Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Iqbal SA[original query] |
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Psychiatric treatment and repeat suicide attempts among adults with substance use, by HIV status, United States, 2014-2020
Iqbal SA , Truman BI , Crosby AE . Public Health Rep 2022 138 (5) 333549221120452 OBJECTIVES: The association among psychiatric treatment history, HIV, and suicide reattempts among people starting treatment for substance use is not well understood. The objective of this study was to describe, by HIV status, the risk and protective factors associated with suicide reattempts among adults seeking treatment for substance use. METHODS: The study included 340 390 US adult residents aged ≥18 years in the Addiction Severity Index-Multimedia Version network from January 1, 2014, through December 31, 2020. We used adjusted logistic regression models to estimate strength of association between prior psychiatric treatment, HIV status, and sociodemographic factors and suicide reattempts within 30 days of treatment evaluation. RESULTS: Adults who had been prescribed psychiatric medication were less likely to have a recent suicide reattempt (adjusted odds ratio [aOR] = 0.8; 95% CI, 0.7-0.8) than adults with no prescription history. Adjusted models found similar protective effects between psychiatric treatment and suicide reattempts among adults reporting abuse, mental illness, injection drug use, and limited activity because of a medical condition. Conversely, the following were associated with recent suicide reattempts: being male (aOR = 1.4; 95% CI, 1.3-1.5), having a high school education/GED (General Educational Development) or less (aOR = 1.2; 95% CI, 1.1-1.2), being single (aOR = 1.2; 95% CI, 1.1-1.3), experiencing a pain problem (aOR = 1.2; 95% CI, 1.2-1.3), and not being referred to substance use treatment by court (aOR = 3.4; 95% CI, 3.2-3.7). CONCLUSIONS: A history of prescribed psychiatric medication is significantly associated with a reduced risk for suicide reattempts among adults seeking substance use treatment. Clinicians should consider incorporating mental health and suicide assessments into substance use treatment plans. |
Association of self-reported depression and anger with law enforcement officers' physical abuse of Black men in 4 Georgia counties, 2011
Iqbal SA , Truman BI , Crosby AE . J Natl Med Assoc 2021 113 (4) 371-381 INTRODUCTION: The association between the behavioral affect of black men and law enforcement officers' physical abuse of those men is not well-understood. This analysis measures the association between self-reported negative affect behavior (anger or depression) by the men and physical abuse by law enforcement officers, controlling for demographic and behavioral attributes. METHODS: A single point-in-time cross-sectional survey was conducted in 2011 through random-digit telephone dialing among a sample of English-speaking black men aged 18-65 years in 4 Georgia (USA) counties. Associations among the outcomes, self-reported history of physical abuse by law enforcement officers, and the predictor variables of interest (self-reported anger or depression) was conducted through multivariable logistic regression. Other independent variables of interest measured were age; country of origin; parental country of origin; education; income; employment status; previous residency in a juvenile, jail, or prison facility; coping styles; and self-reported gender role and racism stress levels. RESULTS: Of the 633 survey participants who had interacted with law enforcement officers within the past 5 years, 129 (20.4%) reported physical abuse by law enforcement officers. Three factors had statistically significant, independent associations with reported law enforcement officer physical abuse: high levels of depression stratified by often or sometimes coping with stress through anger (adjusted odds ratio [aOR] = 4.9; 95% confidence interval [CI]: 1.4-16.9), previous residency in a jail or prison (aOR = 2.3; 95% CI: 1.8-3.1), and higher levels of exposure to racism (aOR [high levels of racism] = 15.0; 95% CI: 6.7-33.7 and aOR [medium levels of racism] = 6.5; 95% CI: 3.4-12.3). CONCLUSION: Cohort studies are needed to determine if a black man's negative coping style, history of incarceration or exposure to racism is causally related to his history of physical abuse by a law enforcement officer. |
Diagnostic code agreement for electronic health records and claims data for tuberculosis
Iqbal SA , Isenhour CJ , Mazurek G , Truman BI . Int J Tuberc Lung Dis 2020 24 (7) 706-711 OBJECTIVE: To measure the frequency of diseases related to latent tuberculosis infection (LTBI) and tuberculosis (TB), we assessed the agreement between diagnosis codes for TB or LTBI in electronic health records (EHRs) and insurance claims for the same person.METHODS: In a US population-based, retrospective cohort study, we matched TB-related Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) EHR codes and International Statistical Classification of Diseases, 10(th) Revision, Clinical Modification (ICD-10-CM) claims codes. Furthermore, LTBI was identified using a published ICD-based algorithm and all LTBI- and TB-related SNOMED CT codes.RESULTS: Of people with the 10 most frequent TB-related claim codes, 50% did not have an exact-matched EHR code. Positive tuberculin skin test was the most frequent unmatched EHR code and people with the 10 most frequent TB EHR codes, 40% did not have an exact-matched claim code. The most frequent unmatched claim code was TB screening encounter. EHR codes for LTBI matched to claims codes for TB testing; pulmonary TB; and nonspecific, positive or adverse tuberculin reaction.CONCLUSION: TB-related EHR codes and claims diagnostic codes often disagree, and people with claims codes for LTBI have unexpected EHR codes, indicating the need to reconcile these coding systems. |
Risk factors for and trends in isoniazid monoresistance at diagnosis of tuberculosis - United States, 1993-2016
Iqbal SA , Armstrong LR , Kammerer JS , Truman BI . J Public Health Manag Pract 2019 27 (4) E162-E172 CONTEXT: Resistance to isoniazid (INH) only (monoresistance), with drug susceptibility to rifampin, pyrazinamide, and ethambutol at diagnosis of tuberculosis (TB) disease, can increase the length of treatment. OBJECTIVE: To describe US trends in INH monoresistance and associated patient characteristics. DESIGN: We performed trend and cross-sectional analyses of US National Tuberculosis Surveillance System surveillance data. We used Joinpoint regression to analyze annual trends in INH monoresistance and logistic regression to identify patient characteristics associated with INH monoresistance. PARTICIPANTS: Culture-positive cases reported to National Tuberculosis Surveillance System during 1993-2016 with drug susceptibility test results to INH, rifampin, pyrazinamide, and ethambutol. MAIN OUTCOME MEASURES: (1) Trends in INH monoresistance; (2) odds ratios for factors associated with INH monoresistance. RESULTS: Isoniazid monoresistance increased significantly from 4.1% of all TB cases in 1993 to 4.9% in 2016. Among US-born patients, INH monoresistance increased significantly from 2003 onward (annual percentage change = 2.8%; 95% confidence interval: 1.4-4.2). During 2003-2016, US-born persons with INH-monoresistant TB were more likely to be younger than 65 years; to be Asian; to be human immunodeficiency virus-infected; or to be a correctional facility resident at the time of diagnosis. Among non-US-born persons, INH resistance did not change significantly during 1993-2016 (annual percentage change = -0.3%; 95% confidence interval: -0.7 to 0.2) and was associated with being aged 15 to 64 years; being Asian, black, or Hispanic; or having a previous history of TB. CONCLUSIONS: INH-monoresistant TB has been stable since 1993 among non-US-born persons; it has increased 2.8% annually among US-born persons during 2003-2016. Reasons for this increase should be further investigated. |
Factors associated with latent tuberculosis infection treatment failure among patients with commercial health insurance - United States, 2005-2016
Iqbal SA , Isenhour CJ , Mazurek G , Langer AJ , Chang MH , Truman BI . J Public Health Manag Pract 2019 27 (4) E151-E161 CONTEXT: Approximately 80% of US tuberculosis (TB) cases verified during 2015-2016 were attributed to untreated latent TB infection (LTBI). Identifying factors associated with LTBI treatment failure might improve treatment effectiveness. OBJECTIVE: To identify patients with indicators of isoniazid (INH) LTBI treatment initiation, completion, and failure. METHODS: We searched inpatient and outpatient claims for International Classification of Diseases (Ninth and Tenth Revisions), National Drug, and Current Procedural Terminology codes. We defined treatment completion as 180 days or more of INH therapy during a 9-month period. We defined LTBI treatment failure as an active TB disease diagnosis more than 1 year after starting LTBI treatment among completers and used exact logistic regression to model possible differences between groups. Among treatment completers, we matched 1 patient who failed treatment with 2 control subjects and fit regression models with covariates documented on medical claims paid 6 months or less before INH treatment initiation. PARTICIPANTS: Commercially insured US patients in a large commercial database with insurance claims paid during 2005-2016. MAIN OUTCOME MEASURES: (1) Trends in treatment completion; (2) odds ratios (ORs) for factors associated with treatment completion and treatment failure. RESULTS: Of 21 510 persons who began LTBI therapy during 2005-2016, 10 725 (49.9%) completed therapy. Treatment noncompletion is associated with those younger than 45 years, living in the Northeast or South Census regions, and women. Among persons who completed treatment, 30 (0.3%) progressed to TB disease. Diagnoses of rheumatoid arthritis during the 6 months before treatment initiation and being aged 65 years or older (reference: ages 0-24 years) were significantly associated with INH LTBI treatment failure (adjusted exact OR = 5.1; 95% CI, 1.2-28.2; and adjusted exact OR = 5.1; 95% CI, 1.2-25.3, respectively). CONCLUSION: Approximately 50% of persons completed INH LTBI therapy, and of those, treatment failure was associated with rheumatoid arthritis and persons 65 years or older among a cohort of US LTBI patients with commercial health insurance. |
Age-period-cohort analyses of tuberculosis incidence rates by nativity, United States, 1996-2016
Iqbal SA , Winston CA , Bardenheier BH , Armstrong LR , Navin TR . Am J Public Health 2018 108 S315-s320 OBJECTIVES: To assess changes in US tuberculosis (TB) incidence rates by age, period, and cohort effects, stratified according to race/ethnicity and nativity. METHODS: We used US National Tuberculosis Surveillance System data for 1996 to 2016 to estimate trends through age-period-cohort models. RESULTS: Controlling for cohort and period effects indicated that the highest rates of TB incidence occurred among those 0 to 5 and 20 to 30 years of age. The incidence decreased by age for successive birth cohorts. There were greater estimated annual percentage decreases among US-born individuals (-7.3%; 95% confidence interval [CI] = -7.5, -7.1) than among non-US-born individuals (-4.3%; 95% CI = -4.5, -4.1). US-born individuals older than 25 years exhibited the largest decreases, a pattern that was not reflected among non-US-born adults. In the case of race/ethnicity, the greatest decreases by nativity were among US-born Blacks (-9.3%; 95% CI = -9.6, -9.1) and non-US-born Hispanics (-5.7%; 95% CI = -6.0, -5.5). CONCLUSIONS: TB has been decreasing among all ages, races and ethnicities, and consecutive cohorts, although these decreases are less pronounced among non-US-born individuals. |
Reproducible Research Practices and Transparency across the Biomedical Literature.
Iqbal SA , Wallach JD , Khoury MJ , Schully SD , Ioannidis JP . PLoS Biol 2016 14 (1) e1002333 There is a growing movement to encourage reproducibility and transparency practices in the scientific community, including public access to raw data and protocols, the conduct of replication studies, systematic integration of evidence in systematic reviews, and the documentation of funding and potential conflicts of interest. In this survey, we assessed the current status of reproducibility and transparency addressing these indicators in a random sample of 441 biomedical journal articles published in 2000-2014. Only one study provided a full protocol and none made all raw data directly available. Replication studies were rare (n = 4), and only 16 studies had their data included in a subsequent systematic review or meta-analysis. The majority of studies did not mention anything about funding or conflicts of interest. The percentage of articles with no statement of conflict decreased substantially between 2000 and 2014 (94.4% in 2000 to 34.6% in 2014); the percentage of articles reporting statements of conflicts (0% in 2000, 15.4% in 2014) or no conflicts (5.6% in 2000, 50.0% in 2014) increased. Articles published in journals in the clinical medicine category versus other fields were almost twice as likely to not include any information on funding and to have private funding. This study provides baseline data to compare future progress in improving these indicators in the scientific literature. |
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