Academic literature on the topic 'Systematic mortality risk'
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Journal articles on the topic "Systematic mortality risk"
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Ludkovski, Michael, and Erhan Bayraktar. "Relative Hedging of Systematic Mortality Risk." North American Actuarial Journal 13, no. 1 (January 2009): 106–40. http://dx.doi.org/10.1080/10920277.2009.10597542.
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Dahl, Mikkel, Martin Melchior, and Thomas Møller. "On systematic mortality risk and risk-minimization with survivor swaps." Scandinavian Actuarial Journal 2008, no. 2-3 (June 2008): 114–46. http://dx.doi.org/10.1080/03461230701795873.
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Hanewald, Katja, John Piggott, and Michael Sherris. "Individual post-retirement longevity risk management under systematic mortality risk." Insurance: Mathematics and Economics 52, no. 1 (January 2013): 87–97. http://dx.doi.org/10.1016/j.insmatheco.2012.11.002.
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Qizilbash, Nawab, Bélène Podmore, Alessandra Lacetera, Itziar Ubillos, Kirsty Andresen, Ana Roncero Martín, Jara Majuelos-Melguizo, et al. "Tocilizumab and Mortality in Hospitalised Patients with Covid-19. A Systematic Review Comparing Randomised Trials with Observational Studies." Pharmaceutics and Pharmacology Research 4, no. 4 (December 3, 2021): 01–29. http://dx.doi.org/10.31579/2693-7247/051.
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Background: Early observational studies suggested that tocilizumab might produce clinical improvement in covid-19 patients leading to the use of tocilizumab. Early underpowered randomised controlled trials (RCTs) however did not show benefit until the most recent largest trial. RECOVERY trial. We aimed to compare the evidence from RCTs and observational studies of the effect of tocilizumab on in-hospital mortality in patients with covid-19. Materials and Methods: Embase and PubMed were searched from July 2020 until 1 March 2021. Observational studies and RCTs assessing in-hospital mortality in patients receiving tocilizumab compared with standard care or placebo were included. The primary outcome was in-hospital mortality closest to 30 days. The risk of bias in observational studies was assessed using the ROBINS-I tool. A fixed effect meta-analysis was used to combine relative risks, with random effects and risk of bias as a sensitivity analysis. Results: Of 5,792 publications screened for inclusion, eight RCTs and 33 observational studies were identified. The RCTs showed an overall relative risk reduction in in-hospital mortality at 30 days of 0.86 (95% confidence interval (CI) 0.78 to 0.96) with no statistically significant heterogeneity. 23 of the observational studies had a severe risk of bias, 10 of which did not adjust for potential confounders. The 10 observational studies with moderate risk of bias reported a larger reduction in mortality at 30-days (relative risk 0.72, 95% CI 0.64 to 0.81) but with significant heterogeneity (P<0.01). Conclusion: This meta-analysis provides strong evidence from RCTs that tocilizumab reduces the risk of mortality in hospitalised covid-19 patients. Observational studies with moderate risk of bias exaggerated the benefits on mortality two-fold and showed heterogeneity. Collectively observational studies provide a less reliable evidence base for evaluating treatments for covid-19.
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Aro, Helena. "Systematic and Nonsystematic Mortality Risk in Pension Portfolios." North American Actuarial Journal 18, no. 1 (January 2, 2014): 59–67. http://dx.doi.org/10.1080/10920277.2013.861340.
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Charroenngam, Nipith, Thanitsara Rittiphairoj, Aunchalee Jaroenlapnopparat, Sofia K. Mettler, Ben Ponvilawan, Unoma Okoli, Patompong Ungprasert, and Mehmet Sercan Marangoz. "LBSAT140 Mortality Risk Following Atypical Femoral Fracture: A Systematic Review And Meta-analysis." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A150—A151. http://dx.doi.org/10.1210/jendso/bvac150.307.
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Abstract Introduction Proximal femoral fracture in elderly (>60 years of age) is known to be associated with a high one-year mortality risk of 21.2% (1). Studies have shown that the mortality rate of atypical femoral fracture (AFF) may be lower than that of typical proximal femoral fracture (2), although results from existing studies are inconsistent. Therefore, we aimed to summarize all available data, using systematic review and meta-analysis, to estimate the one-year mortality risk following AFF and risk ratio of mortality following AFF versus typical femoral fracture (TFF). Methods Potentially eligible studies were identified from Medline and EMBASE databases from inception to February 2022 using a search strategy that comprised keywords "Atypical Femoral Fracture" and "Mortality". Any eligible study must consist of a cohort of patients with AFF. Then, the study must report a one-year mortality risk following AFF or effect estimates with 95% confidence intervals (95% CIs) comparing mortality risks between patients with AFF and TFF. Data were retrieved from each study and were combined using the generic inverse variance method. Results A total of 8,967 articles were identified. After two rounds of independent review by three investigators, we identified 7 studies reporting one-year mortality risks of AFF and 3 studies comparing mortality risks of AFF versus TFF. These studies were included into the meta-analysis. The pooled one-year mortality risk following atypical femoral fracture of 0.10 (95% CI, 0. 05 - 0.16; with high heterogeneity, I2 93.3%). The funnel plot was asymmetric in favor of studies that reported high one-year mortality risks. In the meta-analysis comparing the mortality risks following AFF versus TFF, no significant difference in mortality risks was found between the two conditions, with the pooled risk ratio of 0.98 (95% CI 0.78 - 1.25; with high heterogeneity, I2 96.8%). Conclusion This systematic review and meta-analysis revealed that the one-year mortality risk following AFF was approximately 10%, which may be lower than the reported mortality risk after typical hip fracture of around 20% (1). However, no significant difference was found in the meta-analysis of studies that compared the mortality risks of the two conditions, suggesting the | need for further investigation. The results will be useful for risk-benefit discussions on initiation of antiresorptive and anabolic osteoporotic therapy. References 1. Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL. The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil. 2010;1(1): 6-14. 2. Kharazmi M, Hallberg P, Schilcher J, Aspenberg P, Michaëlsson K. Mortality After Atypical Femoral Fractures: A Cohort Study. Journal of Bone and Mineral Research. 2016;31(3): 491-7 Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
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Wong, Johanna T., Ciara Vance, and Andrew Peters. "Refining livestock mortality indicators: a systematic review." Gates Open Research 5 (April 19, 2021): 75. http://dx.doi.org/10.12688/gatesopenres.13228.1.
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Background: Livestock mortality impacts farmer livelihoods and household nutrition. Capturing trends in livestock mortality at localised or national levels is essential to planning, monitoring and evaluating interventions and programs aimed at decreasing mortality rates. However, livestock mortality data is disparate, and indicators used have not been standardised. This review aims to assess livestock mortality indicator definitions reported in literature, and define the ages where mortality has greatest impact. Methods: A systematic review was conducted, limited to articles focussed on mortality of cattle, sheep and goats. Peer-reviewed articles in Web of Science until year 2020 were assessed for inclusion of age-based definitions for mortality indicators and data on age distribution of mortality. Indicator definitions for each species were collated and similar terms and age groups most targeted were compared. The cumulative distribution of age at mortality was compared across studies graphically where possible; otherwise, age patterns for mortality were collated. Results: Most studies reported mortality risk rather than rate, and there was little agreement between indicator definitions used in the literature. The most common indicators reported were perinatal and neonatal mortality in cattle, and for perinatal, neonatal and pre-weaning mortality indicators for sheep and goats. Direct comparison of age distribution of mortality was only possible for cattle, which found that approximately 80% of all mortalities within the first 12 months had occurred by six months of age. A significant finding of the study is the variation in age groups for which mortality is reported, which impedes the comparison of mortality risk across studies, particularly for sheep and goats. Conclusions: This study demonstrates the importance and value of standardising mortality risk indicators for general use, including a young stock mortality risk indicator measuring mortality in the highest risk period of birth to six months of age in cattle, sheep and goats.
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Odhiambo, Joab, Patrick Weke, and Philip Ngare. "A Deep Learning Integrated Cairns-Blake-Dowd (CBD) Sytematic Mortality Risk Model." Journal of Risk and Financial Management 14, no. 6 (June 8, 2021): 259. http://dx.doi.org/10.3390/jrfm14060259.
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Many actuarial science researchers on stochastic modeling and forecasting of systematic mortality risk use Cairns-Blake-Dowd (CBD) Model (2006) due to its ability to consider the cohort effects. A three-factor stochastic mortality model has three parameters that describe the mortality trends over time when dealing with future behaviors. This study aims to predict the trends of the model, kt(2) by applying the Recurrent Neural Networks within a Short-Term Long Memory (an artificial LSTM architecture) compared to traditional statistical ARIMA (p,d,q) models. The novel deep learning (machine learning) technique helps integrate the CBD model to enhance its accuracy and predictive capacity for future systematic mortality risk in countries with limited data availability, such as Kenya. The results show that Long Short-Term Memory network architecture had higher levels of precision when predicting the future systematic mortality risks than traditional methods. Ultimately, the results can be implemented by Kenyan insurance firms when modeling and forecasting systematic mortality risk helpful in the pricing of Annuities and Assurances.
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Tonelli, Marcello, Natasha Wiebe, Bruce Culleton, Andrew House, Chris Rabbat, Mei Fok, Finlay McAlister, and Amit X. Garg. "Chronic Kidney Disease and Mortality Risk: A Systematic Review." Journal of the American Society of Nephrology 17, no. 7 (May 31, 2006): 2034–47. http://dx.doi.org/10.1681/asn.2005101085.
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Sadana, Divyajot, Simrat Kaur, Kesavan Sankaramangalam, Ishan Saini, Kinjal Banerjee, Matthew Siuba, Valentina Amaral, et al. "Mortality associated with acute respiratory distress syndrome, 2009—2019: a systematic review and meta-analysis." Critical Care and Resuscitation 24, no. 4 (December 6, 2022): 341–51. http://dx.doi.org/10.51893/2022.4.oa4.
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BACKGROUND: Acute respiratory distress syndrome (ARDS) occurs commonly in intensive care units. The reported mortality rates in studies evaluating ARDS are highly variable. OBJECTIVE: To investigate mortality rates due to ARDS from before the 2009 H1N1 influenza pandemic began until the start of coronavirus disease 2019 (COVID-19) pandemic. DESIGN: We performed a systematic search and then ran a proportional meta-analysis for mortality. We ran our analysis in three ways: for randomised controlled trials only, for observational studies only, and for randomised controlled trials and observational studies combined. DATA SOURCES: MEDLINE and Embase, using a highly sensitive criterion and limiting the search to studies published from January 2009 to December 2019. REVIEW METHODS: Two of us independently screened titles and abstracts to first identify studies and then complete full text reviews of selected studies. We assessed risk of bias using the Cochrane RoB-2 (a risk-of-bias tool for randomised trials) and the Cochrane ROBINS-1 (a risk-of-bias tool for non-randomised studies of interventions). RESULTS: We screened 5844 citations, of which 102 fully met our inclusion criteria. These included 34 randomised controlled trials and 68 observational studies, with a total of 24 158 patients. The weighted pooled mortality rate for all 102 studies published from 2009 to 2019 was 39.4% (95% CI, 37.0–41.8%). Mortality was higher in observational studies compared with randomised controlled trials (41.8% [95% CI, 38.9–44.8%] v 34.5% [95% CI, 30.6–38.5%]; P = 0.005). CONCLUSIONS: Over the past decade, mortality rates due to ARDS were high. There is a clear distinction between mortality in observational studies and in randomised controlled trials. Future studies need to report mortality for different ARDS phenotypes and closely adhere to evidence-based medicine. PROSPERO REGISTRATION: CRD42020149712 (April 2020).
Dissertations / Theses on the topic "Systematic mortality risk"
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Laishram, Chanusana. "A systematic review of risk factors for maternal mortality in India." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206929.
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Background: India as one of the rapidly developing economies where health challenges are myriad at the population level has the highest number of maternal death in the world. Understanding risk factors for maternal mortality is paramount because maternal health is the basic indicator for the overall adequacy of healthcare of a country. This study was conducted to review on the various risk factors of maternal mortality and the multifarious challenges for maternal health in India.
Methods: A literature search was conducted with PubMed and Google scholar using the key words of (“risk factors” AND (“maternal mortality” OR “maternal death”) AND India) for articles published from 1970 to May 2014. PubMed was primarily used for the systematic search.
Findings: Twelve studies were identified for the final review of which six were case series studies, three were case studies and three were case control studies. Most of the studies were conducted in institutional settings from the five regions (North, South, West, Central and East) of India with different range of Maternal Mortality Rate (MMR) estimates. Previous literature had highlighted socio economic disadvantages as important determinants for maternal mortality. The current review shows a complex interplay of four factors in general in India: social, obstetrical, behavioural and medical factors. Variables of both social demographic and economic factors such as median age of the women at childbirth, literacy rate of the female population and area of residences are put together in the social factors of this study. Compared to the causes, descriptions on behavioural risk factors were rather limited and so the requisite to examine the risk factors affecting maternal mortality is justified. Intervention strategies include conditional cash transfer scheme, voucher scheme, training of village health volunteers and training of auxiliary mid wives’.
Conclusions: India has a unique social system of diversity and stratification. The pattern of maternal mortality in India is different and varied widely in zones or regions. The variations of challenges should be highlighted so as to give a clear grasp of the inequalities of maternal health as well as also help in reducing the MMR substantially.published_or_final_version
Public Health
Master
Master of Public Health
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Anar, Hatice. "UNCERTAINTY IN MORTALITY TRENDS AND SOLVENCYRE QUIREMENTS FOR LIFE ANNUITIES." Doctoral thesis, Università degli studi di Trieste, 2015. http://hdl.handle.net/10077/11010.
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2013/2014The change in mortality trends experienced over the last decades leads to the use of projected mortality tables in order to avoid underestimation of the future liabilities and costs in long term insurance products such as life annuities and pension funds. Although the projected mortality tables aim to capture the dynamic structure of mortality in the future, the future mortality trend itself is random and systematic deviations from the projected mortality might take place. Being a non-pooling risk, the impact of this ``uncertainty risk'' on the insurance portfolios can be dramatic due to the fact that the severity resulting from it increases as the size of the portfolio. For this reason, a proper modelling of uncertainty risk in mortality trends is required. In this work the uncertainty risk modelling in mortality trends has been studied. In this aspect, the two stochastic models in the literature, scenario based and dynamic models have been adopted and assessed their level of capturing the uncertainty in mortality trends. One of the models, the static model, has been extended to the continuous case with the allowance of the multiple cohorts in the portfolio. As defining the model, two approximation methods has been adopted to define the distribution of total number of deaths in the portfolio. Bayesian inferential procedure has been used in updating the random variables representing the uncertainty risk to the experience in the portfolio.
XXVII Ciclo
1982
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Carrillo-Larco, Rodrigo M., Noël C. Barengo, Leonardo Albitres-Flores, and Antonio Bernabe-Ortiz. "The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta-analysis of population-based cohort studies." John Wiley and Sons Ltd, 2019. http://hdl.handle.net/10757/652468.
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Type 2 diabetes mellitus (T2DM) is associated with a high mortality risk, although the magnitude of this association remains unknown in Latin America (LA). We aimed to assess the strength of the association between T2DM and all-cause and cause-specific mortality in population-based cohort studies in LA. Systematic review and meta-analysis: inclusion criteria were (1) men and women 18 years old and above with T2DM; (2) study outcomes all-cause and/or cause-specific mortality; and (3) using people without T2DM as comparison group. Five databases (Scopus, Medline, Embase, Global Health, and LILACS) were searched. Risk of bias was evaluated with the ROBINS-I criteria. Initially, there were 979 identified studies, of which 17 were selected for qualitative synthesis; 14 were included in the meta-analysis (N = 416 821). Self-reported T2DM showed a pooled relative risk (RR) of 2.49 for all-causes mortality (I-squared [I 2 ] = 85.7%, p < 0.001; 95% confidence interval [CI], 1.96-3.15). T2DM based on a composite definition was associated with a 2.26-fold higher all-cause mortality (I 2 = 93.9%, p < 0.001; 95% CI, 1.36-3.74). The pooled risk estimates were similar between men and women, although higher at younger ages. The pooled RR for cardiovascular mortality was 2.76 (I 2 = 59.2%; p < 0.061; 95% CI, 1.99-3.82) and for renal mortality 15.85 (I 2 = 0.00%; p < 0.645; 95% CI, 9.82-25.57). Using available population-based cohort studies, this work has identified and estimated the strength of the association between T2DM and mortality in LA. The higher mortality risk compared with high-income countries deserves close attention from health policies makers and clinicians to improve diabetes care and control hence preventing complications and delaying death.Revisión por pares
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Galiyeva, Dinara. "Cardiovascular risk factor prevalence, mortality and cardiovascular disease incidence in patients who initiated renal replacement therapy in childhood : systematic review and analyses of two renal registries." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/28837.
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Background. The incidence of starting renal replacement therapy (RRT) among young people (< 20 years of age) in 2013 in Scotland was 7.7 per million (age-related) population. Little knowledge exists about cardiovascular risk factors (CVRFs), long-term survival and cardiovascular disease (CVD) outcomes in patients who initiated RRT in childhood. The main source of routine data for these patients is available from the European Society of Paediatric Nephrology/European Renal Association- European Dialysis and Transplant Association (ESPN/ERA-EDTA) registry. In Scotland nationally comprehensive data on patients receiving RRT is available from the Scottish Renal Registry (SRR). Aim and objectives. The overall aim of the thesis is to review relevant literature and conduct retrospective cohort studies describing CVRF prevalence, all-cause mortality and incidence of CVD outcomes in patients who initiated RRT in childhood. ESPN/ERA-EDTA registry data were used to describe the prevalence of anaemia, hypertension, dyslipidaemia and BMI categories and their association with all-cause and CV mortality. SRR data were used to describe all-cause mortality and CVD incidence and their association with age at start of RRT, sex, primary renal disease (PRD), type of RRT and period of start of RRT. Methods. Systematic searches were performed to identify relevant literature. For the ESPN/ERA-EDTA analyses patients who started RRT between 0 and 20 years of age and who had CVRF data were included. Patients were followed from date of first CVRF measurement until the earliest of death, loss to follow-up, reaching 20 years of age or the end of follow-up (December 31st 2012). Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality, comparing patients with and without each CVRF. For the SRR analyses, patients who started RRT under 18 years of age in the period from 1963 to 2013 were included in the analyses. To describe CVD incidence the SRR data were linked to national registers for death and CVD hospital admissions available from 1981 onwards. These analyses, therefore, included patients who started RRT between 1981 and 2013 with follow-up until first CVD event after start of RRT, end of follow-up period or censoring at death. Cox proportional hazard models were used to examine the association of age at initiation of RRT, sex, PRD, type of RRT and period of initiation of RRT with all-cause mortality and CVD incidence. Results. The systematic reviews revealed a gap in current knowledge about CVD incidence and the association of CVRFs with CVD outcomes in patients who initiated RRT in childhood. In total, 7,845 patients were included in the ESPN/ERA-EDTA registry analysis. The mean age of the patients was 9.5 (SE 0.06) years, 58.9% were male, and the most common PRD was congenital anomalies of kidney and urinary tract (CAKUT). The prevalence of dyslipidaemia, hypertension, anaemia overweight/obesity and underweight was 87.5%, 79.3%, 36.0%, 29.9% and 4.3%, respectively. During median follow-up of 3.7 (IQR 1.7-6.8) years 357 patients died. HRs for anaemia were 2.19 (95% CI 1.64-2.93) and 2.55 (95% CI 1.27-5.12) for all-cause and CVD mortality, respectively. The HR for all-cause mortality for underweight was 1.81 (95% CI 1.30-2.53). No other studied CVRFs were statistically significantly associated with all-cause and CVD mortality. In total, 479 patients were included in the SRR analyses of all-cause mortality. The most common PRD was CAKUT and 55.3% of patients were male. During a median follow-up of 18.3 (IQR 8.7-27.0 years) years 126 patients died. Twenty-year survival among patients initiated RRT in childhood was 77.6% (95% CI 73.8-81.3). Age at start of RRT, PRD and type of RRT were significantly associated with all-cause mortality. HR for all-cause mortality for patients who started RRT under 2 years of age was 2.50 (95% CI 1.19-5.25) compared to patients who started RRT at 12 to 18 years old. HR for all-cause mortality for patients with PRD other than CAKUT or glomerulonephritis (GN) was 1.58 (95% CI 1.05-2.39) compared to patients with CAKUT. HRs for all-cause mortality for patients who only received either HD or PD during follow-up were 19.4 (95% CI 10.4-36.4 and 19.5 (9.65-39.7), respectively, compared to patients who received a renal transplant. In total, 381 patients were included in the SRR analyses of CVD incidence. During a median of 12.9 (IQR 5.6-21.5) years of follow-up after initiation of RRT 134 patients (35.2%) developed CVD. The overall crude CVD incidence was 2.6 (95% CI 2.2-3.0) per 100 person-years. HRs for CVD were 1.69 (95% CI 1.05-2.74) for males compared to females, 1.72 (95% CI 1.02-2.91) for PRD other than CAKUT or GN compared to CAKUT and 8.38 (95% CI 3.31-21.23) and 7.30 (95% CI 2.30-23.16) for patients who only received either HD or PD during follow-up, respectively, compared to patients who received a renal transplant. Conclusions. This thesis has contributed to knowledge about CVRF prevalence, longer-term survival and CVD outcomes in patients who initiated RRT in childhood by identifying high prevalence of CVRFs and that CVD is a common complication. This study did not investigate whether anaemia, hypertension, dyslipidaemia and obesity are associated with a higher risk of developing CVD after start of RRT. Future research is needed to study whether treatment of anaemia, hypertension, dyslipidaemia and controlling body weight will reduce the risk of CVD and mortality in patients who initiated RRT in childhood.
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Akugizibwe, Paula. "Systematic review of the association and dose-response and relationship between silica exposure or silicosis, and risk of TB disease and TB mortality." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6019.
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Chen, Liang. "Small population bias and sampling effects in stochastic mortality modelling." Thesis, Heriot-Watt University, 2017. http://hdl.handle.net/10399/3372.
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Pension schemes are facing more difficulties on matching their underlying liabilities with assets, mainly due to faster mortality improvements for their underlying populations, better environments and medical treatments and historically low interest rates. Given most of the pension schemes are relatively much smaller than the national population, modelling and forecasting the small populations' longevity risk become urgent tasks for both the industrial practitioners and academic researchers. This thesis starts with a systematic analysis on the influence of population size on the uncertainties of mortality estimates and forecasts with a stochastic mortality model, based on a parametric bootstrap methodology with England and Wales males as our benchmark population. The population size has significant effect on the uncertainty of mortality estimates and forecasts. The volatilities of small populations are over-estimated by the maximum likelihood estimators. A Bayesian model is developed to improve the estimation of the volatilities and the predictions of mortality rates for the small populations by employing the information of larger population with informative prior distributions. The new model is validated with the simulated small death scenarios. The Bayesian methodologies generate smoothed estimations for the mortality rates. Moreover, a methodology is introduced to use the information of large population for obtaining unbiased volatilities estimations given the underlying prior settings. At last, an empirical study is carried out based on the Scotland mortality dataset.
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Scorrano, Mariangela. "Pricing the Guaranteed Lifetime Withdrawal Benefit (GLWB) in a Variable Annuity contract." Doctoral thesis, Università degli studi di Trieste, 2015. http://hdl.handle.net/10077/11009.
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2013/2014The past twenty years have seen a massive proliferation in insurance-linked derivative products. The public, indeed, has become more aware of investment opportunities outside the insurance sector and is increasingly trying to seize all the benefits of equity investment in conjunction with mortality protection. The competition with alternative investment vehicles offered by the financial industry has generated substantial innovation in the design of life products and in the range of benefits provided. In particular, equity-linked policies have become ever more popular, exposing policyholders to financial markets and providing them with different ways to consolidate investment performance over time as well as protection against mortality-related risks. Interesting examples of such contracts are variable annuities (VAs). This kind of policies, first introduced in 1952 in the United States, experienced remarkable growth in Europe, especially during the last decade, characterized by “bearish” financial markets and relatively low interest rates. The success of these contracts is due to the presence of tax incentives, but mainly to the possibility of underwriting several rider benefits that provide protection of the policyholder’s savings for the period before and after retirement. In this thesis, we focus in particular on the Guaranteed Lifetime Withdrawal Benefit (GLWB) rider. This option meets medium to long-term investment needs, while providing adequate hedging against market volatility and longevity-related risks. Indeed, based on an initial capital investment, it guarantees the policyholder a stream of future payments, regardless of the performance of the underlying policy, for his/her whole life. In this work, we propose a valuation model for the policy using tractable financial and stochastic mortality processes in a continuous time framework. We have analyzed the policy considering two points of view, the policyholder’s and the insurer’s, and assuming a static approach, in which policyholders withdraw each year just the guaranteed amount. In particular, we have based ourselves on the model proposed in the paper “Systematic mortality risk: an analysis of guaranteed lifetime withdrawal benefits in variable annuities” by M. C. Fung, K. Ignatieva and M. Sherris (2014), with the aim of generalizing it later on. The valuation, indeed, has been performed in a Black and Scholes economy: the sub-account value has been assumed to follow a geometric Brownian motion, thus with a constant volatility, and the term structure of interest rates has been assumed to be constant. These hypotheses, however, do not reflect the situation of financial markets. In order to consider a more realistic model, we have sought to weaken these misconceptions. Specifically we have taken into account a CIR stochastic process for the term structure of interest rates and a Heston model for the volatility of the underlying account, analyzing their effect on the fair price of the contract. We have addressed these two hypotheses separately at first, and jointly afterwards. As part of our analysis, we have implemented the theoretical model using a Monte Carlo approach. To this end, we have created ad hoc codes based on the programming language MATLAB, exploiting its fast matrix-computation facilities. Sensitivity analyses have been conducted in order to investigate the relation between the fair price of the contract and important financial and demographic factors. Numerical results in the stochastic approach display greater fair fee rates compared to those obtained in the deterministic one. Therefore, a stochastic framework is necessary in order to avoid an underestimation of the policy. The work is organized as follows. Chapter 1. This chapter has an introductory purpose and aims at presenting the basic structures of annuities in general and of variable annuities in particular. We offer an historical review of the development of the VA contracts and describe the embedded guarantees. We examine the main life insurance markets in order to highlight the international developments of VAs and their growth potential. In the last part we retrace the main academic contributions on the topic. Chapter 2. Among the embedded guarantees, we focus in particular on the Guaranteed Lifetime Withdrawal Benefit (GLWB) rider. We analyze a valuation model for the policy basing ourselves on the one proposed by M. Sherris (2014). We introduce the two components of the model: the financial market, on the one hand, and the mortality intensity on the other. We first describe them separately, and subsequently we combine them into the insurance market model. In the second part of the chapter we describe the valuation formula considering the GLWB from two perspectives, the policyholder’s and the insurer’s. Chapter 3. Here we implement the theoretical model creating ad hoc codes with the programming language MATLAB. Our numerical experiments use a Monte Carlo approach: random variables have been simulated by MATLAB high level random number generator, whereas concerning the approximation of expected values, scenario- based averages have been evaluated by exploiting MATLAB fast matrix-computation facilities. Sensitivity analyses are conducted in order to investigate the relation between the fair fee rate and important financial and demographic factors. Chapter 4. The assumption of deterministic interest rates, which can be acceptable for short-term options, is not realistic for medium or long-term contracts such as life insurance products. GLWB contracts are investment vehicles with a long-term horizon and, as such, they are very sensitive to interest rate movements, which are uncertain by nature. A stochastic modeling of the term structure is thus appropriate. In this chapter, therefore, we propose a generalization of the deterministic model allowing interest rates to vary randomly. A Cox-Ingersoll-Ross model is introduced. Sensitivity analyses have been conducted. Chapter 5. Empirical studies of stock price returns show that volatility exhibits “random” characteristics. Consequently, the hypothesis of a constant volatility is rather “counterfactual”. In order to consider a more realistic model, we introduce the stochastic Heston process for the volatility. Sensitivity analyses have been con- ducted. Chapter 6. In this chapter we price the GLWB option considering a stochastic process for both the interest rate and the volatility. We present a numerical comparison with the deterministic model. Chapter 7. Conclusions are drawn. Appendix. This section presents a quick survey of the most fundamental concepts from stochastic calculus that are needed to proceed with the description of the GLWB’s valuation model.
Negli ultimi venti anni si `e assistito ad una massiccia proliferazione di prodotti de- rivati di tipo finanziario-assicurativo. Gli individui, infatti, sono diventati sempre piu` consapevoli delle opportunita` di investimento esistenti al di fuori del settore as- sicurativo e pertanto richiedono all’impresa di assicurazione non solo la protezione contro il rischio di mortalit`a/longevit`a, ma anche tutti i benefici di un investimento di capitali. Ed `e proprio per soddisfare le esigenze del mercato e per fronteggiare la concorrenza alimentata da altri competitors (banche, ecc.) che il mercato assi- curativo sta cambiando ed ha iniziato a sviluppare nuovi prodotti assicurativi ad elevato contenuto finanziario. Nell’ambito di questi prodotti, particolare interesse rivestono le cosiddette polizze variable annuities. Introdotte per la prima volta negli Stati Uniti nel 1952, esse hanno raggiunto ben presto un notevole sviluppo anche in Europa, soprattutto nell’ultimo decennio caratterizzato da mercati finanziari bearish e da tassi di interesse relativamente bassi. Il successo di questo tipo di contratti `e dovuto al favorevole trattamento fiscale di cui godono, ma soprattutto all’offerta di opzioni implicite che garantiscono una protezione dei risparmi degli investitori prima e dopo il pensionamento. In questo lavoro di tesi, ci siamo concentrati in particola- re sull’opzione Guaranteed Lifetime Withdrawal Benefit (GLWB). Essa permette di soddisfare esigenze di investimento di medio/lungo periodo e nello stesso tempo offre una discreta copertura al rischio dovuto alla volatilit`a dei mercati e al longevity risk. Infatti, a fronte di un capitale iniziale investito, garantisce all’assicurato un flusso di pagamenti futuri indipendente dalla performance della polizza sottostante per tutta la durata della sua vita. Piu` precisamente, in questo lavoro proponiamo un modello di valutazione per questo tipo di contratto, facendo ricorso a processi stocastici per descrivere la componente finanziaria e quella legata alla mortalità dell’assicurato. Analizziamo la polizza considerando sia il punto di vista del cliente che quello della compagnia di assicurazione. La nostra valutazione si è basata sul modello proposto da M. C. Fung, K. Ignatieva e M. Sherris nell’articolo “Systematic mortality risk: an analysis of guaranteed lifetime withdrawal benefits in variable annuities” (2014). Tuttavia le ipotesi alla base di questa analisi non trovano giustificazione nel mercato; in effetti, considerare un tasso di interesse ed una volatilità costanti sembra poco sensato. Proprio per proporre un modello più fedele al mercato, si è pensato di indebolire questi assunti, prendendo in considerazione un processo stocastico a sé stante per descrivere la dinamica del tasso di interesse e della volatilità. Dapprima abbiamo analizzato separatamente l’impatto dei due processi sul prezzo equo dell’opzione, per poi considerare anche il loro effetto congiunto. Come parte integrante del lavoro, abbiamo implementato il modello teorico proposto impiegando un approccio Monte Carlo. A questo scopo abbiamo creato codici ad hoc utilizzando il linguaggio di programmazione MATLAB, sfruttando al meglio tutte le sue potenzialità di calcolo matriciale. Sono state condotte analisi di sensitività per analizzare l’impatto sul prezzo equo dell’opzione di alcuni importanti parametri finanziari e demografici. I risultati numerici mostrano come effettivamente l’impiego di un approccio stocastico sia più capace di descrivere le fluttuazioni del mercato e quindi permetta di ottenere risultati più realistici. Il valore equo delle commissioni applicate dalla compagnia di assicurazione per l’attivazione della garanzia GLWB aumenta quando si passa da un approccio deterministico ad uno stocastico (soprattutto se quest’ultimo considera congiuntamente tassi di interesse e volatilità stocastici), rivelando come un adeguato modello stocastico sia necessario per evitare una sottovalutazione di tali polizze. Il lavoro è strutturato come segue: Capitolo 1. Questo capitolo ha un ruolo introduttivo e mira a fornire una descrizione delle caratteristiche principali delle polizze variable annuities. Si analizza l'evoluzione storica di tali polizze ed il loro sviluppo nei principali mercati internazionali. Segue una breve rassegna dei principali contributi accademici sulla valutazione di tali contratti e si spiegano le ragioni alla base di questo lavoro. Capitolo 2. Tra le varie garanzie implicite nei contratti variable annuity ci soffermiamo sull'opzione Guaranteed Lifetime Withdrawal Benefit. In questo capitolo analizziamo il modello di valutazione del contratto proposto da M. Sherris (2014); introduciamo le due componenti del modello (il mercato finanziario e l'intensità di mortalità) dapprima descrivendole separatamente, poi combinandole. Nella seconda parte del capitolo studiamo le formule per il calcolo del prezzo equo del contratto considerando due punti di vista, quello dell'assicurato e quello dell'assicuratore. Capitolo 3. In questo capitolo implementiamo il modello teorico creando codici ad hoc con il linguaggio di programmazione MATLAB. Le nostre valutazioni sono state realizzate utilizzando un approccio Monte Carlo. Diverse analisi di sensitività sono state condotte per analizzare l’impatto sul prezzo equo dell’opzione di alcuni importanti parametri finanziari e demografici. Capitolo 4. In questo capitolo si propone una generalizzazione del modello deterministico indebolendo l'ipotesi di struttura a termine dei tassi di interesse costante. Per descrivere la dinamica del tasso di interesse si introduce in particolare un processo Cox- Ingersoll- Ross. Capitolo 5. In questo capitolo si indebolisce l'ipotesi che considera costante la volatilità del fondo d'investimento prevedendo una dinamica descritta dal processo di Heston. Capitolo 6. Si descrive un modello che considera congiuntamente un processo stocastico per i tassi di interesse (CIR) e per la volatilità (Heston). Si conducono analisi di sensitività e si mostrano i risultati ottenuti. Capitolo 7. In questo capitolo traiamo le conclusioni del nostro lavoro. Appendice. Proponiamo una breve rassegna delle principali nozioni di calcolo stocastico necessarie per meglio comprendere la descrizione del modello di valutazione.
XXVII Ciclo
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Odame, Emmanuel A., Ying Li, Shimin Zheng, Ambarish Vaidyanathan, and Ken Silver. "Assessing Heat-Related Mortality Risks among Rural Populations: A Systematic Review and Meta-Analysis of Epidemiological Evidence." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6301.
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Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four continents met the selection criteria, and eleven were included in the meta-analysis. Using the random effects model, the pooled estimates of relative risks (RRs) for all-cause and cardiovascular mortality were 1.030 (95% CI: 1.013, 1.048) and 1.111 (95% CI: 1.045, 1.181) per 1 °C increase in daily mean temperature, respectively. We found excess risks in rural settings not to be smaller than risks in urban settings. Our results suggest that rural populations, like urban populations, are also vulnerable to heat-related mortality. Further evaluation of heat-related mortality among rural populations is warranted to develop public health interventions in rural communities.
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Feakins, Benjamin. "Competing risks methodology in the evaluation of cardiovascular and cancer mortality as a consequence of albuminuria in type 2 diabetes." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:b5e384c6-6826-4a09-9700-9aea2ea0f77a.
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Background: 'Competing risks' are events that either preclude or alter the probability of experiencing the primary study outcome(s). Many standard survival models fail to account for competing risks, introducing an unknown level of bias in their measures of absolute and relative risk. Individuals with type 2 diabetes mellitus (T2DM) and albuminuria are at increased risk of multiple competing causes of mortality, including cardiovascular disease (CVD), cancer and renal disease, yet studies to date have not implemented competing risks methodology. Aim: Using albuminuria in T2DM as a case study, this Thesis set out to quantify differences between standard- and competing-risks-adjusted survival analysis estimates of absolute and relative risk for the outcomes of cardiovascular and cancer mortality. Methods: 86,962 patients aged ≥35 years with T2DM present on or before 2005 were identified in the Clinical Practice Research Datalink. To quantify differences in measures of absolute risk, cumulative risk estimates for cardiovascular and cancer mortality from standard survival analysis methods (Kaplan-Meier estimator) were compared to those from competing-risks-adjusted methods (cumulative incidence competing risk estimator). Cumulative risk estimates were stratified by patient albuminuria level (normoalbuminuria vs albuminuria). To quantify differences in measures of relative risk, estimates for the effect of albuminuria on the relative hazards of cardiovascular and cancer mortality were compared between standard cause-specific hazard (CSH) models (Cox-proportional-hazards regression), competing risk CSH models (unstratified Lunn-McNeil model), and competing risk subdistribution hazard (SDH) models (Fine-Gray model). Results: Patients with albuminuria, compared to those with normoalbuminuria, were older (p<0.001), had higher systolic blood pressure (p<0.001), had worse glycaemic control (p<0.001), and were more likely to be current or ex-smokers (p<0.001). Over the course of nine years of follow-up 22,512 patients died; 8,800 from CVD, 5,239 from cancer, and 8,473 from other causes. Median follow-up was 7.7 years. In patients with normoalbuminuria, nine-year standard and competing-risks-adjusted cumulative risk estimates for cardiovascular mortality were 11.1% (95% confidence interval (CI): 10.8-11.5%) and 10.2% (95% CI: 9.9-10.5%), respectively. For cancer mortality, these figures were 8.0% (95% CI: 7.7-8.3%) and 7.2% (95% CI: 6.9-7.5%). In patients with albuminuria, standard and competing-risks-adjusted estimates for cardiovascular mortality were 21.8% (95% CI: 20.9-22.7%) and 18.5% (95% CI: 17.8-19.3%), respectively. For cancer mortality, these figures were 10.7% (95% CI: 10.0-11.5%) and 8.6% (8.1-9.2%). For the effect of albuminuria on cardiovascular mortality, hazard ratios from multivariable standard CSH, competing risks CSH, and subdistribution hazard ratios from competing risks SDH models were 1.75 (95% CI: 1.63-1.87), 1.75 (95% CI: 1.64-1.87), and 1.58 (95% CI: 1.48-1.69), respectively. For the effect of albuminuria on cancer mortality, these values were 1.27 (95% CI: 1.16-1.39), 1.28 (95% CI: 1.17-1.40), and 1.11 (95% CI: 1.01-1.21). Conclusions: When evaluating measures of absolute risk, differences between standard and competing-risks-adjusted methods were small in absolute terms, but large in relative terms. For the investigation of epidemiological relationships using relative hazards models, standard survival analysis methods produced near-identical risk estimates to the CSH competing risks methods for the clinical associations evaluated in this Thesis. For the evaluation of risk prediction using relative hazards models, CSH models produced consistently higher risk estimates than SDH models, and their use may lead to over-estimation of the predictive effect of albuminuria on either outcome. Where outcomes are less common (like cancer) CSH models provide poor estimates of risk prediction, and SDH models should be used. This research demonstrates that differences can be present between risk estimates derived using CSH and SDH methods, and that the two are not necessarily interchangeable. Moreover, such differences may be present in other clinical areas.
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Hlavandová, Radana. "Modelování parametrického rizika v odhadech úmrtnosti." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-352774.
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In this thesis we focus on modeling stochastic mortality and parameter risk in assessing mortality. We explore two mortality stochastic models for modeling the number of deaths in portfolio which consist of one or more than one cohort. We define the term mixture of distributions and introduce Beta-Binomial and Poisson-Gamma model. We address immediate life annuities and we apply Bayesian Poisson- Gamma model to quantify longevity risk on data. The obvious increasing trend of average lifetime leads insurance companies to greater protection against longevity risk. We show how to deal with solvency rules by internal models designed consistently with the requirement in the standard formula of Solvency II. Powered by TCPDF (www.tcpdf.org)
Books on the topic "Systematic mortality risk"
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Wernli, Karen J., and Erin J. Bowles. Breast Cancer Screening: Evidence and Recommendations. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0002.
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Breast cancer screening in the United States was first recommended to women in 1976. Over the past decade, mammography screening has changed from film screen mammography to primarily digital mammography, which, as of 2016, accounts for over 97% of all mammograms performed in the United States. Several systematic reviews, which have included results from up to 9 randomized clinical trials from the United States, Europe, and Canada, have demonstrated a reduced risk of breast cancer mortality associated with breast cancer screening. Potential harms from breast cancer screening include false-positive mammograms (which may lead to unnecessary additional imaging and benign breast biopsies), overdiagnosis, and radiation exposure. This chapter summarizes evidence from randomized controlled trials for mortality benefit; current society and task force recommendations for mammography screening; evaluation of the evidence; risk–benefit analysis; and supplemental screening in high-risk women.
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Verslype, Chris, David Cassiman, and Johan Verhaeghe. Liver disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0043.
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Liver disease can complicate 5% of pregnancies, putting mother and child at risk for increased morbidity and mortality. Cholestasis, portal hypertension, and liver failure represent three major clinical entities that should be recognized early because of the prognostic implications. Liver disease in pregnancy is generally separated into disorders that are unique to pregnancy and those that coincide with pregnancy. This chapter recommends a systematic approach that focuses on the major differential diagnostic characteristics of pregnancy-related liver diseases and a limited set of tests for pregnancy-unrelated liver diseases. Management of these conditions should be performed by a multidisciplinary team and ranges from simple medical therapies to immediate termination of the pregnancy.
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Sinagra, Gianfranco, Marco Merlo, and Davide Stolfo. Dilated cardiomyopathy: clinical diagnosis and medical management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0356.
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Dilated cardiomyopathy (DCM) is a relatively rare primary heart muscle disease with genetic or post-inflammatory aetiology that affects relatively young patients with a low-risk co-morbidity profile. Therefore, DCM represents a particular heart failure model with specific characteristics and long-term evolution. The progressively earlier diagnosis derived from systematic familial screening programmes and the current therapeutic strategies have greatly modified the prognosis of DCM with a dramatic reduction of mortality over recent decades. A significant number of DCM patients present an impressive response to pharmacological and non-pharmacological evidence-based therapy in terms of haemodynamic improvement with subsequent left ventricular reverse remodelling, which confer a favourable long-term prognosis. However, in some DCM patients the outcome is still severe. This prognostic heterogeneity is possibly related to the aetiological variety of this disease. Maximal effort towards an early aetiological diagnosis of DCM, by using all diagnostic available tools (including cardiovascular magnetic resonance imaging, endomyocardial biopsy, and genetic testing when indicated), as well as the individualized long-term follow-up appear crucial in improving the prognostic stratification and the clinical management of these patients.
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Madden, Anthony P. Informatics and technology for anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0034.
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Health informatics is concerned with the structure, acquisition, and use of health information. Its origins can be traced back to the publication of Bills of Mortality by the parishes of London in the sixteenth century. Interest in health information accelerated during the late nineteenth century with the development of an internationally recognized classification of the causes of death. Further work on the classification of diseases and causes of death has resulted in the ICD-10, while SNOMED CT provides an international thesaurus of medical terms suitable for use in computerized medical record systems. In 1932, Tovell and Dunn described the systematic collection of data about anaesthetics with the aim of identifying areas for improvement. The improvement of healthcare is the main driver for the implementation of electronic patient record systems in hospitals. A natural corollary is the implementation of computerized anaesthetic information management systems. Computerized record systems can automatically store the output of physiological monitors and reduce errors with active and passive decision support. Although the recording and processing of health information in the twenty-first century almost always involves the use of computers, this can give rise to problems with security and inter-operability. Computer technology also has other uses in modern anaesthetic practice. The modelling of physiological processes and the use of simulators in the training of anaesthetists are good examples.
Book chapters on the topic "Systematic mortality risk"
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Shim, Matthew J., David Gimeno, Sandi L. Pruitt, Christopher B. McLeod, Margaret J. Foster, and Benjamin C. Amick. "A Systematic Review of Retirement as a Risk Factor for Mortality." In Applied Demography and Public Health, 277–309. Dordrecht: Springer Netherlands, 2013. http://dx.doi.org/10.1007/978-94-007-6140-7_17.
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Hopkins, Richard, and Aaron Kite-Powell. "Monitoring disease and risk factors: surveillance." In Oxford Handbook of Public Health Practice, edited by Ichiro Kawachi, Iain Lang, and Walter Ricciardi, 154–63. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198800125.003.0014.
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Public health surveillance is ‘the ongoing, systematic collection, analysis, interpretation, and dissemination of data about a health-related event for use in public health action to reduce morbidity and mortality and to improve health. Data disseminated by a public health surveillance system can be used for immediate public health action, program planning and evaluation, and formulating research hypotheses. This chapter discusses purposes for surveillance, surveillance opportunities, surveillance system design, public health informatics, evaluating a surveillance system, and general principles for effective surveillance systems.
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Smulders, Yvo M., Marie-Therese Cooney, and Ian Graham. "Cardiovascular risk estimation at the individual level." In ESC CardioMed, edited by Massimo Piepoli, 846–63. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0208_update_001.
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The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the application to an individual of risk estimates derived from populations is imprecise. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring (very) high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation and management of these risks are discussed.
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Smulders, Yvo M., Marie-Therese Cooney, and Ian Graham. "Cardiovascular risk estimation at the individual level." In ESC CardioMed, edited by Massimo Piepoli, 846–63. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0208.
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The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the occurrence of cardiovascular disease is likely to depend not just on pre-existing risk factors, but also on chance. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation of these risks are discussed.
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O’Doherty, Roseann, and Fionnuala Ní Ainle. "Prevention of postpartum venous thromboembolism (VTE)." In Practical management of the pregnant patient with rheumatic disease, edited by Karen Schreiber, Eliza Chakravarty, and Monika Østensen, 33–38. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198845096.003.0003.
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Venous thromboembolism (VTE) is a leading cause of maternal mortality in developed countries. The baseline pregnancy-associated VTE (PA-VTE) risk is further increased by additional maternal, pregnancy, and delivery characteristics. In a recently developed risk prediction model for postpartum VTE, emergency caesarean section, stillbirth, postpartum haemorrhage, pre-eclampsia/eclampsia, infection, and medical comorbidities were the strongest VTE predictors. While the evidence base supporting optimal strategies for reducing the risk of postpartum VTE in general is weak, for women with prior VTE it appears that this risk may be reduced by up to 75% with low-molecular-weight heparin (LMWH). VTE prevention in women with more common VTE risk factors is a knowledge gap in 2020, with widely varying international guideline recommendations. However, there is no debate surrounding the requirement to perform systematic VTE risk assessment in pregnant and postpartum women.
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Thombs, Brett D., and Roy C. Ziegelstein. "Screening in Cardiovascular Care." In Screening for Depression in Clinical Practice. Oxford University Press, 2009. http://dx.doi.org/10.1093/oso/9780195380194.003.0018.
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There is great interest in screening in cardiovascular settings but little evidence that implementation of screening will affect depression or cardiac outcomes despite the epidemiologic evidence that depression predicts cardiac events and mortality. Since this chapter was accepted, in October 2008 the American Heart Association (AHA) Working Group published a Scientific Advisory recommending that all patients with cardiovascular disease be screened for depression, although this recommendation was not based on a systematic review of the evidence. Several weeks after release of the Scientific Advisory, a systematic review of depression screening in cardiovascular care was published but did not find evidence that patients with cardiovascular disease would benefit from screening for depression. The authors of the review noted that no published trials have assessed whether screening for depression improves depressive symptoms or cardiac outcomes in patients with cardiovascular disease, suggesting that the recommendations of the AHA Scientific Advisory were premature. High rates of depression were first documented among patients with cardiovascular disease (CVD) in the late 1960s. Early research on depression in CVD focused on patients with acute myocardial infarction (AMI) and conceptualized depression as an acute reaction to a catastrophic medical event. In the 1990s, groundbreaking work by Frasure-Smith and colleagues demonstrated a connection between major depression during hospitalization for AMI and subsequent mortality. Since then, many other studies have identified major depression or depressive symptoms as risk factors for mortality and recurrent cardiac events among patients with AMI or unstable angina pectoris (together known as acute coronary syndromes [ACS]) even after controlling for other known risk factors, although not all studies have reported a significant association. Other studies have reported that depression among patients with ACS is related to decreased quality of life and poor adherence to secondary prevention behaviors, including smoking cessation, taking prescribed medications, exercising, and attending cardiac rehabilitation. Less research on the relationship between depression and mortality has been done in other CVD patient groups, although similar links have been reported in studies of patients with congestive heart failure (CHF), for instance.
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Lee, Karen. "New York City." In Urban Health, 309–15. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190915858.003.0033.
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New York City has been a global leader in healthy urban design and in improving the built environment—the human-made environment consisting of our neighborhoods, streets, buildings, and their amenities—to assist in the prevention and control of the current epidemics of noncommunicable disease and their risk factors. This chapter shows how, through the translation of research-based health evidence into the development and implementation of user-friendly resources with and for non–health professionals involved in the planning, design, construction, maintenance, and renovation of the built environment, such as the Active Design Guidelines and its supplements, NYC pioneered formal efforts toward systematic evidence-based environmental design that can decrease physical inactivity and sedentariness, key risk factors for mortality and morbidity around the world today, while addressing other key public health issues like safety and equity.
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Aarnoutse, Floor, Cassandra Renes, Ronald Batenburg, and Marco Spruit. "STRIPA." In Advances in Medical Technologies and Clinical Practice, 114–35. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-5225-0248-7.ch005.
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Polypharmic patients are patients who chronically use five or more medicines. The number of polypharmacy patients continues to increase even though it is a risk factor for morbidity and mortality. A medication review is an important measure to mitigate medication risks. It is known to effectively reduce the number of drug related problems per (polypharmic) patient. STRIP is a Dutch method to perform a structured medication review. Based on this method, the STRIPA(ssistent) tool is developed. However, whether or not this app is considered useful by the healthcare professional is not known yet. In order to assess this, a systematic literature study is conducted. In addition, an effectiveness study design is described. The results show that there is indeed a need for medication reviews and Dutch healthcare professionals are likely to adopt new technologies, an effectiveness study based on a randomized controlled trial is necessary to assess the effectiveness of STRIPA.
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Aarnoutse, Floor, Cassandra Renes, Ronald Batenburg, and Marco Spruit. "STRIPA." In Chronic Illness and Long-Term Care, 764–84. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7122-3.ch038.
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Polypharmic patients are patients who chronically use five or more medicines. The number of polypharmacy patients continues to increase even though it is a risk factor for morbidity and mortality. A medication review is an important measure to mitigate medication risks. It is known to effectively reduce the number of drug related problems per (polypharmic) patient. STRIP is a Dutch method to perform a structured medication review. Based on this method, the STRIPA(ssistent) tool is developed. However, whether or not this app is considered useful by the healthcare professional is not known yet. In order to assess this, a systematic literature study is conducted. In addition, an effectiveness study design is described. The results show that there is indeed a need for medication reviews and Dutch healthcare professionals are likely to adopt new technologies, an effectiveness study based on a randomized controlled trial is necessary to assess the effectiveness of STRIPA.
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Wald, Nicholas, and Malcolm Law. "Medical screening." In Oxford Textbook of Medicine, edited by John D. Firth, Christopher P. Conlon, and Timothy M. Cox, 137–51. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0018.
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Medical screening is the systematic application of a test or inquiry to identify individuals at sufficient risk of a specific disorder to benefit from further investigation or direct preventive action (these individuals not having sought medical attention on account of symptoms of that disorder). Key to this definition is that the early detection of disease is not an end in itself; bringing forward a diagnosis without altering the prognosis is useless and may be harmful. Before a potential screening test is introduced into practice it must be shown to prevent death or serious disability from the disease to an extent sufficient to justify the human and financial costs. Where a detection rate cannot be directly determined (e.g. in cancer screening, or if the efficacy of the intervention is uncertain), a randomized trial is needed to show that screening and subsequent treatment reduce disease-specific mortality.
Conference papers on the topic "Systematic mortality risk"
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Moniruzzaman, Akm, Arminée Kazanjian, Hubert Wong, Md M. Chowdhury, R. K. Elwood, and J. M. Fitzgerald. "A Systematic Review On Risk Factors Of Mortality Among TB Patients." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5460.
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Yustinawati, Ratna, and Anhari Achadi. "Risk Factors for Mortality in Patients with Covid-19: A Systematic Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.01.26.
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ABSTRACT Background: SARS-CoV-2, a new strain of the coronavirus, caused a global outbreak of fatal acute pneumonia. Globally, WHO has recorded 709,511 deaths from COVID-19, and the number is increasing. This study aimed to determine the risk factors for mortality in COVID-19 patients. Subjects and Method: A systematic review was conducted by searching for articles from ScienceDirect, PubMed, SpringerLink, Scopus, and Google Scholar databases. The inclusion criteria were open access, English-language, and full-text articles published in journals between 20019 and 2020. The keywords were (Coronavirus Disease 2019 AND clinical characteristics AND epidemiological characteristics AND comorbidities) OR (COVID-19 AND clinical characteristics AND epidemiological characteristics AND comorbidities). A total of eight articles was reviewed to answer the research question. The data were analyzed by PRISMA flow chart. Results: Based on the reports from China and Korea, a total of 1,314 (100%) COVID-19 patients who died was aged ≥60 years with comorbidity, in which 845 (64%) were male patients. Before the death of patients, the increase D-dimer level of ≥1 μg/ mL and Sequential Organ Failure Assessment (SOFA) score of ≥4 were reported. It indicated the occurrence of multi-organ failure and Acute Respiratory Distress Syndrome (ARDS). Most of the comorbidities were hypertension, diabetes mellitus, and cardiovascular diseases. Conclusion: Risk factors for mortality in COVID-19 patients include age at ≥60 years, male, and presence of comorbidity. The clinical features are D-dimer levels ≥1 μg / mL, high SOFA score (≥4), and ARDS. Comprehensive efforts are needed to identify risk factors early and conduct effective treatment timely to reduce the mortality of COVID-19 patients. Keywords: SARS-CoV-2, COVID-19, risk factors, mortality, comorbidity Correspondence: Ratna Yustinawati. Master of Public Health Program, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia. Email: ratnayustinawati@gmail.com. Mobile: +628179324304. DOI: https://doi.org/10.26911/the7thicph.01.26
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Yustinawati, Ratna, and Anhari Achadi. "Risk Factors for Mortality in Patients with Covid-19: A Systematic Review." In The 7th International Conference On Public Health 2020. Masters Program In Public Helath, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph-fp.01.01.
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Pratiwi, Silvalia Rahma, Hanung Prasetya, and Bhisma Murti. "Low Birth Weight and Neonatal Mortality: Meta Analysis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.113.
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ABSTRACT Background: Low birth weight (LBW) has been used as an important public health indicator. LBW is one of the key drivers and indirect causes of neonatal death. It contributes to 60% to 80% of all neonatal deaths, annually. This study aimed to examine association between LBW and neonatal mortality using meta analysis. Subjects and Methods: This was meta-analysis and systematic review. Published articles in 2010-2020 were collected from Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, ProQuest databases. Keywords used “low birth weight” AND “mortality” OR “birth weight mortality” OR “neonatal death” AND “cross sectional” AND “adjusted odd ratio”. The inclusion criteria were full text, using cross-sectional study design, and reporting adjusted ratio. The data were analyzed by PRISMA flow chart and Revman 5.3. Results: 6 studies were met criteria. This study showed that low birth weight increased the risk of neonatal mortality (aOR= 2.23; 95% CI= 1.12 to 4.44; p= 0.02). Conclusion: Low birth weight increases the risk of neonatal mortality. Keywords: low birth weight, mortality, neonatal death Correspondence: Silvalia Rahma Pratiwi. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: silvaliarahmapratiwi@gmail.com. Mobile: 082324820288. DOI: https://doi.org/10.26911/the7thicph.03.113
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Martins Rocha, Vânia Patrícia, Cátia Paixão, and Alda Marques. "Physical activity and mortality risk in people with interstitial lung disease: a systematic review and meta-analysis." In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa1810.
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Soliman, Nada Hossam, Ahmed T. M. Aboughalia, Tawanda Chivese, Omran A. H. Musa, George Hindy, Noor Al-Wattary, Saifeddin Moh'd Badran, et al. "A Meta-Review of Meta-Analyses and an Updated Meta-Analysis on the Efficacy of Chloroquine and Hydroxychloroquine in treating COVID-19 Infection." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0308.
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Objective: To synthesize the findings presented in systematic reviews and meta-analyses as well as to update the evidence using a meta-analysis in evaluating the efficacy and safety of CQ and HCQ with or without Azithromycin for the treatment of COVID-19 infection. Methods: The design of this meta-review followed the preferred reporting items for overviews of systematic reviews including harms checklist (PRIO-harms). A comprehensive search included several electronic databases in identifying all systematic reviews and meta-analyses as well as experimental studies which investigated the efficacy and safety of CQ, HCQ with or without antibiotics as COVID-19 treatment. Findings from the systematic reviews and metaanalyses were reported using a structured summary including tables and forest plots. The updated metaanalyses of experimental studies was carried out using the distributional assumption-free quality effects model. Risk of bias was assessed using the assessing the methodological quality of systematic reviews (AMSTAR) tool for reviews and the methodological standard for epidemiological research (MASTER) scale for the experimental studies. The main outcome for both the meta-review and the updated metaanalyses was mortality. Secondary outcomes included transfer to the intensive care unit (ICU) or mechanical ventilation, worsening of illness, viral clearance and the occurrence of adverse events. Results: A total of 13 reviews with 40 primary studies comprising 113,000 participants were included. Most of the primary studies were observational (n=27) and the rest were experimental studies. Two meta-analyses reported a high risk of mortality with similar ORs of 2.5 for HCQ with Azithromycin. However, four other metaanalyses reported contradictory results with two reporting a high risk of mortality and the other two reporting no significant association between HCQ with mortality. Most reviews reported that HCQ with or without Azithromycin had no significant effect on virological cure, disease exacerbation or the risk of transfer to the ICU, need for intubation or mechanical ventilation. After exclusion of studies that did not meet the eligibility criteria, the updated meta-analysis contained eight experimental studies (7 RCTs and 1 quasiexperimental trial), with a total of 5279 participants of whom 1856 were on either CQ/HCQ or combined with Azithromycin. CQ/HCQ with or without Azithromycin was significantly associated with a higher risk of adverse events. HCQ was not effective in reducing mortality transfer to the ICU, intubation or need for mechanical ventilation virological cure (RR 1.0, 95%CI 0.9-1.2, I2 =55%, n=5 studies) nor disease exacerbation (RR 1.2, 95%CI 0.3-5.0, I2 =29%, n=3 studies). Conclusion: There is conclusive evidence that CQ and HCQ, with or without Azithromycin are not effective in treating COVID-19 or its exacerbation.
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Abida, Liza Laela, Bhisma Murti, and Hanung Prasetya. "Effect of HIV Infection on Mortality in Patients with Tuberculosis in Asia: A Meta-Analysis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.01.52.
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ABSTRACT Background: TB/HIV coinfectioned remains the leading cause of mortality among people living with HIV (PLHIV). The purpose of this study was to explore the effect of HIV infection on mortality in patients with tuberculosis in Asia. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting published studies from Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, and ProQuest databases, from 2010 to 2020. Keywords used “HIV” AND “mortality” OR “HIV Mortality” OR “Tuberculosis Mortality” AND “cross sectional” AND “adjusted odd ratio”. The inclusion criteria were full text, using English or Indonesian language, using cross-sectional study design, and reporting adjusted odds ratio. The articles were selected by PRISMA flow chart. The quantitative data were analyzed using random effect model run on Review Manager 5.3. Results: 5 studies in Asia (Thailand, China, Malaysia, and Oman) were included for this study. Meta analysis study reported that HIV elevated the risk of mortality in patients with tuberculosis (aOR= 3.45; 95% CI= 1.14 to 10.45; p = 0.030). Conclusion: HIV elevates the risk of mortality in patients with tuberculosis. Keywords: HIV, mortality, Tuberculosis Correspondence: Liza Laela Abida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: lizalaela@gmail.com. Mobile: 085640115633. DOI: https://doi.org/10.26911/the7thicph.01.52
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TAVARES, Lívia Hygino, and Bruno MOURA. "DIABETES IN PREGNANCY AND FETAL CARDIAC RISK: LITERATURE REVIEW." In SOUTHERN BRAZILIAN JOURNAL OF CHEMISTRY 2021 INTERNATIONAL VIRTUAL CONFERENCE. DR. D. SCIENTIFIC CONSULTING, 2022. http://dx.doi.org/10.48141/sbjchem.21scon.45_abstract_tavares.pdf.
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Gestational diabetes mellitus (MGD) is associated with poor cardiac malformation in the fetus. It is related to changes in the clinical course of the disease and pre-gestational periods. The prevalence and incidence of MGD have been increasing worldwide. Early screening, diagnosis, and lifestyle change, such as physical exercise and healthy eating, provide better outcomes for children's health. This study aims to analyze the data concerning gestational diabetes and fetal malformations and to group the various protocols for diagnosis, highlighting the risk factors associated with MGD and their prevention. A systematic review of the literature was conducted with the PubMed, Scielo, Medline databases with English, Portuguese, and Spanish articles. The studies gathered clinical trials, randomized clinical trials, and original articles. In 12 articles analyzed maternal alterations, while 11 articles analyzed fetal alterations, and 9 articles analyzed how to diagnose cardiac changes in the fetus. The patient with MGD should be inserted in multidisciplinary activities seeking the change of lifestyle, physical exercises, and food reeducation, intending to give the fetus the appropriate nutrients and optimize the drug treatment; cardiac malformations are among the most severe and recurrent complications. However, they can be avoided with the control of pre-gestational diabetes (stricter follow-up from the moment the patient feels the desire to become pregnant) and the diagnosis and treatment of early gestational diabetes, as strict control of maternal blood glucose during pregnancy reduces morbidities and mortality. The study showed that hyperglycemic status during pregnancy is related to increased mortality and morbidity, even if it is asymptomatic. Therefore, it is necessary to guide the diabetic woman to plan her pregnancy in a euglycemic period because only this control can guarantee health to the fetus. The diagnosis of pregnant women with gestational diabetes needs to be early to optimize treatment.
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Arif, Rida, Asmaa Abdelmaksoud, Lovemore Mapahla, Albert Chinhenzva, Nazmul Islam, Sohail Doi, and Tawanda Chivese. "The risk of severe COVID-19 and mortality from COVID-19 in people living with HIV compared to individuals without HIV - a systematic review and meta-analysis of 1 268 676 individuals." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2021. http://dx.doi.org/10.29117/quarfe.2021.0152.
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Research Purpose: Findings from existing studies have shown conflicting evidence concerning the risk of severe COVID-19 and death from COVID-19 in people living with HIV (PLHIV) compared to people without HIV. The aim of our review is to compare mortality, hospitalization, and the need for intensive care services due to COVID-19 between PLHIV and individuals without HIV based on data from the existing literature. Methods: A search in major databases of preprints was carried out and eligible studies were screened and selected. From each study, data on numbers of PLHIV and individuals without HIV were extracted. Study quality was assessed using the MethodologicAl STandard for Epidemiological Research (MASTER) scale. Data synthesis used a bias adjusted model where age and geographical subgroups were analysed. Results: From the 2757 records identified, 11 studies were included. The total participants were 1 268 676, of which 13 886 were PLHIV. Overall, the estimated effect of HIV on mortality suggested some worsening (OR 1.3, 95% CI: 0.9 – 2.0, I2 = 78.6%) with very weak evidence against the model hypothesis at this sample size. However, in individuals aged <60 years, the estimated effect on mortality suggested more worsening in PLHIV (OR 2.7, 95% CI: 1.1 -6.5, I2 = 95.7%) with strong evidence against the model hypothesis at this sample size. HIV was also associated with an estimated effect on hospitalization for COVID-19 that suggested worsening (OR 1.6, 95% CI: 1.3-2.1, I2 = 96.0%) with strong evidence against the model hypothesis at this sample size. Conclusion: People living with HIV have higher risk of death and hospitalisation from COVID-19, compared to individuals without HIV with the difference exaggerated in those younger than 60 years old. Our findings suggest that PLHIV are at higher risk than the general population and should be prioritized for vaccine coverage and monitoring if diagnosed with COVID-19.
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Yeung, Philip Chun, Siu Tim Cheung, Kelvin Kwok-Chai Ng, Paul Bo-San Lai, and Charing Ching-Ning Chong. "IDDF2020-ABS-0210 Statin use associated with reduced risk of all-cause mortality in hepatocellular carcinoma patients following liver resection: a systematic review and meta-analysis." In Abstracts of the International Digestive Disease Forum (IDDF), 22–23 November 2020, Hong Kong. BMJ Publishing Group Ltd and British Society of Gastroenterology, 2020. http://dx.doi.org/10.1136/gutjnl-2020-iddf.169.
Full textReports on the topic "Systematic mortality risk"
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Sun, Ying, Yanhui Liu, Yaning Zhu, Ruzhen Luo, Yiwei Luo, Shanshan Wang, and Zihang Feng. Risk Prediction Models of Mortality after Hip Fracture Surgery in the Elderly: A Systematic Review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0111.
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Hua, Minglei, Ling Li, and Linlin Diao. Bronchial asthma and risk of cardiovascular disease and cardiovascular mortality: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0083.
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Horvit, Andrew, and Donald Molony. A Systematic Review and Meta-Analysis of Mortality and Kidney Function in Uranium – Exposed Individuals. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0122.
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Review question / Objective: 1) In humans, how does environmental and/or occupational exposure to uranium affect the risk of mortality due to primary kidney disease compared to unexposed individuals? (2) In humans, how does environmental and/or occupational exposure to uranium affect the risk of developing kidney failure compared to unexposed individuals? Eligibility criteria: We included cohort studies that evaluate the risk of CKD/ESKD due to uranium exposure. We also included cohort studies that evaluate standardized mortality due to all-cause mortality, kidney cancer, chronic kidney disease, diabetes, and cardiovascular disease in humans with exposure to uranium. We also included cross sectional studies that evaluate renal function in humans exposed to uranium via biomarkers and hard clinical measures (such as creatinine clearance) compared to humans with low/no uranium exposure. In order to not include the same cohort multiple times in the statistical analyses, we selected studies that evaluated an outcome of interest for a given cohort for the longest follow-up period. When this was not possible (due to multiple studies using different combinations of cohorts with varying lengths of follow up), the study with the largest study population size was selected.
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Yang, Hui, Xi-Xi Wan, Hui Ma, Zhen LI, Li Weng, Ying Xia, and Xiao-Ming Zhang. Prevalence and mortality risk of low skeletal muscle mass in critically ill patients: an updated systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2022. http://dx.doi.org/10.37766/inplasy2022.11.0132.
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Review question / Objective: The PICOS principle was adopted when we confirmed the study eligibility. The inclusion criteria were as follows: (1) patients were critically ill, which was defined as adult patients who were from the ICU department; (2) exposure: patients had a clear definition of LSMM based on CT scans, anthropometric methods and ultrasound; (3) presented the prevalence of LSMM or could be calculated by the available data from the article; and (4) study design: observational study (cohort study or cross-sectional study). Articles that were reviews, case reports, comments, correspondences, letters or only abstracts were excluded. Condition being studied: Critical illness often results in low skeletal muscle mass for multiple reasons. Multiple studies have explored the association between low skeletal muscle mass and mortality. The prevalence of low skeletal muscle mass and its association with mortality are unclear. This systematic review and meta-analysis aim to identify the prevalence and mortality risk of low skeletal muscle mass among critically ill patients.
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Nam, Jae Hyun, Hee Jin Kwack, Woo Seob Ha, and Jee-Eun Chung. Resuscitation fluids for patients with risk factors of multiple organ failure: A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, July 2022. http://dx.doi.org/10.37766/inplasy2022.7.0091.
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Review question / Objective: P: patients with risk factors of multiple organ failure I: balanced crystalloids C: normal saline O: mortality, in-hospital mortality, renal failure, length of ICU stay, length of hospital stay. Condition being studied: In clinical field, aggressive fluid resuscitation therapy is administered to prevent the progression of multiple organ failures by maintaining tissue and organ perfusion. Normal saline is frequently used, but it has been some concerns. Although large-scale studies with balanced crystalloids have been conducted, they couldn’t reach significant conclusions due to the diversity of disease severity. Therefore, we aims to evaluate and identify the best fluid for patients at high risk of multiple organ failure by comparing the effects of normal saline and balanced crystalloids.
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Zhang, Fangfang, Lili Liu, Tian Li, and Zubing Mei. Prognostic value of metabolic syndrome for risk of stroke recurrence and mortality: A comprehensive systematic review with meta-analysis. INPLASY - International Platform of Registered Systematic Review Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0183.
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Wang, Ying yuan, Zechang Chen, Luxin Zhang, Shuangyi Chen, Zhuomiao Ye, Tingting Xu, and Yingying Zhang c. A systematic review and network meta-analysis: Role of SNPs in predicting breast carcinoma risk. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0092.
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Review question / Objective: P: Breast cancer patient; I: Single nucleotide polymorphisms associated with breast cancer risk; C: Healthy person; O: By comparing the proportion of SNP mutations in the tumor group and the control group, the effect of BREAST cancer risk-related SNP was investigated; S: Case-control study. Condition being studied: Breast cancer (BC) is one of the most common cancers among women, and its morbidity and mortality have continued to increase worldwide in recent years, reflecting the strong invasiveness and metastasis characteristics of this cancer. BC is a complex disease that involves a sequence of genetic, epigenetic, and phenotypic changes. Polymorphisms of genes involved in multiple biological pathways have been identified as potential risks of BC. These genetic polymorphisms further lead to differences in disease susceptibility and severity among individuals. The development of accurate molecular diagnoses and biological indicators of prognosis are crucial for individualized and precise treatment of BC patients.
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Yang, Ming, Youwei Wu, Tao Wang, and Wentao Wang. Iron overload, Infectious Complications and Survival In Liver Transplant Recipients: A Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2022. http://dx.doi.org/10.37766/inplasy2022.11.0022.
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Review question / Objective: Iron overload conditions is a well-established risk factor for infection of pathogens. The possible association of iron overload with infectious complications and prognosis of patients receiving transplants are not well understood. Condition being studied: Liver transplantation often represents a life-saving treatment for an increasing number of patients with end-stage liver disease. With the improvements in surgical techniques, immunosuppression strategies, and post-LT management of complications, the recipient mortality has steadily declined after LT. The survival rates were 83% at 1 year, 71% at 5 years in western countries. However, the use of immunosuppressants increased risk of infections as an adverse effect resulting in severe morbidity. Globally, infection caused by including bacteria, fungus, viruses remain one of the leading causes of morbidity and mortality among transplant recipients. Knowledge of modifiable risk factors and potentially reversible causes is essential to develop targeted preventive strategies.
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Li, Shanshan, Hongyu Yue, Zhaoqin Wang, Ke Cheng, Wei Zhang, Zhangjin Zhang, Lixing Lao, Huangan Wu, and Shifen Xu. The prevalence of depression and its association with the risk of mortality in patients with cancer：a protocol for systematic review and meta analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, July 2021. http://dx.doi.org/10.37766/inplasy2021.7.0065.
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Zhou, Zhongwei, Hao Jin, Huixiang Ju, Mingzhong Sun, Hongmei Chen, and Li Li. Circulating trimethylamine-N-oxide and all-cause or cardiovascular mortality risk in patients with chronic kidney disease: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, October 2021. http://dx.doi.org/10.37766/inplasy2021.10.0049.
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