Integrating clinicians’ opinion in the Bayesian meta-analysis of observational studies: the case of risk factors for falls in community-dwelling older people

Background: despite the widespread application of Bayesian methods in meta-analysis, the incorporation of clinical informative priors based upon expert opinion is rare. Methods: a questionnaire to elicit beliefs about five risk factors for falls in older people was administered to a sample of geriatricians and general practitioners (GPs). The experts were asked to provide a point estimate and upper and lower limits of each relative risk. The elicited opinions were translated into different prior distributions and included in a Bayesian meta-analysis of prospective studies. Frequentist, Bayesian non-informative and fully Bayesian approaches were compared. Results: almost all the clinicians provided the requested information. In most cases, the variability across published studies was greater or similar to that across clinicians. Geriatricians provided more consistent estimates than GPs. When fewer studies were available, the use of the informative prior provided by geriatricians reduced the width of the credibility interval with respect to the frequentist or Bayesian non-informative approaches. Enthusiastic and skeptical priors led to results strongly driven by the prior distribution. Conclusions: this study presents a feasible method for belief elicitation and Bayesian priors’ assessment. The inclusion of external information showed to be useful when only few and/or heterogeneous studies were available from the literature

Pancreatic cancer mortality in Europe: the leveling of an epidemic

Mortality rates from pancreatic cancer have increased throughout Europe between the late 1950s and the 1980s. Trends in 22 European countries, the European Union (EU) and 6 selected eastern European countries have been updated using official death certification data for pancreatic cancer abstracted from the WHO database over the period 1980 to 1999. In EU men, a rise from 7.2 to 7.5/100,000 was observed between the early and the late 1980s, followed by a leveling off in the 1990s. For women, rates tended to rise up to the early 1990s, and to level off thereafter around 4.7/100,000. In eastern countries, rates for both sexes rose between the early 1980s and the mid-1990s, and leveled off thereafter around 8.5/100,000 men and 5/100,000 women. Thus, rates for men only were higher in Eastern Europe than in the EU. This analysis first documents a leveling of pancreatic cancer mortality in Europe, after decades of steady rises. This is partly or largely attributable to the decline in smoking, at least in men, but other factors, including mainly nutrition and diet, may also have played some role on these trends. [Authors]]]> Mortality ; Pancreatic Neoplasms oai:serval.unil.ch:BIB_F326E20D1607 2022-05-07T01:30:01Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F326E20D1607 Mouse Grueneberg ganglion neurons share molecular and functional features with C. elegans amphid neurons. info:doi:10.3389/fnbeh.2013.00193 info:eu-repo/semantics/altIdentifier/doi/10.3389/fnbeh.2013.00193 info:eu-repo/semantics/altIdentifier/pmid/24367309 Brechbühl, J. Moine, F. Broillet, M.C. info:eu-repo/semantics/article article 2013 Frontiers in Behavioral Neuroscience, vol. 7, pp. 193 info:eu-repo/semantics/altIdentifier/eissn/1662-5153 urn:issn:1662-5153 <![CDATA[The mouse Grueneberg ganglion (GG) is an olfactory subsystem located at the tip of the nose close to the entry of the naris. It comprises neurons that are both sensitive to cold temperature and play an important role in the detection of alarm pheromones (APs). This chemical modality may be essential for species survival. Interestingly, GG neurons display an atypical mammalian olfactory morphology with neurons bearing deeply invaginated cilia mostly covered by ensheathing glial cells. We had previously noticed their morphological resemblance with the chemosensory amphid neurons found in the anterior region of the head of Caenorhabditis elegans (C. elegans). We demonstrate here further molecular and functional similarities. Thus, we found an orthologous expression of molecular signaling elements that was furthermore restricted to similar specific subcellular localizations. Calcium imaging also revealed a ligand selectivity for the methylated thiazole odorants that amphid neurons are known to detect. Cellular responses from GG neurons evoked by chemical or temperature stimuli were also partially cGMP-dependent. In addition, we found that, although behaviors depending on temperature sensing in the mouse, such as huddling and thermotaxis did not implicate the GG, the thermosensitivity modulated the chemosensitivity at the level of single GG neurons. Thus, the striking similarities with the chemosensory amphid neurons of C. elegans conferred to the mouse GG neurons unique multimodal sensory properties

Oral contraceptives and colorectal cancer risk: a systematic review and meta-analysis

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Oral Contraceptive Use and Invasive Cervical Cancer

Parazzini F (Mario Negri Institute for Pharmacological Research, 20157 Milan, Italy), La Vecchia C, Negri E and Maggi R. Oral contraceptive use and invasive cervical cancer. International Journal of Epidemiology 1990; 19: 259-263. The relationship between oral contraceptive use and the risk of invasive cervical cancer was investigated using data from a hospital-based case-control study conducted in the greater Milan area, Northern Italy. A total of 367 women under 60 years of age with a histologically confirmed diagnosis of invasive cervical cancer was compared with a group of 323 controls admitted for a spectrum of acute conditions, non-gynaecological, hormonal or neoplastic and apparently unrelated to oral contraceptive use. Cases had used oral contraceptives more frequently than controls, the age-adjusted relative risk (RR) being 1.53 (95% confidence interval 0.99-2.36). The risk increased with duration of use: compared with never users the age-adjusted RR was 1.48 for up to two years and 1.83 for more than two years (x12 = 5.28, p = 0.02). Allowing for major identified potential confounding factors, including sexual and reproductive habits, by means of multiple logistic regression, did not explain the associaton (multivariate RR 1.85 for ever use, 1.05 for up to two years and 2.47 for more than two years). When the interaction between oral contraceptive use and parity or sexual habits was analysed, the effects of various factors appeared independent: the point estimate for multiparous oral contraceptive users versus nulliparous never users was 8.01. There was no consistent influence on risk of invasive cervical cancer of age at first use, whereas the RRs were slightly greater for women who had first used oral contraceptives less than ten years before or had last used them less than five years before diagnosis: these findings, however, were far from significan

Cigarette Smoking, Body Mass and Other Risk Factors for Fractures of the Hip in Women

Determinants of hip fractures were assessed using data from a network of hospital-based case-control studies from northern Italy. For the present analysis, cases were 209 women with fractures of the hip/proximal femur (aged 29 to 74, median age 62) admitted to a network of teaching and general hospitals in the greater Milan area; controls were 1449 women, aged 25 to 74 (median age 55), admitted for non-traumatic, acute conditions to the same network of hospitals. There was a strong direct association with smoking, the relative risk (RR) being significantly and similarly elevated both in ex-and in current smokers (RR 1.7 and 1.5 respectively) which rose to 2.4 for 25 or over cigarettes per day. The risk was associated with duration of smoking and apparently greater in post-menopausal women. Two factors showed significant inverse associations with hip fractures: relative weight, with relative risks of 0.5, 0.4 and 0.3 in subsequent categories of body mass index as compared with thinner ones, and the use of oestrogen replacement treatment (multi-variate RR = 0.4, 95% confidence interval (CI): 0.2-1.1). No association was observed with education or social class, selected indicator foods or alcohol consumption (RR for the highest consumption level = 1.0). The effects of smoking and body mass index appeared independent: compared with never smoking heavier women, the RR for smoking thin women was 4.6. Thus, this case-control study of hip fractures in a predominantly post-menopausal population of Italian women showed a strong association with smoking and appreciable protection from heavier body mass index and the use of oestrogen replacement treatmen

Socioeconomic Groups and Cancer Risk at Death in the Swiss Canton of Vaud

Levi F (Vaud Cancer Registry, University Institute of Social and Preventive Medicine, CHUV BH-06, 1011 Lausanne, Switzerland), Negri E, La Vecchia C and Te V C. Socioeconomic groups and cancer risk at death in the Swiss Canton of Vaud. International Journal of Epidemiology 1988, 17: 711-717. Data collected by the Cancer Registry of the Canton of Vaud, Switzerland, were used to estimate proportional mortality ratios (PMR) and mortality odds ratios (MOR) for various neoplasms according to social class and sector of occupation (agriculture versus others). Mortality ratios were elevated in lower social classes for cancers of the lung (MOR = 1.18 for social class IV or V vs I or II) and other sites strictly related to tobacco (mouth or pharynx, oesophagus and larynx; MOR = 1.70), and (though not significantly) for cancers of the stomach (MOR = 1.16) and uterus (MOR = 1.30 for cervix and 1.47 for corpus uteri). Furthermore, there was a strong negative social class gradient for thyroid cancer (a neoplasm with particularly elevated incidence and mortality in Switzerland), probably attributable to higher prevalence of iodine deficiency in lower social classes (MOR = 3.17). Positive social class gradients emerged for cancers of the intestines (MOR = 0.77 for social class IV or V), skin (MOR = 0.74) and prostate (MOR = 0.87). Agricultural workers showed decreased ratios for cancers of the lung (MOR = 0.75), cervix uteri (MOR = 0.72) and prostate (MOR = 0.80), and excess mortality from cancers of the upper digestive and respiratory sites (MOR = 1.22), stomach (MOR = 1.18), testis (MOR = 2.05) and lymphc-haematopoietic neoplasms, particularly myeloma (MOR = 2.14