SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Crippa Alessio) "

Sökning: WFRF:(Crippa Alessio)

  • Resultat 1-10 av 10
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Crippa, Alessio, et al. (författare)
  • Coffee Consumption and Mortality From All Causes, Cardiovascular Disease, and Cancer : A Dose-Response Meta-Analysis
  • 2014
  • Ingår i: American Journal of Epidemiology. - : OXFORD UNIV PRESS INC. - 0002-9262 .- 1476-6256. ; 180:8, s. 763-775
  • Forskningsöversikt (refereegranskat)abstract
    • Several studies have analyzed the relationship between coffee consumption and mortality, but the shape of the association remains unclear. We conducted a dose-response meta-analysis of prospective studies to examine the dose-response associations between coffee consumption and mortality from all causes, cardiovascular disease (CVD), and all cancers. Pertinent studies, published between 1966 and 2013, were identified by searching PubMed and by reviewing the reference lists of the selected articles. Prospective studies in which investigators reported relative risks of mortality from all causes, CVD, and all cancers for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Twenty-one prospective studies, with 121,915 deaths and 997,464 participants, met the inclusion criteria. There was strong evidence of nonlinear associations between coffee consumption and mortality for all causes and CVD (P for nonlinearity < 0.001). The largest risk reductions were observed for 4 cups/day for all-cause mortality (16%, 95% confidence interval: 13, 18) and 3 cups/day for CVD mortality (21%, 95% confidence interval: 16, 26). Coffee consumption was not associated with cancer mortality. Findings from this meta-analysis indicate that coffee consumption is inversely associated with all-cause and CVD mortality.
  •  
2.
  • Crippa, Alessio (författare)
  • Novel methods for dose-response meta-analysis
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Dose–response meta-analysis is a statistical procedure for combining and contrasting the evidence on the association between a continuous exposure and the risk of a health outcome. Different papers refined selected aspects of the methodology, such as implementation of flexible strategies and extensions to multivariate meta-analysis. However, there were still several relevant questions that needed to be addressed. This thesis aims to address these issues by developing and implementing new strategies and ad-hoc measures (Paper I), including tools for evaluating the goodness-of-fit (Paper II), a new measure for quantifying the impact of heterogeneity (Paper III), a strategy to deal with differences in the exposure range across studies (Paper IV), and a one-stage approach to estimate complex models without excluding relevant studies (Paper V). In Paper I, we described the implementation of the main aspects of the methodology in the dosresmeta R package available on CRAN. Dedicated functions were written to facilitate specific tasks such as definition of the design matrix and prediction of the pooled results. We illustrated how to estimate both linear and non-linear curves, conduct test of hypotheses, and present the results in a tabular and graphical format reanalyzing published aggregated dose–response data. In Paper II, we discussed how to evaluate the goodness-of-fit. The proposed solutions consist of descriptive measures to summarize the agreement between fitted and observed data (the deviance and the coefficient of determination), and graphical tools to visualize the fit of the model (decorrelated residuals-versus-exposure plot). A reanalysis of two published meta-analyses exemplified how these tools can improve the practice of quantitative synthesis of aggregated dose–response data. In Paper III, we proposed and characterized a new measure, Rˆb, to quantify the proportion of the variance of the pooled estimate attributable to the between-study heterogeneity. Contrary to the available measures of heterogeneity, Rˆb does not make any assumption about the distribution of the within-study error variances, nor does it require specification of a typical value for these quantities. The performance of the proposed measure was evaluated in an extensive simulation study. We demonstrated how to present and interpret the Rˆb -analyzing three published meta-analyses. In Paper IV, we extended a point-wise approach to dose–response meta-analysis of aggregated data. The strategy consists of combining predicted relative risks for a fine grid of exposure values based on potentially different dose–response models. A point-wise approach can improve the flexibility in modeling the study-specific curves and may limit the impact of extrapolation by predicting the studyspecific relative risks based on the observe exposure range. We illustrated the methodology using both individual and aggregated participant data. In Paper V, we formalized a one-stage approach for dose–response meta-analysis in terms of a linear mixed model. We explained the main aspects of the methodology and how to address the same questions frequently answered in a two-stage analysis. Using both hypothetical and real data, we showed how the one-stage approach can facilitate the assessment of heterogeneity over the exposure range, model comparison, and prediction of individual dose–response associations. The main advantage is that flexible curves can be estimated regardless of the number of data-points in the individual analyses. In conclusion, the methods presented in this thesis enrich the set of tools available for applying dose–response meta-analyses and for addressing specific questions including goodness-of-fit evaluation (Paper II) and quantification of heterogeneity (Paper III). In addition, we presented alternative models for pooling results in case of heterogeneous exposure range (Paper IV) and for estimating complex models without excluding relevant studies (Paper V). The proposed methods have been illustrated using real data and implemented in user-friendly R packages available on CRAN (Paper I).
  •  
3.
  • Crippa, Alessio, et al. (författare)
  • Red and processed meat consumption and risk of bladder cancer : a dose-response meta-analysis of epidemiological studies.
  • 2018
  • Ingår i: European Journal of Nutrition. - : Springer Science and Business Media LLC. - 1436-6207 .- 1436-6215. ; 57:2, s. 689-701
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/OBJECTIVES: Several epidemiological studies have analyzed the associations between red and processed meat and bladder cancer risk but the shape and strength of the associations are still unclear. Therefore, we conducted a dose-response meta-analysis to quantify the potential association between red and processed meat and bladder cancer risk.METHODS: Relevant studies were identified by searching the PubMed database through January 2016 and reviewing the reference lists of the retrieved articles. Results were combined using random-effects models.RESULTS: Five cohort studies with 3262 cases and 1,038,787 participants and 8 cases-control studies with 7009 cases and 27,240 participants met the inclusion criteria. Red meat was linearly associated with bladder cancer risk in case-control studies, with a pooled RR of 1.51 (95% confidence interval (CI) 1.13, 2.02) for every 100 g increase per day, while no association was observed among cohort studies (P heterogeneity across study design = 0.02). Based on both case-control and cohort studies, the pooled relative risk (RR) for every 50 g increase of processed meat per day was 1.20 (95% CI 1.06, 1.37) (P heterogeneity across study design = 0.22).CONCLUSIONS: This meta-analysis suggests that processed meat may be positively associated with bladder cancer risk. A positive association between red meat and risk of bladder cancer was observed only in case-control studies, while no association was observe in prospective studies.
  •  
4.
  • Crippa, Alessio, et al. (författare)
  • The ProBio trial : molecular biomarkers for advancing personalized treatment decision in patients with metastatic castration-resistant prostate cancer
  • 2020
  • Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Multiple therapies exist for patients with metastatic castration-resistant prostate cancer (mCRPC). However, their improvement on progression-free survival (PFS) remains modest, potentially explained by tumor molecular heterogeneity. Several prognostic molecular biomarkers have been identified for mCRPC that may have predictive potential to guide treatment selection and prolong PFS. We designed a platform trial to test this hypothesis.Methods: The Prostate-Biomarker (ProBio) study is a multi-center, outcome-adaptive, multi-arm, biomarker-driven platform trial for tailoring treatment decisions for men with mCRPC. Treatment decisions in the experimental arms are based on biomarker signatures defined as mutations in certain genes/pathways suggested in the scientific literature to be important for treatment response in mCRPC. The biomarker signatures are determined by targeted sequencing of circulating tumor and germline DNA using a panel specifically designed for mCRPC.Discussion: Patients are stratified based on the sequencing results and randomized to either current clinical practice (control), where the treating physician decides treatment, or to molecularly driven treatment selection based on the biomarker profile. Outcome-adaptive randomization is implemented to early identify promising treatments for a biomarker signature. Biomarker signature-treatment combinations graduate from the platform when they demonstrate 85% probability of improving PFS compared to the control arm. Graduated combinations are further evaluated in a seamless confirmatory trial with fixed randomization. The platform design allows for new drugs and biomarkers to be introduced in the study.Conclusions: The ProBio design allows promising treatment-biomarker combinations to quickly graduate from the platform and be confirmed for rapid implementation in clinical care.
  •  
5.
  • Di Giuseppe, Daniela, et al. (författare)
  • Fish consumption and risk of rheumatoid arthritis : a dose-response meta-analysis
  • 2014
  • Ingår i: Arthritis Research & Therapy. - : BMC. - 1478-6354 .- 1478-6362. ; 16:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The association between fish consumption and rheumatoid arthritis (RA) is unclear. The aim of this paper was to summarize the available evidence on the association between fish consumption and risk of RA using a dose-response meta-analysis. Methods: Relevant studies were identified by a search of MEDLINE and EMBASE through December 2013, with no restrictions. A random-effects dose-response meta-analysis was conducted to combine study specific relative risks. Potential non-linear relation was investigated using restricted cubic splines. A stratified analysis was conducted by study design. Results: Seven studies (four case-controls and three prospective cohorts) involving a total of 174 701 participants and 3346 cases were included in the meta-analysis. For each one serving per week increment in fish consumption, the relative risk (RR) of RA was 0.96 (95% confidence interval (CI) 0.91 to 1.01). Results did not change when stratifying by study design. No heterogeneity or publication bias was observed. When fish consumption was modeled using restricted cubic splines, the risk of RA was 20 to 24% lower for 1 up to 3 servings per week of fish (RR = 0.76, 95% CI: 0.57 to 1.02) as compared to never consumption. Conclusions: Results from this dose-response meta-analysis showed a non-statistically significant inverse association between fish consumption and RA.
  •  
6.
  • Eriksson, Mikael, et al. (författare)
  • Low-Dose Tamoxifen for Mammographic Density Reduction : A Randomized Controlled Trial
  • 2021
  • Ingår i: Journal of Clinical Oncology. - 0732-183X. ; 39:17, s. 1899-
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Tamoxifen prevents breast cancer in high-risk women and reduces mortality in the adjuvant setting. Mammographic density change is a proxy for tamoxifen therapy response. We tested whether lower doses of tamoxifen were noninferior to reduce mammographic density and associated with fewer symptoms.PATIENTS AND METHODS: Women, 40-74 years of age, participating in the Swedish mammography screening program were invited to the 6-month double-blind six-arm randomized placebo-controlled noninferiority dose-determination KARISMA phase II trial stratified by menopausal status (EudraCT 2016-000882-22). In all, 1,439 women were accrued with 1,230 participants accessible for intention-to-treat analysis. The primary outcome was proportion of women treated with placebo, 1, 2.5, 5, and 10 mg whose mammographic density decreased at least as much as the median reduction in the 20 mg arm. The noninferior margin was 17%. Secondary outcome was reduction of symptoms. Post hoc analyses were performed by menopausal status. Per-protocol population and full population were analyzed in sensitivity analysis.RESULTS: The 1,439 participants, 566 and 873 pre- and postmenopausal women, respectively, were recruited between October 1, 2016, and September 30, 2019. The participants had noninferior mammographic density reduction following 2.5, 5, and 10 mg tamoxifen compared with the median 10.1% decrease observed in the 20 mg group, a reduction confined to premenopausal women. Severe vasomotor symptoms (hot flashes, cold sweats, and night sweats) were reduced by approximately 50% in the 2.5, 5, and 10 mg groups compared with the 20 mg group.CONCLUSION: Premenopausal women showed noninferior magnitude of breast density decrease at 2.5 mg of tamoxifen, but fewer side effects compared with the standard dose of 20 mg. Future studies should test whether 2.5 mg of tamoxifen reduces the risk of primary breast cancer.
  •  
7.
  • Hammarström, Mattias, et al. (författare)
  • Side effects of low-dose tamoxifen : results from a six-armed randomised controlled trial in healthy women
  • 2023
  • Ingår i: British Journal of Cancer. - 0007-0920 .- 1532-1827. ; 129:1, s. 61-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Adherence to adjuvant tamoxifen therapy is suboptimal, and acceptance of tamoxifen for primary prevention is poor. Published results indicate effect of low-dose tamoxifen therapy. Using questionnaire data from a randomised controlled trial, we describe side effects of standard and low-dose tamoxifen in healthy women. Methods: In the KARISMA trial, 1440 healthy women were randomised to 6 months of daily intake of 20, 10, 5, 2.5, 1 mg of tamoxifen or placebo. Participants completed a 48-item, five-graded Likert score symptom questionnaire at baseline and follow-up. Linear regression models were used to identify significant changes in severity levels across doses and by menopausal status. Results: Out of 48 predefined symptoms, five were associated with tamoxifen exposure (hot flashes, night sweats, cold sweats, vaginal discharge and muscle cramps). When comparing these side effects in premenopausal women randomised to low doses (2.5, 5 mg) versus high doses (10, 20 mg), the mean change was 34% lower in the low-dose group. No dose-dependent difference was seen in postmenopausal women. Conclusions: Symptoms related to tamoxifen therapy are influenced by menopausal status. Low-dose tamoxifen, in contrast to high-dose, was associated with less pronounced side effects, a finding restricted to premenopausal women. Our findings give new insights which may influence future dosing strategies of tamoxifen in both the adjuvant and preventive settings. Trial registration: ClinicalTrials.gov ID: NCT03346200.
  •  
8.
  •  
9.
  • Larsson, Susanna C, et al. (författare)
  • Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer : A Systematic Review and Meta-Analysis
  • 2015
  • Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 7:9, s. 7749-7763
  • Tidskriftsartikel (refereegranskat)abstract
    • Results from epidemiological studies of milk consumption and mortality are inconsistent. We conducted a systematic review and meta-analysis of prospective studies assessing the association of non-fermented and fermented milk consumption with mortality from all causes, cardiovascular disease, and cancer. PubMed was searched until August 2015. A two-stage, random-effects, dose-response meta-analysis was used to combine study-specific results. Heterogeneity among studies was assessed with the I-2 statistic. During follow-up periods ranging from 4.1 to 25 years, 70,743 deaths occurred among 367,505 participants. The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies. There was substantial heterogeneity among studies of non-fermented milk consumption in relation to mortality from all causes (12 studies; I-2 = 94%), cardiovascular disease (five studies; I-2 = 93%), and cancer (four studies; I-2 = 75%) as well as among studies of fermented milk consumption and all-cause mortality (seven studies; I-2 = 88%). Thus, estimating pooled hazard ratios was not appropriate. Heterogeneity among studies was observed in most subgroups defined by sex, country, and study quality. In conclusion, we observed no consistent association between milk consumption and all-cause or cause-specific mortality.
  •  
10.
  • Trevisan, Caterina, et al. (författare)
  • Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults : A Systematic Review and Meta-Analysis
  • 2019
  • Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 20:5, s. 569-582
  • Forskningsöversikt (refereegranskat)abstract
    • Objectives: To evaluate the association between nutritional status, defined on the basis of a multidimensional evaluation, and body mass index (BMI) with the risk of falls and recurrent falls in communitydwelling older people.Design: Systematic literature review and meta-analysis.Setting and Participants: Community-dwelling older adults.Measures: A systematic literature review was conducted on prospective studies identified through electronic and hand searches until October 2017. A random effects meta-analysis was used to evaluate the relative risk (RR) of experiencing falls and recurrent falls (>= 2 falls within at least 6 months) on the basis of nutritional status, defined by multidimensional scores. A random effects dose-response metaanalysis was used to evaluate the association between BMI and the risk of falls and recurrent falls.Results: People who were malnourished or those at risk for malnutrition had a pooled 45% higher risk of experiencing at least 1 fall than were those well-nourished (9510 subjects). Increased falls risk was observed in subjects malnourished versus well-nourished [RR 1.64, 95% confidence interval (CI) 1.182.28; 3 studies, 8379 subjects], whereas no substantial results were observed for risk of recurrent falls. A U-shaped association was detected between BMI and the risk for falls (P <. 001), with the nadir between 24.5 and 30 (144,934 subjects). Taking a BMI of 23.5 as reference, the pooled RR of falling ranged between 1.09 (95% CI 1.04-1.15) for a BMI of 17, to 1.07 (95% CI 0.92-1.24) for a BMI of 37.5. No associations were observed between BMI and recurrent falls (120,185 subjects).Conclusions/Implications: The results of our work suggest therefore that nutritional status and BMI should be evaluated when assessing the risk for falls in older age.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-10 av 10

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy