Statistical methods to characterize causal mechanisms by which air pollution affects the recurrence of cardiovascular events

描述空气污染影响心血管事件复发因果机制的统计方法

基本信息

  • 批准号:
    10660281
  • 负责人:
  • 金额:
    $ 179.01万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-09-23 至 2026-08-31
  • 项目状态:
    未结题

项目摘要

Project Summary One of our era's greatest scourges is air pollution, and it is well documented that exposure to fine particles (e.g., PM2.5) increases the risk of cardiovascular disease (CVD) and death. However, there are two critical knowledge gaps. First, existing studies have mainly considered the occurrence of the first adverse health event as health out- comes; hence, the impact of overall disease burden and of PM2.5 exposure on disease progression both remain unknown. Second, to our knowledge, there are no studies assessing the causal pathways by which exposure to air pollutants impacts recurrent cardiovascular events. Without a better understanding of disease progression and clinical mediators, our ability to inform regulatory policy and prevent disease is severely hampered. Limited attention has been given to developing methods for assessing the causal effect of time varying ex- posures, especially in the presence of a terminating event like death. A related methodological gap is the ability to identify (time varying) mediators or estimating mediated effects of time varying exposure for a recurrent event outcome. This proposal addresses these two critical methodological gaps in causal inference, the overarching goals being to elucidate (i) the impact of PM2.5 on the burden and progression of CVD; and, (ii) the key causal pathways by which air pollution exposure impacts such events. Accomplishing such goals will be facilitated by new analyses of an unprecedented data collection consisting of (a) an already harmonized and linked Part A Medicare data (33+ million subjects 2000 to 2019) at both the individual (e.g., age, gender, race, date of hospital- ization for any of the possible causes for hospitalizations, date of death) and zip code (e.g., daily PM2.5, O3 and NO2 levels; many potential confounders) levels; and, (b) an augmented version of these data including individu- ally linked Part B data (doctor visits, and outpatient procedures for any cause) for a representative sample of over 15 million Medicare enrollees (2012 to 2019) and, (c) the Medicare Current Beneficiary Survey (MCBS) data for the same study period, as a secondary analysis to account for possible bias due to unmeasured confounding. In methodological terms, we propose robust marginal and structural nested models that allow estimation of both instantaneous and delayed effects of time varying exposure to PM2.5 on recurrence of CVD events (Aim 1). We further propose a semiparametric approach to identify clinically important pathways by which exposure to air pollutants increases the risk of recurrence of CVD hospitalizations and death, and estimate the corresponding mediated effects (Aim 2). We will implement our methods and apply them to the above-described rich data source, focusing specifically on (Aim 3): (i) estimating the causal effects of PM2.5 exposure on two relevant causal estimands for recurrent events in the presence of mortality; (ii) identifying key mediators and characterize clinical pathways through which exposure to air pollution increases risks of CVD progression and death; and, (iii) identifying and investigating the disease groups that are biologically plausible. Finally, we will create and disseminate open-source, peer-reviewed statistical software to ensure ease-of-use and accessibility (Aim 4).
项目摘要 我们这个时代最大的祸害之一是空气污染,有充分的证据表明,接触fiNe颗粒(例如, PM2.5)会增加心血管疾病(CVD)和死亡的风险。然而,有两个关键知识 差距。首先,现有的研究主要认为fi第一次不良健康事件的发生是健康输出- 因此,总体疾病负担和PM2.5暴露对疾病进展的影响仍然存在 未知。第二,据我们所知,目前还没有研究评估暴露于 空气污染物会影响反复发生的心血管事件。没有更好地了解疾病的发展 和临床调解人,我们为监管政策和预防疾病提供信息的能力受到严重阻碍。 人们对开发评估时变因素的因果效应的方法给予了有限的关注。 伪装,尤其是在发生像死亡这样的终结事件的时候。一个相关的方法论差距是能力 识别(时变)介体或估计时变暴露对复发事件的介体效应 结果。这一建议解决了因果推理中的这两个关键的方法论差距,最重要的是 目的是阐明(I)PM2.5对心血管疾病负担和进展的影响;以及(Ii)主要原因 暴露于空气污染影响这类事件的途径。实现这些目标将通过以下方式促进 对史无前例的数据收集的新分析,包括:(A)已经协调一致并相互关联的A部分 2000年至2019年的医疗保险数据(3300万受试者)在个人(例如,年龄、性别、种族、住院日期- 任何可能的住院原因、死亡日期)和邮政编码(例如,每日PM2.5、臭氧和 NO2水平;许多潜在混杂因素)水平;以及,(B)这些数据的增强版本,包括个人- 具有代表性的样本B部分数据(因任何原因就诊和门诊手术) 1,500万联邦医疗保险参保人(2012年至2019年)和,(C)#年联邦医疗保险现行Benefi年度调查(MCBS)数据 在同一研究期间,作为二次分析,以说明由于未测量的混杂可能造成的偏差。 在方法论方面,我们提出了稳健的边际和结构嵌套模型,允许估计 时变暴露于PM2.5对心血管疾病事件复发的瞬时和延迟影响(目标1)。 我们进一步提出了一种半参数方法来确定暴露于空气中的临床重要途径。 污染物增加了心血管疾病住院和死亡的复发风险,并估计相应的 中介效应(目标2)。我们将实现我们的方法,并将它们应用于上述丰富的数据 来源,重点是fi(目标3):(1)估计PM2.5暴露对两个相关的 在存在死亡率的情况下对复发事件的因果估计;(2)确定关键调节因素并确定其特征 暴露于空气污染增加心血管疾病进展和死亡风险的临床途径;以及, (3)确定和调查生物学上可信的疾病组。最后,我们将创建和 传播开放源码、经同行审查的统计软件,以确保易用性和可及性(目标4)。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Francesca Dominici其他文献

Francesca Dominici的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Francesca Dominici', 18)}}的其他基金

CAFÉ: a Research Coordinating Center to Convene, Accelerate, Foster, and Expand the Climate Change and Health Community of Practice
CAF:一个研究协调中心,旨在召集、加速、培育和扩大气候变化与健康实践社区
  • 批准号:
    10689581
  • 财政年份:
    2023
  • 资助金额:
    $ 179.01万
  • 项目类别:
Augmented mapping of the Extreme Heat and Cold Events (EHE/ECE) at continental scale with cloud-based computing
利用基于云的计算对大陆范围内的极热和极冷事件 (EHE/ECE) 进行增强测绘
  • 批准号:
    10826885
  • 财政年份:
    2022
  • 资助金额:
    $ 179.01万
  • 项目类别:
The confluence of extreme heat cold on the health and longevity of an Aging Population with Alzheimers and related Dementia
极热寒冷对患有阿尔茨海默病和相关痴呆症的老年人口的健康和寿命的影响
  • 批准号:
    10448053
  • 财政年份:
    2022
  • 资助金额:
    $ 179.01万
  • 项目类别:
Relationship Between Multiple Environmental Exposures and CVD Incidence and Survival: Vulnerability and Susceptibility
多重环境暴露与 CVD 发病率和生存率之间的关系:脆弱性和易感性
  • 批准号:
    10163485
  • 财政年份:
    2020
  • 资助金额:
    $ 179.01万
  • 项目类别:
Integrating Air Pollution Prediction Models: Uncertainty Quantification and Propagation in Health Studies
整合空气污染预测模型:健康研究中的不确定性量化和传播
  • 批准号:
    9885918
  • 财政年份:
    2020
  • 资助金额:
    $ 179.01万
  • 项目类别:
Integrating Air Pollution Prediction Models: Uncertainty Quantification and Propagation in Health Studies
整合空气污染预测模型:健康研究中的不确定性量化和传播
  • 批准号:
    10543137
  • 财政年份:
    2020
  • 资助金额:
    $ 179.01万
  • 项目类别:
Integrating Air Pollution Prediction Models: Uncertainty Quantification and Propagation in Health Studies
整合空气污染预测模型:健康研究中的不确定性量化和传播
  • 批准号:
    10330579
  • 财政年份:
    2020
  • 资助金额:
    $ 179.01万
  • 项目类别:
Relationship Between Multiple Environmental Exposures and CVD Incidence and Survival: Vulnerability and Susceptibility
多重环境暴露与 CVD 发病率和生存率之间的关系:脆弱性和易感性
  • 批准号:
    10058839
  • 财政年份:
    2017
  • 资助金额:
    $ 179.01万
  • 项目类别:
Relationship Between Multiple Environmental Exposures and CVD Incidence and Survival: Vulnerability and Susceptibility
多重环境暴露与 CVD 发病率和生存率之间的关系:脆弱性和易感性
  • 批准号:
    10310468
  • 财政年份:
    2017
  • 资助金额:
    $ 179.01万
  • 项目类别:
STATISTICAL COMPUTING CORE
统计计算核心
  • 批准号:
    8754136
  • 财政年份:
    2014
  • 资助金额:
    $ 179.01万
  • 项目类别:

相似海外基金

Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
  • 批准号:
    MR/S03398X/2
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Fellowship
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
  • 批准号:
    EP/Y001486/1
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Research Grant
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
  • 批准号:
    2338423
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Continuing Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
  • 批准号:
    MR/X03657X/1
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
  • 批准号:
    2348066
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
  • 批准号:
    AH/Z505481/1
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    EU-Funded
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
  • 批准号:
    2341402
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Standard Grant
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
  • 批准号:
    AH/Z505341/1
  • 财政年份:
    2024
  • 资助金额:
    $ 179.01万
  • 项目类别:
    Research Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了