International journal of epidemiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of methods for analysing cluster randomized trials: an example involving a factorial design.
Studies involving clustering effects are common, but there is little consistency in their analysis. Various analytical methods were compared for a factorial cluster randomized trial (CRT) of two primary care-based interventions designed to increase breast screening attendance. ⋯ Commonly used methods for the analysis of CRT can give divergent results. Simulation studies are needed to compare results from different methods in situations typical of cluster trials but when the true model parameters are known.
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Multicenter Study
Widening socioeconomic inequalities in mortality in six Western European countries.
During the past decades a widening of the relative gap in death rates between upper and lower socioeconomic groups has been reported for several European countries. Although differential mortality decline for cardiovascular diseases has been suggested as an important contributory factor, it is not known what its quantitative contribution was, and to what extent other causes of death have contributed to the widening gap in total mortality. ⋯ Reducing socioeconomic inequalities in mortality in Western Europe critically depends upon speeding up mortality declines from cardiovascular diseases in lower socioeconomic groups, and countering mortality increases from several other causes of death in lower socioeconomic groups.
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Randomized Controlled Trial Clinical Trial
Pulmonary function as a predictor of lung cancer mortality in continuing cigarette smokers and in quitters.
Forced expiratory volume in 1 second (FEV(1)) may be useful for identifying smokers at higher risk of lung cancer. We examined the association of FEV(1) with lung cancer mortality (LCM) among cigarette smokers in the Multiple Risk Factor Intervention Trial (MRFIT). ⋯ These results demonstrate the strong predictive value of FEV(1) for lung cancer among cigarette smokers independent of smoking history; results did not differ by during-trial quit status. FEV(1) may be a biological marker for smoking dose or it may be that genetic susceptibilities to both decreased FEV(1) and lung cancer are associated.
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Comment Biography Historical Article
Commentary: bread and alum, syphilis and sunlight: rickets in the nineteenth century.
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Life expectancy at birth in Russia is over 12 years less than in western Europe. This study explores the possible role of medical care in explaining this gap by examining the evolving pattern of mortality amenable to timely and effective medical care in Russia compared with Estonia, Latvia, and Lithuania, and the UK. ⋯ Our findings suggest that the Soviet health care system has failed to match the achievements of the West over the past three decades, highlighting the need to establish a system that provides effective and equitable care for the Russian population.