. HUTCHINGS ◽

F. DONG ◽

W. LEE ◽

J. K. CHUNG ◽

...

Keyword(s):

Time Series ◽

Linear Trend ◽

Interrupted Time Series ◽

Antibiotic Usage ◽

Cross Resistance ◽

Hospital Formulary ◽

Time Series Analyses ◽

The Mean ◽

The Impact ◽

Change In Mean

SUMMARYThere is concern that widespread usage of ertapenem may promote cross-resistance to other carbapenems. To analyse the impact that adding ertapenem to our hospital formulary had on usage of other broad-spectrum agents and on susceptibilities of nosocomial Enterobacteriaceae and Pseudomonas isolates, we performed interrupted time-series analyses to determine the change in linear trend in antibiotic usage and change in mean proportion and linear trend of susceptibility pre- (March 2004–June 2005) and post- (July 2005–December 2008) ertapenem introduction. Usage of piperacillin-tazobactam (P=0·0013) and ampicillin-sulbactam (P=0·035) declined post-ertapenem introduction. For Enterobacteriaceae, the mean proportion susceptible to ciprofloxacin (P=0·016) and piperacillin-tazobactam (P=0·038) increased, while the linear trend in susceptibility significantly increased for cefepime (P=0·012) but declined for ceftriaxone (P=0·0032). For Pseudomonas, the mean proportion susceptible to cefepime (P=0·011) and piperacillin-tazobactam (P=0·028) increased, as did the linear trend in susceptibility to ciprofloxacin (P=0·028). Notably, no significant changes in carbapenem susceptibility were observed.

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Effects of the FDA Codeine Safety Investigation on Racial and Geographic Disparities in Opioid Prescribing after Pediatric Tonsillectomy and/or Adenoidectomy

Global Pediatric Health ◽

10.1177/2333794x20987444 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2098744

Author(s):

Amy Lawrence ◽

Jennifer N. Cooper ◽

Katherine J. Deans ◽

Peter C. Minneci ◽

Sharon K. Wrona ◽

...

Keyword(s):

Time Series ◽

Interrupted Time Series ◽

Black Box ◽

Opioid Prescription ◽

White Children ◽

Geographic Disparities ◽

Time Series Analyses ◽

The Impact ◽

Metropolitan Counties ◽

The U.S

Objective. Our objective was to examine the impact of the U.S. FDA’s 2013 black box warning against codeine on codeine and other opioid prescription filling after pediatric tonsillectomy and/or adenoidectomy (T/A) overall and by child race and provider urbanity/rurality. Methods. Patients ≤ 18 who underwent T/A in 8/2011 to 8/2016 were identified in Ohio Medicaid claims. Interrupted time series analyses were used to evaluate the impact of the FDA warning on codeine or other opioid prescription filling post-T/A. Results. In August 2011, codeine prescription filling was lower among black than white children ( P < .001) and among children treated at institutions in metropolitan counties than less populous counties ( P < .001). The FDA warning was associated with a 24.0% drop in codeine prescription filling ( P < .001) and 5.5% increase in alternative opioid prescription filling ( P = .046). At conclusion, there remained geographic but no longer racial disparities in codeine prescribing. Conclusion. Codeine prescribing after pediatric T/A decreased after the FDA’s black box warning. However, geographic disparities in codeine prescribing remain.

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Reduction of maternal mortality due to preeclampsia in Colombia-an interrupted time-series analysis

Colombia Medica ◽

10.25100/cm.v45i1.1466 ◽

2014 ◽

pp. 25-31 ◽

Cited By ~ 7

Author(s):

Julian Alberto Herrera Herrera ◽

Rodolfo Herrera-Miranda ◽

Juan Pablo Herrera-Escobar ◽

Aníbal Nieto-Díaz

Keyword(s):

Time Series ◽

Prenatal Care ◽

Time Series Analysis ◽

Maternal Mortality ◽

Care Program ◽

Interrupted Time Series ◽

Mortality Rates ◽

Interrupted Time Series Analysis ◽

Series Analysis ◽

The Impact

Introduction. Preeclampsia is the most important cause of maternal mortality in developing countries. A comprehensive prenatal care program including bio-psychosocial components was developed and introduced at a national level in Colombia. We report on the trends in maternal mortality rates and their related causes before and after implementation of this program. Methods: General and specific maternal mortality rates were monitored for nine years (1998-2006). An interrupted time-series analysis was performed with monthly data on cases of maternal mortality that compared trends and changes in national mortality rates and the impact of these changes attributable to the introduction of a bio-psychosocial model. Multivariate analyses were performed to evaluate correlations between the interventions. Results: Five years after (2002–2006) its introduction the general maternal mortality rate was significantly reduced to 23% (OR= 0.77, CI 95% 0.71-0.82).The implementation of BPSM also reduced the incidence of preeclampsia in 22% (OR= 0.78, CI 95% 0.67-0.88), as also the labor complications by hemorrhage in 25% (OR= 0.75, CI 95% 0.59-0.90) associated with the implementation of red code. The other causes of maternal mortality did not reveal significant changes. Biomedical, nutritional, psychosocial assessments, and other individual interventions in prenatal care were not correlated to maternal mortality (p= 0.112); however, together as a model we observed a significant association (p= 0.042). Conclusions: General maternal mortality was reduced after the implementation of a comprehensive national prenatal care program. Is important the evaluation of this program in others populations.

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Did England's Teenage Pregnancy Strategy reduce pregnancy rates in England? A Natural Experiment study

10.1101/2020.05.12.20099002 ◽

2020 ◽

Author(s):

Andrew J Baxter ◽

Ruth Dundas ◽

Frank Popham ◽

Peter Craig

Keyword(s):

Time Series ◽

Teenage Pregnancy ◽

Interrupted Time Series ◽

Pregnancy Rates ◽

Control Population ◽

Sensitivity Analyses ◽

Synthetic Control ◽

Birth Rates ◽

Time Series Analyses ◽

The Impact

Objective To re-evaluate the impact of England's Teenage Pregnancy Strategy (1999 to 2010) on pregnancy and birth rates. Hailed as a unique, nation-wide, comprehensive, evidence-based intervention, the strategy has been promoted as a reproducible model for other countries with high teenage pregnancy rates. Design Controlled interrupted time series and synthetic control analyses using routinely collected data on births and abortions in 16 countries. Setting The Strategy was published in July 1999 and implemented from 2000-2010, with increased investment in areas with higher rates of under-18 pregnancies from 2006 onwards. Participants Women aged under 20 living in England during the intervention period were considered to be the target population. Women in Scotland and Wales were the control population in our interrupted time series analyses. Women from European and English-speaking high-income countries were the control population in our synthetic control analyses. Main outcome measures The pregnancy rate among women aged under-18 was our primary outcome, as this was the target of the Strategy. We used under-18 births and under-20 pregnancies as secondary outcomes. Results In the controlled interrupted time series analyses, trends in rates of teenage pregnancy in England were similar to Scotland (0.08 fewer pregnancies per 1,000 women per year in England; -0.74 to 0.59) and Wales (0.14 more pregnancies per 1,000 women per year in England; -0.48 to 0.76). In synthetic control analyses, under-18 birth rates were very similar in England and the synthetic control. Under-20 pregnancy rates were marginally higher in England than in the synthetic control. Placebo testing and other sensitivity analyses supported the finding of no observable effect. Conclusion Although teenage pregnancies and births in England fell following implementation of the Teenage Pregnancy Strategy, comparisons with other countries suggest the strategy had little, if any, effect. The strategy should not be used as a model for future public health interventions in England or in other countries. The protocol for the analysis was published online at https://osf.io/tdbr8/

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The impact of an additional year of education on myopia: an interrupted time series in the UK Biobank.

10.21203/rs.3.rs-663858/v1 ◽

2021 ◽

Author(s):

Benjamin Woolf ◽

Riaz Aziz

Keyword(s):

Time Series ◽

Instrumental Variables ◽

Refractive Error ◽

Interrupted Time Series ◽

Quasi Experimental ◽

Time Series Analyses ◽

One Year ◽

The Uk ◽

The Impact ◽

Segmented Regression Model

Abstract Introduction: In the past decade, the minimal school leaving age has been raised twice. Previous studies have found evidence for a link between this type of policy and myopia. We aim to use the 1972 raising of school leaving age to estimate the effect of the raising of school leaving age in 2013 and 2015. Methods: We use a segmented regression model to conduct an instrumental time series analyses of the effect of years of education on myopia using the 1972 raising of school leaving age. To recover the effect of a one-year change, we use the effect of the change on years of education and reflective error in an instrumental variables analysis. Results: We found evidence for a 0.60 (SE = 0.10) increase in years of education and, after adjusting for probability of having missing data and sex, a -0.14d (SE = 0.03) for refractive error. Instrumental variables analyse implies a -0.24 d/year (SE = 0.05) change in refractive error for each additional year in education. Conclusion: Our results triangulate the findings of pervious quasi-experimental methods on the effect of years of education on myopia and imply that each raising of school leaving age in the 2010s should be expected to a lead to -0.07 d/yr change in refractive error in the UK population.

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The impact of measles immunization campaigns in India using a nationally representative sample of 27,000 child deaths

eLife ◽

10.7554/elife.43290 ◽

2019 ◽

Vol 8 ◽

Cited By ~ 2

Author(s):

Benjamin KC Wong ◽

Shaza A Fadel ◽

Shally Awasthi ◽

Ajay Khera ◽

Rajesh Kumar ◽

...

Keyword(s):

Time Series ◽

Mortality Risk ◽

Representative Sample ◽

Interrupted Time Series ◽

Mortality Rates ◽

Multilevel Regression ◽

Child Deaths ◽

Nationally Representative ◽

The Impact ◽

Immunization Campaign

India comprises much of the persisting global childhood measles mortality. India implemented a mass second-dose measles immunization campaign in 2010. We used interrupted time series and multilevel regression to quantify the campaign’s impact on measles mortality using the nationally representative Million Death Study (including 27,000 child deaths in 1.3 million households surveyed from 2005 to 2013). 1–59 month measles mortality rates fell more in the campaign states following launch (27%) versus non-campaign states (11%). Declines were steeper in girls than boys and were specific to measles deaths. Measles mortality risk was lower for children living in a campaign district (OR 0.6, 99% CI 0.4–0.8) or born in 2009 or later (OR 0.8, 99% CI 0.7–0.9). The campaign averted up to 41,000–56,000 deaths during 2010–13, or 39–57% of the expected deaths nationally. Elimination of measles deaths in India is feasible.

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Impact of low and no alcohol beers on purchases of alcohol: interrupted time series analysis of British household shopping data, 2015–2018

BMJ Open ◽

10.1136/bmjopen-2019-036371 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036371 ◽

Cited By ~ 1

Author(s):

Peter Anderson ◽

Eva Jané Llopis ◽

Amy O’Donnell ◽

Jakob Manthey ◽

Jürgen Rehm

Keyword(s):

Time Series ◽

Time Series Analysis ◽

Age Groups ◽

Interrupted Time Series ◽

Interrupted Time Series Analysis ◽

Series Analysis ◽

Younger Age ◽

Time Series Analyses ◽

The Impact ◽

Low Alcohol

ObjectiveTo assess the impact of new low and no alcohol beers and reformulated beers in Great Britain on household purchases of grams of alcohol.DesignInterrupted time series analysis.SettingPurchase data from Kantar Worldpanel’s household shopping panel for 2015–2018.Participants64 286 British households.InterventionsIntroduction of new no and low alcohol beers during 2017–2018 and reformulation of existing beers to contain less alcohol during 2018.Main outcome measuresAverage alcoholic strength of beer and number of grams of alcohol purchased by households.ResultsAs assessed by British household purchase data, 46 new low and no alcohol beer products were introduced during 2015–2018, with a step-jump in volume purchased occurring at the beginning of March 2017 (event 1). During 2015–2018, 33 beer products were reformulated to contain less alcohol, with a step-jump in volume purchased occurring during mid-March 2018 (event 2). Interrupted time series analyses found a combined associated impact of both events with relative reductions of alcohol by volume of beer between 1.2% and 2.3%; purchases of grams of alcohol within beer between 7.1% and 10.2%; and purchases of grams of alcohol as a whole between 2.6% and 3.9%. The reductions were greater for reformulation than for the introduction of new low and no alcohol products. Reductions were independently higher for younger age groups of shoppers and for households that bought the most alcohol.ConclusionsEven though the events were associated with significant beneficial changes, the volume of purchases of new low and no alcohol beer products (2.6% of the volume of all beers purchased during 2018) and of new reformulated beer products (6.9% of the volume of all beers purchased during 2018) was very small. This indicates that there are future opportunities to increase the volume of such products so as to reduce the harm done by alcohol.

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