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Biomedical subjects

K J Rothman

Publications and source records attributed to K J Rothman.

At least 109 records · Page 6Linked to original sources
PubMed1982

Vaginal spermicides and gonorrhea.

All positive cultures for neisseria gonorrhoeae recorded from Dec 20, 1978, through Dec 31, 1980, for women born between 1940 and 1960 were identified among members of Group Health Cooperative of Puget Sound, Seattle, and rates of gonorrhea were calculated for recent oral contraceptive users, recent vaginal spermicide users, and women with surgical sterilization. The risk ratio (RR) estimate, based on the included population, for spermicide users compared with all others was 0.23 (90% confidence interval [Cl], 0.10, 0.50). When women with positive cultures for N gonorrhoeae were compared with women with negative cultures, the RR estimate comparing spermicide users with all others was 0.13 (90% Cl, 0.05, 0.34). The results are consistent with the protective effect of vaginal spermicides against gonorrhea.

Adult↗
PubMed1982

Models of varying parametric form in case-referent studies.

The analysis of case-referent data can be based on a consideration of case and referent counts in various exposure categories as the realization of a set of binomial processes. After appropriate modeling of the binomial parameters, a joint likelihood function can be formed and maximized to obtain estimates of the parameters constituting the model elements. The procedure has been applied to the problem of additive and multiplicative models of disease incidence rates, as encountered in case-referent studies. Likelihood ratios can be used to compare models with equal numbers of parameters. These ratios do not lead to significance tests, but to estimate of the relative degree of corroboration of different hypotheses by the data at hand.

Body Weight↗
PubMed1982

Interaction of alcohol and tobacco in laryngeal cancer.

Both alcohol and tobacco use are accepted risk factors for laryngeal cancer. The authors used case-control data from previous studies to estimate the value of a previously proposed index of interaction between these two risk factors. In addition to the weighting procedure over exposure categories that was previously proposed for estimating a summary index, they applied maximum-likelihood techniques to facilitate the estimation. Overall, they found moderate synergy between alcohol and tobacco in increasing the risk of laryngeal cancer, in that exposure to both factors increased the risk about 50% more than the increase predicted if the effects of tobacco and alcohol were simply additive.

Adult↗
PubMed1982

The incidence and severity of burn injuries following Project Burn Prevention.

Project Burn Prevention, an educational program about burn safety, was implemented in the Greater Boston area from October 1977 through May 1978. The program consisted of three components: a media campaign, a school-initiated intervention, and a community-initiated intervention. Estimates of burn incidence and severity of injury because of scald, flame, electrical or contact burns, or smoke inhalation were made on all patients coming to target- or comparison-area hospitals for a four-year period before the program, the eight months during the program, and the 12 months after the program. Analysis of burn incidence during and after the interventions showed that the school-initiated intervention did not reduce the incidence or severity of burn injuries. The community-initiated intervention may have brought about a moderate, temporary reduction in the rate of burn injuries, although the increase in burn incidence observed for the media campaign of educational messages broadcast to the Greater Boston area suggests that the more plausible explanation for this effect is random variation in burn incidence.

Adult↗
PubMed1982

Occupational risk for laryngeal cancer.

In a case-control analysis, we studied the effects of type of employment on laryngeal cancer risk using the interview data from the Third National Cancer Survey. Effects were measured relative to the risk for those employed in a group of arbitrarily defined industries and occupations with low risk. We excluded females and controlled for age, tobacco use, alcohol use, and race in the analysis. We found ratio estimates above 3.0 for workers in the railroad industry and the lumber industry; and for sheetmetal workers, grinding wheel operators, and automobile mechanics.

Adult↗
PubMed1982

An independent analysis of the National Cancer Institute study on non-nutritive sweeteners and bladder cancer.

We evaluated the possible relation between use of non-nutritive sweeteners and bladder cancer using data obtained from the National Cancer Institute Bladder Cancer Study under the Freedom of Information Act. In the general study group, there was no evidence for an association between non-nutritive sweeteners and bladder cancer. Control for a variety of factors through multivariate techniques diminished the plausibility of earlier interpretations of these data, which had raised the possibility that certain subgroups of users or non-nutritive sweeteners might be at an increased risk for bladder cancer. We found that the putative effects of non-nutritive sweeteners were not consistent among subgroups with similar baseline risk, did not display consistent dose-response trends, and were subject to considerable sampling error. We concluded that the data provided little evidence that non-nutritive sweeteners increase risk for bladder cancer among subgroups of users, and that definitive evidence on this question is beyond the reach of conventional research.

Adult↗
PubMed1982

Spermicide use and Down's syndrome.

A connection has been suggested between use of vaginal spermicides and the occurrence of Down's syndrome among offspring born to women who used these contraceptive agents. This hypothesis was evaluated with data from a case-control study of congenital heart disease, which included among the subjects 16 infants with Down's syndrome. The estimated ratio of the proportion of Down's syndrome births among spermicide users to the proportion in non-users was 3.6, with a 90 per cent confidence interval of 1.2 to 9.0, thus providing a tentative confirmation of the hypothesis.

Adult↗
PubMed1981

Hospitalization rates in vasectomized men.

Six thousand ninety-two men who had undergone vasectomy were observed for 20,491 person-years of observation in a prepaid group practice. The incidences of first-time hospitalizations for a variety of diagnoses were examined as a proxy for disease incidence rates and compared with similarly derived rates in the remaining male membership of the practice. Vasectomized men had comparatively high rates of hospitalization for a variety of diseases of the genitourinary system during the early postvasectomy period. Apart from these, there were no important, statistically convincing elevations in the new hospitalization rates among vasectomized men, as compared with those of the nonvasectomized comparison group.

Adult↗
PubMed1981

Vaginal spermicides and congenital disorders.

Among 763 liveborn infants of white women who had obtained a vaginal spermicide in the ten months before conception, the prevalence of certain major congenital anomalies was 2.2%. The prevalence of such anomalies in a comparison group of 3,902 infants was 1.0%. The difference between these groups was due to an excess of limb-reduction deformities, neoplasms, syndromes associated with chromosomal abnormalities, and hypospadias in the infants whose mothers are presumed to have used vaginal spermicides. Pregnancies in women who had used vaginal spermicides ended in spontaneous abortion requiring hospitalization 1.8 times more commonly than did pregnancies in those who had not. Since a well-defined syndrome among babies with congenital disorders whose mothers used spermicides was not present, these results should be considered tentative until confirmed by other data.

Abnormalities, Drug-Induced↗
PubMed1981

Vasectomy and non-fatal myocardial infarction.

The incidence of non-fatal myocardial infarction among 4830 vasectomised men was 0.9 cases per 1000 man-years during 24 420 man-years of observation. This was slightly lower than the rate in 24 150 non-vasectomised men, matched with a vasectomised man for calendar year of birth and duration of observation. Review of medical records for a matched sample of study subjects indicated no measurable confounding by important cardiac risk factors.

Adult↗
PubMed1981

Early menopause and the risk of myocardial infarction.

We evaluated the relation between age at menopause and the risk of nonfatal myocardial infarction (MI) among 121,964 nurses who responded to a mail questionnaire. Of 279 women who reported having been hospitalized for MI, 123 (44%) were postmenopausal (i.e., no longer menstruating) at the time of hospitalization, compared with 1,859 (33%) of 5,580 age-matched control subjects. Among women who became menopausal because of bilateral oophorectomy, the estimated relative risk of MI increased with decreasing age at menopause, and women who underwent bilateral oophorectomy before age 35 were estimated to have a risk of hospitalization for MI approximately 7.2 times (95% confidence interval, 4.5 to 11.4) that of premenopausal women. Hysterectomy without the removal of both ovaries was only weakly associated with an increased risk. The data support the hypothesis that premature cessation of ovarian function increases the risk of nonfatal MI.

Adult↗
PubMed1981

Induction and latent periods.

Induction and latent periods are distinguishable concepts referring respectively to the period between causal action and disease initiation, and the period between disease initiation and detection. A disease cannot be characterized as having a long or short induction period, except in relation to a specific etiologic component. Inappropriate assumptions, explicit or implicit, about the length of the combined induction and latent period (the "empirical induction period") in an analytic study result in nondifferential misclassification and bias toward the null. Repeated analyses, varying the assumptions about the length of the empirical induction period, can be used to minimize such misclassification, thereby providing estimates for an undiluted measure of effect and the mode of the empirical induction period.

Disease↗