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? 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 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?: 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.

scholarly journals Evidence of detrimental effects of prenatal alcohol exposure on offspring birthweight and neurodevelopment from a systematic review of quasi-experimental studies

2020 ◽  
Author(s):  
Loubaba Mamluk ◽  
Timothy Jones ◽  
Sharea Ijaz ◽  
Hannah B Edwards ◽  
Jelena Savović ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Observational Studies ◽  
Mendelian Randomization ◽  
Prenatal Alcohol Exposure ◽  
Experimental Studies ◽  
Alcohol Exposure ◽  
Risk Of Bias ◽  
Quasi Experimental ◽  
Prenatal Alcohol

Abstract Background Systematic reviews of prenatal alcohol exposure effects generally only include conventional observational studies. However, estimates from such studies are prone to confounding and other biases. Objectives To systematically review the evidence on the effects of prenatal alcohol exposure from randomized controlled trials (RCTs) and observational designs using alternative analytical approaches to improve causal inference. Search strategy Medline, Embase, Web of Science, PsychINFO from inception to 21 June 2018. Manual searches of reference lists of retrieved papers. Selection criteria RCTs of interventions to stop/reduce drinking in pregnancy and observational studies using alternative analytical methods (quasi-experimental studies e.g. Mendelian randomization and natural experiments, negative control comparisons) to determine the causal effects of prenatal alcohol exposure on pregnancy and longer-term offspring outcomes in human studies. Data collection and analysis One reviewer extracted data and another checked extracted data. Risk of bias was assessed using customized risk of bias tools. A narrative synthesis of findings was carried out and a meta-analysis for one outcome. Main results Twenty-three studies were included, representing five types of study design, including 1 RCT, 9 Mendelian randomization and 7 natural experiment studies, and reporting on over 30 outcomes. One study design–outcome combination included enough independent results to meta-analyse. Based on evidence from several studies, we found a likely causal detrimental role of prenatal alcohol exposure on cognitive outcomes, and weaker evidence for a role in low birthweight. Conclusion None of the included studies was judged to be at low risk of bias in all domains, results should therefore be interpreted with caution. Systematic review registration This study is registered with PROSPERO, registration number CRD42015015941

scholarly journals Vitamin D Status and Mortality: A Systematic Review of Observational Studies

2019 ◽  
Vol 16 (3) ◽  
pp. 383 ◽  
Author(s):  
Alicia Heath ◽  
Iris Kim ◽  
Allison Hodge ◽  
Dallas English ◽  
David Muller
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Observational Studies ◽  
Causes Of Death ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Weak Evidence ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Epidemiological evidence suggests that vitamin D deficiency is associated with increased mortality, but it is unclear whether this is explained by reverse causation, and if there are specific causes of death for which vitamin D might be important. We conducted a systematic review of observational studies investigating associations between circulating 25-hydroxyvitamin D (25(OH)D) concentration and all-cause or cause-specific mortality in generally healthy populations. Relevant studies were identified using PubMed and EMBASE searches. After screening 722 unique records and removing those that were ineligible, 84 articles were included in this review. The vast majority of studies reported inverse associations between 25(OH)D concentration and all-cause mortality. This association appeared to be non-linear, with progressively lower mortality with increasing 25(OH)D up to a point, beyond which there was no further decrease. There is moderate evidence that vitamin D status is inversely associated with cancer mortality and death due to respiratory diseases, while for cardiovascular mortality, there is weak evidence of an association in observational studies, which is not supported by the data from intervention or Mendelian randomization studies. The relationship between vitamin D status and other causes of death remains uncertain due to limited data. Larger long-term studies are required to clarify these associations.

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.

scholarly journals Association between alcohol consumption and impaired work performance (presenteeism): a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029184 ◽  
Author(s):  
Mikkel Magnus Thørrisen ◽  
Tore Bonsaksen ◽  
Neda Hashemi ◽  
Ingvild Kjeken ◽  
Willem van Mechelen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alcohol Consumption ◽  
Observational Studies ◽  
Work Performance ◽  
Statistical Tests ◽  
Data Extraction ◽  
Alcohol Exposure ◽  
Research Literature ◽  
Research Quality ◽  
Eligibility Criteria

ObjectivesThe aim of this review was to explore the notion of alcohol-related presenteeism; that is, whether evidence in the research literature supports an association between employee alcohol consumption and impaired work performance.DesignSystematic review of observational studies.Data sourcesMEDLINE, Web of Science, PsycINFO, CINAHL, AMED, Embase and Swemed+ were searched through October 2018. Reference lists in included studies were hand searched for potential relevant studies.Eligibility criteriaWe included observational studies, published 1990 or later as full-text empirical articles in peer-reviewed journals in English or a Scandinavian language, containing one or more statistical tests regarding a relationship between a measure of alcohol consumption and a measure of work performance.Data extraction and synthesisTwo independent reviewers extracted data. Tested associations between alcohol consumption and work performance within the included studies were quality assessed and analysed with frequency tables, cross-tabulations and χ2tests of independence.ResultsTwenty-six studies were included, containing 132 tested associations. The vast majority of associations (77%) indicated that higher levels of alcohol consumption were associated with higher levels of impaired work performance, and these positive associations were considerably more likely than negative associations to be statistically significant (OR=14.00,phi=0.37, p<0.001). Alcohol exposure measured by hangover episodes and composite instruments were over-represented among significant positive associations of moderate and high quality (15 of 17 associations). Overall, 61% of the associations were characterised by low quality.ConclusionsEvidence does provide some support for the notion of alcohol-related presenteeism. However, due to low research quality and lack of longitudinal designs, evidence should be characterised as somewhat inconclusive. More robust and less heterogeneous research is warranted. This review, however, does provide support for targeting alcohol consumption within the frame of workplace interventions aimed at improving employee health and productivity.PROSPERO registration numberCRD42017059620.

The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review of the Literature

2021 ◽  
pp. 152483802098554
Author(s):  
Anita Stubbs ◽  
Cassandra Szoeke
Keyword(s):  
Systematic Review ◽  
Intimate Partner Violence ◽  
Health Outcomes ◽  
Physical Health ◽  
Partner Violence ◽  
Intimate Partner ◽  
Physical Health Outcomes ◽  
Health Related Behaviors ◽  
Health Related

Aim: The long-term effects of intimate partner violence (IPV) on physical health outcomes and health-related behaviors are underresearched in comparison to the effects on mental health and pregnancy. This systematic review examines the recent research in this area from 2012 through 2019. Methods: SCOPUS, PubMed, EBSCOhost, and gray literature were searched using the key words “intimate partner violence” and “health.” To meet inclusion criteria, studies needed to be original research and focus on IPV during adulthood and its effects on the physical health or health-related behaviors of women. Fifty-two studies were qualitatively analyzed, with results grouped into broad categories of effects, including cardiovascular, endocrine, infectious diseases, and health screening. Results: IPV was shown to have negative effects on physical health outcomes for women, including worsening the symptoms of menopause and increasing the risk of developing diabetes, contracting sexually transmitted infections, engaging in risk-taking behaviors including the abuse of drugs and alcohol, and developing chronic diseases and pain. It also has significant effects on human immunodeficiency virus outcomes, worsening CD4+ cell depletion. Results varied regarding the effects of IPV on cardiovascular health outcomes. Conclusion: The result of this review demonstrates that women who have experienced violence and abuse are at significantly increased risk of poor health outcomes in a variety of areas and so require specialized and tailored primary care. This review highlights significant gaps in this field of research, particularly in relation to cardiovascular disease, endocrine dysfunction, and neurological symptoms and conditions. It demonstrates a need for additional long-term studies in this field to better inform the health care of women who have experienced IPV and to establish the physiological mediators of these outcomes.

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