Proton Pump Inhibitors and Risk of Dementia: A Hypothesis Generated but Not Adequately Tested

We reviewed the evidence on proton pump inhibitors (PPIs) and dementia. PPIs are among the most widely utilized drugs in the world. Dementia affects roughly 5% of the population of the United States (US) and world aged 60 years and older. With respect to PPIs and dementia, basic research has suggested plausible mechanisms but descriptive and analytic epidemiological studies are not inconsistent. In addition, a single large-scale randomized trial showed no association. When the evidence is incomplete, it is appropriate for clinicians and researchers to remain uncertain. Regulatory or public health authorities sometimes need to make real-world decisions based on real-world data. When the evidence is complete, then the most rational judgments for individual patients the health of the general public are possible At present, the evidence on PPIs and dementia suggests more reassurance than alarm. Further large-scale randomized evidence is necessary to do so.

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Real-world longitudinal data collected from the SleepHealth mobile app study

Scientific Data ◽

10.1038/s41597-020-00753-2 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Sean Deering ◽

Abhishek Pratap ◽

Christine Suver ◽

A. Joseph Borelli ◽

Adam Amdur ◽

...

Keyword(s):

Real World ◽

Large Scale ◽

Digital Health ◽

The United States ◽

Mobile App ◽

Environmental Data ◽

Sleep Habits ◽

Real World Data ◽

Disease Manifestation ◽

Novel Approach

AbstractConducting biomedical research using smartphones is a novel approach to studying health and disease that is only beginning to be meaningfully explored. Gathering large-scale, real-world data to track disease manifestation and long-term trajectory in this manner is quite practical and largely untapped. Researchers can assess large study cohorts using surveys and sensor-based activities that can be interspersed with participants’ daily routines. In addition, this approach offers a medium for researchers to collect contextual and environmental data via device-based sensors, data aggregator frameworks, and connected wearable devices. The main aim of the SleepHealth Mobile App Study (SHMAS) was to gain a better understanding of the relationship between sleep habits and daytime functioning utilizing a novel digital health approach. Secondary goals included assessing the feasibility of a fully-remote approach to obtaining clinical characteristics of participants, evaluating data validity, and examining user retention patterns and data-sharing preferences. Here, we provide a description of data collected from 7,250 participants living in the United States who chose to share their data broadly with the study team and qualified researchers worldwide.

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Unraveling COVID-19: a large-scale characterization of 4.5 million COVID-19 cases using CHARYBDIS

10.21203/rs.3.rs-279400/v1 ◽

2021 ◽

Author(s):

Daniel Prieto-Alhambra ◽

Kristin Kostka ◽

Talita Duarte-Salles ◽

Albert Prats-Uribe ◽

Anthony Sena ◽

...

Keyword(s):

Real World ◽

Large Scale ◽

The United States ◽

The Novel ◽

Real World Data ◽

Great Utility ◽

Scale Characterization ◽

Novel Coronavirus ◽

The Uk

Abstract Background: Routinely collected real world data (RWD) have great utility in aiding the novel coronavirus disease (COVID-19) pandemic response [1,2]. Here we present the international Observational Health Data Sciences and Informatics (OHDSI) [3] Characterizing Health Associated Risks, and Your Baseline Disease In SARS-COV-2 (CHARYBDIS) framework for standardisation and analysis of COVID-19 RWD.Methods: We conducted a descriptive cohort study using a federated network of data partners in the United States, Europe (the Netherlands, Spain, the UK, Germany, France and Italy) and Asia (South Korea and China). The study protocol and analytical package were released on 11th June 2020 and are iteratively updated via GitHub [4]. Findings: We identified three non-mutually exclusive cohorts of 4,537,153 individuals with a clinical COVID-19 diagnosis or positive test, 886,193 hospitalized with COVID-19, and 113,627 hospitalized with COVID-19 requiring intensive services. All comorbidities, symptoms, medications, and outcomes are described by cohort in aggregate counts, and are available in an interactive website: https://data.ohdsi.org/Covid19CharacterizationCharybdis/. Interpretation: CHARYBDIS findings provide benchmarks that contribute to our understanding of COVID-19 progression, management and evolution over time. This can enable timely assessment of real-world outcomes of preventative and therapeutic options as they are introduced in clinical practice.

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4CPS-301 Association of antibiotics and proton pump inhibitors on clinical activity of firstline pembrolizumab for non-small cell lung cancer: 2 years of real world data

10.1136/ejhpharm-2021-eahpconf.133 ◽

2021 ◽

Author(s):

A Castro Balado ◽

M Tourís Lores ◽

R Álvarez Sánchez ◽

B Bernárdez Ferrán ◽

E López Montero ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Cell Lung Cancer ◽

Real World ◽

Small Cell ◽

Clinical Activity ◽

Small Cell Lung ◽

Real World Data

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Users’ Beliefs Toward Physical Distancing in Facebook Pages of Public Health Authorities During COVID-19 Pandemic in Early 2020

Health Education & Behavior ◽

10.1177/10901981211014428 ◽

2021 ◽

pp. 109019812110144

Author(s):

Soon Guan Tan ◽

Aravind Sesagiri Raamkumar ◽

Hwee Lin Wee

Keyword(s):

Public Health ◽

Health Belief Model ◽

United States Public Health ◽

Health Belief ◽

The United States ◽

Health Authorities ◽

Public Health Authorities ◽

Control And Prevention ◽

Belief Model ◽

The Health Belief Model

This study aims to describe Facebook users’ beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures ( n = 3,463; 3.3%) was three times higher than perceived barriers ( n = 1,062; 1.0%). Perceived susceptibility to COVID-19 ( n = 2,934; 2.8%) was higher compared with perceived severity ( n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users’ beliefs at a basic level, and it provides a scope for further improvement.

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Real-world utilization and costs with biosimilar and reference filgrastim in patients with breast cancer receiving myelosuppressive chemotherapy in a community oncology setting from 2015 to 2017.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.57 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 57-57

Author(s):

Robert M. Rifkin ◽

Lisa Herms ◽

Chuck Wentworth ◽

Anupama Vasudevan ◽

Kimberley Campbell ◽

...

Keyword(s):

Breast Cancer ◽

Real World ◽

Initial Period ◽

The United States ◽

Time Frame ◽

Real World Data ◽

Electronic Health Record Data ◽

Myelosuppressive Chemotherapy ◽

Community Oncology ◽

The Us

57 Background: Biosimilars have potential to reduce healthcare costs and increase access in the United States, but lack of uptake has contributed to lost savings. Filgrastim-sndz was the first FDA-approved biosimilar, and much can be learned by evaluating its uptake. In February 2016, the US Oncology Network converted to filgrastim-sndz as its short-acting granulocyte colony-stimulating factor (GCSF) of choice for prevention of febrile neutropenia (FN) following myelosuppressive chemotherapy (MCT). To understand utilization and cost patterns, this study analyzes real-world data of GCSFs within a community oncology network during the initial period of conversion to the first biosimilar available in the US. Methods: This descriptive retrospective observational study used electronic health record data for female breast cancer (BC) patients receiving GCSF and MCT at high risk of FN. Patient cohorts were defined by first receipt of either filgrastim or filgrastim-sndz during the 410 days before and after biosimilar conversion. Healthcare resource utilization (HCRU) and costs for GCSF and complete blood counts (CBC) were collected at GCSF initiation through the earliest of 30 days following end of MCT, loss to follow up, death, or data cutoff. Results: 146 patients were identified: 81 (55.5%) filgrastim and 65 (44.5%) filgrastim-sndz. No directional differences existed in baseline characteristics between the cohorts. Higher proportions of filgrastim-sndz patients received dose-dense MCT (33.8% vs 22.2%). Time trends show an initial spike in HCRU and cost for filgrastim-sndz patients after formulary conversion, which subsequently decreased and converged to that of the filgrastim cohort after 12 months. When aggregated, the overall median total administration counts, per patient per month (PPPM) and dosage, were marginally higher for filgrastim-sndz (5 vs 3; 2.9 vs 1.4; 1920 vs 1440 mcg, respectively). Median PPPM costs were higher for filgrastim-sndz ($803 vs $545). Median CBC utilization and costs were higher for filgrastim-sndz (2.8 vs 2.5; $28 vs $23, respectively). Conclusions: This study provides insight into real-world HCRU and cost patterns after formulary conversion to a biosimilar for BC patients receiving MCT and GCSF. As a descriptive study, causal inferences cannot be made and an underlying effect from index chemotherapy cannot be excluded. Convergence of HCRU and costs after 12 months suggests that overall results may be driven by behavior at initial formulary switch. Since filgrastim-sndz was the first US biosimilar approved, the uptake may be indicative of an experience with biosimilar acceptance in general. Future real-world studies of biosimilars must consider inconsistent utilization and practice trends during the time frame directly following formulary conversion.

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Spatial air pollution modelling for a West-African town

Geospatial health ◽

10.4081/gh.2015.321 ◽

2015 ◽

Vol 10 (2) ◽

Cited By ~ 5

Author(s):

Sirak Zenebe Gebreab ◽

Danielle Vienneau ◽

Christian Feigenwinter ◽

Hampâté Bâ ◽

Guéladio Cissé ◽

...

Keyword(s):

Land Use ◽

Air Pollution ◽

Cost Effective ◽

Epidemiological Studies ◽

West African ◽

Data Availability ◽

Air Pollution Modelling ◽

Health Authorities ◽

Public Health Authorities ◽

Leave One Out

Land use regression (LUR) modelling is a common approach used in European and Northern American epidemiological studies to assess urban and traffic related air pollution exposures. Studies applying LUR in Africa are lacking. A need exists to understand if this approach holds for an African setting, where urban features, pollutant exposures and data availability differ considerably from other continents. We developed a parsimonious regression model based on 48-hour nitrogen dioxide (NO2) concentrations measured at 40 sites in Kaédi, a medium sized West-African town, and variables generated in a geographic information system (GIS). Road variables and settlement land use characteristics were found to be important predictors of 48-hour NO2 concentration in the model. About 68% of concentration variability in the town was explained by the model. The model was internally validated by leave-one-out cross-validation and it was found to perform moderately well. Furthermore, its parameters were robust to sampling variation. We applied the model at 100 m pixels to create a map describing the broad spatial pattern of NO2 across Kaédi. In this research, we demonstrated the potential for LUR as a valid, cost-effective approach for air pollution modelling and mapping in an African town. If the methodology were to be adopted by environmental and public health authorities in these regions, it could provide a quick assessment of the local air pollution burden and potentially support air pollution policies and guidelines.

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Transmission of SARS-CoV-2 Considering Shared Chairs in Outpatient Dialysis: A Real-World Case-Control Study

10.1101/2021.02.20.21251855 ◽

2021 ◽

Author(s):

Ravi Thadhani ◽

Joanna Willetts ◽

Catherine Wang ◽

John Larkin ◽

Hanjie Zhang ◽

...

Keyword(s):

Real World ◽

Case Control Study ◽

The United States ◽

Hemodialysis Patients ◽

Case Control ◽

Positive Patient ◽

Sensitivity Analyses ◽

Real World Data ◽

World Data ◽

Control Study

AbstractBackgroundSARS-CoV-2 is primarily transmitted through aerosolized droplets; however, the virus can remain transiently viable on surfaces.ObjectiveWe examined transmission within hemodialysis facilities, with a specific focus on the possibility of indirect patient-to-patient transmission through shared dialysis chairs.DesignWe used real-world data from hemodialysis patients treated between February 1st and June 8th, 2020 to perform a case-control study matching each SARS-CoV-2 positive patient (case) to a non-SARS-CoV-2 patient (control) in the same dialysis shift and traced back 14 days to capture possible exposure from chairs sat in by SARS-CoV-2 patients. Cases and controls were matched on age, sex, race, facility, shift date, and treatment count.Setting2,600 hemodialysis facilities in the United States.PatientsAdult (age ≥18 years) hemodialysis patients.MeasurementsConditional logistic regression models tested whether chair exposure after a positive patient conferred a higher risk of SARS-CoV-2 infection to the immediate subsequent patient.ResultsAmong 170,234 hemodialysis patients, 4,782 (2.8%) tested positive for SARS-CoV-2 (mean age 64 years, 44% female). Most facilities (68.5%) had 0 to 1 positive SARS-CoV-2 patient. We matched 2,379 SARS-CoV-2 positive cases to 2,379 non-SARS-CoV-2 controls; 1.30% (95%CI 0.90%, 1.87%) of cases and 1.39% (95%CI 0.97%, 1.97%) of controls were exposed to a chair previously sat in by a shedding SARS-CoV-2 patient. Transmission risk among cases was not significantly different from controls (OR=0.94; 95%CI 0.57 to 1.54; p=0.80). Results remained consistent in adjusted and sensitivity analyses.LimitationAnalysis used real-world data that could contain errors and only considered vertical transmission associated with shared use of dialysis chairs by symptomatic patients.ConclusionsThe risk of indirect patient-to-patient transmission of SARS-CoV-2 infection from dialysis chairs appears to be low.Primary Funding SourceFresenius Medical Care North America; National Institute of Diabetes and Digestive and Kidney Diseases (R01DK130067)

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