Preventive medicine
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Preventive medicine · Aug 2022
Review Meta AnalysisShould we abandon annual physical examination? - A meta-analysis of annual physical examination and all-cause mortality in adults based on observational studies.
Several meta-analyses based on randomized clinical trials data have failed to find an association between the annual physical examination (APE) and reduced mortality; however, no comparable meta-analysis based on observational data exists. We conducted a meta-analysis of observational studies comparing APE versus non-APE in adults for all-cause mortality. English-language searches of four databases (PubMed, CINAHL, EMBASE, and Google Scholar) between the years 2000 to 2019 yielded seven observational studies that investigated APE versus non-APE in healthy adults in relation to all-cause mortality. ⋯ APE was significantly associated with a 45% lower hazard of all-cause mortality, with pooled hazard ratio of 0.55 (95% CI 0.48 to 0.64, P < 0.01) for all participants. This meta-analysis of seven observational studies in the past 20 years provides evidence of an association between APE and a lower hazard of all-cause mortality, a finding that contrasts with findings based on meta-analyses of randomized clinical trials data. Nonetheless, at present the evidence available about the effectiveness or ineffectiveness of APE on all-cause mortality still needs further study.
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Preventive medicine · Aug 2022
Randomized Controlled TrialChildhood COVID-19 vaccine acceptance and preference from caregivers and healthcare workers in China: A survey experiment.
With approval of more COVID-19 vaccines for children, vaccine attributes may influence parental acceptance and choices. We aimed to assess effects of vaccine attributes and information on herd immunity on childhood COVID-19 vaccine acceptance. A survey experiment was conducted with caregivers of children aged 6 months to 11 years old and health care workers (HCWs) in China from September 14 to November 18, 2021. ⋯ To achieve herd immunity target (> 80% vaccination coverage), vaccine efficacy should reach over 70% and risk of adverse reactions lower than 1 in 10,000. Knowledge on herd immunity target increased the odds of vaccine acceptance (1.82 [1.34-2.46] for caregivers; 2.42 [1.58-3.72] for HCWs). Childhood COVID-19 vaccine acceptance was high in China, independent of child's age, and depended on vaccine attributes.
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Preventive medicine · Aug 2022
Emergency health services use and medically-treated suicidal behaviors following depression screening among adolescents: A longitudinal cohort study.
The primary goal of depression screening is to reduce adverse psychiatric outcomes, which may have downstream implications for reducing avoidable health services use. The objective of this study was to examine the association of depression screening with emergency health services use and medically-treated suicidal behaviors among adolescents in the U. S. ⋯ Associations were similar in magnitude among male and female adolescents. The results of this study suggest that depression screening, as it is currently practiced in the U. S., may not deter avoidable health services use among adolescents.
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Preventive medicine · Aug 2022
Childhood socioeconomic status, healthy lifestyle, and colon cancer risk in a cohort of U.S. women.
Colon cancer is the third most common cancer in the US. While the socioeconomic status -health gradient has been established, findings linking adult socioeconomic status to colon cancer incidence specifically are mixed. Considering childhood socioeconomic status (CSES) and relevant risk factors, including related lifestyle behaviors, may provide more insight. ⋯ Compared to women whose parents were white collar workers, women whose parents were farmers had lower colon cancer risk (HR = 0.84; 95%CI: 0.72, 0.98), but no differences were evident for women whose parents were blue collar workers in models adjusting for age and familial history of colon cancer. Using the same comparison group, risk of adopting an unhealthy lifestyle over follow-up was not significantly different in women with farmer parents (HR = 0.96, 95% CI: 0.91, 1.02), while children of blue collar workers had slightly greater risk (HR = 1.07; 95%CI: 1.03, 1.12) in age-adjusted models. These findings suggest the impact of CSES on colon cancer risk is modest and varies across outcomes and occupational status.
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Preventive medicine · Aug 2022
Observational StudyCharacteristics of statewide prescription drug monitoring programs and potentially inappropriate opioid prescribing to patients with non-cancer chronic pain: A machine learning application.
Unnecessary/unsafe opioid prescribing has become a major public health concern in the U. S. Statewide prescription drug monitoring programs (PDMPs) with varying characteristics have been implemented to improve safe prescribing practice. ⋯ The results show that among 1,886,146 NCCP opioid-related claims, 22.8% had an opioid dosage ≥50 MME/day and 8.9% ≥90 MME/day, 70.3% had days supply ≥7 days, and 10.3% were when benzodiazepine was filled ≤7 days ago. GBM had superior model performance. We identified the most salient PDMP characteristics that predict opioid-related PIPs (e.g., broader access to patient prescription history, monitoring Schedule IV controlled substances), which could be informative to the states considering the redesign of PDMPs.