The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.
The Association between Mediated Deprivation and Ovarian Cancer Survival among African American Women.
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DOI：
10.3390/cancers15194848
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发表时间：
2023-10-04
期刊：
影响因子：
5.2
通讯作者：
Schildkraut, Joellen
中科院分区：
文献类型：
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作者：
Lawson, Andrew B.;Kim, Joanne;Johnson, Courtney;Ratnapradipa, Kendra L.;Alberg, Anthony J.;Akonde, Maxwell;Hastert, Theresa;Bandera, Elisa V.;Terry, Paul;Mandle, Hannah;Cote, Michele L.;Bondy, Melissa;Marks, Jeffrey;Peres, Lauren C.;Schildkraut, Joellen
关键词：
根据地区一级的社会经济指标建立的发展指数可以评估社会经济地位与健康结果之间公认的关系。在卵巢癌生存的中介分析中，尚未评估它们在调整剥夺中的作用。在本文中，我们提出了一种贝叶斯SEM方法，因果调解的直接和间接影响的DI的背景下，一个队列的非裔美国妇女卵巢癌。背景：在健康研究中，延迟指数经常用于调整社会经济差异。它们的作用已被部分评估为某些人群水平的癌症结果，但其在卵巢癌中的作用的检查是有限的。在这项研究中，我们评估了一系列公认的剥夺指数与癌症生存率的关系，在一个自我认定的黑人妇女诊断为卵巢癌的队列。本研究旨在确定临床或诊断特征是否位于社会经济地位（SES）和剥夺与卵巢癌生存率之间的中介途径上，这些少数人群的卵巢癌生存率较差。研究方法：我们使用中介分析来研究剥夺指数的直接和间接因果效应，主要中介是诊断时的SEER阶段和残留疾病。分析采用贝叶斯结构方程模型与变量选择。我们采用了联合贝叶斯结构模型的调解人，包括威布尔混合模型的重要结果与剥夺曝光。我们通过蒙特卡洛模型选择程序选择改性剂。结果如下：结果表明，高SES相关指数，如Yost，Kolak城市化（URB），流动性（MOB）和SES维度，以及集中劣势指数（CDI），都对改善生存有显着影响。相比之下，地区贫困指数/辛格和地区一级贫困没有产生重大影响。在某些情况下，间接效应具有非常宽的可信区间，因此尽管估计了直接效应，但总效应仍无法很好地估计。结论：首先，很明显，常用的指标，如Yost或CDI都显着影响诊断为上皮性卵巢癌的黑人妇女的生存经验。此外，Kolak维度指数（URB，MOB，混合移民：云母和SES）也表现出显着的关联，这取决于中介。调解效果因所选择的调解人而异。
Deprivation indices (DIs), constructed from area-level socio-economic indicators, allow to assess the acknowledged relationship between socio-economic status and health outcomes. Their role in adjusting for deprivation has not been evaluated within a mediation analysis of ovarian cancer survival. In this paper, we present a Bayesian SEM approach to causal mediation for direct and indirect effects of DIs in the context of a cohort of African American women with ovarian cancer. Background: Deprivation indices are often used to adjust for socio-economic disparities in health studies. Their role has been partially evaluated for certain population-level cancer outcomes, but examination of their role in ovarian cancer is limited. In this study, we evaluated a range of well-recognized deprivation indices in relation to cancer survival in a cohort of self-identified Black women diagnosed with ovarian cancer. This study aimed to determine if clinical or diagnostic characteristics lie on a mediating pathway between socioeconomic status (SES) and deprivation and ovarian cancer survival in a minority population that experiences worse survival from ovarian cancer. Methods: We used mediation analysis to look at the direct and indirect causal effects of deprivation indices with main mediators of the SEER stage at diagnosis and residual disease. The analysis employed Bayesian structural equation models with variable selection. We applied a joint Bayesian structural model for the mediator, including a Weibull mixed model for the vital outcome with deprivation as exposure. We selected modifiers via a Monte Carlo model selection procedure. Results: The results suggest that high SES-related indices, such as Yost, Kolak urbanicity (URB), mobility (MOB) and SES dimensions, and concentrated disadvantage index (CDI), all have a significant impact on improved survival. In contrast, area deprivation index (ADI)/Singh, and area level poverty (POV) did not have a major impact. In some cases, the indirect effects have very wide credible intervals, so the total effect is not well estimated despite the estimation of the direct effect. Conclusions: First, it is clear that commonly used indices such as Yost, or CDI both significantly impact the survival experience of Black women diagnosed with epithelial ovarian cancer. In addition, the Kolak dimension indices (URB, MOB, mixed immigrant: MICA and SES) also demonstrate a significant association, depending on the mediator. Mediation effects differ according to the mediator chosen.
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影响因子：
2.8
作者：
Madhav, K. C.;Oral, Evrim;Rung, Ariane L.;Trapido, Edward J.;Rozek, Laura S.;Fontham, Elizabeth T. H.;Bensen, Jeannette T.;Farnan, Laura;Steck, Susan E.;Song, Lixin;Mohler, James L.;Peters, Edward S.
通讯作者：
Peters, Edward S.
DOI：
10.1111/j.1467-985x.2004.00349.x
发表时间：
2005-01-01
影响因子：
2
作者：
Greenland, S
通讯作者：
Greenland, S
DOI：
10.1080/10618600.2016.1172487
发表时间：
2017-01-01
影响因子：
2.4
作者：
de Valpine, Perry;Turek, Daniel;Bodik, Rastislav
通讯作者：
Bodik, Rastislav
影响因子：
--
作者：
Singh GK;Jemal A
通讯作者：
Jemal A
影响因子：
4
作者：
通讯作者：
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