Outcomes ascertainment and adjudication methods in the women's health initiative

Curb, J. David; McTiernan, Anne; Heckbert, Susan R.; Kooperberg, Charles; Stanford, Janet L.; Nevitt, M.; Johnson, Karen C.; Proulx-Burns, Lori; Pastore, Lisa M.; Criqui, Michael H.; Daugherty, Sandra A.

doi:10.1016/s1047-2797(03)00048-6

Cited by 631 publications

(621 citation statements)

References 5 publications

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“…Outcomes in the OS were identified through self-report at annual contacts, and specific details were obtained as needed using standardized questionnaires and request of medical records. 15 Data linkage with the National Death Index was performed to assure completeness of survival data, and causes of death were actively investigated. Adjudication of outcomes was performed by physicians at the Clinical Centers, the Clinical Coordinating Center, and the National Institutes of Health, using a staged approach.…”

Section: Discussionmentioning

confidence: 99%

Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women’s Health Initiative

et al. 2014

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BACKGROUND: Data are limited regarding the influence of diet drink consumption on cardiovascular disease (CVD) outcomes. OBJECTIVE: We aimed to evaluate the relationship between diet drink intake and cardiovascular events. DESIGN: We conducted a retrospective cohort study, utilizing data from the national, multicenter Women's Health Initiative Observational Study (WHI OS), recruiting subjects from 1993 to 1998. PATIENTS: Post-menopausal women with available diet drink intake data, without pre-existing CVD and who survived ≥ 60 days were included in the study. MAIN MEAURES: A composite of incident coronary heart disease, heart failure, myocardial infarction, coronary revascularization procedure, ischemic stroke, peripheral arterial disease and CVD death was used as the primary outcome. CVD death and all-cause mortality were secondary outcomes. Adjusted Cox proportional hazards models were used to compare primary and secondary outcomes across diet drink intake strata. KEY RESULTS: In all, 59,614 women, mean age 62.8 years, were included for analysis. In unadjusted analysis over a follow-up of 8.7±2.7 years, the primary outcome occurred in 8.5 % of the women consuming ≥ 2 diet drinks/day, compared to 6.9 %, 6.8 % and 7.2 % in the 5-7/week, 1-4/week and 0-3/month groups, respectively. After controlling for other CVD risk factors, women who consumed ≥ 2 drinks/day had a higher adjusted risk of CVD events (HR 1.3, 95 % CI 1.1-1.5), CVD mortality (HR 1.5, 95 % CI 1.03-2.3) and overall mortality (HR 1.3, 95 % CI 1.04-1.5) compared to the reference group (0-3 drinks/month). CONCLUSIONS: This analysis demonstrates an association between high diet drink intake and CVD outcomes and mortality in post-menopausal women in the WHI OS.

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Section: Discussionmentioning

confidence: 99%

Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women’s Health Initiative

et al. 2014

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“…Study design and descriptions of baseline characteristics have been published previously 58, 61, 62. Data collection methods, data management, and verification of data accuracy also are documented elsewhere 61, 63. For the present study, we used data from the WHI Observational Study with follow‐up through 2010.…”

Section: Methodsmentioning

confidence: 99%

“…Stroke during follow‐up was assessed with annual self‐report questionnaires and centrally adjudicated via medical records by vascular neurologists 63. Among women without a history of stroke, stroke was defined as the first postbaseline occurrence of ischemic or hemorrhagic stroke through the first WHI extension period (2010).…”

Section: Methodsmentioning

confidence: 99%

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Jacobson

Hade

Collins

et al. 2018

JAHA

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BackgroundStroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity.Methods and ResultsData were taken from the Women's Health Initiative Observational Study with follow‐up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the Women's Health Initiative Observational Study, 2699 (3.4%) had experienced a stroke within a follow‐up period of 12.6 years. The average age was 63.7 years at baseline. Fifty‐eight percent (n=46 699) reported ever breastfeeding; 83% were non‐Hispanic white, 8% were non‐Hispanic black, 4% were Hispanic, and 5% were of other race/ethnicity. After adjustment for nonmodifiable potential confounders, compared with women who had never breastfed, women who reported ever breastfeeding had a 23% lower risk of stroke (adjusted hazard ratio=0.77; 95% confidence interval 0.70‐0.83). This association was strongest for non‐Hispanic black women (adjusted hazard ratio=0.52; 95% confidence interval 0.37‐0.71). Further, breastfeeding for a relatively short duration (1‐6 months) was associated with a 19% lower risk of stroke (adjusted hazard ratios=0.81; 95% confidence interval 0.74‐0.89). This association appeared stronger with longer breastfeeding duration and among non‐Hispanic white and non‐Hispanic black women (test for trend P<0.01).ConclusionsStudy results show an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women after adjustment for multiple stroke risk factors and lifestyle variables. Further investigation is warranted.

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“…Outcome definitions and methods for ascertaining, documenting, and classifying outcomes have been published. 8 Women with a history of myocardial infarction, angina, coronary revascularization or stroke prior to study entry were excluded. Cases were defined as all incident acute myocardial infarction requiring overnight hospitalization and/or CHD death in either clinical trial that occurred in the first 4 years of follow-up.…”

Section: Methodsmentioning

confidence: 99%

Usefulness of Baseline Lipids and C-Reactive Protein in Women Receiving Menopausal Hormone Therapy as Predictors of Treatment-Related Coronary Events

Bray

Larson

LaCroix

et al. 2008

The American Journal of Cardiology

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Outcomes ascertainment and adjudication methods in the women's health initiative

Cited by 631 publications

References 5 publications

Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women’s Health Initiative

Diet Drink Consumption and the Risk of Cardiovascular Events: A Report from the Women’s Health Initiative

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Usefulness of Baseline Lipids and C-Reactive Protein in Women Receiving Menopausal Hormone Therapy as Predictors of Treatment-Related Coronary Events

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