Eur J Epidemiol
· 2026 Mar · PMID 41721988
·
Full text
Non-communicable diseases (NCDs) represent a significant health burden in Europe, accounting for the vast majority of deaths and consuming a substantial portion of healthcare resources. Despite the largely preventable na...Non-communicable diseases (NCDs) represent a significant health burden in Europe, accounting for the vast majority of deaths and consuming a substantial portion of healthcare resources. Despite the largely preventable nature of NCDs through modifiable behavioral risk factors, current prevention efforts remain limited. This project aims to establish a comprehensive data infrastructure to enhance understanding and prevention of NCDs. Leveraging Denmark’s extensive national data resources, this study plans to integrate diverse datasets, including health registers, genomic data, environmental exposures, and national health surveys, covering a total study population up to 8.7 million individuals, including all living and deceased in Denmark since 1975. By integrating these datasets, the project will establish the Danish Chronic Disease Cohort, a platform designed to uncover complex risk patterns associated with non-communicable disease (NCD) development. Future machine learning applications will analyze the range of health determinants, supporting the development of interpretable predictive models to guide targeted prevention and policy initiatives across Europe.
Ease of access to big data and automated analysis tools can facilitate the rapid generation of poorly designed epidemiological studies, which collectively pose a risk to the quality of medical literature. Member organiza...Ease of access to big data and automated analysis tools can facilitate the rapid generation of poorly designed epidemiological studies, which collectively pose a risk to the quality of medical literature. Member organizations of the TriNetX network have the ability to mass-produce retrospective cohort studies at speed using the federated data network's statistical power and streamlined analytics pipeline. This exploratory meta-research study collated 13 published TriNetX-based retrospective cohort studies that claim to have used a design that is, in fact, impossible on the platform (the setting of a pseudo-index event on the TriNetX platform). Of these, 8 studies described their analysis as being conducted on the platform alone, making their description of the index event impossible. When we queried seven different generative artificial intelligence (AI) tools for advice on how to set an index event on TriNetX, six tools suggested at least one strategy that cannot be implemented on the platform. Unlike previously documented errors in TriNetX-based studies, we argue that the reporting of impossible index event designs in the identified publications likely constitute either distortion of the reported methods or the uncritical adoption of false AI-generated methodological advice. In an age of accelerating and increasingly automated medical research, editors and peer-reviewers must be informed of limitations with emerging epidemiological datasets and analytic tools.
Bolliger C, Michalopoulou E, Kreis C
… +7 more, Lorez M, Schindera C, Kasenda B, Kuehni CE, Dyntar D, Roser K, Spycher BD
Eur J Epidemiol
· 2026 Apr · PMID 41721986
·
Full text
Cancers in adolescents and young adults (AYAs, aged 15-39 years) have distinct features and distribution of cancer types. This study investigated incidence, mortality, and cumulative risk of AYA cancers in Switzerland. D...Cancers in adolescents and young adults (AYAs, aged 15-39 years) have distinct features and distribution of cancer types. This study investigated incidence, mortality, and cumulative risk of AYA cancers in Switzerland. Data on adolescent cancers (15-19 years; Swiss Childhood Cancer Registry) and young adult cancers (20-39 years; National Agency for Cancer Registration) were combined. We calculated age-standardized incidence and mortality rates, and accounted for incomplete regional coverage of cancer registration. We used joinpoint regression to investigate cancer incidence and mortality trends and estimate average annual percent changes. We included 44,048 cancers recorded between 1980 and 2019 and, after adjusting for incomplete coverage, we estimated a total of 69,901 cancers. Cancer incidence increased from 56.6 [95% confidence interval: 55.3, 58.0] per 100,000 person-years in 1980-1989 to 72.2 [71.1, 73.3] in 2010-2019, with a steeper increase for females. The most common cancers were carcinomas, mainly of the breast (9,629 cancers estimated), gastrointestinal tract (5,033) and thyroid (4,785), gonadal and related tumors (11,303), melanomas (9,695), and lymphomas (8,208). There were 9,865 AYA cancer deaths recorded over the study period. The age-standardized mortality rate declined from 13.3 [12.8, 13.7] per 100,000 person-years in 1980-1989 to 6.2 [5.9, 6.5] in 2010-2019, showing similar decreases in both sexes. This first comprehensive, nationwide study of AYA cancers in Switzerland showed increasing incidence and declining mortality, potentially due to changes in lifestyle or improved cancer registration and screening practices. Our results emphasize the need for ongoing surveillance and preventive strategies with a focus on AYAs.
Yao M, Wang M, Ma Y
… +9 more, Busse JW, Hu X, Liu Y, Luo X, Liang Q, Liang X, Zou K, Li L, Sun X
Eur J Epidemiol
· 2026 Mar · PMID 41721984
·
Full text
This study projected the incidence, prevalence, death and disability-adjusted life-years (DALYs) attributable to total strokes and pathological types in people aged ≥ 15 years for 204 countries and territories to 2050. A...This study projected the incidence, prevalence, death and disability-adjusted life-years (DALYs) attributable to total strokes and pathological types in people aged ≥ 15 years for 204 countries and territories to 2050. Age- and sex-specific trends in rates were developed using XGBoost models incorporating national human development index, gross domestic product per capita, and demographic data from the Global Burden of Disease study, the World Bank, and the United Nations. Uncertainty intervals were calculated as the 2.5th and 97.5th percentiles of the distribution using a bootstrap-like method. From 2021 to 2050, the global absolute number of incident strokes is anticipated to increase by 31.64% (27.78–35.61), prevalent strokes by 58.00% (54.68–60.62), deaths from stroke by 11.88% (5.83–19.28), and DALYs due to stroke by 17.86% (10.63–25.18). Meanwhile, the age-standardised rate of stroke prevalence will increase by 2.67% (1.47–4.23). However, the age-standardised rates of stroke incidence, death and DALYs are projected to decrease by 8.54% (6.87–10.07), 21.51% (19.18–23.92) and 18.44% (15.83–20.95), respectively. In 2050, males are projected to exceed females across all age-standardised metrics. Ischaemic stroke will account for the largest proportion of the total-stroke burden, the burden of stroke in low to middle SDI countries will account for more than half of the total global burden of stroke, and Southeast Asia, East Asia, and Oceania are projected to have the highest stroke burden in absolute numbers. Our projections suggested the global burden of stroke will increase substantially from 2021 to 2050, despite reductions in age-standardised rates.
The association between diabetes and low-level arsenic exposure in drinking water has not been adequately investigated. We conducted a two-stage meta-analysis of dose-response relationships from studies reporting inciden...The association between diabetes and low-level arsenic exposure in drinking water has not been adequately investigated. We conducted a two-stage meta-analysis of dose-response relationships from studies reporting incidence or prevalence of diabetes with average exposure up to 150 µg/L arsenic in drinking water. We conducted a literature search and included cross-sectional, case control and cohort studies and we extracted results for exposure to arsenic up to average concentration of 150 µg/L water. Prevalence and incidence were generically referred to as risk. We conducted study-specific linear regression to estimate the relative risk (RR) of diabetes for a 10 µg/L increase of arsenic, and combined the study-specific results in a random-effect meta-analysis. We addressed publication bias by excluding studies with the largest standard error; and identified a subset of high-quality studies. We also performed a one-stage meta-regression. We selected 11 studies including 12 populations from seven countries. The meta-analysis of their results yielded a relative risk (RR) of type 2 diabetes for a 10 µg/L arsenic increase within the range 0-150 µg/L equal to 1.07 (95% confidence interval [CI] 1.02-1.21, p heterogeneity = 0.006). There was evidence of publication bias (p = 0.004); after accounting for publication bias, the summary RR was 1.02 (95% CI 0.99-1.06, eight studies). The RR based on the high-quality studies was 1.03 (95% CI 0.97-1.09, five studies). The corresponding RR of the meta-regression was 1.007 (95% CI 0.998-1.017, 32 risk estimates). Accounting for publication bias and study quality, and considering heterogeneity of risk estimates, our two-stage meta-analysis supports a null association between low levels of arsenic in drinking water and type 2 diabetes.
During the COVID-19 pandemic, vaccine development took center stage in the media and minds of the global community. This same daily scrutiny was also applied to the first public registered vaccine trial of anthrax preven...During the COVID-19 pandemic, vaccine development took center stage in the media and minds of the global community. This same daily scrutiny was also applied to the first public registered vaccine trial of anthrax prevention among livestock led by French scientist Louis Pasteur in 1881. At a meeting with the president of the Agricultural Society of Melun, Pasteur outlined what might be considered the first "registered" vaccine trial protocol. The trial proposed a three-arm trial where anthrax-naïve sheep (n = 60) and cows (n = 10) would be assigned either to a treatment group consisting of a 2-dose anthrax vaccination in addition to an anthrax challenge, a control group consisting of an unvaccinated group given the anthrax challenge or a second control group which received neither vaccine nor anthrax challenge. All vaccinated sheep and cows were alive 48 h post-challenge. All unvaccinated sheep who received the anthrax challenge died within 48 h post-challenge, and the unvaccinated cows developed large edemas at the site of inoculation. Witnessing the 100% efficacy of Pasteur's vaccine were hundreds of, mostly skeptical, onlookers including journalists who disseminated the big news across Europe within days. Two months later, the results of the trial reached North America, via attendees who had heard Pasteur's address at the International Medical Congress in London in August 1881. Pasteur's anthrax vaccine trial laid the foundations for the systematic, public, and a priori reporting of clinical trial procedures and codes of conduct which developed into the registered clinical trial protocols of today.
Ahlqvist VH, Sjöqvist H, Sjölander A
… +4 more, Berglind D, Lambert PC, Lee BK, Madley-Dowd P
Eur J Epidemiol
· 2026 Mar · PMID 41579296
·
Full text
Findings from family-based analyses, such as sibling comparisons, are often reported using only odds ratios or hazard ratios. We demonstrate how this can be improved upon by applying the marginalized between-within frame...Findings from family-based analyses, such as sibling comparisons, are often reported using only odds ratios or hazard ratios. We demonstrate how this can be improved upon by applying the marginalized between-within framework. We provide an overview of sibling comparison methods and the marginalized between-within framework, which enables estimation of absolute risks and clinically relevant metrics while accounting for shared familial confounding. We illustrate the approach using Swedish registry data to examine the association between maternal smoking and infant mortality, estimating absolute quantities (e.g., cumulative risks), average treatment effects, attributable fractions, and numbers needed to harm (or treat). The marginalized between-within model decomposes effects into within- and between-family components while applying a global baseline across all families. Although it typically yields similar relative estimates to conditional logistic or stratified Cox regression, the model's specification of a baseline enables the estimation of absolute measures. In the applied example, absolute measures provided more interpretable and policy-relevant insights than relative estimates alone. Code for implementation in Stata and R is provided. The marginalized between-within framework may strengthen the interpretability of family-based analysis by enabling absolute and policy-relevant estimates for both binary and time-to-event outcomes, moving beyond the limitations of solely relying on relative effect measures.
Ioannidou E, Aune D, Theodosopoulos I
… +1 more, Heath AK
Eur J Epidemiol
· 2026 Apr · PMID 41579295
·
Full text
Circulating lipids are potentially modifiable risk factors for aortic aneurysm, however, associations between levels of specific lipids and aortic aneurysm are unclear. We analysed associations between blood lipids and a...Circulating lipids are potentially modifiable risk factors for aortic aneurysm, however, associations between levels of specific lipids and aortic aneurysm are unclear. We analysed associations between blood lipids and aortic aneurysm in the UK Biobank and summarized the available data in a systematic review and meta-analysis of published cohort studies. Up to 429,610 participants aged 38-73 years at baseline in 2006-2010 in UK Biobank were included. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between serum/plasma lipids (total cholesterol, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol, triglycerides, apolipoprotein A1, apolipoprotein B, and lipoprotein(a)) and risk of aortic aneurysm. PubMed and Embase databases were searched up to November 11th, 2025, to identify relevant cohort studies. Random-effects models were used to estimate summary relative risks (RRs) and 95% CIs for the associations between blood lipid levels and aortic aneurysm risk. In UK Biobank, 2,434 aortic aneurysm cases occurred during 12.3 years of follow-up. Positive associations were observed between the highest vs. lowest quintile of total cholesterol (HR 1.22, 95% CI 1.07-1.41), LDL cholesterol (1.39, 1.21-1.60), apolipoprotein B (1.52, 1.33-1.74), non-HDL cholesterol (1.50, 1.29-1.73), triglycerides (1.23, 1.06-1.42), lipoprotein(a) (1.34, 1.17-1.54) and aortic aneurysm risk, while HDL cholesterol (0.57, 0.48-0.67) and apolipoprotein A1 (0.54, 0.46-0.63) were inversely associated. Eighteen cohort studies were included in the meta-analysis. The summary RR (95% CI) per 1 mmol/L increase was 1.16 (1.10-1.22, I = 74%, n = 15) for total cholesterol, 1.11 (1.04-1.19,I = 63%, n = 4) for LDL cholesterol, 1.28 (0.98-1.67, I = 89%, n = 2) for non-HDL cholesterol, 0.59 (0.50-0.70, I = 72%, n = 5) for HDL cholesterol, 1.02 (0.95-1.10, I = 55%, n = 7) for triglycerides, and 1.34 (1.17-1.55, I = 57%, n = 4) per 50 mg/dl incrememt in lipoprotein(a). Additional positive (apolipoprotein B, non-HDL cholesterol) and inverse (apolipoprotein A1) associations were observed in high vs. low meta-analyses. These findings suggest higher levels of total cholesterol, LDL cholesterol, apolipoprotein B, non-HDL cholesterol, lipoprotein(a), and possibly triglycerides are associated with increased risk of aortic aneurysm, while higher levels of HDL cholesterol and apolipoprotein A1 are associated with lower risk.
Foffani G, Urso D, Hiller J
… +3 more, Piccininni M, Marin B, Logroscino G
Eur J Epidemiol
· 2026 Jan · PMID 41579294
·
Full text
Amyotrophic lateral sclerosis (ALS) is a multifactorial neurodegenerative disease whose incidence increases with age. According to the gene-time-environment hypothesis, ALS onset occurs through the interaction between ge...Amyotrophic lateral sclerosis (ALS) is a multifactorial neurodegenerative disease whose incidence increases with age. According to the gene-time-environment hypothesis, ALS onset occurs through the interaction between genes and environmental exposures during ageing, which may involve a continuous accumulation process. Alternatively, the multistep pathogenic hypothesis, based on the Armitage-Doll multistep model from cancer research, posits that a discrete number of specific sequential "hits" are necessary to trigger ALS. Here we analyzed three large population-based epidemiological datasets of ALS to formally test whether the ALS age-incidence curve is better described by a power law, as predicted by the Armitage-Doll model, or by an exponential function, which is generally associated to continuous accumulation of damage and is incompatible with the Armitage-Doll model. We obtained moderate-to-extreme Bayesian evidence in favor of the exponential function compared to the power law. Cancer data were instead better aligned, as expected, with the power law. These results suggest that the multistep pathogenesis hypothesis based on the Armitage-Doll model cannot be extended from cancer to ALS, because it is incompatible with the epidemiological data. This calls for a re-consideration of the current understanding of ALS pathogenesis. Our work also warns against extending the Armitage-Doll multistep model from cancer to other aging-related diseases solely based on age-incidence curves.
Zhang X, Zhao L, Zhang K
… +8 more, Vlahov D, Chen Y, Hsing A, Nguyen MH, McGlynn KA, Taddei T, Hou L, Zhang X
Eur J Epidemiol
· 2026 Feb · PMID 41579292
·
Full text
Social determinants of health (SDOH) are crucial in shaping liver health outcomes, yet comprehensive assessments that span key SDOH domains are lacking. To address this knowledge gap, we developed a Social Determinants D...Social determinants of health (SDOH) are crucial in shaping liver health outcomes, yet comprehensive assessments that span key SDOH domains are lacking. To address this knowledge gap, we developed a Social Determinants Disadvantage Score (SDDS) and examined its association with major adverse liver conditions. We conducted a cross-sectional analysis of 117,783 participants from the All of Us Research Program. The SDDS was systematically constructed using validated questionnaires covering economic stability, education, healthcare access and quality, neighborhood and built environment, and social and community context. Each question was scored on a 0 (most advantage) to 1 (most disadvantage) scale. Total SDDS was calculated as the mean of all questions, ranging from 0 to 1. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of SDDS with total and individual adverse liver conditions, including steatotic liver disease (SLD), metabolic dysfunction-associated steatohepatitis (MASH), alcoholic liver disease (ALD), cirrhosis, hepatocellular carcinoma (HCC), chronic hepatitis B virus (HBV), chronic hepatitis C virus (HCV), and hepatic failure based on the Electronic Health Record. Higher SDDS was associated with a higher risk of adverse liver conditions. The highest SDDS quintile (most disadvantaged) compared to the lowest SDDS quintile had an OR = 1.67 (95% CI: 1.55-1.79) for total adverse liver condition risk after adjusting for age, sex, race, and other covariates. Similar associations were observed for individual liver conditions. Per 10% higher SDDS, the adjusted OR (95% CI) was 1.25 (1.22-1.29) for SLD, 1.27 (1.19-1.35) for MASH, 1.15 (0.99-1.34) for ALD, 1.31 (1.25-1.39) for cirrhosis, 1.35 (1.15-1.59) for HCC, 1.24 (1.14-1.35) for HBV infection, 1.40 (1.33-1.48) for HCV infection, and 1.35 (1.21-1.50) for hepatic failure. Consistent associations were found for disadvantages in individual SDOH domains, score excluding missingness, and score with selected factors. The SDDS provides a comprehensive, validated tool for assessing SDOH and their associations with liver health. Our findings highlight significant associations between social disadvantage and the prevalence of adverse liver conditions, emphasizing the need for future longitudinal studies to inform targeted interventions.
The rapid expansion of large-scale electronic health record (EHR) data has underscored the necessity for advanced analytical methods, such as disease network analyses, to comprehensively identify and interpret multimorbi...The rapid expansion of large-scale electronic health record (EHR) data has underscored the necessity for advanced analytical methods, such as disease network analyses, to comprehensively identify and interpret multimorbidity patterns and disease progression pathways. To overcome existing obstacles associated with performing sophisticated disease network analyses on EHR data, we developed DiNetxify, an open-source Python package implementing our recently introduced three-dimensional (3D) disease network analysis method ( https://hzcohort.github.io/DiNetxify/ ). DiNetxify provides a dedicated data class for handling various EHR data, comprehensive modular functions for executing complete 3D disease network analyses, and visualization functions for interactive exploration of results. The package is efficient, user-friendly, and optimized for large-scale EHR datasets. It supports diverse study designs, customizable analysis parameters, and parallel computing for enhanced performance. Through a case study utilizing UK Biobank data to investigate disease networks associated with short leukocyte telomere length, we demonstrated the capability of DiNetxify to identify meaningful disease clusters and progression patterns consistent with established knowledge while uncovering novel insights. Computationally, the software successfully completed analyses involving cohorts exceeding half a million exposed individuals within 17 h, using moderate computational resources. We thus anticipate that DiNetxify can significantly reduce technical barriers to facilitate broader adoption of advanced disease network analysis techniques by different researchers, thereby enhancing the exploration of EHR data to improve the understanding of holistic health dynamics.
A considerable number of studies have highlighted that engaging in physical activity (PA) improves health and reduces risk of mortality. But is there a limit? Some evidence suggests a U-shaped exposure-response in which...A considerable number of studies have highlighted that engaging in physical activity (PA) improves health and reduces risk of mortality. But is there a limit? Some evidence suggests a U-shaped exposure-response in which the protective benefits of strenuous exercise eventually diminish (at some point) and the risk of a cardiovascular event or death increases, thereby questioning a linear association between exercise volume, intensity, and cardiovascular events/mortality. This review evaluates the evidence and critically appraises studies assessing whether strenuous exercise is associated with increased cardiovascular-related events from an epidemiological perspective. After a comprehensive literature search, 1,908 records were identified; 1,068 remained after deduplication. Title/abstract screening excluded 950 records; 66 full texts were assessed; 14 studies were included for critical review. Two independent assessors appraised study quality and risk of bias, focusing on exposure and outcome measurement, confounder control, and whether timeframes and follow-up were adequate to observe associations. Evidence supporting a U-shaped exposure-response was limited. No study achieved the highest quality rating. Common limitations included inconsistent intensity classification, absence of repeated exposure measurement, inconsistencies with outcome measures, insufficient follow-up to capture long-term effects, and incomplete adjustment for key confounders. The current evidence supports the benefits of regular PA, including strenuous activity, with benefits appearing to plateau at very high doses. Further rigorous epidemiological research with repeated exposure measures, standardised outcomes, adequate follow-up, and more robust control for confounding is needed.
Zhu C, Thong MSY, Doege D
… +10 more, Koch-Gallenkamp L, Bertram H, Eberle A, Holleczek B, Nennecke A, Waldmann A, Zeißig SR, Pritzkuleit R, Brenner H, Arndt V
Eur J Epidemiol
· 2026 Feb · PMID 41579289
·
Full text
The association between healthy lifestyles and mortality in cancer survivors remains inconclusive with few evidence among long-term cancer survivors (LTCS, survived ≥ 5 years post-diagnosis). Our study aims to investigat...The association between healthy lifestyles and mortality in cancer survivors remains inconclusive with few evidence among long-term cancer survivors (LTCS, survived ≥ 5 years post-diagnosis). Our study aims to investigate the association between individual and combined healthy lifestyle factors and mortality in LTCS. We included 6,057 LTCS of breast, colorectal or prostate cancer from a multiple regions study in Germany. A healthy lifestyle score (HLS) comprising alcohol consumption, body mass index (BMI), physical activity and smoking was created and was classified into tertiles with higher tertile indicating healthier lifestyle. We used Cox proportional hazards regression to examine the associations of individual lifestyle factors and HLS with all-cause mortality among LTCS. A total of 2,015 death events occurred over a maximum follow-up period of 12.3 years. Compared with the lowest tertile, participants in the middle and highest tertile experienced a 27% and 32% lower mortality (middle [hazard ratio (HR), 0.73; 95% CI 0.65-0.83]; highest [HR, 0.68, 95% CI 0.61-0.76]). A significant dose-response relationship was observed (p < 0.001). These associations were consistent across different demographic and clinical characteristics. In addition, full adherence to lifestyle recommendations for smoking (HR, 0.51, 95% CI 0.44-0.59), physical activity (HR, 0.78, 95% CI 0.70-0.86) and BMI (HR, 0.87, 95% CI 0.77-0.99) were significantly related to a lower mortality, after full adjustment. Adherence to an overall healthy lifestyle was associated with significantly lower all-cause mortality in LTCS, emphasizing the importance of maintaining and promoting a healthier lifestyle among LTCS.
Hilbert J, Topfstedt F, Matuschik L
… +4 more, Schmitt L, Panzeri I, Pospisilik JA, Seifert G
Eur J Epidemiol
· 2026 Mar · PMID 41579288
·
Full text
Early-onset colorectal cancer (eoCRC), defined by diagnosis before age 50, is increasing worldwide. Metabolic disorders are suspected contributors. We performed a systematic review and meta-analysis to quantify associati...Early-onset colorectal cancer (eoCRC), defined by diagnosis before age 50, is increasing worldwide. Metabolic disorders are suspected contributors. We performed a systematic review and meta-analysis to quantify associations between eoCRC and obesity, type 2 diabetes, hyperlipidemia, arterial hypertension and metabolic syndrome. We systematically searched MEDLINE, Cochrane Central Register of systematic reviews, EMBASE, ClinicalTrials.gov, and Web of Science from March 2023 to December 2024. A univariate meta-analysis was performed for outcomes with at least four studies and comparable means of association. 38 studies were included. Obesity at diagnosis was associated significantly with a 1.45-fold increased risk of eoCRC. Elevated BMI during late adolescence, at age 20, and at age 30 were associated with higher eoCRC risk in multiple cohort studies. as independent risk factors. Among male individuals aged 20-49, Type 2 diabetes increased eoCRC risk, with affected individuals exhibiting a 10-year colorectal cancer risk comparable to that of the general population at age 50,but occurring 4-5 years earlier. Additional positive associations were reported for hyperlipidemia (ages 20-39), arterial hypertension in males (ages 20-39), and metabolic syndrome, although findings were heterogeneous. A higher number of metabolic comorbidities was positively correlated with increased eoCRC risk. Early metabolic dysregulation appears to accelerate colorectal carcinogenesis, increasing the impact of metabolic risk factors at younger ages. As metabolic disorders rise among adolescents and young adults, the eoCRC burden likely will grow. Life-course studies integrating metabolic trajectories, molecular biomarkers, epidemiologic data while accounting for screening exposure are needed to clarify causal pathways and guide prevention and screening.
Eur J Epidemiol
· 2026 Feb · PMID 41579287
·
Full text
Excess mortality during the COVID-19 pandemic partly exceeded COVID-19-related deaths, indicating that other causes may have contributed. We conducted a retrospective data-linkage study including all Dutch inhabitants to...Excess mortality during the COVID-19 pandemic partly exceeded COVID-19-related deaths, indicating that other causes may have contributed. We conducted a retrospective data-linkage study including all Dutch inhabitants to investigate the impact of COVID-19 vaccination on excess mortality using a modified self-controlled case series method. We found a 44% lower relative incidence of all-cause deaths in the first three weeks after the primary vaccination compared to more than three weeks after vaccination (IRR 0.56, 95%CI 0.54-0.57). This lower incidence was consistent across vaccine types, doses, genders, age groups, and individuals with or without prior SARS-CoV-2 infection or comorbidities, and for non-COVID-19 related deaths. For booster vaccinations, the relative incidence was similar (IRR 0.49, 95%CI 0.49-0.50). In comparison, we observed a 16-fold higher incidence of all-cause deaths in the three weeks following a registered positive SARS-CoV-2 infection compared to more than three weeks after infection (IRR 16.19, 95%CI 15.78-16.60). A lower relative incidence of short-term deaths following COVID-19 vaccination support that COVID-19 vaccination is not associated with the observed excess mortality.
Pineda-Moncusí M, Rahman M, Axson EL
… +2 more, Hodgson S, Delmestri A
Eur J Epidemiol
· 2026 Feb · PMID 41579286
·
Full text
Since its establishment in the late 1980s, the UK Clinical Practice Research Datalink (CPRD) has become one of the most widely utilised data resources in both national and international research. Its value lies in the ri...Since its establishment in the late 1980s, the UK Clinical Practice Research Datalink (CPRD) has become one of the most widely utilised data resources in both national and international research. Its value lies in the richness, scale and quality of its routinely collected primary care data, as well as the availability of numerous linkable datasets. This study provides comprehensive scientometric analyses of CPRD-related research output, impact, and data usage from 1988 to 2024. A total of 3779 peer-reviewed publications were identified, and for 98.78% of them, enriched bibliometric metadata were retrieved through Scopus and Web of Science. The UK emerged as the leading contributing country, with the United States and Canada ranking second and third. 'McGill University' was the most frequently affiliated institution, followed by the 'University of Manchester' and the 'University of Oxford', with seven UK universities among the top ten. The three journals most frequently publishing CPRD-based research overall, and since 2020, were 'BMJ Open', 'Pharmacoepidemiology and Drug Safety' and 'British Journal of General Practice'. Analyses of primary care data sources utilisation revealed that overall, 86.35% of manuscripts used CPRD GOLD exclusively, 8.39% used both CPRD GOLD and CPRD Aurum, and 4.76% used CPRD Aurum alone, although recent years showed an increased use of CPRD Aurum. Between 2016 and 2024, most articles (80.26%) were associated with CPRD research applications that referenced linked or CPRD algorithm-derived datasets. The three most frequently used were 'Hospital Episode Statistics' (69.77%), 'Small Area Linkages' (62.27%) and 'Office for National Statistics' mortality data (53.28%).