@article {cite-key,
	title = {Inequalities in treatment among patients with colon and rectal cancer: a multistate survival model using data from England national cancer registry 2012{\textendash}2016},
	journal = {British Journal of Cancer},
	year = {2023},
	abstract = {Individual and tumour factors only explain part of observed inequalities in colorectal cancer survival in England. This study aims to investigate inequalities in treatment in patients with colorectal cancer.},
	isbn = {1532-1827},
	doi = {10.1038/s41416-023-02440-6},
	url = {https://doi.org/10.1038/s41416-023-02440-6},
	author = {Ling, Suping and Luque-Fernandez, Miguel Angel and Quaresma, Manuela and Belot, Aurelien and Rachet, Bernard}
}
@article {SMITH2023,
	title = {Application of targeted maximum likelihood estimation in public health and epidemiological studies: a systematic review},
	journal = {Annals of Epidemiology},
	year = {2023},
	abstract = {Background The Targeted Maximum Likelihood Estimation (TMLE) statistical data analysis framework integrates machine learning, statistical theory, and statistical inference to provide a least biased, efficient and robust strategy for estimation and inference of a variety of statistical and causal parameters. We describe and evaluate the epidemiological applications that have benefited from recent methodological developments. Methods We conducted a systematic literature review in PubMed for articles that applied any form of TMLE in observational studies. We summarised the epidemiological discipline, geographical location, expertise of the authors, and TMLE methods over time. We used the Roadmap of Targeted Learning and Causal Inference to extract key methodological aspects of the publications. We showcase the contributions to the literature of these TMLE results. Results Of the 89 publications included, 33\% originated from the University of California at Berkeley, where the framework was first developed by Professor Mark van der Laan. By 2022, 59\% of the publications originated from outside the United States and explored up to 7 different epidemiological disciplines in 2021{\textendash}22. Double-robustness, bias reduction and model misspecification were the main motivations that drew researchers towards the TMLE framework. Through time, a wide variety of methodological, tutorial and software-specific articles were cited, owing to the constant growth of methodological developments around TMLE. Conclusions There is a clear dissemination trend of the TMLE framework to various epidemiological disciplines and to increasing numbers of geographical areas. The availability of R packages, publication of tutorial papers, and involvement of methodological experts in applied publications have contributed to an exponential increase in the number of studies that understood the benefits, and adoption, of TMLE.},
	keywords = {causal inference, Epidemiology, observational studies, Systematic review, Targeted Maximum Likelihood Estimation (TMLE)},
	issn = {1047-2797},
	doi = {https://doi.org/10.1016/j.annepidem.2023.06.004},
	url = {https://www.sciencedirect.com/science/article/pii/S1047279723001151},
	author = {Matthew J. Smith and Rachael V. Phillips and Luque-Fernandez, Miguel Angel and Maringe, Camille}
}
@manuascript {https://doi.org/10.1111/dme.15121,
	title = {The utility of plasma glycated CD59 in predicting postpartum glucose intolerance: a prospective study of women diagnosed with GDM during a period of universal GDM screening},
	journal = {Diabetic Medicine},
	volume = {n/a},
	number = {n/a},
	year = {2023},
	note = {e15121 DME-2022-00495.R2},
	pages = {e15121},
	abstract = {Abstract Aims Gestational diabetes (GDM) is associated with the development of postpartum (PP) glucose intolerance. Plasma glycated CD59 (pGCD59) is an emerging biomarker for the detection of hyperglycaemia. The aim of this study was to assess the ability of PP pGCD59 to predict the development of PP GI as defined by the 2h 75 g OGTT using the ADA criteria, in a cohort of women diagnosed with prior GDM in the index pregnancy using the 2h 75 g OGTT at 24-28 weeks of gestation according to the World Health Organisation (WHO) 2013 criteria Methods Of the 2017 pregnant women recruited prospectively 140 women with gestational diabetes had samples for pGCD59 taken PP at the time of the OGTT. The ability of pGCD59 to predict the results of the PP OGTT was assessed using nonparametric receiver operating characteristic (ROC) curves. Results Women with PP glucose intolerance had significantly higher PP pGCD59 levels compared to women with normal glucose tolerance PP (3.8 vs 2.7 SPU). PP pGCD59 identified women who developed glucose intolerance PP with an AUC of 0.80 (95\% CI:0.70-0.91). A PP pGCD59 cut-off value of 1.9 SPU generated a sensitivity of 100\% (95\%CI:83.9-100), specificity of 16.9\% (95\%CI:9.8-26.3), positive predictive value of 22.1\% (95\%CI:21.0-22.6), and negative predictive value of 100\% (95\%CI:87.4-100). PP fasting plasma glucose generated an AUC of 0.96 (95\%CI:0.89-0.99) for the identification of PP glucose intolerance. Conclusion Our study found that PP pGCD9 may be a promising biomarker to identify women not requiring PP glucose intolerance screening using the traditional OGTT. While the diagnostic accuracy of pGCD59 is good, fasting plasma glucose remains a better test for the identification of PP glucose intolerance.},
	keywords = {biomarker, CD59, Gestational diabetes, postpartum glucose intolerance},
	doi = {https://doi.org/10.1111/dme.15121},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.15121},
	author = {Delia Bogdanet and Toth Castillo, Michelle and Doheny, Helen and Dervan, Louise and Luque-Fernandez, Miguel Angel and Halperin, Jose and O{\textquoteright}Shea, Paula M. and Dunne, Fidelma P.}
}
@manuascript {smith2023application,
	title = {Application of targeted maximum likelihood estimation in public health and epidemiological studies: a systematic review},
	year = {2023},
	abstract = {The Targeted Maximum Likelihood Estimation (TMLE) statistical data analysis framework integrates machine learning, statistical theory, and statistical inference to provide a least biased, efficient and robust strategy for estimation and inference of a variety of statistical and causal parameters. We describe and evaluate the epidemiological applications that have benefited from recent methodological developments. We conducted a systematic literature review in PubMed for articles that applied any form of TMLE in observational studies. We summarised the epidemiological discipline, geographical location, expertise of the authors, and TMLE methods over time. We used the Roadmap of Targeted Learning and Causal Inference to extract key methodological aspects of the publications. We showcase the contributions to the literature of these TMLE results. Of the 81 publications included, 25\% originated from the University of California at Berkeley, where the framework was first developed by Professor Mark van der Laan. By the first half of 2022, 70\% of the publications originated from outside the United States and explored up to 7 different epidemiological disciplines in 2021-22. Double-robustness, bias reduction and model misspecification were the main motivations that drew researchers towards the TMLE framework. Through time, a wide variety of methodological, tutorial and software-specific articles were cited, owing to the constant growth of methodological developments around TMLE. There is a clear dissemination trend of the TMLE framework to various epidemiological disciplines and to increasing numbers of geographical areas. The availability of R packages, publication of tutorial papers, and involvement of methodological experts in applied publications have contributed to an exponential increase in the number of studies that understood the benefits, and adoption, of TMLE.},
	url = {https://arxiv.org/abs/2303.07329},
	author = {Matthew J. Smith and Rachael V. Phillips and Luque-Fernandez, Miguel Angel and Maringe, Camille}
}
@article {cite-key,
	title = {The ability of pGCD59 to predict adverse pregnancy outcomes: a prospective study of non-diabetic pregnant women in Ireland},
	journal = {Acta Diabetologica},
	year = {2022},
	abstract = {Even though most pregnancies are uneventful, occasionally complications do occur. Gestational diabetes is linked to an increased risk of adverse pregnancy outcomes. Early identification of women at risk of experiencing adverse outcomes, ideally through a single blood test, would facilitate early intervention. Plasma glycated CD59 (pGCD59) is an emerging biomarker which has shown promise in identifying hyperglycaemia during pregnancy and has been associated with the risk of delivering an LGA infant. The aim of this study was to explore the ability of the first- and second-trimester pGCD59 to predict adverse pregnancy outcomes.},
	isbn = {1432-5233},
	doi = {10.1007/s00592-022-01983-z},
	url = {https://doi.org/10.1007/s00592-022-01983-z},
	author = {Delia Bogdanet and Toth Castillo, Michelle and Doheny, Helen and Dervan, Louise and Luque-Fernandez, Miguel Angel and Halperin, Jose A. and Paula M. O{\textquoteright}Shea and Dunne, Fidelma P.}
}
@article { IncidentCardiovascularDiseasesAmongSurvivorsofHighRiskStageIIIIIColorectalCancerAClusterWideCohortStudy,
	title = {Incident Cardiovascular Diseases Among Survivors of High-Risk Stage II{\textendash}III Colorectal Cancer: A Cluster-Wide Cohort Study},
	journal = {Journal of the National Comprehensive Cancer Network},
	volume = {20},
	number = {10},
	year = {2022},
	pages = {1125 - 1133.e10},
	publisher = {National Comprehensive Cancer Network},
	address = {Huntington NY, USA},
	doi = {10.6004/jnccn.2022.7042},
	url = {https://jnccn.org/view/journals/jnccn/20/10/article-p1125.xml},
	author = {Lee, Shing Fung and Pui Lam Yip and Balamurugan A. Vellayappan and Cheng Ean Chee and Lea Choung Wong and Wan, Eric Yuk-Fai and Esther Wai-Yin Chan and Chak-Fei Lee and Francis Ann-Shing Lee and Luque-Fernandez, Miguel Angel}
}
@article {cancers14205082,
	title = {Mediating Effects of Diagnostic Route on the Comorbidity Gap in Survival of Patients with Diffuse Large B-Cell or Follicular Lymphoma in England},
	journal = {Cancers},
	volume = {14},
	number = {20},
	year = {2022},
	abstract = {Background: Socioeconomic inequalities in survival from non-Hodgkin lymphoma persist. Comorbidities are more prevalent amongst those in more deprived areas and are associated with diagnostic delay (emergency diagnostic route), which is also associated with poorer survival probability. We aimed to describe the effect of comorbidity on the probability of death mediated by diagnostic route (emergency vs. elective route) amongst patients with diffuse large B-cell (DLBCL) or follicular lymphoma (FL). Methods: We linked the English population-based cancer registry and hospital admission records (2005\&ndash;2013) of patients aged 45\&ndash;99 years. We decomposed the effect of comorbidity on survival into an indirect effect acting through diagnostic route and a direct effect not mediated by diagnostic route. Furthermore, we estimated the proportion of the comorbidity effect on survival mediated by diagnostic route. Results: For both DLBCL (n = 27,379) and FL (n = 14,043), those with any comorbidity, or living in more deprived areas, were more likely to experience diagnostic delay and poorer survival. The indirect effect of comorbidity on mortality through diagnostic route was highest at 12 months since diagnosis (DLBCL: Odds Ratio 1.10 [95\% CI 1.07\&ndash;1.13], FL: OR 1.09 [95\% CI 1.04\&ndash;1.14]). Within the first 12 months since diagnosis, emergency diagnostic route accounted for 24\% (95\% CI 17.5\&ndash;29.5) and 16\% (95\% CI 6.0\&ndash;25.6) of the comorbidity effect on mortality, for DLBCL and FL, respectively. Conclusion: Efforts to reduce diagnostic delay (emergency diagnosis) amongst patients with comorbidity would reduce inequalities in DLBCL and FL survival by 24\% and 16\%, respectively. Further public health programs and interventions are needed to reduce diagnostic delay amongst lymphoma patients with comorbidities.},
	issn = {2072-6694},
	doi = {10.3390/cancers14205082},
	url = {https://www.mdpi.com/2072-6694/14/20/5082},
	author = {Matthew J. Smith and Rachet, Bernard and Luque-Fernandez, Miguel Angel}
}
@article {cite-key,
	title = {Association of socioeconomic deprivation with life expectancy and all-cause mortality in Spain, 2011{\textendash}2013},
	journal = {Scientific Reports},
	volume = {12},
	number = {1},
	year = {2022},
	pages = {15554},
	abstract = {Life tables summarise a population{\textquoteright}s mortality experience during a time period. Sex- and age-specific life tables are needed to compute various cancer survival measures. However, mortality rates vary according to socioeconomic status. We present sex- and age-specific life tables based on socioeconomic status at the census tract level in Spain during 2011{\textendash}2013 that will allow estimating cancer relative survival estimates and life expectancy measures by socioeconomic status. Population and mortality data were obtained from the Spanish Statistical Office. Socioeconomic level was measured using the Spanish Deprivation Index by census tract. We produced sex- and age-specific life expectancies at birth by quintiles of deprivation, and life tables by census tract and province. Life expectancy at birth was higher among women than among men. Women and men in the most deprived census tracts in Spain lived 3.2 and 3.8 years less than their counterparts in the least deprived areas. A higher life expectancy in the northern regions of Spain was discovered. Life expectancy was higher in provincial capitals than in rural areas. We found a significant life expectancy gap and geographical variation by sex and socioeconomic status in Spain. The gap was more pronounced among men than among women. Understanding the association between life expectancy and socioeconomic status could help in developing appropriate public health programs. Furthermore, the life tables we produced are needed to estimate cancer specific survival measures by socioeconomic status. Therefore, they are important for cancer control in Spain.},
	isbn = {2045-2322},
	doi = {10.1038/s41598-022-19859-1},
	url = {https://doi.org/10.1038/s41598-022-19859-1},
	author = {Daniel Redondo-S{\'a}nchez and S{\'a}nchez, Maria-Jos{\'e} and Pablo Fern{\'a}ndez-Navarro and Rachet, Bernard and Luque-Fernandez, Miguel Angel}
}
@article {10.1210/clinem/dgac498,
	title = {The role of early pregnancy maternal pGCD59 levels in predicting neonatal hypoglycaemia- sub-analysis of the DALI study},
	journal = {The Journal of Clinical Endocrinology \& Metabolism},
	year = {2022},
	note = {dgac498},
	month = {09},
	abstract = {The aim of this study was to assess the association between early pregnancy maternal levels of plasma glycated CD59 (pGCD59) and neonatal hypoglycaemia (NH).This is an observational study of pregnant women with a pre-pregnancy body mass index (BMI) >= 29 kg/m2 screened for eligibility to participate in the Vitamin D and Lifestyle Intervention for Gestational Diabetes (DALI) trial. This analysis included 399 pregnancies. Levels of pGCD59, were measured in fasting maternal samples taken at the time of a 75 g, 2-hour oral glucose tolerance test (OGTT) performed in early pregnancy (\&lt;20 weeks). NH, the study outcome, was defined as a heel-prick capillary glucose level of less than 2.6 mmol/L within 48 h of delivery.We identified 30 infants with NH. Maternal levels of pGCD59 in early pregnancy, were positively associated with the prevalence of NH (ANOVA one-way, p-value \&lt;0.001). The odds of NH were higher in infants from mothers in the Tertile 3 of pGCD59 levels as compared to those from mothers in Tertile 1 (OR: 2.41, 95\% CI: 1.03{\textendash}5.63). However, this was attenuated when adjusted for maternal BMI (OR: 2.28 (95\% CI: 0.96{\textendash}5.43). The cross-validated area under the curve (AUC) was 0.64 (95\% CI: 0.54{\textendash}0.74), and adjusted for maternal BMI, age, and ethnicity, the AUC was 0.70 (95\% CI: 0.56{\textendash}0.78).Although pGCD59 levels in early pregnancy in women with BMI >=29 kg/m2 are associated with NH, our results indicate that this biomarker by itself is only a fair predictor of NH.},
	issn = {0021-972X},
	doi = {10.1210/clinem/dgac498},
	url = {https://doi.org/10.1210/clinem/dgac498},
	author = {Delia Bogdanet and Luque-Fernandez, Miguel Angel and Toth-Castillo, Michelle and Gernot Desoye and O{\textquoteright}Shea, Paula M and Dunne, Fidelma P and Halperin, Jose A and DALI Core Investigator Group}
}
@article {BOGDANET2022110023,
	title = {The utility of first trimester plasma glycated CD59 (pGCD59) in predicting gestational diabetes mellitus: a prospective study of non-diabetic pregnant women in Ireland},
	journal = {Diabetes Research and Clinical Practice},
	year = {2022},
	pages = {110023},
	abstract = {Aims To evaluate the ability of first trimester plasma glycated CD59 (pGCD59) to predict gestational diabetes mellitus (GDM) at 24-28 weeks of gestation. Methods Prospectively, in 378 pregnant women, GDM was diagnosed using the one step 2h 75g oral glucose tolerance test adjudicated by the World Health Organisation (WHO) 2013 criteria. The ability of pGCD59 to predict GDM was assessed using receiver operating characteristic (ROC) curves adjusted for maternal age, body mass index (BMI), maternal ethnicity, parity, previous GDM, family history of diabetes mellitus and week of gestation at time of pGCD59 sampling. Results pGCD59 generated an adjusted area under the curve (AUC) of a) 0.63 (95\%CI:0.56-0.70, p,
	keywords = {biomarker, gestational diabetes mellitus, prediction},
	issn = {0168-8227},
	doi = {https://doi.org/10.1016/j.diabres.2022.110023},
	url = {https://www.sciencedirect.com/science/article/pii/S0168822722008373},
	author = {Delia Bogdanet and Toth Castillo, Michelle and Doheny, Helen and Dervan, Louise and Luque-Fernandez, Miguel Angel and Halperin, Jose and Paula M. O{\textquoteright}Shea and Dunne, Fidelma P.}
}
@article {jcm11133895,
	title = {The Diagnostic Accuracy of Second Trimester Plasma Glycated CD59 (pGCD59) to Identify Women with Gestational Diabetes Mellitus Based on the 75 g OGTT Using the WHO Criteria: A Prospective Study of Non-Diabetic Pregnant Women in Ireland},
	journal = {Journal of Clinical Medicine},
	volume = {11},
	number = {13},
	year = {2022},
	abstract = {: The aim of this study was to evaluate the ability of second trimester plasma glycated CD59 (pGCD59), a novel biomarker, to predict the results of the 2 h 75 g oral glucose tolerance test at 24\&ndash;28 weeks of gestation, employing the 2013 World Health Organisation criteria. This was a prospective study of 378 pregnant women. The ability of pGCD59 to predict gestational diabetes (GDM) was assessed using adjusted ROC curves for maternal age, BMI, maternal ethnicity, parity, previous GDM, and family history of diabetes. The pGCD59 levels were significantly higher in women with GDM compared to women with normal glucose tolerance (p = 0.003). The pGCD59 generated an adjusted AUC for identifying GDM cases of 0.65 (95\% CI: 0.58\&ndash;0.71, p \&lt; 0.001). The pGCD59 predicted GDM status diagnosed by a fasting glucose value of 5.1 mmol/L with an adjusted AUC of 0.74 (95\%CI: 0.65\&ndash;0.81, p \&lt; 0.001). Analysis of BMI subgroups determined that pGCD59 generated the highest AUC in the 35 kg/m2 \&le; BMI \&lt; 40 kg/m2 (AUC: 0.84 95\%CI: 0.69\&ndash;0.98) and BMI \&ge; 40 kg/m2 (AUC: 0.96 95\%CI: 0.86\&ndash;0.99) categories. This study found that second trimester pGCD59 is a fair predictor of GDM status diagnosed by elevated fasting glucose independent of BMI and an excellent predictor of GDM in subjects with a very high BMI.},
	issn = {2077-0383},
	doi = {10.3390/jcm11133895},
	url = {https://www.mdpi.com/2077-0383/11/13/3895},
	author = {Delia Bogdanet and Toth Castillo, Michelle and Doheny, Helen and Dervan, Louise and Miguel-Angel Luque-Fernandez and Halperin, Jose A. and O{\textquoteright}Shea, Paula M. and Dunne, Fidelma P.}
}
@article {delta,
	title = {The Delta-Method and Influence Function in Medical Statistics: a Reproducible Tutorial},
	year = {2022},
	publisher = {arXiv},
	abstract = {:Approximate statistical inference via determination of the asymptotic distribution of a statistic is routinely used for inference in applied medical statistics (e.g. to estimate the standard error of the marginal or conditional risk ratio). One method for variance estimation is the classical Delta-method but there is a knowledge gap as this method is not routinely included in training for applied medical statistics and its uses are not widely understood. Given that a smooth function of an asymptotically normal estimator is also asymptotically normally distributed, the Delta-method allows approximating the large-sample variance of a function of an estimator with known large-sample properties. In a more general setting, it is a technique for approximating the variance of a functional (i.e., an estimand) that takes a function as an input and applies another function to it (e.g. the expectation function). Specifically, we may approximate the variance of the function using the functional Delta-method based on the influence function (IF). The IF explores how a functional ϕ(θ) changes in response to small perturbations in the sample distribution of the estimator and allows computing the empirical standard error of the distribution of the functional. The ongoing development of new methods and techniques may pose a challenge for applied statisticians who are interested in mastering the application of these methods. In this tutorial, we review the use of the classical and functional Delta-method and their links to the IF from a practical perspective. We illustrate the methods using a cancer epidemiology example and we provide reproducible and commented code in R and Python using symbolic programming. The code can be accessed at this https URL https://github.com/migariane/DeltaMethodInfluenceFunction},
	keywords = {FOS: Computer and information sciences, Methodology (stat.ME)},
	doi = {10.48550/ARXIV.2206.15310},
	url = {https://arxiv.org/abs/2206.15310},
	author = {Zepeda-Tello, Rodrigo and Schomaker, Michael and Maringe, Camille and Matthew J. Smith and Belot, Aurelien and Rachet, Bernard and Mireille E. Schnitzer and Luque-Fernandez, Miguel Angel}
}
@article {10.3389/ijph.2022.1604907,
	title = {The Management of the COVID-19 Pandemic Evidences the Need to Transform Spain{\textquoteright}s Public Health Education},
	journal = {International Journal of Public Health},
	volume = {67},
	year = {2022},
	issn = {1661-8564},
	doi = {10.3389/ijph.2022.1604907},
	url = {https://www.ssph-journal.org/articles/10.3389/ijph.2022.1604907},
	author = {Luque-Fernandez, Miguel Angel and Tobias, Aurelio}
}
@article {Andrewse054773,
	title = {Plasma-glycated CD59 as an early biomarker for gestational diabetes mellitus: prospective cohort study protocol},
	journal = {BMJ Open},
	volume = {12},
	number = {4},
	year = {2022},
	publisher = {British Medical Journal Publishing Group},
	abstract = {Introduction The significant maternal and neonatal outcomes of gestational diabetes mellitus (GDM) make it a major public health concern. Mothers with GDM are at greater risk of pregnancy complications and their offspring are at higher risk of diabetes and obesity. Currently, GDM is diagnosed with glucose load methods which are time-consuming and inconvenient to administer more than once during pregnancy; for this reason, there is a recognised need for a more accurate and simpler test for GDM. Previous studies indicate that plasma-glycated CD59 (pGCD59) is a novel biomarker for GDM. We present here the protocol of a prospective cohort study designed to (1) determine the accuracy of pGCD59 as an early, first trimester predictor of GDM and gestational impaired glucose tolerance and (2) assess the associations between pGCD59 levels and adverse maternal and neonatal outcomes.Methods and analysis We will obtain discarded plasma samples from pregnant women at two time points: first prenatal visit (usually \&lt;14 weeks gestation) and gestational weeks 24{\textendash}28. A study-specific medical record abstraction tool will be used to obtain relevant maternal and neonatal clinical data from the EPIC clinical database. The prevalence of GDM will be determined using standard of care glucose load test results. We will determine the sensitivity and specificity of pGCD59 to predict the diagnosis of GDM and gestational impaired glucose tolerance, as well as the associations between levels of pGCD59 and the prevalence of maternal and neonatal outcomes.Ethics and dissemination This study has been approved by the Mass General Brigham Institutional Review Board (protocol 2011P002254). The results of this study will be presented at international meetings and disseminated in peer-reviewed journals.},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2021-054773},
	url = {https://bmjopen.bmj.com/content/12/4/e054773},
	author = {Andrews, Chloe and Toth-Castillo, Michelle and Aktas, Huseyin and Luque-Fernandez, M.A. and Wong, Steven Koon and Sen, Sarbattama and Halperin, Jose}
}
@article {cite-key,
	title = {Bayesian variable selection and survival modeling: assessing the Most important comorbidities that impact lung and colorectal cancer survival in Spain},
	journal = {BMC Medical Research Methodology},
	volume = {22},
	number = {1},
	year = {2022},
	pages = {95},
	abstract = {Cancer survival represents one of the main indicators of interest in cancer epidemiology. However, the survival of cancer patients can be affected by several factors, such as comorbidities, that may interact with the cancer biology. Moreover, it is interesting to understand how different cancer sites and tumour stages are affected by different comorbidities. Identifying the comorbidities that affect cancer survival is thus of interest as it can be used to identify factors driving the survival of cancer patients. This information can also be used to identify vulnerable groups of patients with comorbidities that may lead to worst prognosis of cancer. We address these questions and propose a principled selection and evaluation of the effect of comorbidities on the overall survival of cancer patients. In the first step, we apply a Bayesian variable selection method that can be used to identify the comorbidities that predict overall survival. In the second step, we build a general Bayesian survival model that accounts for time-varying effects. In the third step, we derive several posterior predictive measures to quantify the effect of individual comorbidities on the population overall survival. We present applications to data on lung and colorectal cancers from two Spanish population-based cancer registries. The proposed methodology is implemented with a combination of the R-packages mombf and rstan. We provide the code for reproducibility at https://github.com/migariane/BayesVarImpComorbiCancer.},
	isbn = {1471-2288},
	doi = {10.1186/s12874-022-01582-0},
	url = {https://doi.org/10.1186/s12874-022-01582-0},
	author = {Francisco Javier Rubio and Alvares, Danilo and Redondo-Sanchez, Daniel and Marcos-Gragera, Rafael and S{\'a}nchez, Maria-Jose and Luque-Fernandez, Miguel Angel}
}
@article {LEE2022100363,
	title = {Cardiovascular diseases among diffuse large B-cell lymphoma long-term survivors in Asia: a multistate model study},
	journal = {ESMO Open},
	volume = {7},
	number = {1},
	year = {2022},
	pages = {100363},
	abstract = {Background We modeled the clinical course of a cohort of diffuse large B-cell lymphoma (DLBCL) patients with no prior cardiovascular diseases (CVDs) using a multistate modeling framework. Patients and methods Data on 2600 patients with DLBCL diagnosed between 2000 and 2018 and had received chemotherapy with or without radiotherapy were obtained from a population-wide electronic health database of Hong Kong. We used the Markov illness-death model to quantify the impact of doxorubicin and various risk factors (therapeutic exposure, demographic, comorbidities, cardiovascular risk factors, and lifestyle factors which included smoking) on the clinical course of DLBCL (transitions into incident CVD, lymphoma death, and other causes of death). Results A total of 613 (23.6\%) and 230 (8.8\%) of 2600 subjects died of lymphoma and developed incident CVD, respectively. Median follow-up was 7.0 years (interquartile range 3.8-10.8 years). Older ages [hazard ratio (HR) for >75 versus <=60 years 1.88; 95\% confidence interval (CI) 1.25-2.82 and HR for 61-75 versus <=60 years 1.60; 95\% CI 1.12-2.30], hypertension (HR 4.92; 95\% CI 2.61-9.26), diabetes (HR 1.43; 95\% CI 1.09-1.87), and baseline use of aspirin (HR 5.30; 95\% CI 3.93-7.16) were associated with an increased risk of incident CVD. In a subgroup of anticipated higher-risk patients (aged 61-75 years, smoked, had diabetes, and received doxorubicin), we found that they remained on average 7.9 (95\% CI 7.2-8.8) years in the DLBCL state and 0.1 (95\% CI 0.0-0.4) years in the CVD state, if they could be followed up for 10 years. The brief time in the CVD state is consistent with the high chance of death in patients who developed CVD. Other causes of death have overtaken DLBCL-related death after about 5~years. Conclusions In this Asian population-based cohort, we found that incident CVDs can occur soon after DLBCL treatment and continued to occur throughout survivorship. Clinicians are advised to balance the risks and benefits of treatment choices to minimize the risk of CVD.},
	keywords = {chemotherapy, diffuse large B-cell lymphoma, non-Hodgkin{\textquoteright}s lymphoma, radiotherapy, Survival},
	issn = {2059-7029},
	doi = {https://doi.org/10.1016/j.esmoop.2021.100363},
	url = {https://www.sciencedirect.com/science/article/pii/S2059702921003252},
	author = {Lee, S. F. and B.A. Vellayappan and L.C. Wong and C.L. Chiang and S.K. Chan and E.Y.-F. Wan and I.C.-K. Wong and P.C. Lambert and Rachet, B. and A.K. Ng and Luque-Fernandez, M.A.}
}
@article {Smithe049087,
	title = {Association between multimorbidity and socioeconomic deprivation on short-term mortality among patients with diffuse large B-cell or follicular lymphoma in England: a nationwide cohort study},
	journal = {BMJ Open},
	volume = {11},
	number = {11},
	year = {2021},
	publisher = {British Medical Journal Publishing Group},
	abstract = {Objectives We aimed to assess the association between multimorbidity and deprivation on short-term mortality among patients with diffuse large B-cell (DLBCL) and follicular lymphoma (FL) in England.Setting The association of multimorbidity and socioeconomic deprivation on survival among patients diagnosed with DLBCL and FL in England between 2005 and 2013. We linked the English population-based cancer registry with electronic health records databases and estimated adjusted mortality rate ratios by multimorbidity and deprivation status. Using flexible hazard-based regression models, we computed DLBCL and FL standardised mortality risk by deprivation and multimorbidity at 1 year.Results Overall, 41 422 patients aged 45{\textendash}99 years were diagnosed with DLBCL or FL in England during 2005{\textendash}2015. Most deprived patients with FL with multimorbidities had three times higher hazard of 1-year mortality (HR: 3.3, CI 2.48 to 4.28, p\&lt;0.001) than least deprived patients without comorbidity; among DLBCL, there was approximately twice the hazard (HR: 1.9, CI 1.70 to 2.07, p\&lt;0.001).Conclusions Multimorbidity, deprivation and their combination are strong and independent predictors of an increased short-term mortality risk among patients with DLBCL and FL in England. Public health measures targeting the reduction of multimorbidity among most deprived patients with DLBCL and FL are needed to reduce the short-term mortality gap.Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available via application to the Public Health England Office for Data Release, but restrictions apply to the availability of these data. No additional data available.},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2021-049087},
	url = {https://bmjopen.bmj.com/content/11/11/e049087},
	author = {Smith, Matthew James and Njagi, Edmund Njeru and Belot, Aurelien and Leyrat, Cl{\'e}mence and Bonaventure, Audrey and Majano, Sara Benitez and Rachet, Bernard and Luque-Fernandez, Miguel Angel}
}
@article {cancers13225805,
	title = {Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England},
	journal = {Cancers},
	volume = {13},
	number = {22},
	year = {2021},
	abstract = {(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients{\textquoteright} comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient{\textquoteright}s comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient{\textquoteright}s area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95\% confidence interval (CI): 1.18{\textendash}1.27) and 1.45 (95\% CI: 1.30{\textendash}1.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.},
	issn = {2072-6694},
	doi = {10.3390/cancers13225805},
	url = {https://www.mdpi.com/2072-6694/13/22/5805},
	author = {Smith, Matthew James and Belot, Aur{\'e}lien and Quartagno, Matteo and Miguel Angel Luque Fernandez and Bonaventure, Audrey and Gachau, Susan and Majano, Sara Benitez and Rachet, Bernard and Njagi, Edmund Njeru}
}
@article {https://doi.org/10.1002/sim.9234,
	title = {Introduction to computational causal inference using reproducible Stata, R, and Python code: A tutorial},
	journal = {Statistics in Medicine},
	volume = {n/a},
	number = {n/a},
	year = {2021},
	month = {29 Oct 2021},
	abstract = {
	Abstract The main purpose of many medical studies is to estimate the effects of a treatment or exposure on an outcome. However, it is not always possible to randomize the study participants to a particular treatment, therefore observational study designs may be used. There are major challenges with observational studies; one of which is confounding. Controlling for confounding is commonly performed by direct adjustment of measured confounders; although, sometimes this approach is suboptimal due to modeling assumptions and misspecification. Recent advances in the field of causal inference have dealt with confounding by building on classical standardization methods. However, these recent advances have progressed quickly with a relative paucity of computational-oriented applied tutorials contributing to some confusion in the use of these methods among applied researchers. In this tutorial, we show the computational implementation of different causal inference estimators from a historical perspective where new estimators were developed to overcome the limitations of the previous estimators (ie, nonparametric and parametric g-formula, inverse probability weighting, double-robust, and data-adaptive estimators). We illustrate the implementation of different methods using an empirical example from the Connors study based on intensive care medicine, and most importantly, we provide reproducible and commented code in Stata, R, and Python for researchers to adapt in their own observational study. The code can be accessed at



	Link to the GitHub Repo Including the CODE (Python, R and Stata)

},
	keywords = {causal inference, double-robust methods, g-formula, g-methods, inverse probability weighting, machine learning, Propensity Score, regression adjustment, targeted maximum likelihood estimation},
	doi = {https://doi.org/10.1002/sim.9234},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/sim.9234},
	author = {Matthew J. Smith and Mohammad A. Mansournia and Maringe, Camille and Paul N. Zivich and Stephen R. Cole and Leyrat, Cl{\'e}mence and Belot, Aur{\'e}lien and Rachet, Bernard and Luque-Fernandez, Miguel A.}
}
@article {Leee046618,
	title = {Trends in gender of authors of original research in oncology among major medical journals: a retrospective bibliometric study},
	journal = {BMJ Open},
	volume = {11},
	number = {10},
	year = {2021},
	publisher = {British Medical Journal Publishing Group},
	abstract = {Objective We evaluated the temporal trend in gender ratios of first and last authors in the field of oncological research published in major general medical and oncology journals and examined the gender pattern in coauthorship.Design We conducted a retrospective study in PubMed using the R package RISmed. We retrieved original research articles published in four general medical journals and six oncology specialty journals. These journals were selected based on their impact factors and popularity among oncologists. We identified the names of first and last authors from 1 January 2002 to 31 December 2019. The gender of the authors was identified and validated using the Gender API database (https://gender-api.com/).Primary and secondary outcome measures The percentages of first and last authors by gender and the gender ratios (male to female) and temporal trends in gender ratios of first and last authors were determined.Results We identified 34 624 research articles, in which 32 452 had the gender of both first and last authors identified. Among these 11 650 (33.6\%) had women as the first author and 7908 (22.8\%) as the last author, respectively. The proportion of female first and last authors increased from 26.6\% and 16.2\% in 2002, to 32.9\% and 27.5\% in 2019, respectively. However, the gender ratio (male to female) of first and last authors decreased by 1.5\% and 2.6\% per year, respectively, which were statistically significant (first author: incidence rate ratio (IRR) 0.98, 95\% CI 0.97 to 1.00; last author: IRR 0.97, 95\% CI 0.96 to 0.99). Male first and last authorship was the most common combination. Male{\textendash}female and female{\textendash}female pairs increased by 2.0\% and 5.0\%, respectively (IRR 1.02, 95\% CI 1.01 to 1.03 and IRR 1.05, 95\% CI 1.04 to 1.06, respectively).Conclusions The continued under-representation of women means that more efforts to address parity for advancement of women in academic oncology are needed.Data are available in a public, open access repository.},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2020-046618},
	url = {https://bmjopen.bmj.com/content/11/10/e046618},
	author = {Lee, Shing Fung and Redondo S{\'a}nchez, Daniel and S{\'a}nchez, Mar{\'{\i}a-Jos{\'e} and Gelaye, Bizu and Chiang, Chi Leung and Wong, Irene Oi Ling and Cheung, Denise Shuk Ting and Luque-Fernandez, Miguel Angel}
}
@article {10.1186/s12885-021-08801-9,
	title = {The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study},
	journal = {BMC Cancer},
	volume = {21},
	number = {1},
	year = {2021},
	pages = {1048},
	abstract = {Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or >= 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis. In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index. We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6\%), diabetes (20.7\%) and heart failure (16.8\%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40\% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95\%CI: 1.1{\textendash}1.7; aHR for multimorbidity: 1.4, 95\%CI: 1.1{\textendash}1.8), when relevant confounding factors were considered. The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain.},
	doi = {10.1186/s12885-021-08801-9},
	author = {Niksic, Maja and Redondo-Sanchez, Daniel and Chang, Yoe-Ling and RODRIGUEZ-BARRANCO, MIGUEL and Exposito-Hernandez, Jose and Marcos-Gragera, Rafael and Oliva-Poch, Ester and Bosch-Barrera, Joaquim and Sanchez, Maria-Jose and Luque-Fernandez, Miguel Angel}
}
@article {cite-key,
	title = {Socioeconomic inequalities in treatment and relative survival among patients with diffuse large B-cell lymphoma: a Hong Kong population-based study},
	journal = {Scientific Reports},
	volume = {11},
	number = {1},
	year = {2021},
	pages = {17950},
	abstract = {The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4017 patients with DLBCL, 2363 (58.8\%) patients received both chemotherapy and rituximab and 740 (18.4\%) patients received chemotherapy alone, while 1612 (40.1\%) and 914 (22.8\%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio $[$OR$]$ 0.44; 95\% CI 0.34{\textendash}0.57) and rituximab (OR 0.41; 95\% CI 0.32{\textendash}0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95\% CI 1.67{\textendash}3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients{\textquoteright}SES.},
	isbn = {2045-2322},
	doi = {10.1038/s41598-021-97455-5},
	url = {https://doi.org/10.1038/s41598-021-97455-5},
	author = {Lee, Shing Fung and Evens, Andrew M. and Ng, Andrea K. and Miguel-Angel Luque-Fernandez}
}
@article {cite-key,
	title = {Investigating the inequalities in route to diagnosis amongst patients with diffuse large B-cell or follicular lymphoma in England},
	journal = {British Journal of Cancer},
	year = {2021},
	abstract = {Diagnostic delay is associated with lower chances of cancer survival. Underlying comorbidities are known to affect the timely diagnosis of cancer. Diffuse large B-cell (DLBCL) and follicular lymphomas (FL) are primarily diagnosed amongst older patients, who are more likely to have comorbidities. Characteristics of clinical commissioning groups (CCG) are also known to impact diagnostic delay. We assess the association between comorbidities and diagnostic delay amongst patients with DLBCL or FL in England during 2005{\textendash}2013.},
	isbn = {1532-1827},
	doi = {10.1038/s41416-021-01523-6},
	url = {https://doi.org/10.1038/s41416-021-01523-6},
	author = {Matthew J. Smith and Luque-Fernandez, Miguel Angel and Belot, Aur{\'e}lien and Quartagno, Matteo and Bonaventure, Audrey and Majano, Sara Benitez and Rachet, Bernard and Njagi, Edmund Njeru}
}
@article {cancers13112820,
	title = {Lung, Breast and Colorectal Cancer Incidence by Socioeconomic Status in Spain: A Population-Based Multilevel Study},
	journal = {Cancers},
	volume = {13},
	number = {11},
	year = {2021},
	abstract = {Socioeconomic inequalities in cancer incidence are not well documented in southern Europe. We aim to study the association between socioeconomic status (SES) and colorectal, lung, and breast cancer incidence in Spain. We conducted a multilevel study using data from Spanish population-based cancer registries, including incident cases diagnosed for the period 2010{\textendash}2013 in nine Spanish provinces. We used Poisson mixed-effects models, including the census tract as a random intercept, to derive cancer incidence rate ratios by SES, adjusted for age and calendar year. Male adults with the lowest SES, compared to those with the highest SES, showed weak evidence of being at increased risk of lung cancer (risk ratio (RR): 1.18, 95\% CI: 0.94{\textendash}1.46) but showed moderate evidence of being at reduced risk of colorectal cancer (RR: 0.84, 95\% CI: 0.74{\textendash}0.97). Female adults with the lowest SES, compared to those with the highest SES, showed strong evidence of lower breast cancer incidence with 24\% decreased risk (RR: 0.76, 95\% CI: 0.68{\textendash}0.85). Among females, we did not find evidence of an association between SES and lung or colorectal cancer. The associations found between SES and cancer incidence in Spain are consistent with those obtained in other European countries.},
	issn = {2072-6694},
	doi = {10.3390/cancers13112820},
	url = {https://www.mdpi.com/2072-6694/13/11/2820},
	author = {Daniel Redondo-S{\'a}nchez and Marcos-Gragera, Rafael and Carulla, Mari{\`a} and Lopez de Munain, Arantza and Sabater Gregori, Consol and Jimenez Chillar{\'o}n, Rosario and Guevara, Marcela and Olivier Nu{\~n}ez and Pablo Fern{\'a}ndez-Navarro and Mar{\'\i}a-Jos{\'e} S{\'a}nchez and Luque-Fernandez, Miguel Angel}
}
@article {cancers13071514,
	title = {Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort},
	journal = {Cancers},
	volume = {13},
	number = {7},
	year = {2021},
	abstract = {We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the Townsend Deprivation Index. Among 18,917 participants with an incident malignancy in the UK Biobank cohort, 89 tested positive for COVID-19. The overall COVID-19 incidence was 4.7 cases per 1000 incident cancer patients (95\%CI 3.8{\textendash}5.8). Compared with the least deprived cancer patients, those living in the most deprived areas had an almost three times higher risk of testing positive (RR 2.6, 95\%CI 1.1{\textendash}5.8). Other independent risk factors were ethnic minority background, obesity, unemployment, smoking, and being diagnosed with a haematological cancer for less than five years. A consistent pattern of socioeconomic inequalities in COVID-19 among incident cancer patients in the UK highlights the need to prioritise the cancer patients living in the most deprived areas in vaccination planning. This socio-demographic profiling of vulnerable cancer patients at increased risk of infection can inform prevention strategies and policy improvements for the coming pandemic waves.},
	issn = {2072-6694},
	doi = {10.3390/cancers13071514},
	url = {https://www.mdpi.com/2072-6694/13/7/1514},
	author = {Lee, Shing Fung and Nik{\v s}i{\'c}, Maja and Rachet, Bernard and Sanchez, Maria-Jose and Luque-Fernandez, Miguel Angel}
}
@article {BOUVIER2021,
	title = {Differences in the management and survival of metastatic colorectal cancer in Europe. A population-based study},
	journal = {Digestive and Liver Disease},
	year = {2021},
	abstract = {Background The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using a flexible cumulative hazard model. Results Among the 13 227 patients with colorectal cancer diagnosed between 2010 and 2013 in cancer registries from 10 European countries, 3140 were metastatic. 62\% of metastatic patients received chemotherapy. Compared to Spain, the related adjusted odds ratios ranged from 0.7 to 4.0 (P,
	keywords = {colorectal cancer, Disease Management, Europe, metastasis, Registries, Survival},
	issn = {1590-8658},
	doi = {https://doi.org/10.1016/j.dld.2021.01.021},
	url = {https://www.sciencedirect.com/science/article/pii/S1590865821000360},
	author = {Anne-Marie Bouvier and Val{\'e}rie Jooste and Maria Jos{\'e} Sanchez-Perez and Maria Jos{\'e} Bento and Jessica Rocha Rodrigues and Marcos-Gragera, Rafael and Maria Carmen Carmona-Garcia and Luque-Fernandez, Miguel Angel and Pamela Minicozzi and V{\'e}ronique Bouvier and Kaire Innos and Milena Sant and L. Van Eycken and K. Henau and T. Grozeva and Z. Valerianova and K. Innos and M. M{\"a}gi and V. Bouvier and G. Launoy and M. Robaszkiewicz and A.M. Bouvier and V. Jooste and V. Babaev and A. Katalinic and E.J. {\'O}lafsd{\'o}ttir and L. Tryggvad{\'o}ttir and C. Amati and P. Baili and S. Bonfarnuzzo and C. Margutti and E. Meneghini and Minicozzi, P. and G. Moretti and Sant, M. and C. Cirilli and G. Carrozzi and E. Spata and R. Tumino and P. Giorgi Rossi and M. Vicentini and F. Stracci and F. Bianconi and P. Contiero and G. Tagliabue and W. Kycler and M. Oko and P. Macek and J. Smok-Kalwat and M. Bielska-Lasota and W. Kycler and M. Oko and M.J. Bento and J Rodrigues and A. Mayer-da-Silva and A. Miranda and M. Primic-{\v Z}akelj and K. Jarm and E. Almar and A. Mateos and J. Bidaurrazaga and De La Cruz, M. and C. Alberich and A. Torrella-Ramos and J.M. D{\'\i}az Garc{\'\i}a and AI Marcos-Navarro and C. Carmona-Garcia and R. Marcos-Gragera and Luque-Fernandez, M.A. and M.J. S{\'a}nchez-P{\'e}rez and E. Ardanaz and M. Guevara and C. Bouchardy and E. Fournier}
}
@article {10.1093/aje/kwab036,
	title = {Estimating the Marginal Causal Effect and Potential Impact of Waterpipe Smoking on Multiple Sclerosis Using Targeted Maximum Likelihood Estimation Method: a Large Population-Based Incident Case-Control Study},
	journal = {American Journal of Epidemiology},
	year = {2021},
	note = {kwab036},
	month = {02},
	abstract = {There are few if any reports regarding the role of lifetime waterpipe smoking in multiple sclerosis (MS) etiology. The authors investigated the association between waterpipe and MS, adjusted for confounders. This was a population-based incident case-control study conducted in Tehran, Iran. Cases (n=547) were 15{\textendash}50-year-old patients identified from the Iranian Multiple Sclerosis Society between 2013 and 2015. Population-based controls (n=1057) were 15{\textendash}50-year old recruited by random digit telephone dialing. A double robust estimator method known as targeted maximum likelihood estimator (TMLE) was used to estimate the marginal risk ratio and odds ratio between waterpipe and MS. The both estimated RR and OR was 1.70 (95\% CI: 1.34, 2.17). The population attributable fraction was 21.4\% (95\% CI: 4.0\%, 38.8\%). Subject to the limitations of case-control studies in interpreting associations causally, this study suggests that waterpipe use, or its strongly related but undetermined factors, increases the risk of MS. Further epidemiological studies including nested case-control studies are needed to confirm these results.},
	issn = {0002-9262},
	doi = {10.1093/aje/kwab036},
	url = {https://doi.org/10.1093/aje/kwab036},
	author = {Ibrahim Abdollahpour and Nedjat, Saharnaz and Almasi-Hashiani, Amir and Nazemipour, Maryam and Mohammad Ali Mansournia and Luque-Fernandez, Miguel Angel}
}
@webarticle {smith2020tutorial,
	title = {Tutorial: Introduction to computational causal inference using reproducible Stata, R and Python code},
	journal = {https://arxiv.org/abs/2012.09920},
	volume = {2020},
	number = {December-2020},
	year = {2020},
	abstract = {The purpose of many health studies is to estimate the effect of an exposure on an outcome. It is not always ethical to assign an exposure to individuals in randomised controlled trials, instead observational data and appropriate study design must be used. There are major challenges with observational studies, one of which is confounding that can lead to biased estimates of the causal effects. Controlling for confounding is commonly performed by simple adjustment for measured confounders; although, often this is not enough. Recent advances in the field of causal inference have dealt with confounding by building on classical standardisation methods. However, these recent advances have progressed quickly with a relative paucity of computational-oriented applied tutorials contributing to some confusion in the use of these methods among applied researchers. In this tutorial, we show the computational implementation of different causal inference estimators from a historical perspective where different estimators were developed to overcome the limitations of the previous one. Furthermore, we also briefly introduce the potential outcomes framework, illustrate the use of different methods using an illustration from the health care setting, and most importantly, we provide reproducible and commented code in Stata, R and Python for researchers to apply in their own observational study. The code can be accessed at https://github.com/migariane/TutorialCausalInferenceEstimators},
	url = {https://arxiv.org/abs/2012.09920},
	author = {Matthew J. Smith and Maringe, Camille and Rachet, Bernard and Mohammad A. Mansournia and Paul N. Zivich and Stephen R. Cole and Luque-Fernandez, Miguel Angel}
}
@article {Cano-Ibanez2020,
	title = {Maternal Dietary Patterns during Pregnancy and Their Association with Gestational Weight Gain and Nutrient Adequacy},
	journal = {International Journal of Environmental Research and Public Health 2020, Vol. 17, Page 7908},
	volume = {17},
	number = {21},
	year = {2020},
	month = {oct},
	pages = {7908},
	publisher = {Multidisciplinary Digital Publishing Institute},
	abstract = {Several epidemiologic studies have shown an association between Gestational Weight Gain (GWG) and offspring complications. The GWG is directly linked to maternal dietary intake and women\&rsquo;s nutritional status during pregnancy. The aim of this study was (1) to assess, in a sample of Spanish pregnant women, the association between maternal dietary patterns and GWG and (2) to assess maternal dietary patterns and nutrient adequate intake according to GWG. A retrospective study was conducted in a sample of 503 adult pregnant women in five hospitals in Eastern Andalusia (Spain). Data on demographic characteristics, anthropometric values, and dietary intake were collected from clinical records by trained midwives. Usual food intake was gathered through a validated Food Frequency Questionnaire (FFQ), and dietary patterns were obtained by principal component analysis. Nutrient adequacy was defined according to European dietary intake recommendations for pregnant women. Regression models adjusted by confounding factors were constructed to study the association between maternal dietary pattern and GWG, and maternal dietary patterns and nutritional adequacy. A negative association was found between GWG and the Mediterranean dietary pattern (crude \&beta; = \&minus;0.06, 95\% CI: \&minus;0.11, \&minus;0.04). Independent of maternal dietary pattern, nutrient adequacy of dietary fiber, vitamin B9, D, E, and iodine was related to a Mediterranean dietary pattern (p \textless 0.05). A Mediterranean dietary pattern is related to lower GWG and better nutrient adequacy. The promotion of healthy dietary behavior consistent with the general advice promoted by the Mediterranean Diet (based on legumes, vegetables, nuts, olive oil, and whole cereals) will offer healthful, sustainable, and practical strategies to control GWG and ensure adequate nutrient intake during pregnancy.},
	keywords = {gestational gain weight, maternal dietary patterns, offspring, Pregnancy},
	doi = {10.3390/IJERPH17217908},
	url = {https://www.mdpi.com/872216},
	author = {Cano-Ib{\'a}{\~n}ez, Naomi and Mart{\'\i}nez-Galiano, Juan Miguel and Luque-Fern{\'a}ndez, Miguel Angel and Mart{\'\i}n-Pel{\'a}ez, Sandra and Bueno-Cavanillas, Aurora and Delgado-Rodr{\'\i}guez, Miguel}
}
@article {10.1182/bloodadvances.2020002737,
	title = {Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong},
	journal = {Blood Advances},
	volume = {4},
	number = {20},
	year = {2020},
	month = {10},
	pages = {5107-5117},
	abstract = {Evidence regarding the dose-related impact of doxorubicin on subsequent cardiovascular diseases (CVDs) in Asian patients with diffuse large B-cell lymphoma (DLBCL) without preexisting CVDs is lacking. From a territory-wide electronic database in Hong Kong, we identified adults who were diagnosed with DLBCL and treated with chemotherapy between 2000 and 2018. We evaluated the patients for incident CVDs (including ischemic heart disease, heart failure, and cardiomyopathy). We evaluated the cause-specific cumulative incidence (csCI) of CVD with levels of doxorubicin exposure by using flexible parametric competing risk analysis and adjusting for demographics, comorbidities, therapeutic exposure, cardiovascular risk factors, and lifestyle factors. Controls were age- and sex-matched to DLBCL patients. We analyzed 2600 patients and 13 000 controls. The adjusted cause-specific hazard ratio (HR) for CVD in patients treated with gt;500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95\% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2\%, 11.3\%, and 12.8\% in patients vs 3.1\%, 4.4\%, and 5.2\% in controls, respectively. Hypertension (HR, 6.20; 95\% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P \&lt; .001 to .002) might confer a higher risk of subsequent CVDs. In this Hong Kong population-based study, doxorubicin exposure (absolute dose gt;500 mg), together with hypertension or baseline use of medication for cardiovascular risk factors, was found to be associated with an increase in csCIs of CVDs. Tailoring therapeutic strategies to underlying CVD risk factors and risk-adapted monitoring and follow-up of susceptible DLBCL patients are advisable.},
	issn = {2473-9529},
	doi = {10.1182/bloodadvances.2020002737},
	url = {https://doi.org/10.1182/bloodadvances.2020002737},
	author = {Lee, Shing Fung and Luque-Fernandez, Miguel Angel and Chen, Yu Hui and Paul J. Catalano and Chiang, Chi Leung and Wan, Eric Yuk-Fai and Wong, Ian Chi-Kei and Chen, Ming Hui and Ng, Andrea K.}
}
@article {NUNEZ2020101794,
	title = {Deprivation gap in colorectal cancer survival attributable to stage at diagnosis: A population-based study in Spain},
	journal = {Cancer Epidemiology},
	volume = {68},
	year = {2020},
	pages = {101794},
	abstract = {Objective Socioeconomic inequalities in colorectal cancer (CRC) survival are a major concern of the Spanish public health system. If these inequalities were mainly due to differences in stage at diagnosis, population-based screening programs might reduce them substantially. We aimed to determine to what extent adverse stage distribution contributed to survival inequalities in a Spanish region before the implementation of a CRC screening program. Methods We analyzed data from a population-based cohort study that included all patients living in a region of southern Spain with CRC diagnosed between 2004 and 2013. The European Deprivation Index was used to assign each patient a socioeconomic level based on their area of residence. The role of tumor stage in survival disparities between socioeconomic groups was assessed using a causal mediation analysis. Results A total of 2802 men and 1957 women were included in the study. For men, the adjusted difference in deaths between the most deprived and the most affluent areas was 131 deaths per 1000 person-years by the first year after diagnosis. Of these deaths, 42 (per 1000 person-years) were attributable to differences in stage at diagnosis. No socioeconomic disparities in survival were detected among female patients. Conclusions In this study, we mainly detected socioeconomic disparities in short term survival of male patients. More than two thirds of these inequalities could not be attributed to differences in stage at diagnosis. Our results suggest that in addition to a screening program, other public health interventions are necessary to reduce the deprivation gap in survival.},
	keywords = {Causal mediation, colorectal cancer, Deprivation, Net survival, Population-based study},
	issn = {1877-7821},
	doi = {https://doi.org/10.1016/j.canep.2020.101794},
	url = {http://www.sciencedirect.com/science/article/pii/S1877782120301284},
	author = {Olivier Nu{\~n}ez and Miguel Rodr{\'\i}guez Barranco and Pablo Fern{\'a}ndez-Navarro and Daniel Redondo Sanchez and Luque-Fernandez, Miguel Angel and Marina Poll{\'a}n Santamar{\'\i}a and Mar{\'\i}a-Jos{\'e} S{\'a}nchez}
}
@article {Luque-Fernandez2020,
	title = {Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study},
	journal = {Clinical Epidemiology},
	volume = {Volume 12},
	year = {2020},
	month = {jul},
	pages = {797{\textendash}806},
	publisher = {Dove Press},
	abstract = {Background: Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain.Methods: We conducted a multilevel population-based cohort study, including CRC cases for the period 2011{\textendash} 2013. The study time-to-event outcome was death, and the primary exposure was CRC patients{\textquoteright} socioeconomic status assessed by the Spanish deprivation index at the census tract level. We used a mixed-effects flexible hazard model, including census tract as a random intercept, to derive overall survival estimates by deprivation.Results: Among 3589 CRC patients and 12,148 person-years at risk (pyr), 964 patients died before the end of the follow-up. Mortality by deprivation showed the highest mortality rate for the most deprived group (96.2 per 1000 pyr, 95\% CI: 84.0{\textendash} 110.2). After adjusting for sex, age, cancer stage, and the area of residence, the most deprived had a 60\% higher excess mortality risk than the less deprived group (excess mortality risk ratio: 1.6, 95\% CI: 1.1{\textendash} 2.3).Conclusions: We found a consistent association between deprivation and CRC excess mortality and survival. The reasons behind these inequalities need further investigation in order to improve equality cancer outcomes in all social groups.Keywords: socioeconomic inequalities, colorectal cancer, survival, population-based epidemiology, epidemiological methods, multilevel},
	issn = {1179-1349},
	doi = {10.2147/CLEP.S261355},
	url = {https://www.dovepress.com/socioeconomic-inequalities-in-colorectal-cancer-survival-in-southern-s-peer-reviewed-article-CLEP},
	author = {Luque-Fernandez, Miguel Angel and Redondo-Sanchez, Daniel and RODRIGUEZ-BARRANCO, MIGUEL and Yoe-Ling, Chang-Chan and Salamanca-Fernandez, Elena and Nunez, Olivier and Fernandez-Navarro, Pablo and Pollan, Marina and Sanchez, Maria-Jose}
}
@article {655786,
	title = {Protocolo del Estudio Poblacional Multinivel de las Desigualdades Socioecon{\'o}micas en la Distribuci{\'o}n Geogr{\'a}fica de la Incidencia, la Mortalidad y la Supervivencia Neta del C{\'a}ncer en Espa{\~n}a: Estudio DESOCANES},
	journal = {Gaceta Sanitaria},
	year = {2020},
	type = {10.1016/j.gaceta.2020.02.015},
	abstract = {La incidencia y la mortalidad brindan informaci{\'o}n sobre la carga de la morbilidad del c{\'a}ncer y los a{\~n}os potenciales de vida perdidos debido al c{\'a}ncer. Se ha desarrollado el {\'I}ndice de Privaci{\'o}n (IP) como una medida estandarizada para medir la privaci{\'o}n socioecon{\'o}mica en Espa{\~n}a a nivel de secci{\'o}n censal. Adem{\'a}s, se puede combinar la informaci{\'o}n del IP con variables ecol{\'o}gicas poblacionales y los datos de los Estudios Europeos de Alta Resoluci{\'o}n en C{\'a}ncer. El objetivo de este estudio es caracterizar las desigualdades socioecon{\'o}micas en la incidencia, el exceso de mortalidad, la mortalidad prematura y la supervivencia neta para tres de los c{\'a}nceres m{\'a}s incidentes (pulm{\'o}n, colon-recto y mama) en Espa{\~n}a usando el IP. Este estudio nacional multinivel de base poblacional evaluar{\'a} el impacto de las desigualdades socioecon{\'o}micas. Se usar{\'a}n el an{\'a}lisis espacial, la modelizaci{\'o}n multinivel, la supervivencia neta y la evaluaci{\'o}n del impacto econ{\'o}mico. Los resultados ser{\'a}n {\'u}tiles para el apoyo a la toma de decisiones y la planificaci{\'o}n y la gesti{\'o}n de intervenciones en salud p{\'u}blica destinadas a reducir el impacto de las desigualdades socioecon{\'o}micas en el diagn{\'o}stico y el pron{\'o}stico de los pacientes de c{\'a}ncer en Espa{\~n}a. ER},
	isbn = {02139111},
	author = {Miguel {\'A}ngel Luque-Fern{\'a}ndez and Daniel Redondo-S{\'a}nchez and Fern{\'a}ndez, Pablo and Elena Salamanca-Fern{\'a}ndez and Marcos-Gragera, Rafael and Guevara, Marcela and Carulla Arest{\'e}, Mari{\`a} and Jim{\'e}nez, Rosario and N{\'u}{\~n}ez, Olivier and Sabater, Consol and L{\'o}pez de Munain Marqu{\'e}s, Arantxa and Chirlaque, Mar{\'\i}a Dolores and Mateos, Antonio and Miguel Rodr{\'\i}guez-Barranco and Esp{\'\i}n Balbino, Jaime and Poll{\'a}n, Marina and Mar{\'\i}a-Jos{\'e} S{\'a}nchez}
}
@article {Pazosbjophthalmol-2020-316296,
	title = {SD-OCT peripapillary nerve fibre layer and ganglion cell complex parameters in glaucoma: principal component analysis},
	journal = {British Journal of Ophthalmology},
	year = {2020},
	publisher = {BMJ Publishing Group Ltd},
	abstract = {{Background/aims To identify objective glaucoma-related structural features based on peripapillary (p) and macular (m) spectral domain optical coherence tomography (SD-OCT) parameters and assess their discriminative ability between healthy and glaucoma patients.Methods Two hundred and sixty eyes (91 controls and 169 glaucoma) were included in this prospective study. After a complete examination, all participants underwent the posterior pole and the peripapillary retinal nerve fibre layer (pRNFL) protocols of the Spectralis SD-OCT. Principal component analysis (PCA), a data reduction method, was applied to identify and characterise the main information provided by the ganglion cell complex (GCC). The discriminative ability between healthy and glaucomatous eyes of the first principal components (PCs) was compared with that of conventional SD-OCT parameters (pRNFL, macular RNFL (mRNFL), macular ganglion cell layer (mGCL)and macular inner plexiform layer (mIPL)) using 10-fold cross-validated areas under the curve (AUC).Results The first PC explained 58\% of the total information contained in the GCC and the pRNFL parameters and was the result of a general combination of almost all variables studied (diffuse distribution). Other PCs were driven mainly by pRNFL and mRNFL measurements. PCs and pRNFL had similar AUC (0.95 vs 0.96},
	issn = {0007-1161},
	doi = {10.1136/bjophthalmol-2020-316296},
	url = {https://bjo.bmj.com/content/early/2020/06/03/bjophthalmol-2020-316296},
	author = {Pazos, Marta and Biarnes, Marc and Blasco-Alberto, Andres and Dyrda, Agnieszka and Luque-Fernandez, Miguel Angel and G{\'o}mez, Alicia and Mora, Clara and Milla, Elena and Muniesa, M Jesus and Anton, Alfonso and Diaz-Aleman, Valentin Tinguaro}
}
@article {cite-key,
	title = {Prediction model for short-term mortality after palliative radiotherapy for patients having advanced cancer: a cohort study from routine electronic medical data},
	journal = {Scientific Reports},
	volume = {10},
	number = {1},
	year = {2020},
	pages = {5779},
	abstract = {{We developed a predictive score system for 30-day mortality after palliative radiotherapy by using predictors from routine electronic medical record. Patients with metastatic cancer receiving first course palliative radiotherapy from 1 July, 2007 to 31 December, 2017 were identified. 30-day mortality odds ratios and probabilities of the death predictive score were obtained using multivariable logistic regression model. Overall, 5,795 patients participated. Median follow-up was 39.6 months (range, 24.5{\textendash}69.3) for all surviving patients. 5,290 patients died over a median 110 days, of whom 995 (17.2\%) died within 30 days of radiotherapy commencement. The most important mortality predictors were primary lung cancer (odds ratio: 1.73, 95\% confidence interval: 1.47{\textendash}2.04) and log peripheral blood neutrophil lymphocyte ratio (odds ratio: 1.71, 95\% confidence interval: 1.52{\textendash}1.92). The developed predictive scoring system had 10 predictor variables and 20 points. The cross-validated area under curve was 0.81 (95\% confidence interval: 0.79{\textendash}0.82). The calibration suggested a reasonably good fit for the model (likelihood-ratio statistic: 2.81},
	isbn = {2045-2322},
	doi = {10.1038/s41598-020-62826-x},
	url = {https://doi.org/10.1038/s41598-020-62826-x},
	author = {Lee, Shing Fung and Luk, Hollis and Wong, Aray and Ng, Chuk Kwan and Wong, Frank Chi Sing and Luque-Fernandez, Miguel Angel}
}
@article {LUQUEFERNANDEZ20204,
	title = {Multimorbidity and short-term overall mortality among colorectal cancer patients in Spain: A population-based cohort study},
	journal = {European Journal of Cancer},
	volume = {129},
	year = {2020},
	pages = {4 - 14},
	abstract = {Background Numerous studies have analysed the effect of comorbidity on cancer outcomes, but evidence on the association between multimorbidity and short-term mortality among colorectal cancer patients is limited. We aimed to assess this association and the most frequent patterns of multimorbidity associated with a higher short-term mortality risk among colorectal cancer patients in Spain. Methods Data were obtained from two Spanish population-based cancer registries and electronic health records. We estimated the unadjusted cumulative incidence of death by comorbidity status at 6 months and 1 year. We used a flexible parametric model to derive the excess mortality hazard ratios (HRs) for multimorbidity after adjusting for sex, age at diagnosis, cancer stage and treatment. We estimated the adjusted cumulative incidence of death by comorbidity status and identified multimorbidity patterns. Results Among the study participants, 1,048 cases were diagnosed with cancers of the colon and rectum, 2 cases with cancer of the anus with overlapping sites of the rectum and 11 cases with anal adenocarcinomas but treated as colorectal cancer patients. Among 1,061 colorectal cancer patients, 171 (16.2\%) died before 6 months, 246 (23.3\%) died before the 1-year follow-up, and 324 (30.5\%) had multimorbidity. Patients with multimorbidity had two times higher mortality risk than those without comorbidities at 6 months (adjusted HR: 2.04; 95\% confidence interval [CI]: 1.30{\textendash}3.20, p~=~0.002). The most frequent multimorbidity pattern was congestive heart failure~+~diabetes. However, patients with rheumatologic disease~+~diabetes had two times higher 1-year mortality risk than those without comorbidities (HR: 2.23; 95\% CI: 1.23{\textendash}4.07, p~=~0.008). Conclusions Multimorbidity was a strong independent predictor of short-term mortality at 6 months and 1 year among the colorectal cancer patients in Spain. The identified multimorbidity pattern was consistent. Our findings might help identify patients at a higher risk for poor cancer and treatment outcomes.},
	keywords = {cancer, Cancer epidemiology, colorectal cancer, Multimorbidity, Survival Analysis},
	issn = {0959-8049},
	doi = {https://doi.org/10.1016/j.ejca.2020.01.021},
	url = {http://www.sciencedirect.com/science/article/pii/S0959804920300368},
	author = {Luque-Fernandez, Miguel A. and Karen Gon{\c c}alves and Elena Salamanca-Fern{\'a}ndez and Redondo-Sanchez, Daniel and Shing F. Lee and Miguel Rodr{\'\i}guez-Barranco and Ma C. Carmona-Garc{\'\i}a and Marcos-Gragera, Rafael and Mar{\'\i}a-Jos{\'e} S{\'a}nchez}
}
@article { ref10.1210/clinem/dgaa087,
	title = {Plasma Glycated CD59 Predicts Early Gestational Diabetes and Large for Gestational Age Newborns},
	journal = {The Journal of Clinical Endocrinology \&$\#$38; Metabolism},
	year = {2020},
	month = {02},
	abstract = {Gestational diabetes mellitus (GDM) diagnosed in early pregnancy is a health care challenge because it increases the risk of adverse outcomes. Plasma glycated CD59 (pGCD59) is an emerging biomarker for diabetes and GDM. The aim of this study was to assess the performance of pGCD59 as a biomarker of early GDM and its association with delivering a large for gestational age (LGA) infant.Study: Blood levels of pGCD59{\^A} were measured in samples from 693 obese women (BMI \&gt;29) undergoing a 75g, 2-hour oral glucose tolerance test (OGTT) at \&lt;20 weeks gestation in the DALI study: the main analyses included 486 subjects who had normal glucose tolerance throughout the pregnancy, 207 who met criteria for GDM at \&lt;20 weeks and 77 diagnosed with GDM at pregnancy week 24-28.Reference tests: 75g, 2-hour OGTT adjudicated based on IADPSG criteria.Index test: pGCD59 ELISA.Primary aim: To assess the performance of pGCD59 to identify women with GDM in early pregnancy (GDM\&lt;20).Secondary aim: To assess the association of pGCD59 with LGA and potentially others adverse neonatal outcomes linked to GDM. Mean pGCD59 levels were significantly higher (p-value \&lt;0.001) in women with GDM\&lt;20 (3.9 {\textpm}1.1 SPU) than in those without (2.7 {\textpm}0.7 SPU). pGCD59 accurately identified GDM in early pregnancy with an AUC ROC curves of 0.86 (95\% CI: 0.83-0.90). One unit increase in maternal pGCD59 level was associated with 36\% increased odds of delivering a large for gestational age (LGA) infant (odds ratio for LGA vs non-LGA infant: 1.4; 95\%CI: 1.1-1.8; p-value: 0.016). Our results indicate that pGCD59 is a simple and accurate biomarker for detection of GDM in early pregnancy and risk assessment of LGA.},
	issn = {0021-972X},
	doi = {10.1210/clinem/dgaa087},
	author = {Ma, Dongdong and Luque-Fernandez, Miguel Angel and Delia Bogdanet and Gernot Desoye and Fidelma Dunne and Halperin, Jose A}
}
@article {cite-key,
	title = {Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers},
	journal = {BMC Cancer},
	volume = {20},
	number = {1},
	year = {2020},
	pages = {2},
	abstract = {The presence of comorbidity affects the care of cancer patients, many of whom are living with multiple comorbidities. The prevalence of cancer comorbidity, beyond summary metrics, is not well known. This study aims to estimate the prevalence of comorbid conditions among cancer patients in England, and describe the association between cancer comorbidity and socio-economic position, using population-based electronic health records.},
	isbn = {1471-2407},
	doi = {10.1186/s12885-019-6472-9},
	url = {https://doi.org/10.1186/s12885-019-6472-9},
	author = {Fowler, Helen and Belot, Aurelien and Ellis, Libby and Maringe, Camille and Luque-Fernandez, Miguel Angel and Njagi, Edmund Njeru and Navani, Neal and Sarfati, Diana and Rachet, Bernard}
}
@article { Luque-FernandezMA2020,
	title = {Multimorbidity by Patient and Tumor Factors and Time-to-Surgery Among Colorectal Cancer Patients in Spain : A Population-Based Study},
	journal = {Clinical Epidemiology},
	volume = {2020:12},
	year = {2020},
	pages = {31-40},
	abstract = {Background: Cancer treatment and outcomes can be influenced by tumor characteristics, patient overall health status, and comorbidities. While previous studies have analyzed the influence of comorbidity on cancer outcomes, limited information is available regarding factors associated with the increased prevalence of comorbidities and multimorbidity among patients with colorectal cancer in Spain.Patients and Methods: This cross-sectional study obtained data from all colorectal cancer cases diagnosed in two Spanish provinces in 2011 from two population-based cancer registries and electronic health records. We calculated the prevalence of comorbidities according to patient and tumor factors, identified factors associated with an increased prevalence of comorbidity and multimorbidity, analyzed the association between comorbidities and time-to-surgery, and developed an interactive web application (https://comcor.netlify.com/).Results: The most common comorbidities were diabetes (23.6\%), chronic obstructive pulmonary disease (17.2\%), and congestive heart failure (14.5\%). Among all comorbidities, 52\% of patients were diagnosed at more advanced stages (stage III/IV). Patients with advanced age, restricted performance status or who were disabled, obese, and smokers had a higher prevalence of multimorbidity. Patients with multimorbidity had a longer time-to-surgery than those without comorbidity (17 days, 95\% confidence interval: 3{\textendash} 29 days).Conclusion: We identified a consistent pattern of factors associated with a higher prevalence of comorbidities and multimorbidity at diagnosis and an increased time-to-surgery among patients with colorectal cancer with multimorbidity in Spain. This pattern may provide insights for further etiological and preventive research and help to identify patients at a higher risk for poorer cancer outcomes and suboptimal treatment.},
	doi = {https://doi.org/10.2147/CLEP.S229935},
	author = {Luque-Fernandez, M.A. and D Redondo-Sanchez and S F Lee and M Rodriguez-Barranco and M Carmona-Garcia and R Marcos-Gragera and M J Sanchez}
}
@article {cite-key,
	title = {Bayesian smoothed small-areas analysis of urban inequalities in fertility across 1999{\textendash}2013},
	journal = {Fertility Research and Practice},
	volume = {5},
	number = {1},
	year = {2019},
	pages = {17},
	abstract = {Since the 2008 economic crisis in Spain, overall fertility has continued to decrease, while urban inequalities have increased. There is a general lack of studies of fertility patterns in small-areas of Spanish cities. We explored the effects of the economic crisis on fertility during three time periods in urban settings in Spain.},
	isbn = {2054-7099},
	doi = {10.1186/s40738-019-0066-8},
	url = {https://doi.org/10.1186/s40738-019-0066-8},
	author = {Le{\'o}n-G{\'o}mez, Brenda Biaani and Gotsens, Merc{\`e} and Mari-Dell{\textquoteright}Olmo, Marc and Dom{\i}nguez-Berj{\'o}n, Ma. Felicitas and Luque-Fernandez, Miguel {\'A}ngel and Unai Martin and Rodr{\i}guez-Sanz, Maica and P{\'e}rez, Gloria}
}
@article {cite-key,
	title = {Sexual violence and eclampsia: analysis of data from Demographic and Health Surveys from seven low- and middle-income countries},
	journal = {Journal of Global Health},
	volume = {9},
	number = {2},
	year = {2019},
	month = {12},
	pages = {020434},
	publisher = {Edinburgh University Global Health Society},
	abstract = {BACKGROUND: Scientific literature has provided clear evidence of the profound impact of sexual violence on women{\textquoteright}s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia. METHODS: We considered all the seven Demographic and Health Surveys (DHS) that included data on sexual violence and on signs and symptoms suggestive of eclampsia for women of reproductive age (15-49 years). We computed unadjusted and adjusted odds ratios (OR) to evaluate the risk of suggestive eclampsia by ever subjected to sexual violence. A sensitivity analysis was conducted restricting the study population to women who had their last live birth over the 12 months before the interview. RESULTS: Self-reported experience of sexual violence ranged from 3.7\% in Mali to 9.2\% in India while prevalence of women reporting signs and symptoms compatible with eclampsia ranged from 14.3\% in Afghanistan to 0.7\% in the Philippines. Reported sexual violence was associated with a 2-fold increased odd of signs and symptoms suggestive of eclampsia in the pooled analysis. The sensitivity analysis confirmed the strength of the association between sexual violence and eclampsia in Afghanistan and in India. CONCLUSIONS: Women and girls in low-and-middle-income countries are at high risk of sexual violence, which may represent a risk factor for hypertensive obstetric complication. Accurate counseling by health care providers during antenatal care consultations may represent an important opportunity to prevent adverse outcomes during pregnancy.},
	isbn = {2047-2978; 2047-2986},
	author = {Bellizzi, Saverio and Nivoli, Alessandra and Salaris, Paola and Ronzoni, Anna Rita and Pichierri, Giuseppe and Palestra, Francesca and Wazwaz, Ola and Luque-Fernandez, Miguel Angel}
}
@article {cite-key,
	title = {Benign Adrenocortical Tumors and the Detection of Nonadrenal Neoplasia},
	journal = {International Journal of Endocrinology},
	volume = {2019},
	year = {2019},
	pages = {9},
	type = {10.1155/2019/9035407},
	abstract = {Context. Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia. Objective. To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected. Design and Participants. Case-control study of patients with benign adrenocortical tumors (cases; n = 400) and normal adrenal glands (controls; n = 400), who underwent repeated abdominal cross-sectional imaging. Main Outcomes. Primary analyses: association between case-control status and benign abdominal neoplasia detected via cross-sectional imaging. Secondary analyses: association between case-control status and tumors detected via other imaging modalities. Results. The mean interval of abdominal imaging was 4.7 (SD = 3.8) years for cases and 5.9 (4.8) years for controls. Cases were more likely to have detected intraductal papillary mucinous neoplasms (IPMNs) of the pancreas (8.5\% vs. 4.5\%, adjusted OR = 2.22, 95\% CI (1.11, 4.63)) compared with controls. In secondary analyses, cases were more likely to have detected thyroid nodules (25.5\% vs. 17.0\%, adjusted OR = 1.77, 95\% CI (1.15, 2.74)), hyperparathyroidism or parathyroid adenomas (3.5\% vs. 1.3\%, adjusted OR = 3.00, 95\% CI (1.00, 11.64)), benign breast masses (6.0\% vs. 3.3\%, adjusted OR = 3.25, 95\% CI (1.28, 8.78)), and benign prostatic hyperplasia (20.5\% vs. 5.3\%, adjusted OR = 3.20, 95\% CI (1.14, 10.60)). Using a composite outcome, cases had higher odds of detection of the composite of IPMN, thyroid nodules, parathyroid tumors, benign breast masses, and prostate hyperplasia (adjusted OR = 2.36, 95\% CI: 1.60, 3.50) when compared with controls. Conclusions. Patients with benign adrenocortical tumors had higher odds of detected pancreatic IPMN, as well as thyroid nodules, parathyroid tumors, benign breast masses, and prostate hyperplasia compared with patients with normal adrenal glands. These associations may have important implications for patient care and healthcare economics, regardless of whether they reflect incidental discoveries due to imaging detection or frequency bias, or a common risk for developing multiple neoplasia.},
	url = {https://doi.org/10.1155/2019/9035407 },
	author = {Hao, Meng and Luque-Fernandez, Miguel Angel and Lopez, Diana and Cote, Kathryn and Newfield, Jessica and Connors, Molly and Vaidya, Anand}
}
@article {PUIGBARRACHINA2019,
	title = {Decline in fertility induced by economic recession in Spain},
	journal = {Gaceta Sanitaria},
	year = {2019},
	abstract = {Objective To describe trends in fertility in Spain before (pre-recession; 1998-2008) and during (recession period; 2009-2013) the economic crisis of 2008, taking into account women{\textquoteright}s age and regional unemployment in 2010. Method The study consisted of a panel design including cross-sectional ecological data for the 17 regions of Spain. We describe fertility trends in Spain in two time periods, pre-recession (1998-2008) and recession (2009-2013). We used a cross-sectional, ecological study of Spanish-born women to calculate changes in fertility rates for each period using a linear regression model adjusted for year, period, and interaction between them. Results We found that compared to the pre-recession period, the fertility rate in Spain generally decreased during the economic recession. However, in some regions, such as the Canary Islands, this decrease began before the onset of the recession, while in other regions, such as the Basque country, the fertility rate continued to grow until 2011. The effects of the recession on the fertility rate are clearly observed in women aged 30-34 years. Conclusions The current economic recession has disrupted the positive trend in fertility that began at the start of this century. Since Spain already had very low fertility rates, the further decline caused by the economic recession could jeopardize the sustainability of welfare-state systems. Resumen Objetivo Describir las tendencias de la fecundidad en Espa{\~n}a en la {\'e}poca precrisis (1998-2008) y durante la crisis (2009-2013) econ{\'o}mica, teniendo en cuenta la edad de las mujeres y el desempleo regional en 2010. M{\'e}todo Se utiliza un dise{\~n}o panel que incluye datos ecol{\'o}gicos transversales para las 17 comunidades aut{\'o}nomas de Espa{\~n}a. Se describen las tendencias de fecundidad en los dos periodos. Para calcular los cambios en las tasas de fecundidad se utiliza un modelo de regresi{\'o}n lineal ajustado por a{\~n}o, periodo e interacci{\'o}n de ellas. Resultados En comparaci{\'o}n con el periodo anterior, la tasa de fecundidad global en Espa{\~n}a disminuy{\'o} durante la crisis econ{\'o}mica. Sin embargo, en algunas comunidades, como las Islas Canarias, esta disminuci{\'o}n comenz{\'o} antes del inicio de la crisis, mientras que en otras, como el Pa{\'\i}s Vasco, la tasa de fecundidad continu{\'o} creciendo hasta 2011. Los efectos de la crisis en la fecundidad se observan claramente en mujeres de 30 a 34 a{\~n}os. Conclusiones La crisis econ{\'o}mica actual ha interrumpido la tendencia positiva en la fecundidad que comenz{\'o} a principios de este siglo. Dado que Espa{\~n}a ya ten{\'\i}a tasas de fecundidad muy bajas, el descenso causado por la crisis econ{\'o}mica podr{\'\i}a poner en peligro la sostenibilidad de los sistemas de bienestar social.},
	keywords = {Crisis econ{\'o}mica, Desempleo, Economic recession, Espa{\~n}a, Fecundidad, Fertility, Modelos de regresi{\'o}n, spain, Statistical regression, Unemployment},
	issn = {0213-9111},
	doi = {https://doi.org/10.1016/j.gaceta.2019.05.011},
	url = {http://www.sciencedirect.com/science/article/pii/S0213911119301554},
	author = {Puig-Barrachina, Vanessa and Rodr{\'\i}guez-Sanz, Maica and Mar{\'\i}a Felicitas Dom{\'\i}nguez-Berj{\'o}n and Unai Mart{\'\i}n and Miguel {\'A}ngel Luque and Miguel Ruiz and Gl{\`o}ria Perez}
}
@article {doi:10.1177/1536867X19874237,
	title = {cvauroc: Command to compute cross-validated area under the curve for ROC analysis after predictive modeling for binary outcomes},
	journal = {The Stata Journal},
	volume = {19},
	number = {3},
	year = {2019},
	pages = {615-625},
	abstract = {Receiver operating characteristic (ROC) analysis is used for comparing predictive models in both model selection and model evaluation. ROC analysis is often applied in clinical medicine and social science to assess the tradeoff between model sensitivity and specificity. After fitting a binary logistic or probit regression model with a set of independent variables, the predictive performance of this set of variables can be assessed by the area under the curve (AUC) from an ROC curve. An important aspect of predictive modeling (regardless of model type) is the ability of a model to generalize to new cases. Evaluating the predictive performance (AUC) of a set of independent variables using all cases from the original analysis sample often results in an overly optimistic estimate of predictive performance. One can use K-fold cross-validation to generate a more realistic estimate of predictive performance in situations with a small number of observations. AUC is estimated iteratively for k samples (the {\textquotedblleft}test{\textquotedblright} samples) that are independent of the sample used to predict the dependent variable (the {\textquotedblleft}training{\textquotedblright} sample). cvauroc implements k-fold cross-validation for the AUC for a binary outcome after fitting a logit or probit regression model, averaging the AUCs corresponding to each fold, and bootstrapping the cross-validated AUC to obtain statistical inference and 95\% confidence intervals. Furthermore, cvauroc optionally provides the cross-validated fitted probabilities for the dependent variable or outcome, contained in a new variable named \_fit; the sensitivity and specificity for each of the levels of the predicted outcome, contained in two new variables named \_sen and \_spe; and the plot of the mean cross-validated AUC and k-fold ROC curves.},
	doi = {10.1177/1536867X19874237},
	url = {https://doi.org/10.1177/1536867X19874237},
	author = {Luque-Fernandez, Miguel Angel and Daniel Redondo-S{\'a}nchez and Maringe, Camille}
}
@article {doi:10.1002/sim.8340,
	title = {Using longitudinal targeted maximum likelihood estimation in complex settings with dynamic interventions},
	journal = {Statistics in Medicine},
	year = {2019},
	abstract = {Longitudinal targeted maximum likelihood estimation (LTMLE) has very rarely been used to estimate dynamic treatment effects in the context of time-dependent confounding affected by prior treatment when faced with long follow-up times, multiple time-varying confounders, and complex associational relationships simultaneously. Reasons for this include the potential computational burden, technical challenges, restricted modeling options for long follow-up times, and limited practical guidance in the literature. However, LTMLE has desirable asymptotic properties, ie, it is doubly robust, and can yield valid inference when used in conjunction with machine learning. It also has the advantage of easy-to-calculate analytic standard errors in contrast to the g-formula, which requires bootstrapping. We use a topical and sophisticated question from HIV treatment research to show that LTMLE can be used successfully in complex realistic settings, and we compare results to competing estimators. Our example illustrates the following practical challenges common to many epidemiological studies: (1) long follow-up time (30 months); (2) gradually declining sample size; (3) limited support for some intervention rules of interest; (4) a high-dimensional set of potential adjustment variables, increasing both the need and the challenge of integrating appropriate machine learning methods; and (5) consideration of collider bias. Our analyses, as well as simulations, shed new light on the application of LTMLE in complex and realistic settings: We show that (1) LTMLE can yield stable and good estimates, even when confronted with small samples and limited modeling options; (2) machine learning utilized with a small set of simple learners (if more complex ones cannot be fitted) can outperform a single, complex model, which is tailored to incorporate prior clinical knowledge; and (3) performance can vary considerably depending on interventions and their support in the data, and therefore critical quality checks should accompany every LTMLE analysis. We provide guidance for the practical application of LTMLE.},
	keywords = {causal inference, g-methods, HIV treatment, TMLE},
	doi = {10.1002/sim.8340},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/sim.8340},
	author = {Schomaker, M. and Luque-Fernandez, M.A. and Leroy, V. and Davies, M.A.}
}
@article {10.1093/eurpub/ckz086,
	title = {Secular trends in stillbirth by maternal socioeconomic status in Spain 2007{\textendash}15: a population-based study of 4 million births},
	journal = {European Journal of Public Health},
	year = {2019},
	month = {05},
	abstract = {Stillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain.We developed a population-based observational study, including 4 083 919 births during 2007{\textendash}15. We estimate stillbirth rates and secular trends by maternal SES. We also evaluated the joint effect of maternal educational attainment and the Human Development Index (HDI) of women{\textquoteright}s country of origin on the risk of stillbirth. The data and statistical analysis can be accessed for reproducibility in a GitHub repository: https://github.com/migariane/StillbirthWe found a consistent pattern of socioeconomic inequalities in the risk of delivering a stillborn, mainly characterized by a persistently higher risk, over time, among women with lower SES. Overall, women from countries with low HDIs and low educational attainments had approximately a four times higher risk of stillbirth (RR: 4.44; 95\%CI: 3.71{\textendash}5.32). Furthermore, we found a paradoxical reduction of the stillbirth gap over time between the highest and the lowest SESs, which is mostly due to the significant and increasing trend of stillbirth risk among highly educated women of advanced maternal age.Our findings highlight no improvement in stillbirth rates among women of lower SES and an increasing trend among highly educated women of advanced maternal age over recent years. Public health policies developing preventive programmes to reduce stillbirth rates among women with lower SES are needed as well as the necessity of further study to understand the growing trend of age-related stillbirths among highly educated women in Spain.},
	issn = {1101-1262},
	doi = {10.1093/eurpub/ckz086},
	url = {https://doi.org/10.1093/eurpub/ckz086},
	author = {Luque-Fernandez, Miguel Angel and Thomas, Aurielle and Gelaye, Bizu and Racape, Judith and Sanchez, Maria Jose and Michelle A. Williams}
}
@article {Lee2019,
	title = {Is cancer-related death associated with circadian rhythm?},
	journal = {Cancer Communications},
	volume = {39},
	number = {1},
	year = {2019},
	month = {May},
	pages = {27},
	abstract = {We investigated the temporal pattern of death in cancer patients using a large sample size and robust statistical methods to account for chronobiological periodicity.We did not detect a circadian pattern of cancer death. The present study evaluated the temporal pattern of death among cancer patients using trigonometric functions and with time modeled in a circular scale.To conclude, we found no evidence of a chronobiological circadian pattern in death among cancer patients by using robust statistical methods and data from a large population in a hospital setting. Increased understanding of the temporal pattern of deaths may yield important insights toward understanding external factors associated with cancer death.},
	issn = {2523-3548},
	doi = {10.1186/s40880-019-0373-9},
	url = {https://doi.org/10.1186/s40880-019-0373-9},
	author = {Lee, Shing Fung and Luque-Fernandez, Miguel Angel}
}
@article {LUQUEFERNANDEZ2019,
	title = {Education in public health, epidemiology and biostatistics in Spain from a global and comparative perspective},
	journal = {Gaceta Sanitaria},
	year = {2019},
	abstract = {In the last ten years, there have been intense debates to boost the discipline, make it relevant to the genomic revolution, and place it at the forefront of the digital era. As a result, training in public health and epidemiology has been renewed, with marked statistical and methodological reinforcement, such as the current emphasis on causal inference, or the inclusion of master{\textquoteright}s in data science for health as a new academic degree in some schools of public health https://www.hsph.harvard.edu/health-data-science/.},
	issn = {0213-9111},
	doi = {https://doi.org/10.1016/j.gaceta.2019.02.005},
	url = {http://www.sciencedirect.com/science/article/pii/S0213911119300767},
	author = {Miguel {\'A}ngel Luque-Fern{\'a}ndez and Elsa Negro Calduch}
}
@article {doi:10.2105/AJPH.2018.304916,
	title = {Effect Modification and Collapsibility in Evaluations of Public Health Interventions},
	journal = {American Journal of Public Health},
	volume = {109},
	number = {3},
	year = {2019},
	note = {PMID: 30726131},
	pages = {e12-e13},
	abstract = {The Evaluating Public Health Interventions AJPH series offers excellent practical guidance to public health researchers. The eighth part of the series provides a valuable introduction to effect estimations of time-invariant public health interventions. In their commentary Spiegelman and Zhou suggest that, in terms of bias and efficiency, there is no advantage to using modern causal inference methods over classical multivariable modeling. However, this statement is not always true. Most important, both effect modification and collapsibility are critical concepts when assessing the validity of using regression for causal effect estimation.Suppose that one is interested in the effect of combined radiotherapy and chemotherapy versus chemotherapy only on one-year mortality among patients diagnosed with colorectal cancer. A clinician may ask: how different would the risk of death have been had everyone received dual therapy as compared with if everyone had experienced monotherapy? The causal marginal odds ratio (MOR) offers an answer to this question. Each individual has a pair of potential outcomes: the outcome he or she would have experienced had he or she been exposed to dual treatment (A = 1), denoted Y(1), and the outcome had he or she been unexposed, Y(0). The MOR is defined as[P(Y(1) = 1)/(1 - P(Y(1) = 1))]/[P(Y(0) = 1)/(1 - P(Y(0) = 1))].A common approach would be to use logistic regression to model the odds of mortality given the intervention and adjust for confounders (W) such as clinical stage and comorbidities. Note that this regression will provide an estimate of the conditional odds ratio (COR), which is[P(Y = 1   A = 1,W) / (1 - P(Y = 1   A = 1,W))] / [P(Y = 1   A = 0,W) / (1 - P(Y = 1   A = 0,W))]. The MOR and COR are typically not identical. First, if there is effect modification (e.g., if the effect of dual therapy is different between patients with no comorbidities and those who have hypertension), logistic regression including an interaction term will not provide a marginal effect estimate but only the conditional effect of the interaction term between dual therapy and hypertension. Second, the odds ratio is noncollapsible, which means that the MOR is not necessarily equal to the stratum-specific odds ratio (i.e., the COR). This holds even when a covariate is related to the outcome but not the intervention and is thus not a confounder.Extended note: Monte Carlo simulations and\&nbsp; code supporting the letter can be found at https://github.com/migariane/hetmor},
	doi = {10.2105/AJPH.2018.304916},
	url = {https://doi.org/10.2105/AJPH.2018.304916},
	author = {Luque-Fernandez, Miguel Angel and Redondo-Sanchez, Daniel and Schomaker, Michael}
}
@article {LUQUE-FERNANDEZ526673,
	title = {The pattern of Comorbidities and Associated Risk Factors among Colorectal Cancer Patients in Spain: CoMCoR study},
	journal = {bioRxiv},
	year = {2019},
	publisher = {Cold Spring Harbor Laboratory},
	abstract = {Colorectal cancer is the second most frequently diagnosed cancer in Spain. Cancer treatment and outcomes can be influenced by tumor characteristics, patient general health status and comorbidities. Numerous studies have analyzed the influence of comorbidity on cancer outcomes, but limited information is available regarding the frequency and distribution of comorbidities in colorectal cancer patients, particularly elderly ones, in the Spanish population. We developed a population-based study of all incident colorectal cases diagnosed in Spain in 2011 to describe the frequency and distribution of comorbidities, as well as tumor and healthcare factors. Data were obtained from two population-based cancer registries and the complete version of patients{\textquoteright} digitalized clinical records history. We then characterized the most prevalent comorbidities, as well as dementia and multimorbidity, and developed an interactive web application to visualize our findings (http://watzilei.com/shiny/CoMCoR/). The most common comorbidities were diabetes (23.6\%), chronic obstructive pulmonary disease (17.2\%), and congestive heart failure (14.5\%). Dementia was the most common comorbidity among patients aged \&gt;=75 years. Patients with dementia had a 30\% higher prevalence of being diagnosed at stage IV and the highest prevalence of emergency hospital admission after colorectal cancer diagnosis (33\%). Colorectal cancer patients with dementia were nearly three times more likely to not be offered surgical treatment. Age \&gt;=75 years, obesity, male sex, being a current smoker, having surgery more than 60 days after cancer diagnosis, and not receiving surgical treatment were associated with a higher risk of multimorbidity. Patients with multimorbidity aged \&gt;=75 years showed a higher prevalence of hospital emergency admission followed by surgery the same day of the admission (37\%). We found a consistent pattern in the distribution and frequency of comorbidities and multimorbidity among colorectal cancer patients. The high frequency of stage IV diagnosis among patients with dementia and the high proportion of older patients not receiving surgical treatment are significant findings that require policy actions.},
	doi = {10.1101/526673},
	url = {https://www.biorxiv.org/content/early/2019/01/26/526673},
	author = {Luque-Fernandez, Miguel Angel and Redondo-Sanchez, Daniel and RODRIGUEZ-BARRANCO, MIGUEL and Carmona Garcia, Maria Carmen and Marcos-Gragera, Rafael and Sanchez, Maria Jose}
}
@article {MIGUEL_ANGEL_LUQUE_FERNANDEZ52181034,
	title = {Summarizing and communicating on survival data according to the audience: a tutorial on different measures illustrated with population-based cancer registry data},
	journal = {Clinical Epidemiology},
	year = {2019},
	abstract = {Survival data analysis results are usually communicated through the overall survival probability. Alternative measures provide additional insights and may help in communicating the results to a wider audience. We describe these alternative measures in two data settings, the overall survival setting and the relative survival setting, the latter corresponding to the particular competing risk setting in which the cause of death is unavailable or unreliable. In the overall survival setting, we describe the overall survival probability, the conditional survival probability and the restricted mean survival time (restricted to a prespecified time window). In the relative survival setting, we describe the net survival probability, the conditional net survival probability, the restricted mean net survival time, the crude probability of death due to each cause and the number of life years lost due to each cause over a prespecified time window. These measures describe survival data either on a probability scale or on a timescale. The clinical or population health purpose of each measure is detailed, and their advantages and drawbacks are discussed. We then illustrate their use analyzing England population-based registry data of men 15{\textendash}80\&nbsp;years old diagnosed with colon cancer in 2001{\textendash}2003, aiming to describe the deprivation disparities in survival. We believe that both the provision of a detailed example of the interpretation of each measure and the software implementation will help in generalizing their use.},
	doi = {10.2147/CLEP.S173523},
	url = {http://doi.org/10.2147/CLEP.S173523},
	author = {Miguel Angel Luque Fernandez and Belot, Aur{\'e}lien and Aminata Ndiaye and Miguel-Angel Luque-Fernandez and Dimitra-Kleio Kipourou and Maringe, Camille and Francisco Javier Rubio and Rachet, Bernard}
}
@article {doi:10.1093/ije/dyy275,
	title = {Educational Note: Paradoxical collider effect in the analysis of non-communicable disease epidemiological data: a reproducible illustration and web application},
	journal = {International Journal of Epidemiology},
	year = {2019},
	pages = {dyy275},
	abstract = {Classical epidemiology has focused on the control of confounding, but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g. an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed acyclic graph (DAG), a collider is the variable in the middle of an inverted fork (i.e. the variable C in A {\textrightarrow} C {\textleftarrow} Y). Controlling for, or conditioning an analysis on a collider (i.e. through stratification or regression) can introduce a spurious association between its causes. This potentially explains many paradoxical findings in the medical literature, where established risk factors for a particular outcome appear protective. We use an example from non-communicable disease epidemiology to contextualize and explain the effect of conditioning on a collider. We generate a dataset with 1000 observations, and run Monte-Carlo simulations to estimate the effect of 24-h dietary sodium intake on systolic blood pressure, controlling for age, which acts as a confounder, and 24-h urinary protein excretion, which acts as a collider. We illustrate how adding a collider to a regression model introduces bias. Thus, to prevent paradoxical associations, epidemiologists estimating causal effects should be wary of conditioning on colliders. We provide R code in easy-to-read boxes throughout the manuscript, and a GitHub repository [https://github.com/migariane/ColliderApp] for the reader to reproduce our example. We also provide an educational web application allowing real-time interaction to visualize the paradoxical effect of conditioning on a collider [http://watzilei.com/shiny/collider/].},
	doi = {10.1093/ije/dyy275},
	url = {http://dx.doi.org/10.1093/ije/dyy275},
	author = {Luque-Fernandez, Miguel Angel and Schomaker, Michael and Redondo-Sanchez, Daniel and Perez, Maria Jose Sanchez and Vaidya, Anand and Schnitzer, Mireille E}
}
@article { doi:10.1093/eurpub/cky250,
	title = {The impact of the economic recession on inequalities in induced abortion in the main cities of Spain},
	journal = {European Journal of Public Health},
	year = {2018},
	abstract = {The aim of this study was to analyse the trends in socioeconomic inequalities in induced abortion during the pre-crisis and crisis periods in the postcodes of two major cities of Spain. Ecological regression model showed that rates of induced abortion tended to increase between the two pre-crisis periods, but remained stable between the second pre-crisis period and the crisis period. In addition, we observed socioeconomic inequalities in induced abortion in both cities and in all age groups, and that these inequalities persisted across the three study periods.},
	doi = {10.1093/eurpub/cky250},
	author = {Gloria Perez and Merce Gotsens and Carlos Cevallos-Garcia and Maria Felicitas Dominguez-Berjon and Elia Diez and Amaia Bacigalupe and Laia Palencia and Brenda B Leon-Gomez and Miguel A Luque-Fernandez and Marc Mari-DellOlmo and Unai Martin and Puig-Barrachina, Vanessa and Maica Rodriguez-Sanz and Miguel Ruiz}
}
@article {luque2018educational,
	title = {Educational Note: Paradoxical Collider Effect in the Analysis of Non-Communicable Disease Epidemiological Data: a reproducible illustration and web application},
	journal = {arXiv preprint arXiv:1809.07111},
	year = {2018},
	abstract = {Classical epidemiology has focused on the control of confounding but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g., an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed acyclic graph (DAG), a collider is the variable in the middle of an inverted fork (i.e., the variable C in A -\&gt; C \&lt;- Y). Controlling for, or conditioning an analysis on a collider (i.e., through stratification or regression) can introduce a spurious association between its causes. This potentially explains many paradoxical findings in the medical literature, where established risk factors for a particular outcome appear protective. We use an example from non-communicable disease epidemiology to contextualize and explain the effect of conditioning on a collider. We generate a dataset with 1,000 observations and run Monte-Carlo simulations to estimate the effect of 24-hour dietary sodium intake on systolic blood pressure, controlling for age, which acts as a confounder, and 24-hour urinary protein excretion, which acts as a collider. We illustrate how adding a collider to a regression model introduces bias. Thus, to prevent paradoxical associations, epidemiologists estimating causal effects should be wary of conditioning on colliders. We provide R-code in easy-to-read boxes throughout the manuscript and a GitHub repository (this https URL) for the reader to reproduce our example. We also provide an educational web application allowing real-time interaction to visualize the paradoxical effect of conditioning on a collider this http URL},
	author = {Luque-Fernandez, Miguel Angel and Schomaker, Michael and Redondo-Sanchez, Daniel and Perez, Maria Jose Sanchez and Vaidya, Anand and Schnitzer, Mireille E}
}
@article {Rodr{\'\i}guez-Barranco2018,
	title = {Patient, tumor, and healthcare factors associated with regional variability in lung cancer survival: a Spanish high-resolution population-based study},
	journal = {Clinical and Translational Oncology},
	year = {2018},
	month = {Oct},
	abstract = {PURPOSE:The third most frequently diagnosed cancer in Europe in 2018 was lung cancer; it is also the leading cause of cancer death in Europe. We studied patient and tumor characteristics, and patterns of healthcare provision explaining regional variability in lung cancer survival in southern Spain.METHODS:A population-based cohort study included all 1196 incident first invasive primary lung cancer (C33-C34 according to ICD-10) cases diagnosed between 2010 and 2011 with follow-up until April 2015. Data were drawn from local population-based cancer registries and patients{\textquoteright} hospital medical records from all public and private hospitals from two regions in southern Spain.RESULTS:There was evidence of regional differences in lung cancer late diagnosis (58\% stage IV in Granada vs. 65\% in Huelva, p value \&lt; 0.001). Among patients with stage I, only 67\% received surgery compared with 0.6\% of patients with stage IV. Patients treated with a combination of radiotherapy, chemotherapy, and surgery had a 2-year mortality risk reduction of 94\% compared with patients who did not receive any treatment (excess mortality risk 0.06; 95\% CI 0.02-0.16). Geographical differences in survival were observed between the two regions: 35\% vs. 26\% at 1-year since diagnosis.CONCLUSIONS:The observed geographic differences in survival between regions are due in part to the late cancer diagnosis which determines the use of less effective therapeutic options. Results from our study justify the need for promoting lung cancer early detection strategies and the harmonization of the best practice in lung cancer management and treatment.\&nbsp;},
	issn = {1699-3055},
	doi = {10.1007/s12094-018-1962-9},
	url = {https://doi.org/10.1007/s12094-018-1962-9},
	author = {Rodr{\'\i}guez-Barranco, M. and Salamanca-Fern{\'a}ndez, E. and Fajardo, M. L. and Bayo, E. and Chang-Chan, Y.-L. and Exp{\'o}sito, J. and Garc{\'\i}a, C. and Tall{\'o}n, J. and Minicozzi, P. and Sant, M. and Petrova, D. and S{\'a}nchez, M.-J. and Luque-Fernandez, M.A.}
}
@article {Belotthoraxjnl-2017-211395,
	title = {Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: A population-based study},
	journal = {Thorax},
	year = {2018},
	publisher = {BMJ Publishing Group Ltd},
	abstract = {Introduction We investigated socioeconomic disparities and the role of the main prognostic factors in receiving major surgical treatment in patients with lung cancer in England.Methods Our study comprised 31 351 patients diagnosed with non-small cell lung cancer in England in 2012. Data from the national population-based cancer registry were linked to Hospital Episode Statistics and National Lung Cancer Audit data to obtain information on stage, performance status and comorbidities, and to identify patients receiving major surgical treatment. To describe the association between prognostic factors and surgery, we performed two different analyses: one using multivariable logistic regression and one estimating cause-specific hazards for death and surgery. In both analyses, we used multiple imputation to deal with missing data.Results We showed strong evidence that the comorbidities {\textquoteleft}congestive heart failure{\textquoteright}, {\textquoteleft}cerebrovascular disease{\textquoteright} and {\textquoteleft}chronic obstructive pulmonary disease{\textquoteright} reduced the receipt of surgery in early stage patients. We also observed gender differences and substantial age differences in the receipt of surgery. Despite accounting for sex, age at diagnosis, comorbidities, stage at diagnosis, performance status and indication of having had a PET-CT scan, the socioeconomic differences persisted in both analyses: more deprived people had lower odds and lower rates of receiving surgery in early stage lung cancer.Discussion Comorbidities play an important role in whether patients undergo surgery, but do not completely explain the socioeconomic difference observed in early stage patients. Future work investigating access to and distance from specialist hospitals, as well as patient perceptions and patient choice in receiving surgery, could help disentangle these persistent socioeconomic inequalities.},
	issn = {0040-6376},
	doi = {10.1136/thoraxjnl-2017-211395},
	url = {https://thorax.bmj.com/content/early/2018/08/11/thoraxjnl-2017-211395},
	author = {Belot, Aur{\'e}lien and Fowler, Helen and Njagi, Edmund Njeru and Miguel-Angel Luque-Fernandez and Maringe, Camille and Magadi, Winnie and Exarchakou, Aimilia and Quaresma, Manuela and Turculet, Adrian and Peake, Michael D and Navani, Neal and Rachet, Bernard}
}
@article {Larrabure-Torrealva2018,
	title = {Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru},
	journal = {BMC Pregnancy and Childbirth},
	volume = {18},
	number = {1},
	year = {2018},
	month = {Jul},
	pages = {303},
	abstract = {Gestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring. However, data on the prevalence and risk factors of GDM in Latin America are scarce.},
	issn = {1471-2393},
	doi = {10.1186/s12884-018-1904-0},
	url = {https://doi.org/10.1186/s12884-018-1904-0},
	author = {Larrabure-Torrealva, Gloria T. and Martinez, Stephanie and Luque-Fernandez, Miguel Angel and Sixto E. Sanchez and Mascaro, Pedro A. and Ingar, Hugo and Castillo, Walter and Zumaeta, Rina and Mirtha Grande and Vicky Motta and Pacora, Percy and Gelaye, Bizu and Michelle A. Williams}
}
@article {doi:10.1002/sim.7628,
	title = {Targeted maximum likelihood estimation for a binary treatment: A tutorial},
	journal = {Statistics in Medicine},
	volume = {2018},
	year = {2018},
	month = {2018},
	abstract = {When estimating the average effect of a binary treatment (or exposure) on an outcome, methods that incorporate propensity scores, the G-formula, or targeted maximum likelihood estimation (TMLE) are preferred over na{\"\i}ve regression approaches, which are biased under misspecification of a parametric outcome model. In contrast propensity score methods require the correct specification of an exposure model. Double-robust methods only require correct specification of either the outcome or the exposure model. Targeted maximum likelihood estimation is a semiparametric double-robust method that improves the chances of correct model specification by allowing for flexible estimation using (nonparametric) machine-learning methods. It therefore requires weaker assumptions than its competitors. We provide a step-by-step guided implementation of TMLE and illustrate it in a realistic scenario based on cancer epidemiology where assumptions about correct model specification and positivity (ie, when a study participant had 0 probability of receiving the treatment) are nearly violated. This article provides a concise and reproducible educational introduction to TMLE for a binary outcome and exposure. The reader should gain sufficient understanding of TMLE from this introductory tutorial to be able to apply the method in practice. Extensive R-code is provided in easy-to-read boxes throughout the article for replicability. Stata users will find a testing implementation of TMLE and additional material in the Appendix S1 and at the following GitHub repository:https://github.com/migariane/SIM-TMLE-tutorial},
	keywords = {causal inference, ensemble Learning, machine learning, observational studies, targeted maximum likelihood estimation},
	doi = {10.1002/sim.7628},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/sim.7628},
	author = {Miguel Angel Luque-Fernandez and Schomaker, Michael and Rachet, Bernard and Mireille E. Schnitzer}
}
@article {doi:10.1093/eurpub/cky017,
	title = {Trends in small-for-gestational age before and after the economic crisis in Spain},
	journal = {European Journal of Public Health},
	year = {2018},
	pages = {cky017},
	abstract = {The aim of this study was to evaluate trends in small-for-gestational age covering the period before and after the Spanish economic crisis, taking into account mother{\textquoteright}s age, nationality and the autonomous community where she resides. We performed a trend study including children born to fertile women in Spain between 2002 and 2013. Poisson mixed models showed that the prevalence of small-for-gestational age increased following the onset of the crisis, and that a previous downward trend was interrupted. },
	doi = {10.1093/eurpub/cky017},
	url = {http://dx.doi.org/10.1093/eurpub/cky017},
	author = {Pal{\`e}ncia, Laia and Puig-Barrachina, Vanessa and Mar{\'\i}-dell{\textquoteright}Olmo, Marc and Gotsens, Merc{\`e} and Rodr{\'\i}guez-Sanz, Maica and Bartoll, Xavier and Luque-Fernandez, M. A. and P{\'e}rez, Gl{\`o}ria}
}
@article {schomaker2018using,
	title = {Using Longitudinal Targeted Maximum Likelihood Estimation in Complex Settings with Dynamic Interventions},
	journal = {arXiv preprint arXiv:1802.05005},
	year = {2018},
	abstract = {Longitudinal targeted maximum likelihood estimation (LTMLE) has hardly ever been used to estimate dynamic treatment effects in the context of time-dependent confounding affected by prior treatment when faced with long follow-up times, multiple time-varying confounders, and complex associational relationships simultaneously. Reasons for this include the potential computational burden, technical challenges, restricted modeling options for long follow-up times, and limited practical guidance in the literature. However, LTMLE has desirable asymptotic properties, i.e. it is doubly robust, and can yield valid inference when used in conjunction with machine learning. We use a topical and sophisticated question from HIV treatment research to show that LTMLE can be used successfully in complex realistic settings and compare results to competing estimators. Our example illustrates the following practical challenges common to many epidemiological studies 1) long follow-up time (30 months), 2) gradually declining sample size 3) limited support for some intervention rules of interest 4) a high-dimensional set of potential adjustment variables, increasing both the need and the challenge of integrating appropriate machine learning methods. Our analyses, as well as simulations, shed new light on the application of LTMLE in complex and realistic settings: we show that (i) LTMLE can yield stable and good estimates, even when confronted with small samples and limited modeling options; (ii) machine learning utilized with a small set of simple learners (if more complex ones can{\textquoteright}t be fitted) can outperform a single, complex model, which is tailored to incorporate prior clinical knowledge; (iii) performance can vary considerably depending on interventions and their support in the data, and therefore critical quality checks should accompany every LTMLE analysis.},
	url = {https://arxiv.org/abs/1802.05005},
	author = {Schomaker, Michael and Luque-Fernandez, Miguel Angel and Leroy, Valeriane and Davies, Mary-Ann}
}
@article {Ghosh:2017aa,
	title = {Plasma Glycated CD59, a Novel Biomarker for Detection of Pregnancy-Induced Glucose Intolerance},
	journal = {Diabetes Care},
	year = {2018},
	abstract = {OBJECTIVE:Plasma glycated CD59 (pGCD59) is an emerging biomarker in diabetes. We assessed whether pGCD59 could predict the following: the results of the glucose challenge test (GCT) for screening of gestational diabetes mellitus (GDM) (primary analysis); and the diagnosis of GDM and prevalence of large for gestational age (LGA) newborns (secondary analyses).RESEARCH DESIGN AND METHODS:Case-control study of 1,000 plasma samples from women receiving standard prenatal care, 500 women having a normal GCT (control subjects) and 500 women with a failed GCT and a subsequent oral glucose tolerance test (case patients).RESULTS:Compared with control subjects, the median (interquartile range) pGCD59 value was 8.5-fold higher in case patients and 10-fold higher in GDM patients, as follows: control subjects 0.33 (0.19); case patients 2.79 (1.4); GDM patients 3.23 (1.43) (P \&lt; 0.001); area under the receiver operating characteristic curve 0.92. LGA prevalence was 4.3\% in the lowest quartile and 13.5\% in the highest quartile of pGCD59.CONCLUSIONS:One pGCD59 measurement during weeks 24-28 identifies pregnancy-induced glucose intolerance with high sensitivity and specificity and can potentially identify the risk for LGA.\&nbsp;},
	author = {Luque-Fernandez, Miguel A. and Ghosh, Pamela and Vaidya, Anand and Ma, Dongdong and Sahoo, Rupam and Chorev, Michael and Zera, Chloe and McElrath, Thomas F. and Michelle A. Williams and Seely, Ellen W. and Halperin, Jose A.}
}
@article {Leee017904,
	title = {Prognostic value of lymphocyte-to-monocyte ratio and neutrophil-to-lymphocyte ratio in follicular lymphoma: a retrospective cohort study},
	journal = {BMJ Open},
	volume = {7},
	number = {11},
	year = {2017},
	publisher = {British Medical Journal Publishing Group},
	abstract = {Objectives The clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient{\textquoteright}s immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy.Design A retrospective cohort study.Setting Regional cancer centre in Hong Kong.Participants 88 patients with histologically proven FL diagnosed between 2000 and 2014.Materials and methods The best LMR and NLR cut-off values were determined using cross-validated areas under the receiver operating characteristic curves. The extent to which progression-free survival (PFS) and overall survival differed by NLR and LMR cut-off values was assessed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazards model was fitted to adjust for confounders.Results The best cut-off values for LMR and NLR were 3.20 and 2.18, respectively. The 5-year PFS was 73.6\%. After multivariate adjustment, high LMR (\&gt;3.20) at diagnosis was associated with superior PFS, with a HR of 0.31 (95\% CI 0.13 to 0.71), whereas high NLR at relapse was associated with poorer postprogression survival (HR 1.24, 95\% CI 1.04 to 1.49).Conclusions Baseline LMR and NLR at relapse were shown to be independent prognostic factors in FL. LMR and NLR are cheap and widely available biomarkers that could be used in combination with the Follicular Lymphoma International Prognostic Index by clinicians to better predict prognosis.},
	issn = {2044-6055},
	doi = {10.1136/bmjopen-2017-017904},
	url = {http://bmjopen.bmj.com/content/7/11/e017904},
	author = {Lee, Shing Fung and Luque-Fernandez, Miguel Angel}
}
@article {doi:10.7326/M17-0882,
	title = {The spectrum of subclinical primary aldosteronism and incident hypertension: A cohort study},
	journal = {Annals of Internal Medicine},
	year = {2017},
	abstract = {Background: Primary aldosteronism is recognized as a severeform of renin-independent aldosteronism that results in excessivemineralocorticoid receptor (MR) activation.Objective: To investigate whether a spectrum of subclinicalrenin-independent aldosteronism that increases risk for hypertensionexists among normotensive persons.Design: Cohort study.Setting: National community-based study.Participants: 850 untreated normotensive participants in MESA(Multi-Ethnic Study of Atherosclerosis) with measurements of serumaldosterone and plasma renin activity (PRA).Measurements: Longitudinal analyses investigated whether aldosteroneconcentrations, in the context of physiologic PRA phenotypes(suppressed, <=0.50 μg/L per hour; indeterminate, 0.51to 0.99 μg/L per hour; unsuppressed, >=1.0 μg/L per hour), wereassociated with incident hypertension (defined as systolic bloodpressure >=140 mm Hg, diastolic blood pressure >=90 mm Hg, orinitiation of antihypertensive medications). Cross-sectional analysesinvestigated associations between aldosterone and MR activity,assessed via serum potassium and urinary fractional excretionof potassium.Results: A suppressed renin phenotype was associated with ahigher rate of incident hypertension than other PRA phenotypes(incidence rates per 1000 person-years of follow-up: suppressedrenin phenotype, 85.4 events [95\% CI, 73.4 to 99.3 events]; indeterminaterenin phenotype, 53.3 events [CI, 42.8 to 66.4events]; unsuppressed renin phenotype, 54.5 events [CI, 41.8 to71.0 events]). With renin suppression, higher aldosterone concentrationswere independently associated with an increasedrisk for incident hypertension, whereas no association betweenaldosterone and hypertension was seen when renin was not suppressed.Higher aldosterone concentrations were associatedwith lower serum potassium and higher urinary excretion of potassium,but only when renin was suppressed.Limitation: Sodium and potassium were measured severalyears before renin and aldosterone.Conclusion: Suppression of renin and higher aldosterone concentrationsin the context of this renin suppression are associatedwith an increased risk for hypertension and possibly alsowith increased MR activity. These findings suggest a clinicallyrelevant spectrum of subclinical primary aldosteronism (reninindependentaldosteronism) in normotension.},
	doi = {10.7326/M17-0882},
	url = {http://annals.org/aim/article/2657166/spectrum-subclinical-primary-aldosteronism-incident-hypertension-cohort-study},
	author = {Brown, J.M. and Robinson-Cohen, C. and Luque-Fernandez, M.A. and et al.}
}
@article {luque2017data,
	title = {Data-Adaptive Estimation for Double-Robust Methods in Population-Based Cancer Epidemiology: Risk differences for lung cancer mortality by emergency presentation},
	journal = {American Journal of Epidemiology},
	year = {2017},
	abstract = {We propose a structural framework for population-based cancer epidemiology and evaluate the performance of double-robust estimators for a binary exposure in cancer mortality. We performed numerical analyses to study the bias and efficiency of these estimators. Furthermore, we compared two different model selection strategies based on 1) the Akaike and Bayesian Information Criteria and 2) machine-learning algorithms, and illustrated double-robust estimators{\textquoteright} performance in a real setting. In simulations with correctly specified models and near-positivity violations, all but the na{\"\i}ve estimators presented relatively good performance. However, the augmented inverse-probability treatment weighting estimator showed the largest relative bias. Under dual model misspecification and near-positivity violations, all double-robust estimators were biased. Nevertheless, the targeted maximum likelihood estimator showed the best bias-variance trade-off, more precise estimates, and appropriate 95\% confidence interval coverage, supporting the use of the data-adaptive model selection strategies based on machine-learning algorithms. We applied these methods to estimate adjusted one-year mortality risk differences in 183,426 lung cancer patients diagnosed after admittance to an emergency department versus non-emergency cancer diagnosis in England, 2006{\textendash}2013. The adjusted mortality risk (for patients diagnosed with lung cancer after admittance to an emergency department) was 16\% higher in men and 18\% higher in women, suggesting the importance of interventions targeting early detection of lung cancer signs and symptoms.},
	author = {Luque-Fernandez, Miguel Angel and Belot, Aur{\'e}lien and Valeri, Linda and Ceruli, Giovanni and Maringe, Camille and Rachet, Bernard}
}
@article {559576,
	title = {Persistent inequalities in 90-day colon cancer mortality: an English cohort study},
	journal = {Br J CancerBr J CancerBr J Cancer},
	year = {2017},
	note = {1532-1827Fowler, HBelot, ANjagi, E NLuque-Fernandez, M AMaringe, CQuaresma, MKajiwara, MRachet, BJournal ArticleEnglandBr J Cancer. 2017 Aug 31. doi: 10.1038/bjc.2017.295.},
	month = {Aug 31},
	edition = {2017/09/01},
	abstract = {BACKGROUND: Variation in colon cancer mortality occurring shortly after diagnosis is widely reported between socio-economic status (SES) groups: we investigated the role of different prognostic factors in explaining variation in 90-day mortality. METHODS: National cancer registry data were linked with national clinical audit data and Hospital Episode Statistics records for 69 769 adults diagnosed with colon cancer in England between January 2010 and March 2013. By gender, logistic regression was used to estimate the effects of SES, age and stage at diagnosis, comorbidity and surgical treatment on probability of death within 90 days from diagnosis. Multiple imputations accounted for missing stage. We predicted conditional probabilities by prognostic factor patterns and estimated the effect of SES (deprivation) from the difference between deprivation-specific average predicted probabilities. RESULTS: Ninety-day probability of death rose with increasing deprivation, even after accounting for the main prognostic factors. When setting the deprivation level to the least deprived group for all patients and keeping all other prognostic factors as observed, the differences between deprivation-specific averaged predicted probabilities of death were greatly reduced but persisted. Additional analysis suggested stage and treatment as potential contributors towards some of these inequalities. CONCLUSIONS: Further examination of delayed diagnosis, access to treatment and post-operative care by deprivation group may provide additional insights into understanding deprivation disparities in mortality.British Journal of Cancer advance online publication, 31 August 2017; doi:10.1038/bjc.2017.295 www.bjcancer.com.},
	isbn = {0007-0920},
	author = {Fowler, H. and Belot, A. and Njagi, E. N. and Luque-Fernandez, M.A. and Maringe, C. and Quaresma, M. and Kajiwara, M. and Rachet, B.}
}
@article {10.1371/journal.pone.0172814,
	title = {Reproducibility, reliability and validity of population-based administrative health data for the assessment of cancer non-related comorbidities},
	journal = {PLOS ONE},
	volume = {12},
	number = {3},
	year = {2017},
	month = {03},
	pages = {1-14},
	publisher = {Public Library of Science},
	abstract = {Background Patients with comorbidities do not receive optimal treatment for their cancer, leading to lower cancer survival. Information on individual comorbidities is not straightforward to derive from population-based administrative health datasets. We described the development of a reproducible algorithm to extract the individual Charlson index comorbidities from such data. We illustrated the algorithm with 1,789 laryngeal cancer patients diagnosed in England in 2013. We aimed to clearly set out and advocate the time-related assumptions specified in the algorithm by providing empirical evidence for them. Methods Comorbidities were assessed from hospital records in the ten years preceding cancer diagnosis and internal reliability of the hospital records was checked. Data were right-truncated 6 or 12 months prior to cancer diagnosis to avoid inclusion of potentially cancer-related comorbidities. We tested for collider bias using Cox regression. Results Our administrative data showed weak to moderate internal reliability to identify comorbidities (ICC ranging between 0.1 and 0.6) but a notably high external validity (86.3\%). We showed a reverse protective effect of non-cancer related Chronic Obstructive Pulmonary Disease (COPD) when the effect is split into cancer and non-cancer related COPD (Age-adjusted HR: 0.95, 95\% CI:0.7{\textendash}1.28 for non-cancer related comorbidities). Furthermore, we showed that a window of 6 years before diagnosis is an optimal period for the assessment of comorbidities. Conclusion To formulate a robust approach for assessing common comorbidities, it is important that assumptions made are explicitly stated and empirically proven. We provide a transparent and consistent approach useful to researchers looking to assess comorbidities for cancer patients using administrative health data.},
	doi = {10.1371/journal.pone.0172814},
	url = {http://dx.doi.org/10.1371\%2Fjournal.pone.0172814},
	author = {Maringe, Camille and Fowler, Helen and Rachet, Bernard and Luque-Fernandez, Miguel Angel}
}
@article { Gelaye2016,
	title = {Poor sleep quality, antepartum depression and suicidal ideation among pregnant women.},
	journal = {Journal of affective disorders},
	volume = {209},
	year = {2016},
	month = {Nov},
	pages = {195-200},
	abstract = {To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester METHODS: A cross-sectional study was conducted among 1298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95\% confidence intervals (95\% CI) after adjusting for putative confounders.},
	issn = {1573-2517},
	doi = {10.1016/j.jad.2016.11.020},
	author = {Gelaye, Bizu and Gifty Addae and Beemnet Neway and Larrabure-Torrealva, Gloria T. and Chunfang Qiu and Lee Stoner and Miguel Angel Luque Fernandez and Sanchez, Sixto E and Michelle A. Williams}
}
@article {luque2016adjusting,
	title = {Adjusting for overdispersion in piecewise exponential regression models to estimate excess mortality rate in population-based research},
	journal = {BMC Medical Research Methods},
	year = {2016},
	publisher = {http://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-016-0234-z},
	author = {Luque-Fernandez, Miguel Angel and Belot, Aur{\'e}lien and Quaresma, Manuela and Maringe, Camille and Rachet, Bernard and Coleman, Michel P.}
}
@article {doi:10.7326/M16-0547,
	title = {{\textquotedblleft}Nonfunctional{\textquotedblright} Adrenal Tumors and the Risk for Incident Diabetes and Cardiovascular OutcomesA Cohort Study{\textquotedblleft}Nonfunctional{\textquotedblright} Adrenal Tumors and the Risk for Incident Diabetes},
	journal = {Annals of Internal Medicine},
	year = {2016},
	doi = {10.7326/M16-0547},
	url = {+ http://dx.doi.org/10.7326/M16-0547},
	author = {Lopez, Diana and Luque-Fernandez, Miguel Angel and Steele, Amy and Adler, Gail K. and Turchin, Alexander and Vaidya, Anand}
}
@article {442131,
	title = {Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain},
	journal = {Gaceta sanitaria/SESPAS},
	year = {2016},
	isbn = {1578-1283},
	author = {P{\'e}rez, G and Gotsens, M and Pal{\`e}ncia, L and Mar{\'\i}-Dell{\textquoteright}Olmo, M and Dom{\'\i}nguez-Berj{\'o}n, MF and Rodr{\'\i}guez-Sanz, M and Puig, V and Bartoll, X and Gandarillas, A and Mart{\'\i}n, U}
}
@article {382316,
	title = {Body Mass Index, Smoking and Hypertensive Disorders during Pregnancy: A Population Based Case-Control Study.},
	journal = {PLoS One},
	volume = {11},
	number = {3},
	year = {2016},
	month = {2016},
	pages = {e0152187},
	abstract = {While obesity is an indicated risk factor for hypertensive disorders of pregnancy, smoking during pregnancy has been shown to be inversely associated with the development of preeclampsia and gestational hypertension. The purpose of this study was to investigate the combined effects of high body mass index and smoking on hypertensive disorders during pregnancy. This was a case-control study based on national registers, nested within all pregnancies in Iceland 1989-2004, resulting in birth at the Landspitali University Hospital. Cases (n = 500) were matched 1:2 with women without a hypertensive diagnosis who gave birth in the same year. Body mass index (kg/m2) was based on height and weight at 10-15 weeks of pregnancy. We used logistic regression models to calculate odds ratios and corresponding 95\% confidence intervals as measures of association, adjusting for potential confounders and tested for additive and multiplicative interactions of body mass index and smoking. Women{\textquoteright}s body mass index during early pregnancy was positively associated with each hypertensive outcome. Compared with normal weight women, the multivariable adjusted odds ratio for any hypertensive disorder was 1.8 (95\% confidence interval, 1.3-2.3) for overweight women and 3.1 (95\% confidence interval, 2.2-4.3) for obese women. The odds ratio for any hypertensive disorder with obesity was 3.9 (95\% confidence interval 1.8-8.6) among smokers and 3.0 (95\% confidence interval 2.1-4.3) among non-smokers. The effect estimates for hypertensive disorders with high body mass index appeared more pronounced among smokers than non-smokers, although the observed difference was not statistically significant. Our findings may help elucidate the complicated interplay of these lifestyle-related factors with the hypertensive disorders during pregnancy.},
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0152187},
	author = {Gudnad{\'o}ttir, Thuridur A and Bateman, Brian T and Hern{\'a}dez-D{\'\i}az, Sonia and Luque-Fernandez, Miguel Angel and Valdimarsdottir, Unnur and Zoega, Helga}
}
@article {382126,
	title = {Obstetric Outcomes of Mothers Previously Exposed to Sexual Violence.},
	journal = {PLoS One},
	volume = {11},
	number = {3},
	year = {2016},
	month = {2016},
	pages = {e0150726},
	abstract = {BACKGROUND: There is a scarcity of data on the association of sexual violence and women{\textquoteright}s subsequent obstetric outcomes. Our aim was to investigate whether women exposed to sexual violence as teenagers (12-19 years of age) or adults present with different obstetric outcomes than women with no record of such violence.

METHODS: We linked detailed prospectively collected information on women attending a Rape Trauma Service (RTS) to the Icelandic Medical Birth Registry (IBR). Women who attended the RTS in 1993-2010 and delivered (on average 5.8 years later) at least one singleton infant in Iceland through 2012 formed our exposed cohort (n = 1068). For each exposed woman{\textquoteright}s delivery, nine deliveries by women with no RTS attendance were randomly selected from the IBR (n = 9126) matched on age, parity, and year and season of delivery. Information on smoking and Body mass index (BMI) was available for a sub-sample (n = 792 exposed and n = 1416 non-exposed women). Poisson regression models were used to estimate Relative Risks (RR) with 95\% confidence intervals (CI).

RESULTS: Compared with non-exposed women, exposed women presented with increased risks of maternal distress during labor and delivery (RR 1.68, 95\% CI 1.01-2.79), prolonged first stage of labor (RR 1.40, 95\% CI 1.03-1.88), antepartum bleeding (RR 1.95, 95\% CI 1.22-3.07) and emergency instrumental delivery (RR 1.16, 95\% CI 1.00-1.34). Slightly higher risks were seen for women assaulted as teenagers. Overall, we did not observe differences between the groups regarding the risk of elective cesarean section (RR 0.86, 95\% CI 0.61-1.21), except for a reduced risk among those assaulted as teenagers (RR 0.56, 95\% CI 0.34-0.93). Adjusting for maternal smoking and BMI in a sub-sample did not substantially affect point estimates.

CONCLUSION: Our prospective data suggest that women with a history of sexual assault, particularly as teenagers, are at increased risks of some adverse obstetric outcomes.},
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0150726},
	author = {Gisladottir, Agnes and Luque-Fernandez, Miguel Angel and Harlow, Bernard L and Gudmundsdottir, Berglind and Jonsdottir, Eyrun and Bjarnadottir, Ragnheidur I and Hauksdottir, Arna and Aspelund, Thor and Cnattingius, Sven and Valdimarsdottir, Unnur A}
}
@article {381656,
	title = {Deconstructing the smoking-preeclampsia paradox through a counterfactual framework.},
	journal = {Eur J Epidemiol},
	year = {2016},
	month = {2016 Mar 14},
	abstract = {Although smoking during pregnancy may lead to many adverse outcomes, numerous studies have reported a paradoxical inverse association between maternal cigarette smoking during pregnancy and preeclampsia. Using a counterfactual framework we aimed to explore the structure of this paradox as being a consequence of selection bias. Using a case-control study nested in the Icelandic Birth Registry (1309 women), we show how this selection bias can be explored and corrected for. Cases were defined as any case of pregnancy induced hypertension or preeclampsia occurring after 20~weeks{\textquoteright} gestation and controls as normotensive mothers who gave birth in the same year. First, we used directed acyclic graphs to illustrate the common bias structure. Second, we used classical logistic regression and mediation analytic methods for dichotomous outcomes to explore the structure of the bias. Lastly, we performed both deterministic and probabilistic sensitivity analysis to estimate the amount of bias due to an uncontrolled confounder and corrected for it. The biased effect of smoking was estimated to reduce the odds of preeclampsia by 28~\% (OR 0.72, 95~\%CI 0.52, 0.99) and after stratification by gestational age at delivery (~1, revealing the structure of the paradox. The bias-adjusted estimation of the smoking effect on preeclampsia showed an OR of~1.22 (95~\%CI 0.41, 6.53). The smoking-preeclampsia paradox appears to be an example of (1) selection bias most likely caused by studying cases prevalent at birth rather than all incident cases from conception in a pregnancy cohort, (2) omitting important confounders associated with both smoking and preeclampsia (preventing the outcome to develop) and (3) controlling for a collider (gestation weeks at delivery). Future studies need to consider these aspects when studying and interpreting the association between smoking and pregnancy outcomes.},
	issn = {1573-7284},
	doi = {10.1007/s10654-016-0139-5},
	author = {Luque-Fernandez, Miguel Angel and Zoega, Helga and Valdimarsdottir, Unnur and Michelle A. Williams}
}
@article {Qiu2015,
	title = {Circadian clock-related genetic risk scores and risk of placental abruption},
	journal = {Placenta},
	year = {2015},
	pages = {-},
	abstract = {AbstractIntroduction The circadian clock plays an important role in several aspects of female reproductive biology. Evidence linking circadian clock-related genes to pregnancy outcomes has been inconsistent. We sought to examine whether variations in single nucleotide polymorphisms (SNPs) of circadian clock genes are associated with \PA\ risk. Methods Maternal blood samples were collected from 470 \PA\ case and 473 controls. Genotyping was performed using the Illumina Cardio-MetaboChip platform. We examined 119 \SNPs\ in 13 candidate genes known to control circadian rhythms (e.g., CRY2, ARNTL, and RORA). Univariate and penalized logistic regression models were fit to estimate odds ratios (ORs); and the combined effect of multiple \SNPs\ on \PA\ risk was estimated using a weighted genetic risk score (wGRS). Results A common \SNP\ in the \RORA\ gene (rs2899663) was associated with a 21\% reduced odds of \PA\ (P~\&lt;~0.05). The odds of \PA\ increased with increasing wGRS (Ptrend~\&lt;~0.001). The corresponding \ORs\ were 1.00, 1.83, 2.81 and 5.13 across wGRS quartiles. Participants in the highest wGRS quartile had a 5.13-fold (95\% confidence interval: 3.21{\textendash}8.21) higher odds of \PA\ compared to those in the lowest quartile. Although the test for interaction was not significant, the odds of \PA\ was substantially elevated for preeclamptics with the highest wGRS quartile (OR~=~14.44, 95\%CI: 6.62{\textendash}31.53) compared to normotensive women in the lowest wGRS quartile. Discussion Genetic variants in circadian rhythm genes may be associated with \PA\ risk. Larger studies are needed to corroborate these findings and to further elucidate the pathogenesis of this important obstetrical complication.},
	keywords = {Pregnancy},
	issn = {0143-4004},
	doi = {http://dx.doi.org/10.1016/j.placenta.2015.10.005},
	url = {http://www.sciencedirect.com/science/article/pii/S0143400415300655},
	author = {Chunfang Qiu and Gelaye, Bizu and Marie Denis and Mahlet G. Tadesse and Miguel Angel Luque Fernandez and Daniel A. Enquobahrie and Cande V. Ananth and Sixto E. Sanchez and Michelle A. Williams}
}
@article { Rice2015,
	title = {High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.},
	journal = {BMC pregnancy and childbirth},
	volume = {15},
	year = {2015},
	month = {09},
	abstract = {Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries.},
	issn = {1471-2393},
	doi = {10.1186/s12884-015-0633-x},
	author = {Jayne R Rice and Larrabure-Torrealva, Gloria T. and Miguel Angel Luque Fernandez and Mirtha Grande and Vicky Motta and Yasmin V Barrios and Sixto Sanchez and Gelaye, Bizu and Michelle A. Williams}
}
@article {265611,
	title = {An international contrast of rates of placental abruption: an age-period-cohort analysis.},
	journal = {PLoS One},
	volume = {10},
	number = {5},
	year = {2015},
	month = {2015},
	pages = {e0125246},
	abstract = {BACKGROUND: Although rare, placental abruption is implicated in disproportionately high rates of perinatal morbidity and mortality. Understanding geographic and temporal variations may provide insights into possible amenable factors of abruption. We examined abruption frequencies by maternal age, delivery year, and maternal birth cohorts over three decades across seven countries.

METHODS: Women that delivered in the US (n = 863,879; 1979-10), Canada (4 provinces, n = 5,407,463; 1982-11), Sweden (n = 3,266,742; 1978-10), Denmark (n = 1,773,895; 1978-08), Norway (n = 1,780,271, 1978-09), Finland (n = 1,411,867; 1987-10), and Spain (n = 6,151,508; 1999-12) were analyzed. Abruption diagnosis was based on ICD coding. Rates were modeled using Poisson regression within the framework of an age-period-cohort analysis, and multi-level models to examine the contribution of smoking in four countries.

RESULTS: Abruption rates varied across the seven countries (3-10 per 1000), Maternal age showed a consistent J-shaped pattern with increased rates at the extremes of the age distribution. In comparison to births in 2000, births after 2000 in European countries had lower abruption rates; in the US there was an increase in rate up to 2000 and a plateau thereafter. No birth cohort effects were evident. Changes in smoking prevalence partially explained the period effect in the US (P = 0.01) and Sweden (P,
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0125246},
	author = {Ananth, Cande V and Keyes, Katherine M and Hamilton, Ava and Gissler, Mika and Wu, Chunsen and Liu, Shiliang and Luque-Fernandez, Miguel Angel and Skj{\ae}rven, Rolv and Michelle A. Williams and Tikkanen, Minna and Cnattingius, Sven}
}
@article {HEAD:HEAD12571,
	title = {Fasting Lipid and Lipoproteins Concentrations in Pregnant Women With a History of Migraine},
	journal = {Headache: The Journal of Head and Face Pain},
	year = {2015},
	pages = {n/a{\textendash}n/a},
	abstract = {Background Migraine is associated with a number of cardiometabolic risk factors including abnormalities in lipid metabolism. However, little is known about these associations among pregnant migraineurs. We conducted the present study to evaluate the extent to which altered lipid profiles are associated with history of migraine among pregnant women. Methods A cohort of 1062 Peruvian women were interviewed at 24-28 weeks of gestation. Migraine status was classified based on the International Classification of Headache Disorders-II diagnostic criteria. Serum lipid concentrations were measured enzymatically using standardized assays. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95\% confidence intervals (CIs) as measures of associations of migraine status with varying concentrations of lipids and lipoproteins during pregnancy. Results Approximately 18.5\% of the study participants were identified as migraineurs (196 of 1062). Maternal serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and total cholesterol : HDL ratio were all statistically significantly elevated among pregnant migraineurs compared with pregnant non-migraineurs. In multivariate adjusted models, pregnant women with migraine had higher odds of elevated total cholesterol, LDL, and total cholesterol : HDL ratio as compared with pregnant women without migraine. For instance, the AOR and 95\% CI for successive quartiles of the total cholesterol associated with history of migraine were Q2 (219-247 mg/dL): 1.05 (0.64-1.70), Q3 (248-281 mg/dL): 1.16 (0.72-1.86), and Q4 (>=282 mg/dL): 1.87 (1.20-2.91) with the lowest quartile (,
	keywords = {Cholesterol, Lipids, migraine, Pregnancy},
	issn = {1526-4610},
	doi = {10.1111/head.12571},
	url = {http://dx.doi.org/10.1111/head.12571},
	author = {Gelaye, Bizu and Larrabure-Torrealva, Gloria T. and Chunfang Qiu and Luque-Fernandez, Miguel Angel and Peterlin, B. Lee and Sanchez, Sixto E and Michelle A. Williams}
}
@article {230896,
	title = {Is the fetoplacental ratio a differential marker of fetal growth restriction in small for gestational age infants?},
	journal = {Eur J Epidemiol},
	year = {2015},
	month = {2015 Jan 29},
	abstract = {Higher placental weight relative to birthweight has been described as an adaptive mechanism to fetal hypoxia in small for gestational age (SGA) infants. However, placental weight alone may not be a good marker reflecting intrauterine growth restriction. We hypothesized that fetoplacental ratio (FPR)-the ratio between birthweight and placental weight-may serve as a good marker of SGA after adjustment for surrogates of fetal hypoxemia (maternal iron deficiency anemia, smoking and choriodecidual necrosis). We conducted a within-sibling analysis using data from the US National Collaborative Perinatal Project (1959-1966) of 1,803 women who delivered their first two (or more) consecutive infants at term (n~=~3,494). We used variance-component fixed-effect linear regression models to explore the effect of observed time-varying factors on placental weight and conditional logistic regression to estimate the effects of the tertiles of FPRs (1st small, 2nd normal and 3rd large) on the odds of SGA infants. We found placental weights to be 15~g [95~\% confidence interval (CI) 8, 23] higher and -7~g (95~\% CI -13, -2) lower among women that had anemia and choriodecidual necrosis, respectively. After multivariable adjustment, newborns with a small FPR (1st-tertile <=7) had twofold higher odds of being SGA (OR 2.0, 95~\% CI 1.2, 3.5) than their siblings with a large FPR (3nd-tertile >=9). A small FPR was associated with higher odds of SGA, suggesting that small FPR may serve as an indicator suggestive of adverse intrauterine environment. This observation may help to distinguish pathological from constitutional SGA.},
	issn = {1573-7284},
	doi = {10.1007/s10654-015-9993-9},
	author = {Luque-Fernandez, Miguel Angel and Ananth, Cande V and Jaddoe, Vincent W V and Gaillard, Romy and Albert, Paul S and Schomaker, Michael and McElduff, Patrick and Daniel A. Enquobahrie and Gelaye, Bizu and Michelle A. Williams}
}
@article {223421,
	title = {Assessment of tuberculosis surveillance by capture-recapture in the Balearic Islands, Spain, 2005-2007.},
	journal = {Enferm Infecc Microbiol Clin},
	year = {2014},
	month = {2014 Dec 11},
	abstract = {The tuberculosis surveillance system in the Balearic Islands was assessed from 2005 to 2007. Applying the capture-recapture method the completeness of this system was evaluated to be 58.4\%. When a new electronic recorded data was included in Primary Health Care, up to 66.5\% was obtained. This new source of data increased the detected cases of pulmonary tuberculosis from 572 to 681. As a result, the estimated annual incidence rate increases from 18.9 cases/10(5) to 22.6 cases/10(5) [95\% CI, 20.9-24.3], similar to figures issued by WHO.},
	issn = {1578-1852},
	doi = {10.1016/j.eimc.2014.10.008},
	author = {Gim{\'e}nez-Duran, Jaume and Galm{\'e}s-Truyols, Ant{\`o}nia and Luque-Fern{\'a}ndez, Miguel-{\'A}ngel and Bonilla-Vargas, Luis Alberto and Bosch-Isabel, Catalina and Nicolau-Riutort, Antonio and de Mateo-Onta{\~n}{\'o}n, Salvador}
}
@article {220991,
	title = {Absence of circadian rhythms of preterm premature rupture of membranes and preterm placental abruption.},
	journal = {Ann Epidemiol},
	volume = {24},
	number = {12},
	year = {2014},
	month = {2014 Oct 15},
	pages = {882-887},
	abstract = {PURPOSE: Data regarding circadian rhythm in the onset of spontaneous preterm premature rupture of membranes (PROM) and placental abruption (PA) cases are conflicting. We modeled the time of onset of preterm PROM and PA cases and examined if the circadian profiles varied based on the gestational age at delivery.

METHODS: We used parametric and nonparametric methods, including trigonometric regression in the framework of generalized linear models, to test the presence of circadian rhythms in the time of onset of preterm PROM and PA cases among 395 women who delivered a singleton between 2009 and 2010 in Lima, Peru.

RESULTS: We found a diurnal circadian pattern, with a morning peak at 07:32 AM (95\% confidence interval, 05:46 AM-09:18 AM) among moderate preterm PROM cases (P value < .001), and some evidence of a diurnal circadian periodicity among PA cases in term infants (P value~=~.067). However, we did not find evidence of circadian rhythms in the time of onset of extremely or very preterm PROM (P value~=~.259) and preterm PA (P value~=~.224).

CONCLUSIONS: The circadian rhythms of the time of onset of preterm PROM and PA cases varied based on gestational weeks at delivery. Although circadian rhythms were presented among moderate preterm PROM and term PA cases, there was no evidence of circadian rhythms among preterm PA and very or extremely preterm PROM cases, underlying other mechanisms associated with the time of onset.},
	issn = {1873-2585},
	doi = {10.1016/j.annepidem.2014.10.002},
	author = {Luque-Fernandez, Miguel Angel and Ananth, Cande V and Sanchez, Sixto E and Qiu, Chun-Fang and Hernandez-Diaz, Sonia and Valdimarsdottir, Unnur and Gelaye, Bizu and Michelle A. Williams}
}
@article {157101,
	title = {Early Pregnancy Urinary Biomarkers of Fatty Acid and Carbohydrate Metabolism in Pregnancies Complicated by Gestational Diabetes},
	journal = {Diabetes Research and Clinical Practice},
	year = {2014},
	pages = {http://dx.doi.org/10.1016/j.diabres.2014.03.001},
	abstract = {Aims Alterations in organic acid biomarkers from fatty acid and carbohydrate metabolism have been documented in type 2 diabetes patients. However, their association with gestational diabetes mellitus (GDM) is largely unknown. Methods Participants were 25 GDM cases and 25 non-GDM controls. Biomarkers of fatty acid (adipate, suberate and ethylmalonate) and carbohydrate (pyruvate, L-lactate and β-hydroxybutyrate) metabolism were measured in maternal urine samples collected in early pregnancy (17 weeks) using liquid chromatography-mass spectrometry methods. Logistic regression were used to calculate odds ratios (OR) and 95\% confidence intervals (CI). Results GDM cases and controls differed in median urinary concentrations of ethylmalonate (3.0 vs. 2.3 μg/mg creatinine), pyruvate (7.4 vs. 2.1 μg/mg creatinine), and adipate (4.6 vs. 7.3 μg/mg creatinine) (all p-values \&lt;0.05). Women in the highest tertile for ethylmalonate or pyruvate concentrations had 11.4-fold (95\%CI 1.10-117.48) and 3.27-fold (95\%CI 0.72-14.79) increased risk of GDM compared with women in the lowest tertile for ethylmalonate and pyruvate concentrations, respectively. Women in the highest tertile for adipate concentrations, compared with women in the lowest tertile, had an 86\% reduction in GDM risk (95\%CI 0.02-0.97). Conclusions These preliminary findings underscore the importance of altered fatty acid and carbohydrate metabolism in the pathogenesis of GDM.},
	url = {http://www.sciencedirect.com/science/article/pii/S0168822714001089?cc=y},
	author = {Chunfang Qiu and Daniel A. Enquobahrie and Ihunnaya O. Frederick and Tanya K. Sorensen and Miguel-Angel Luque-Fernandez and Robert M. David and J. Alexander Bralley and Michelle A. Williams}
}
@article {136951,
	title = {Seasonal Variation of 25-Hydroxyvitamin D among non-Hispanic Black and White Pregnant Women from Three US Pregnancy Cohorts},
	journal = {Pediatrics and Perinatal Epidemiology},
	year = {2013},
	pages = {10.1111/ppe.12103},
	abstract = {Background: Vitamin D deficiency during pregnancy has been associated with increased risk of complications and adverse perinatal outcomes. We evaluated seasonal variation of 25-hydroxyvitamin D [25(OH)D] among pregnant women, focusing on patterns and determinants of variation. Methods: Data came from three cohort studies in the US that included 2583 non-Hispanic Black and White women having prenatal 25(OH)D concentrations determined. Fourier time series and generalised linear models were used to estimate the magnitude of 25(OH)D seasonality. We modelled seasonal variability using a stationary cosinor model to estimate the phase shift, peak{\textendash}trough difference, and annual mean of 25(OH)D. Results: We observed a peak for 25(OH)D in summer, a nadir in winter, and a phase of 8 months, which resulted from fluctuations in 25(OH)D3 rather than 25(OH)D2. After adjustment for covariates, the annual mean concentrations and estimated peak{\textendash}trough difference of 25(OH)D among Black women were 19.8 ng/mL [95\% confidence interval (CI) 18.9, 20.5] and 5.8 ng/mL [95\% CI 4.7, 6.7], and for non-Hispanic White women were 33.0 ng/mL [95\% CI 32.6, 33.4] and 7.4 ng/mL [95\% CI 6.0, 8.9]. Conclusions: Non-Hispanic Black women had lower average 25(OH)D concentrations throughout the year and smaller seasonal variation levels than non-Hispanic White women. This study{\textquoteright}s confirmation of 25(OH)D seasonality over a calendar year has the potential to enhance public health interventions targeted to improve maternal and perinatal outcomes.},
	url = {http://onlinelibrary.wiley.com/doi/10.1111/ppe.12103/abstract},
	author = {Luque-Fernandez, M. A. and Gelaye, B. and VanderWeele, Tyler and Ferre,Cynthia and Siega-Riz, A.M and Holzman, C and Enquobahrie, D. and Dole N and Williams, M.A.}
}
@article {120196,
	title = {Unemployment and stillbirth risk among foreign-born and Spanish pregnant women in Spain, 2007-2010: a multilevel analysis study},
	journal = {European Journal of Epidemiology},
	volume = {Epub ahead of print},
	year = {2013},
	abstract = {We describe stillbirth and unemployment rates by autonomous region in Spain and analyse whether women who gave birth in regions with high unemployment rates were more likely to have a stillborn. We designed a multilevel population-based observational study of births from 2007 to 2010. We defined stillbirth as the outcome, individual maternal socioeconomic and pregnancy-related characteristics as covariates, and maternal autonomous region of residence as the contextual covariate. We used mixed-logistic regression models to account for differences across regions. In total, 1,920,235 singleton births and 5,560 stillbirths were included in the study. Women residing in autonomous regions with the highest rates of unemployment had a two-times-greater chance of delivering a stillborn (adjusted OR 2.60; 95 \% CI 2.08-3.21). The region where women resided explained 14 \% of the total individual differences in the risk of delivering a stillborn. The odds of stillbirth were 1.82 (95 \% CI 1.62-2.05) times higher for African-born women than for Spanish-born women and 1.90 (95 \% CI 1.68-2.15) times higher for women with low educational attainment than for women with higher education. In conclusion, regional disparities in stillbirth rates in Spain in the period 2007-2010 were mainly associated with mothers who had low levels of education, were African-born, and lived in regions with higher unemployment.},
	url = {http://www.ncbi.nlm.nih.gov/pubmed/24142267},
	author = {Luque Fernandez, M. A. and M Franco and G Gelaye and Schomaker, M. and IG Garitano and C D{\textquoteright}Este and Williams, M.A.}
}
@article {107116,
	title = {Sleep-Disordered Breathing and Gestational Diabetes Mellitus},
	journal = {Diabetes Care},
	volume = {36},
	year = {2013},
	pages = {3353-3360},
	abstract = {Recently, sleep-disordered breathing (SDB) has been reported to be associated with the development of gestational diabetes mellitus (GDM). Accordingly, as this is emergent area of research that has significant clinical relevance, the objective of this meta-analysis is to examine the relationship between SDB with GDM. We searched several electronic databases for all of the studies published before January 2013 and reviewed references of published articles. Meta-analytic procedures were used to estimate the unadjusted and BMI-adjusted odds ratios (ORs) using a random effects model. Significant values, weighted effect sizes, and 95\% CIs were calculated, and tests of homogeneity of variance were performed. Results from nine independent studies with a total of 9,795 pregnant women showed that SDB was significantly associated with an increased risk of GDM. Women with SDB had a more than threefold increased risk of GDM, with a pooled BMI-adjusted OR 3.06 (95\% CI 1.89{\textendash}4.96). These findings demonstrate a significant association between SDB and GDM that is evident even after considered confounding by obesity. This meta-analysis indicates a need to evaluate the role of early recognition and treatment of SDB early during pregnancy.},
	url = {http://care.diabetesjournals.org/content/36/10/3353.full},
	author = {Luque-Fernandez, M. A. and Bain, P. and Gelaye, B. and Redline, S. and Williams, M.A.}
}
@article {76351,
	title = {Effectiveness of patient adherence groups as a model of care for stable patients on antiretroviral therapy in Khayelitsha, Cape Town, South Africa},
	journal = {PloS one},
	volume = {8},
	year = {2013},
	note = {Luque-Fernandez, Miguel AngelVan Cutsem, GillesGoemaere, EricHilderbrand, KatherineSchomaker, MichaelMantangana, NompumeleloMathee, ShaheedDubula, VuyisekaFord, NathanHernan, Miguel ABoulle, AndrewR01 AI102634/AI/NIAID NIH HHS/U01AI069924-01/AI/NIAID NIH HHS/PLoS One. 2013;8(2):e56088. doi: 10.1371/journal.pone.0056088. Epub 2013 Feb 13.},
	pages = {e56088},
	type = {Research Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov{\textquoteright}t},
	edition = {2013/02/19},
	abstract = {BACKGROUND: Innovative models of care are required to cope with the ever-increasing number of patients on antiretroviral therapy in the most affected countries. This study, in Khayelitsha, South Africa, evaluates the effectiveness of a group-based model of care run predominantly by non-clinical staff in retaining patients in care and maintaining adherence. METHODS AND FINDINGS: Participation in "adherence clubs" was offered to adults who had been on ART for at least 18 months, had a current CD4 count >200 cells/ml and were virologically suppressed. Embedded in an ongoing cohort study, we compared loss to care and virologic rebound in patients receiving the intervention with patients attending routine nurse-led care from November 2007 to February 2011. We used inverse probability weighting to estimate the intention-to-treat effect of adherence club participation, adjusted for measured baseline and time-varying confounders. The principal outcome was the combination of death or loss to follow-up. The secondary outcome was virologic rebound in patients who were virologically suppressed at study entry. Of 2829 patients on ART for >18 months with a CD4 count above 200 cells/microl, 502 accepted club participation. At the end of the study, 97\% of club patients remained in care compared with 85\% of other patients. In adjusted analyses club participation reduced loss-to-care by 57\% (hazard ratio [HR] 0.43, 95\% CI = 0.21-0.91) and virologic rebound in patients who were initially suppressed by 67\% (HR 0.33, 95\% CI = 0.16-0.67). DISCUSSION: Patient adherence groups were found to be an effective model for improving retention and documented virologic suppression for stable patients in long term ART care. Out-of-clinic group-based models facilitated by non-clinical staff are a promising approach to assist in the long-term management of people on ART in high burden low or middle-income settings.},
	isbn = {1932-6203 (Electronic)1932-6203 (Linking)},
	url = {http://www.elmundo.es/elmundosalud/2013/04/05/hepatitissida/1365157417.html},
	author = {Luque-Fernandez, M. A. and Van Cutsem, G. and E. Goemaere and Hilderbrand, K. and Schomaker, M. and Mantangana, N. and Mathee, S. and Dubula, V. and Ford, N. and Hernan, M. A. and A. Boulle}
}
@article {76356,
	title = {Elevation and cholera: an epidemiological spatial analysis of the cholera epidemic in Harare, Zimbabwe, 2008-2009},
	journal = {BMC public healthBMC public healthBMC public health},
	volume = {12},
	year = {2012},
	note = {Luque Fernandez, Miguel ASchomaker, MichaelMason, Peter RFesselet, Jean FBaudot, YvesBoulle, AndrewMaes, PeterBMC Public Health. 2012 Jun 18;12(1):442.},
	month = {Jun 18},
	pages = {442},
	edition = {2012/06/20},
	abstract = {ABSTRACT: BACKGROUND: In highly populated African urban areas where access to clean water is a challenge, water source contamination is one of the most cited risk factors in a cholera epidemic. During the rainy season, where there is either no sewage disposal or working sewer system, runoff of rains follows the slopes and gets into the lower parts of towns where shallow wells could easily become contaminated by excretes. In cholera endemic areas, spatial information about topographical elevation could help to guide preventive interventions. This study aims to analyze the association between topographic elevation and the distribution of cholera cases in Harare during the cholera epidemic in 2008 and 2009. METHODS: We developed an ecological study using secondary data. First, we described attack rates by suburb and then calculated rate ratios using whole Harare as reference. We illustrated the average elevation and cholera cases by suburbs using geographical information. Finally, we estimated a generalized linear mixed model (under the assumption of a Poisson distribution) with an Empirical Bayesian approach to model the relation between the risk of cholera and the elevation in meters in Harare. We used a random intercept to allow for spatial correlation of neighbouring suburbs. RESULTS: This study identifies a spatial pattern of the distribution of cholera cases in the Harare epidemic, characterized by a lower cholera risk in the highest elevation suburbs of Harare. The generalized linear mixed model showed that for each 100 meters of increase in the topographical elevation, the cholera risk was 30\% lower with a rate ratio of 0.70 (95\% confidence interval=0.66-0.76). Sensitivity analysis confirmed the risk reduction with an overall estimate of the rate ratio between 20\% and 40\%. DISCUSSION: This study highlights the importance of considering topographical elevation as a geographical and environmental risk factor in order to plan cholera preventive activities linked with water and sanitation in endemic areas. Furthermore, elevation information, among other risk factors, could help to spatially orientate cholera control interventions during an epidemic.},
	isbn = {1471-2458 (Electronic)1471-2458 (Linking)},
	author = {Luque Fernandez, M. A. and Schomaker, M. and Mason, P. R. and Fesselet, J. F. and Baudot, Y. and A. Boulle and Maes, P.}
}
@article {76366,
	title = {Descriptive spatial analysis of the cholera epidemic 2008-2009 in Harare, Zimbabwe: a secondary data analysis},
	journal = {Trans R Soc Trop Med Hyg},
	volume = {105},
	year = {2011},
	month = {Jan},
	pages = {38-45},
	edition = {2010/11/16},
	abstract = {This ecological study describes the cholera epidemic in Harare during 2008-2009 and identifies patterns that may explain transmission. Rates ratios of cholera cases by suburb were calculated by a univariate regression Poisson model and then, through an Empirical Bayes modelling, smoothed rate ratios were estimated and represented geographically. Mbare and southwest suburbs of Harare presented higher rate ratios. Suburbs attack rates ranged from 1.2 (95\% Cl = 0.7-1.6) cases per 1000 people in Tynwald to 90.3 (95\% Cl = 82.8-98.2) in Hopley. The identification of this spatial pattern in the spread, characterised by low risk in low density residential housing, and a higher risk in high density south west suburbs and Mbare, could be used to advocate for improving water and sanitation conditions and specific preparedness measures in the most affected areas.},
	keywords = {Adolescent, Adult, Child, Child, Preschool, Cholera/*epidemiology/transmission, Disease Outbreaks/*statistics \& numerical data, Female, Geographic Information Systems, Humans, Incidence, Infant, Infant, Newborn, Male, Middle Aged, Poisson Distribution, Population Surveillance, Regression Analysis, Risk Factors, Sanitation/*standards, Space-Time Clustering, Young Adult, Zimbabwe/epidemiology},
	isbn = {1878-3503 (Electronic)0035-9203 (Linking)},
	url = {http://fieldresearch.msf.org/msf/handle/10144/118765?mode=full},
	author = {Luque Fernandez, M. A. and Mason, P. R. and Gray, H. and Bauernfeind, A. and Fesselet, J. F. and Maes, P.}
}
@article {76381,
	title = {Differences in the reproductive pattern and low birthweight by maternal country of origin in Spain, 1996-2006},
	journal = {European journal of public healthEuropean journal of public healthEuropean journal of public health},
	volume = {21},
	year = {2011},
	note = {Fernandez, Miguel Angel LuqueCavanillas, Aurora Buenode Mateo, SalvadorEnglandEur J Public Health. 2011 Feb;21(1):104-8. doi: 10.1093/eurpub/ckp224. Epub 2010 Apr 12.},
	month = {Feb},
	pages = {104-8},
	edition = {2010/04/14},
	abstract = {BACKGROUND: Numerous studies have highlighted poorer reproductive and perinatal health outcomes among migrant mothers in developed countries. Due to the fact that no conclusive data is currently available at national level in Spain, this study aimed to explore potential differences by comparing the prevalence of low and multiple live births and the proportion of live births by maternal age and country of origin during 1996-2006. METHODS: A cross-sectional study was conducted using data from the National Statistics Institute. Low birthweight (LBW) was compared by mothers{\textquoteright} country of origin using a logistic regression model. Odds ratios (ORs) and their respective 95\% confidence intervals (CIs) are stratified by multiplicity and maternal age. Results: LBW was associated with a combination of older maternal age and multiple pregnancies in the case of women who had been born in Europe (EU15). However, this association was not found in women who originated from outside the EU15, mostly from countries who have shown significant emigration to Spain during the last decade. LBW was present among all age groups, in both singleton and multiple births, and in particular Romanian mothers showed the highest OR 2.34 (95\% CI 1.20-4.80). CONCLUSION: This study confirms differences in the reproductive pattern and LBW depending on maternal country of origin. These results allow a better understanding of the reproductive pattern and the implications of mothers{\textquoteright} country of origin in LBW. Thus, helping health decisions makers to plan future health interventions aimed at reducing the LBW prevalence in Spain.},
	keywords = {*Infant, Low Birth Weight, *Reproductive History, Adult, Cross-Sectional Studies, Female, Humans, Infant, Newborn, Maternal Age, Spain/epidemiology, Transients and Migrants/*statistics \& numerical data},
	isbn = {1464-360X (Electronic)1101-1262 (Linking)},
	author = {Fernandez, M. A. and Cavanillas, A. B. and de Mateo, S.}
}
@article {76371,
	title = {Increased risk of maternal deaths associated with foreign origin in Spain: a population based case-control study},
	journal = {European journal of public healthEuropean journal of public healthEuropean journal of public health},
	volume = {21},
	year = {2011},
	note = {Luque Fernandez, Miguel AngelGutierrez Garitano, IgnacioCavanillas, Aurora BuenoEnglandEur J Public Health. 2011 Jun;21(3):292-4. Epub 2010 Jun 21.},
	month = {Jun},
	pages = {292-4},
	type = {Comparative Study},
	edition = {2010/06/24},
	abstract = {In Europe, different studies have identified immigrant women coming from developing countries as a risk group for maternal death. In Spain, an ecological study showed higher maternal mortality rates among foreign mothers compared with Spanish mothers during 2003-04. To examine whether the maternal death risk among foreign mothers in Spain is increased, we performed a population-based matched case-control study. Each case of maternal death during 1999-2006 was matched with four mothers who had given birth during the same year the case occurred. The National Statistics Institute provided the data. The variables in the study were maternal age and country of origin. We used a conditional logistic regression analysis. Adjusted by age, the risk of maternal death was 87\% higher among foreign mothers. This study confirms that there is an increased risk of maternal death among foreign mothers in Spain. It would be desirable to analyse the socio-economic and healthcare circumstances surrounding the deaths.},
	keywords = {*Developing Countries, *Emigrants and Immigrants, Adolescent, Adult, Case-Control Studies, Databases, Factual, Female, Humans, Maternal Age, Maternal Mortality/*ethnology, Risk Assessment, Spain/epidemiology, Young Adult},
	isbn = {1464-360X (Electronic)1101-1262 (Linking)},
	author = {Luque Fernandez, M. A. and Gutierrez Garitano, I. and Cavanillas, A. B.}
}
@article {76361,
	title = {Stillbirth risk by maternal socio-economic status and country of origin: a population-based observational study in Spain, 2007-08},
	journal = {European journal of public healthEuropean journal of public healthEuropean journal of public health},
	year = {2011},
	month = {Jun 20},
	edition = {2011/06/22},
	abstract = {BACKGROUND: Socio-economic differences are a major determinant of perinatal outcomes. The impact of low socio-economic status on the risk of stillbirth, and the association between socio-economic status and stillbirth by maternal country of origin at a national level in Spain are unknown. We aimed to analyse the effect of maternal socio-economic status on the risk of stillbirth by maternal country of origin in Spain for the years 2007 and 2008. METHODS: We designed a population-based observational study that included 970 740 live births and 2464 stillbirths from 2007 to 2008. Univariate risk ratios (RRs) of stillbirth were calculated by maternal education, country of origin, age, parity, and gestational age. Adjusted stillbirth RRs were calculated using a generalized linear model with the Poisson family. Then, adjusted attributable risks and aetiological fractions in the population were calculated as measures of impact. RESULTS: Stillbirth rate ranged from 1.0 to 4.7 deaths per 1000 births. The stillbirth risk among mothers having secondary or lower education was double than that of mothers with a tertiary education with an adjusted RR of 2.13 [95\% confidence interval (CI): 1.74-2.60]. African mothers, compared with mothers from Spain, showed an adjusted stillbirth RR of 1.75 (95\% CI: 1.54-2.00). Discussion: This study confirms the differences of stillbirth risk by maternal socio-economic status. Regardless of socio-economic status, African mothers had the highest risk of stillbirth. These results point out the necessity to reduce factors related to social and health inequalities in perinatal mortality in Spain, and more specifically, to take into consideration the special vulnerability of African mothers.},
	isbn = {1464-360X (Electronic)1101-1262 (Linking)},
	author = {Luque-Fernandez, M. A. and Lone, N. I. and Gutierrez-Garitano, I. and Bueno-Cavanillas, A.}
}
@article {76376,
	title = {[Tuberculosis surveillance in the Balearic Islands and characteristics of unreported cases from 2005 to 2007]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {25},
	year = {2011},
	note = {Gimenez Duran, JaumeGalmes Truyols, Antonia MHerrera Guibert, DionisioBonilla Vargas, Luis ALuque Fernandez, Miguel ABosch Isabel, CatalinaNicolau Riutort, AntoniCayla Buqueras, JoanSpainGac Sanit. 2011 Jan-Feb;25(1):84-6.},
	month = {Jan-Feb},
	pages = {84-6},
	type = {Research Support, Non-U.S. Gov{\textquoteright}t},
	edition = {2011/02/15},
	abstract = {We performed a descriptive study of tuberculosis cases detected by the Epidemiological Surveillance System in the Balearic Islands in the triennium 2005-2007. Our goal was to characterize underreported cases in sociodemographic terms and their contact with primary care. Overall, underreporting of tuberculosis was approximately 20\%. Significant factors in multivariate analysis were social marginality (consisting of alcoholism, intravenous drug use or indigence) (aOR: 2.6 [1.2 to 5.3]), contact with primary care (aOR: 3.2 [1.4 to 7.1]), and extrapulmonary tuberculosis (aOR: 5.5[3.2-9.6]). We recommend strengthening notification by hospital specialists through the use of hospital electronic records. Our findings show that the information obtained from the primary care computerized history is helpful in improving the epidemiological surveillance of tuberculosis.},
	keywords = {*Population Surveillance, Adult, Alcoholism/epidemiology, Comorbidity, Disease Notification/*statistics \& numerical data, Electronic Health Records, Emigrants and Immigrants/statistics \& numerical data, Female, HIV Infections/epidemiology, Hospitals, Public/statistics \& numerical data, Humans, Male, Middle Aged, Multivariate Analysis, Poverty, Primary Health Care/utilization, Socioeconomic Factors, Spain/epidemiology, Substance Abuse, Intravenous/epidemiology, Tuberculosis/*epidemiology},
	isbn = {1578-1283 (Electronic)0213-9111 (Linking)},
	author = {Gimenez Duran, J. and Galmes Truyols, A. M. and Herrera Guibert, D. and Bonilla Vargas, L. A. and Luque Fernandez, M. A. and Bosch Isabel, C. and Nicolau Riutort, A. and Cayla Buqueras, J.}
}
@article {76391,
	title = {Accuracy of MUAC in the detection of severe wasting with the new WHO growth standards},
	journal = {PediatricsPediatricsPediatrics},
	volume = {126},
	year = {2010},
	note = {Fernandez, Miguel Angel LuqueDelchevalerie, PascaleVan Herp, MichelPediatrics. 2010 Jul;126(1):e195-201. Epub 2010 Jun 29.},
	month = {Jul},
	pages = {e195-201},
	type = {Comparative Study},
	edition = {2010/07/01},
	abstract = {OBJECTIVES: The objectives of this study were to estimate the accuracy of using mid-upper-arm circumference (MUAC) measurements to diagnose severe wasting by comparing the new standards from the World Health Organization (WHO) with those from the US National Center for Health Statistics (NCHS) and to analyze the age independence of the MUAC cutoff values for both curves. METHODS: We used cross-sectional anthropometric data for 34,937 children between the ages of 6 and 59 months, from 39 nutritional surveys conducted by Doctors Without Borders. Receiver operating characteristic curves were used to examine the accuracy of MUAC diagnoses. MUAC age independence was analyzed with logistic regression models. RESULTS: With the new WHO curve, the performance of MUAC measurements, in terms of sensitivity and specificity, deteriorated. With different cutoff values, however, the WHO standards significantly improved the predictive value of MUAC measurements over the NCHS standards. The sensitivity and specificity of MUAC measurements were the most age independent when the WHO curve, rather than the NCHS curve, was used. CONCLUSIONS: This study confirms the need to change the MUAC cutoff value from ,
	keywords = {*World Health Organization, Anthropometry/*methods, Area Under Curve, Body Height, Body Weight, Child Development/physiology, Child, Preschool, Cross-Sectional Studies, Developing Countries, Female, Humans, Infant, Logistic Models, Male, Malnutrition/*diagnosis/epidemiology, Needs Assessment, Nutrition Surveys, Probability, Risk Assessment, Severity of Illness Index, Upper Extremity/*anatomy \& histology, Wasting Syndrome/*diagnosis/epidemiology},
	isbn = {1098-4275 (Electronic)0031-4005 (Linking)},
	author = {Fernandez, M. A. and Delchevalerie, P. and Van Herp, M.}
}
@article {76386,
	title = {Excess of maternal mortality in foreign nationalities in Spain, 1999-2006},
	journal = {European journal of obstetrics, gynecology, and reproductive biologyEuropean journal of obstetrics, gynecology, and reproductive biology},
	volume = {149},
	year = {2010},
	month = {Mar},
	pages = {52-6},
	edition = {2010/02/02},
	abstract = {OBJECTIVE: This study aimed to compare maternal mortality by province, autonomous region and mother{\textquoteright}s country of birth in Spain during 1999-2006. STUDY DESIGN: A cross-sectional ecological study with all live births and maternal mortality cases occurring during 1999-2006 in Spain was done. Data were drawn from the National Statistics Institute (INE) and we used the Movement of Natural Persons (MNP) and death statistics broken down by cause of death. Maternal mortality rates by province, autonomous region and mother{\textquoteright}s country of birth were calculated. To compare maternal mortality by province, standardised mortality ratios were calculated using an indirect standardisation. The risk of maternal death by autonomous region, age and mother{\textquoteright}s country of birth was calculated by a Poisson regression. RESULTS: Sub-Saharan nationalities present the highest maternal mortality rates. Adjusted by age and autonomous region, foreign nationalities had 67\% higher risk of maternal mortality (RR=1.67; 95\%CI=1.22-2.33). Adjusted by mother{\textquoteright}s country of birth and age, two autonomous regions had a significant mortality excess: Andalusia (RR=1.84; 95\%CI=1.32-2.57) and Asturias (RR=2.78 95\%CI=1.24-6.24). CONCLUSION: This study shows inequalities in maternal mortality by province, autonomous region and mother{\textquoteright}s country of birth in Spain. It would be desirable to implement a maternal mortality active surveillance system and the use of confidential qualitative surveys for analysis of socio-economic and healthcare circumstances surrounding deaths. These measures would be invaluable for in-depth understanding and characterisation of a preventable phenomenon such as maternal death.},
	keywords = {*Emigrants and Immigrants, Cause of Death, Cross-Sectional Studies, Female, Humans, Maternal Health Services, Maternal Mortality/*ethnology, Pregnancy, Registries, Risk, Risk Factors, Socioeconomic Factors, Spain/ethnology},
	isbn = {1872-7654 (Electronic)0301-2115 (Linking)},
	url = {http://www.sciencedirect.com/science/article/pii/S0301211509007428},
	author = {Luque Fernandez, M. A. and Bueno Cavanillas, A. and de Mateo, S.}
}
@article {76396,
	title = {[Incidence and risk factors for acute gastroenteritis among pilgrims following the French way to Santiago de Compostela (Spain) in summer 2008]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {24},
	year = {2010},
	note = {Duran, Jaume GimenezFernandez, Miguel Angel LuqueUrrego, Johana RodriguezGil, Cristina LinaresVargas, Luis Alberto BonillaSavulescu, CameliaClerger, GuerrierMartinez-Lamas, LuciaPousa, AnxelaDonado, Juan de MataHerrera, DionisioMartinez, Maria VictoriaSpainGac Sanit. 2010 Nov-Dec;24(6):487-90. Epub 2010 Oct 12.},
	month = {Nov-Dec},
	pages = {487-90},
	type = {Research Support, Non-U.S. Gov{\textquoteright}t},
	edition = {2010/10/15},
	abstract = {OBJECTIVES: To determine the incidence of acute gastroenteritis in pilgrims on St. James{\textquoteright} Way, as well as associated risk factors and microbiological characteristics. METHODS: Two studies were designed simultaneously: a cross-sectional study through self-completed questionnaires among pilgrims reaching Santiago, and a case-control study of pilgrims traveling along the Way. Multivariate analysis was performed using logistic regression. RESULTS: In the cross-sectional study, the incidence rate was 23.5 episodes of acute gastroenteritis/10(3) pilgrims-day (95\% CI: 18.9-2.4/10(3). In the case-control study, the major risk factors were age ,
	keywords = {Acute Disease, Adult, Case-Control Studies, Catholicism, Cross-Sectional Studies, Female, France, Gastroenteritis/*epidemiology/microbiology, Humans, Incidence, Male, Middle Aged, Risk Factors, Seasons, spain, Young Adult},
	isbn = {1578-1283 (Electronic)0213-9111 (Linking)},
	author = {Duran, J. G. and Fernandez, M. A. and Urrego, J. R. and Gil, C. L. and Vargas, L.A and Savulescu, C. and Clerger, G. and Martinez-Lamas, L. and Pousa, A. and Donado Jde, M. and Herrera, D. and Martinez, M. V.}
}
@article {76416,
	title = {Increase in maternal mortality associated with change in the reproductive pattern in Spain: 1996-2005},
	journal = {J Epidemiol Community HealthJ Epidemiol Community HealthJ Epidemiol Community Health},
	volume = {63},
	year = {2009},
	note = {Fernandez, M A LuqueCavanillas, A BuenoDramaix-Wilmet, MSoria, F Sde Mata Donado Campos, JGuibert, D HEnglandJ Epidemiol Community Health. 2009 Jun;63(6):433-8. Epub 2009 Feb 15.},
	month = {Jun},
	pages = {433-8},
	type = {Multicenter Study},
	edition = {2009/02/18},
	abstract = {BACKGROUND: In Europe, different studies forecast an increase in maternal mortality in the coming years, associated with advanced maternal age and delay in maternity. This study aims to analyse the age-related trend in the maternal mortality ratio among mothers in Spain for the decade 1996-2005, and to describe the causes of death and associated sociodemographic factors for the years with highest mortality. METHODS: An ecological study on trends, for the age-related trend in the maternal mortality ratio; an indirect standardisation and Poisson regression model was used. For the description of the causes of death, a cross-sectional study was used. RESULTS: Prevalence of live births among mothers aged 35 years and over was 15\% higher in Spain than in Europe. The maternal mortality rate increased by 20\% (standardised mortality ratio of 1.2, 95\% CI 0.9 to 1.4) in 2005 with respect to 1996. The age-related risk of maternal mortality was three times higher (relative risk of 2.90, 95\% CI 2.01 to 4.06) among mothers aged 35-44 years versus those aged under 35 years. The highest mortality was detected during 2003-2004. The risk of maternal mortality was higher in foreign mothers. CONCLUSION: This study confirms that there was a change in the maternal mortality trend characterised by an increase in deaths, associated with advanced maternal age, as well as an increase in the prevalence of live births among mothers aged 35 years and over. This change in pattern identifies the need to intensify maternal mortality surveillance by collecting the necessary set of variables that allows investigation of the causes and determinant factors underlying deaths.},
	keywords = {Adult, Age Factors, Epidemiologic Methods, Europe/epidemiology, Female, Humans, Maternal Age, Maternal Mortality/*trends, Middle Aged, Spain/epidemiology},
	isbn = {1470-2738 (Electronic)0143-005X (Linking)},
	author = {Fernandez, M. A. and Cavanillas, A. B. and Dramaix-Wilmet, M. and Soria, F. S. and de Mata Donado Campos, J. and Guibert, D. H.}
}
@article {76406,
	title = {Influence of temperature and rainfall on the evolution of cholera epidemics in Lusaka, Zambia, 2003-2006: analysis of a time series},
	journal = {Trans R Soc Trop Med HygTrans R Soc Trop Med HygTrans R Soc Trop Med Hyg},
	volume = {103},
	year = {2009},
	note = {Luque Fernandez, Miguel AngelBauernfeind, ArianeJimenez, Julio DiazGil, Cristina LinaresEl Omeiri, NathalieGuibert, Dionisio HerreraEnglandTrans R Soc Trop Med Hyg. 2009 Feb;103(2):137-43. Epub 2008 Sep 9.},
	month = {Feb},
	pages = {137-43},
	edition = {2008/09/12},
	abstract = {In this study, we aimed to describe the evolution of three cholera epidemics that occurred in Lusaka, Zambia, between 2003 and 2006 and to analyse the association between the increase in number of cases and climatic factors. A Poisson autoregressive model controlling for seasonality and trend was built to estimate the association between the increase in the weekly number of cases and weekly means of daily maximum temperature and rainfall. All epidemics showed a seasonal trend coinciding with the rainy season (November to March). A 1 degrees C rise in temperature 6 weeks before the onset of the outbreak explained 5.2\% [relative risk (RR) 1.05, 95\% CI 1.04-1.06] of the increase in the number of cholera cases (2003-2006). In addition, a 50 mm increase in rainfall 3 weeks before explained an increase of 2.5\% (RR 1.02, 95\% CI 1.01-1.04). The attributable risks were 4.9\% for temperature and 2.4\% for rainfall. If 6 weeks prior to the beginning of the rainy season an increase in temperature is observed followed by an increase in rainfall 3 weeks later, both exceeding expected levels, an increase in the number of cases of cholera within the following 3 weeks could be expected. Our explicative model could contribute to developing a warning signal to reduce the impact of a presumed cholera epidemic.},
	keywords = {*Climate, Cholera/*epidemiology, Disease Outbreaks/*statistics \& numerical data, Humans, Models, Statistical, Population Surveillance, Rain, Risk Factors, Seasons, Zambia/epidemiology},
	isbn = {1878-3503 (Electronic)0035-9203 (Linking)},
	author = {Luque Fernandez, M. A. and Bauernfeind, A. and Jimenez, J. D. and Gil, C. L. and El Omeiri, N. and Guibert, D. H.}
}
@article {76411,
	title = {Reply to comment on: Influence of temperature and rainfall on the evolution of cholera epidemics in Lusaka, Zambia, 2003-2006: analysis of a time series},
	journal = {Trans R Soc Trop Med HygTrans R Soc Trop Med HygTrans R Soc Trop Med Hyg},
	year = {2009},
	note = {Letter},
	month = {Jul 9},
	isbn = {1878-3503 (Electronic)},
	author = {Luque Fernandez, M. A. and Bauernfeind, A.}
}
@article {76401,
	title = {[Fertility in Spain, 1996-2006: foreign versus Spanish women]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {23 Suppl 1},
	year = {2009},
	note = {Luque Fernandez, Miguel AngelBueno-Cavanillas, AuroraSpainGac Sanit. 2009 Dec;23 Suppl 1:67-71. Epub 2009 May 21.},
	month = {Dec},
	pages = {67-71},
	type = {Comparative StudyResearch Support, Non-U.S. Gov{\textquoteright}t},
	edition = {2009/05/26},
	abstract = {OBJECTIVES: To determine fertility trends in Spain and whether women{\textquoteright}s specific fertility rates differ by age and nationality during the period 1996-2006. METHODS: We performed a population-based, cross-sectional study. Direct standardization was used to compare fertility rates by nationality. Foreign versus Spanish women{\textquoteright}s fertility rates by age and the period under review were compared by a generalized linear model. The trend by nationality was described by time plots and was analyzed by simple linear regression models. RESULTS: Foreign women had more children (total fertility rate: 2 versus 1.2) and at younger age. The upward trend observed in the fertility of Spanish women (p,
	keywords = {*Fertility, Adolescent, Adult, Cross-Sectional Studies, Emigrants and Immigrants/*statistics \& numerical data, Female, Humans, Middle Aged, Parity, Pregnancy, Pregnancy in Adolescence/statistics \& numerical data, Retrospective Studies, spain, Young Adult},
	isbn = {1578-1283 (Electronic)0213-9111 (Linking)},
	author = {Luque Fernandez, M. A. and Bueno-Cavanillas, A.}
}
@article {76421,
	title = {Cohort study of an outbreak of viral gastroenteritis in a nursing home for elderly, Majorca, Spain, February 2008},
	journal = {Euro surveillance : bulletin europeen sur les maladies transmissibles = European communicable disease bulletinEuro Surveill},
	volume = {13},
	year = {2008},
	month = {Dec 18},
	type = {Research Support, Non-U.S. Gov{\textquoteright}t},
	edition = {2008/12/20},
	abstract = {An outbreak of acute gastroenteritis occurred in a nursing home
for elderly in Majorca between 4 and 23 February 2008. To know
its aetiology and mechanism of transmission a retrospective cohort
study was conducted with a fixed cohort including 146 people
(96 residents and 50 employees). The data were collected from
clinical histories and through a survey by questionnaire. In total 71
cases were identified (53 residents, 18 employees), corresponding
to an overall attack rate (AR) of 48.6\%. The consumption of tap
water, adjusted by age, sex and consumption of meals provided at
the nursing home, presented a relative risk (RR) of 4.03 (95\%CI,
1.4-11.4). The microbiological analyses confirmed the presence
of norovirus and/or rotavirus in five of the seven stool samples
submitted. The slow appearance of cases at the beginning of the
outbreak is characteristic of a person to person transmission, while
the sudden peak in the middle of the month suggests a common
source such as the tap water. We therefore concluded that the
outbreak likely originated from two sources: an infected employee of
the nursing home and the tap water. The high number of dependent
residents most probably facilitated the spread of the outbreak.},
	keywords = {*Population Surveillance, Aged, Aged, 80 and over, Caliciviridae Infections/*epidemiology, Cohort Studies, Disease Outbreaks/*statistics \& numerical data, Female, Gastroenteritis/*epidemiology, Humans, Incidence, Male, Nursing Homes/*statistics \& numerical data, Risk Assessment/*methods, Risk Factors, Rotavirus Infections/*epidemiology, Spain/epidemiology},
	isbn = {1560-7917 (Electronic)1025-496X (Linking)},
	url = {http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19070},
	author = {Luque Fernandez, M. A. and Galmes Truyols, A. and Herrera Guibert, D. and Arbona Cerda, G. and Sancho Gaya, F.}
}
@article {76426,
	title = {[Frequency of sexually transmitted infections and related factors in Pweto, Democratic Republic of Congo, 2004]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {22},
	year = {2008},
	note = {Luque Fernandez, Miguel AngelBauernfeind, ArianePalma Urrutia, Pedro PabloRuiz Perez, IsabelSpainGac Sanit. 2008 Jan-Feb;22(1):29-34.},
	month = {Jan-Feb},
	pages = {29-34},
	type = {Comparative StudyEvaluation Studies},
	edition = {2008/02/12},
	abstract = {OBJECTIVES: To estimate the prevalence of genital ulcer and urethral discharge in Pweto, Democratic Republic of Congo, and to analyze the association between the estimated prevalence and age, marital status, profession, and number of sexual partners. METHODS: We performed a descriptive cross-sectional study through a survey conducted in May 2004 in a representative sample of 106 men in Pweto aged between 15 and 65 years old, with a precision of 9.5\%. Questionnaire items about current or previous ulceration and urethral discharge where self-reported and referred to the previous year as of the date of the survey. To study the associations, crude and adjusted odds ratios (OR) were calculated using multivariate logistic regression. RESULTS: The prevalence was 39.6\% (95\% confidence interval [CI], 30-49) for urethral discharge and 33\% (95\%CI, 24-42) for genital ulcer. Soldiers were identified as a risk group independently of age, the number of sexual partners during the previous year, and marital status. The multivariate analysis showed an adjusted OR of 3.25 (95\%CI, 1.10-9.95) (p < 0.05) for the frequency of urethral discharge in soldiers compared with other professions. CONCLUSIONS: The high prevalence of sexually transmitted infections in Pweto and the associated factors identified prompted the initiation of a controlled condom donation program for soldiers. In conflict situations with a high prevalence of sexually transmitted infections and lack of health services, humanitarian aid organizations should implement prevention activities focused on risk groups.},
	keywords = {*Public Health, Adolescent, Adult, Age Factors, Aged, Condoms/utilization, Confidence Intervals, Democratic Republic of the Congo/epidemiology, HIV Infections/prevention \& control, Humans, Logistic Models, Male, Marital Status, Middle Aged, Military Personnel, Occupations, Odds Ratio, Prevalence, Risk Factors, Sexual Partners, Sexually Transmitted Diseases/*epidemiology/prevention \& control},
	isbn = {0213-9111 (Print)0213-9111 (Linking)},
	author = {Luque Fernandez, M. A. and Bauernfeind, A. and Palma Urrutia, P. P. and Ruiz Perez, I.}
}
@article {76431,
	title = {[Trends in the risk of late fetal mortality, prematurity and low birth weight associated with advanced maternal age in Spain [1996-2005]]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {22},
	year = {2008},
	note = {Luque Fernandez, Miguel AngelSpainGac Sanit. 2008 Sep-Oct;22(5):396-403.},
	month = {Sep-Oct},
	pages = {396-403},
	type = {Comparative Study},
	edition = {2008/11/13},
	abstract = {OBJECTIVES: To describe trends in fertility, fetal death rate, prematurity and low birth weight, as well as their association with advanced maternal age, in Spain from 1996 to 2005. METHODS: We performed an ecological study. The association between low birth weight and prematurity with maternal age was analyzed through contingency tables. The pattern of fetal mortality rate was analyzed through direct standardization. To study the risk of late fetal mortality, adjusted by age and prematurity, a Poisson regression model was used. RESULTS: The rates of fertility and late fetal mortality increased in women aged more than 35 years, especially in women aged more than 45 years. The risk of late fetal mortality was 2.7 times higher in women aged 45 years and above (rate ratio, 2.7; 95\%CI: 1.8-3), with an etiological fraction of exposure of 69\% (95\%CI: 55.2-78.6). The prevalence rate of prematurity and low birth weight was three times higher in this age group, with a prevalence rate of prematurity of 2.9 (95\%CI: 2.7-3.1) and of low birth weight of 3.1 (95\%CI: 2.9-3.3). CONCLUSIONS: The high risk found in women aged more than 45 years is explained by the increase in the proportion of pregnancies within this age group during the period analyzed. Further studies in perinatal epidemiology that analyze the impact of assisted reproduction techniques in pregnancies in older women are required, as well as a national registry of assisted reproduction techniques.},
	keywords = {*Infant, Low Birth Weight, *Infant, Premature, *Maternal Age, *Reproductive Techniques, Assisted, Adult, Age Factors, Data Interpretation, Statistical, Female, Fetal Mortality/*trends, Humans, Infant, Newborn, Middle Aged, Poisson Distribution, Pregnancy, Prevalence, Risk Factors, spain},
	isbn = {0213-9111 (Print)0213-9111 (Linking)},
	author = {Luque Fernandez, M. A.}
}
@article {76436,
	title = {[Epidemiology: discipline or method]},
	journal = {Gaceta sanitaria / S.E.S.P.A.SGac Sanit},
	volume = {20},
	year = {2006},
	note = {Luque Fernandez, M AngelSpainGac Sanit. 2006 Sep-Oct;20(5):412-3.},
	month = {Sep-Oct},
	pages = {412-3},
	type = {Letter},
	edition = {2006/10/17},
	keywords = {*Epidemiologic Methods, *Epidemiology},
	isbn = {0213-9111 (Print)0213-9111 (Linking)},
	author = {Luque Fernandez, M. A.}
}
