Use of medical care biases associations between Parkinson disease and other medical conditions

Gross, Anat; Racette, Brad A.; Camacho‐Soto, Alejandra; Dube, Umber; Nielsen, Susan Searles

doi:10.1212/wnl.0000000000005678

Cited by 17 publications

(25 citation statements)

References 29 publications

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“…We also examined the effect of adjustment for several individual level variables, including use of medical care. We adjusted for use of medical care because we previously found that greater use of care is associated with a greater PD case ascertainment in the present study and can bias associations [60]. In the present analysis, our concern was that use of medical care could be a nuisance mediator.…”

Section: Discussionmentioning

confidence: 94%

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Well Water and Parkinson’s Disease in Medicare Beneficiaries: A Nationwide Case-Control Study

Silver

Racette

Dube

et al. 2020

JPD

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Background-Well water frequently is considered a risk factor for Parkinson disease (PD), but few studies were designed appropriately to test whether geographic factors affect PD risk. Objective-To determine the risk of PD in relation to residential use of private well water. Methods-In a nationwide, population-based case-control study, we identified all incident PD cases (N=89,790) and all comparable controls (N=21,549,400) age 66-90 who solely relied on Medicare coverage in the U.S. in 2009. We estimated the probability of use of private well water using zip code of residence at diagnosis/reference and U.S. Census data on household water source. We modeled this exposure linearly in logistic regression to calculate the odds ratio (OR) and 95% confidence interval (CI) of PD risk in relation to well water use. We adjusted for age, sex and race/ethnicity, and verified that smoking and use of medical care did not confound results. We repeated analyses with a 2-year exposure lag and separately within each U.S. state. Results-Use of well water was inversely associated with PD risk (OR=0.87, 95% CI 0.85-0.89). We confirmed this association in a Cox survival analysis in which we followed controls for 5 years, death or PD diagnosis. There was little evidence that well water use increased risk of PD in any individual state. Conclusions-Although it remains possible that exposures in well water in more narrow geographic regions increase PD risk, in general these results suggest that exposures more common in urban/suburban areas might also be relevant.

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Section: Discussionmentioning

confidence: 94%

“…We estimated the probability (0% to 100%) of "ever smoking" tobacco using a multifaceted approach [42,60]. We assigned a probability of 100% to any beneficiary with a diagnosis or procedure code specific to tobacco use, primarily ICD-9 305.1 (tobacco use disorder) or ICD-9 V15.82 (history of tobacco use).…”

Section: Determination Of Covariatesmentioning

confidence: 99%

Well Water and Parkinson’s Disease in Medicare Beneficiaries: A Nationwide Case-Control Study

Silver

Racette

Dube

et al. 2020

JPD

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“…A limitation of studies evaluating the associations between two conditions is that patients diagnosed with one condition have higher health services utilization than healthy individuals and may subsequently be more likely to be diagnosed with another condition 64 . No study included in our systematic review accounted for increased health care use.…”

Section: Discussionmentioning

confidence: 99%

Co-occurrence of Asthma and the Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis

Kuenzig

Bishay

Leigh

et al. 2018

Clinical and Translational Gastroenterology

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BackgroundInflammatory bowel diseases (IBD) and asthma share genetic and environmental risk factors. Consequently, several observational studies have explored an association between IBD and asthma. We systematically reviewed and summarized the literature on the co-occurrence of asthma and IBD.MethodsMEDLINE and EMBASE (to April 2017) were searched to identify observational studies on the association between asthma and IBD. Relative risks (RR) were pooled using random effects models. Heterogeneity was assessed using the I2 and Cochran Q statistics. Meta-regression based on study design, source of patients (population-based vs. tertiary-care center) and study location was conducted to explain between-study heterogeneity.ResultsEighteen studies were identified (15 Crohn’s disease, 15 ulcerative colitis (UC)). Asthma was associated with both Crohn’s disease (pooled RR 1.30, 95% confidence interval (CI) 1.16–1.47, I2 = 88%) and UC (RR 1.34, 95% CI 1.24–1.44, I2 = 93%). The study design and source of patients and study location explained between-study heterogeneity in Crohn’s disease, but not UC.ConclusionAsthma is associated with both Crohn’s disease and UC. Additional research is needed to determine if one disease influences the risk of developing the other or if the frequent co-occurrence of these diseases result from shared genetic, environmental, and microbial risk factors.

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“…Even in combination, these four codes are not sufficiently sensitive to characterize tobacco smoking history accurately. 9, 10 Therefore, we created and validated a smoking variable as the probability of having ever smoked based on sex, race/ethnicity, birth cohort, and > 600 ICD-9 and CPT codes including the above tobacco-specific codes and 17 other medical conditions. 2 We estimated this probability with a logistic regression model that we developed from Behavioral Risk Factor Surveillance System (BRFSS) survey data from a population-based sample of Medicare-aged respondents.…”

Section: Methodsmentioning

confidence: 99%

β2‐adrenoreceptor medications and risk of Parkinson disease

Nielsen

Gross

Camacho‐Soto

et al. 2018

Annals of Neurology

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Use of medical care biases associations between Parkinson disease and other medical conditions

Abstract: Use of care should be considered when evaluating associations between PD and other medical conditions to ensure that positive associations are not attributable to bias and that inverse associations are not masked.

Cited by 17 publications

References 29 publications

Well Water and Parkinson’s Disease in Medicare Beneficiaries: A Nationwide Case-Control Study

Well Water and Parkinson’s Disease in Medicare Beneficiaries: A Nationwide Case-Control Study

Co-occurrence of Asthma and the Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis

β2‐adrenoreceptor medications and risk of Parkinson disease

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