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Biostatistics Core Publications


Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality

The Patient Protection and Affordable Care Act eliminated cost sharing for preventive services, including colorectal cancer screening for individuals aged 50-75 years with private health insurance. This study examines the impact of the Affordable Care Act...
Author(s): Lee C; Kushi LH; Reed ME; Eldridge EH; Lee JK; Zhang J; Spiegelman D

Am J Prev Med. 2021 Nov 08.

PubMed abstract

Treatment and Follow-up Care Associated With Patient-Scheduled Primary Care Telemedicine and In-Person Visits in a Large Integrated Health System

Telemedicine visits can offer patients convenient access to a clinician, but it is unclear whether treatment differs from that with in-person visits or how often patients require in-person follow-up. To examine whether physician prescribing and orders dif...
Author(s): Reed M; Huang J; Graetz I; Muelly E; Millman A; Lee C

JAMA Netw Open. 2021 Nov 01;4(11):e2132793. Epub 2021-11-01.

PubMed abstract

Hypotonic-hyporesponsive Episodes After Diphtheria, Tetanus and Acellular Pertussis Vaccination

Hypotonic-hyporesponsive episode (HHE) after whole cell pertussis vaccination is a known adverse event. Less is known about the risk of HHE after administration of acellular pertussis vaccines. Using parental interviews, this study actively surveyed for H...
Author(s): Hansen J; Decker MD; Lewis E; Fireman B; Pool V; Greenberg DP; Johnson DR; Black S; Klein NP

Pediatr Infect Dis J. 2021 Aug 20.

PubMed abstract


Author(s): Escobar GJ; Schuler A; Lee C

Am J Obstet Gynecol. 2021 Apr 22.

PubMed abstract

Editorial Expression of Concern: Exposure to Magnetic Field Non-Ionizing Radiation and the Risk of Miscarriage: A Prospective Cohort Study

Author(s): Li DK; Chen H; Ferber JR; Odouli R; Quesenberry C

Sci Rep. 2021 03 10;11(1):6021. Epub 2021-03-10.

PubMed abstract

Particulate Matter and Cardiovascular Risk in Adults with Chronic Obstructive Pulmonary Disease

People with chronic obstructive pulmonary disease have increased risk of cardiovascular disease and may be more susceptible to air pollution exposure. However, no study has examined the association between long-term fine particulate matter exposure (<2.5 ...
Author(s): Alexeeff SE; Deosaransingh K; Liao NS; Van Den Eeden SK; Schwartz J; Sidney S

Am J Respir Crit Care Med. 2021 Mar 04.

PubMed abstract

Association of Pregnancy Intentions With Substance Use During Early Pregnancy

The goal of this study was to evaluate the association between pregnancy intentions and substance use in early pregnancy among pregnant women receiving prenatal care in a large, integrated healthcare system. The sample comprised 29,787 Kaiser Permanente N...
Author(s): Young-Wolff KC; Slama N; Sarovar V; Conway A; Tucker LY; Goler N; Terplan M; Ansley D; Adams SR; Armstrong MA

J Addict Med. 2021 Feb 16.

PubMed abstract

Racial Disparities in COVID-19 Testing and Outcomes : Retrospective Cohort Study in an Integrated Health System

Racial disparities exist in outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To evaluate the contribution of race/ethnicity in SARS-CoV-2 testing, infection, and outcomes. Retrospective cohort study (1 February 2020 t...
Author(s): Escobar GJ; Adams AS; Liu VX; Soltesz L; Chen YI; Parodi SM; Ray GT; Myers LC; Ramaprasad CM; Dlott R; Lee C

Ann Intern Med. 2021 Feb 09.

PubMed abstract

Fitting a shared frailty illness-death model to left-truncated semi-competing risks data to examine the impact of education level on incident dementia

Semi-competing risks arise when interest lies in the time-to-event for some non-terminal event, the observation of which is subject to some terminal event. One approach to assessing the impact of covariates on semi-competing risks data is through the illn...
Author(s): Lee C; Gilsanz P; Haneuse S

BMC Med Res Methodol. 2021 Jan 11;21(1):18. Epub 2021-01-11.

PubMed abstract

Long-Term PM2.5 Exposure and Risks of Ischemic Heart Disease and Stroke Events: Review and Meta-Analysis

Background Fine particulate matter <2.5 µm in diameter (PM2.5) has known effects on cardiovascular morbidity and mortality. However, no study has quantified and compared the risks of incident myocardial infarction, incident stroke, ischemic heart disease ...
Author(s): Alexeeff SE; Liao NS; Liu X; Van Den Eeden SK; Sidney S

J Am Heart Assoc. 2020 Dec 31:e016890.

PubMed abstract

Exercise During the First Trimester of Pregnancy and the Risks of Abnormal Screening and Gestational Diabetes Mellitus

To estimate the effects of exercise during the first trimester on the risks of abnormal screening and gestational diabetes mellitus (GDM). Data come from PETALS, a prospectively followed pregnancy cohort (n = 2,246, 79% minorities) receiving care at Kaise...
Author(s): Ehrlich SF; Ferrara A; Hedderson MM; Feng J; Neugebauer R

Diabetes Care. 2020 Dec 21.

PubMed abstract

Bisphosphonate Treatment Beyond 5 Years and Hip Fracture Risk in Older Women

Clinical trials have demonstrated the antifracture efficacy of bisphosphonate drugs for the first 3 to 5 years of therapy. However, the efficacy of continuing bisphosphonate for as long as 10 years is uncertain. To examine the association of discontinuing...
Author(s): Izano MA; Lo JC; Adams AL; Ettinger B; Ott SM; Chandra M; Hui RL; Niu F; Li BH; Neugebauer RS

JAMA Netw Open. 2020 Dec 01;3(12):e2025190. Epub 2020-12-01.

PubMed abstract

Development and Validation of Machine Learning Models: Electronic Health Record Data To Predict Visual Acuity After Cataract Surgery

To develop predictive models of final corrected distance visual acuity (CDVA) following cataract surgery using machine learning algorithms and electronic health record data. In this predictive modeling study we used decision tree, random forest, and gradi...
Author(s): Alexeeff SE; Uong S; Liu L; Shorstein NH; Carolan J; Amsden LB; Herrinton LJ

Perm J. 2020 Dec;25:1.

PubMed abstract


Increasing numbers of delivering women experience major morbidity and mortality. Limited work has been done on automated predictive models that could be used for prevention. Using only routinely collected obstetric data, we aimed to develop a predictive m...
Author(s): Escobar GJ; Soltesz L; Schuler A; Niki H; Malenica I; Lee C

Am J Obstet Gynecol. 2020 Oct 21.

PubMed abstract

Consequences of depletion of susceptibles for hazard ratio estimators based on propensity scores

We use simulated data to examine the consequences of depletion of susceptibles for hazard ratio (HR) estimators based on a propensity score (PS). First, we show that the depletion of susceptibles attenuates marginal HRs toward the null by amounts that inc...
Author(s): Fireman B; Wyss R; et al.

Epidemiology. 2020 Aug 06.

PubMed abstract

A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial

Excess gestational weight gain (GWG) among women with overweight or obesity synergistically increases their already elevated risk of having gestational diabetes, a caesarean delivery, a large for gestational age infant, and post-partum weight retention, a...
Author(s): Ferrara A; Hedderson MM; Brown SD; Ehrlich SF; Tsai AL; Feng J; Galarce M; Marcovina S; Catalano P; Quesenberry CP

Lancet Diabetes Endocrinol. 2020 Jun;8(6):490-500.

PubMed abstract

Comparative Effectiveness of 2 Diabetes Prevention Lifestyle Programs in the Workplace: The City and County of San Francisco Diabetes Prevention Trial

Data on the comparative effectiveness of Diabetes Prevention Programs (DPPs) in the workplace are limited. Between September 2015 and July 2016, employees of the City and County of San Francisco who were at risk for type 2 diabetes (N = 158) were randomly...
Author(s): Ferrara A; McDonald JC; Brown SD; Alexander JG; Christian-Herman JL; Fisher S; Quesenberry CP

Prev Chronic Dis. 2020 May 28;17:E38. Epub 2020-05-28.

PubMed abstract

Exploiting nonsystematic covariate monitoring to broaden the scope of evidence about the causal effects of adaptive treatment strategies

In studies based on electronic health records (EHR), the frequency of covariate monitoring can vary by covariate type, across patients, and over time, which can limit the generalizability of inferences about the effects of adaptive treatment strategies. I...
Author(s): Kreif N; Sofrygin O; Schmittdiel JA; Adams AS; Grant RW; Zhu Z; van der Laan MJ; Neugebauer R

Biometrics. 2020 Apr 15.

PubMed abstract

Adjuvant endocrine therapy for breast cancer patients: impact of a health system outreach program to improve adherence

Reports suggest that up to 50% of women with hormone receptor-positive (HR+) breast cancer (BC) do not complete the recommended 5 years of adjuvant endocrine therapy (AET). We examined the impact of an outreach program at Kaiser Permanente Northern Califo...
Author(s): Lee C; Check DK; Manace Brenman L; Kushi LH; Epstein MM; Neslund-Dudas C; Pawloski PA; Achacoso N; Laurent C; Fehrenbacher L; Habel LA

Breast Cancer Res Treat. 2020 Jan 23.

PubMed abstract

Comparison of Mortality and Major Cardiovascular Events Among Adults With Type 2 Diabetes Using Human vs Analogue Insulins

The comparative cardiovascular safety of analogue and human insulins in adults with type 2 diabetes who initiate insulin therapy in usual care settings has not been carefully evaluated using machine learning and other rigorous analytic methods. To examine...
Author(s): Neugebauer R; Schmittdiel JA; Dyer W; Pimentel N; O'Connor PJ; et al.

JAMA Netw Open. 2020 Jan 03;3(1):e1918554. Epub 2020-01-03.

PubMed abstract

Depletion-of-susceptibles bias in influenza vaccine waning studies: how to ensure robust results

Vaccine effectiveness studies are subject to biases due to depletion-of-persons at risk of infection, or at especially high risk of infection, at different rates from different groups (depletion-of-susceptibles bias), a problem that can also lead to biase...
Author(s): Lipsitch M; Goldstein E; Ray GT; Fireman B

Epidemiol Infect. 2019 Nov 27;147:e306. Epub 2019-11-27.

PubMed abstract

Validity of Self-reported Cannabis Use Among Pregnant Females in Northern California

Most clinical and epidemiologic estimates of prenatal cannabis use are based on self-report, and the validity of self-reported cannabis use has not been examined in a large, representative population of pregnant women. We determined the validity of self-r...
Author(s): Young-Wolff KC; Sarovar V; Tucker LY; Goler N; Conway A; Weisner C; Armstrong MA; Alexeeff S

J Addict Med. 2019 Nov 04.

PubMed abstract

Use of Time-Dependent Propensity Scores to Adjust Hazard Ratio Estimates in Cohort Studies with Differential Depletion of Susceptibles

Estimating hazard ratios (HR) presents challenges for time-to-event analyses of cohorts with differential depletion of susceptibles. When the treatment effect is not null, cohorts that were balanced at baseline tend to become unbalanced on baseline charac...
Author(s): Wyss R; Fireman B; et al.

Epidemiology. 2019 Sep 26.

PubMed abstract

Time-to-event analysis when the event is defined on a finite time interval

Acute graft-versus-host disease (GVHD) is a frequent complication following hematopoietic cell transplantation (HCT). Research on risk factors for acute GVHD has tended to ignore two important clinical issues. First, post-transplant mortality is high. In ...
Author(s): Lee C; Lee SJ; Haneuse S

Stat Methods Med Res. 2019 Aug 22:962280219869364.

PubMed abstract

Depletion of Susceptibles Bias in Analyses of Intra-season Waning of Influenza Vaccine Effectiveness

Bias arises in studies of waning vaccine effectiveness when higher-risk individuals are depleted from the population at-risk, at different rates between study groups. We examine how this bias arises and how it can be avoided. Reanalysis of data from Calif...
Author(s): Ray GT; Lewis N; Klein NP; Daley MF; Lipsitch M; Fireman B

Clin Infect Dis. 2019 Jul 28.

PubMed abstract