Robert J Glynn
Biographic Data
| ID | 5138071 |
|---|---|
| NAME | Robert J Glynn |
| GIVEN NAMES | Robert J |
| FAMILY NAME | Glynn |
| SIGNATURE | GLYNN R J |
| AFFILIATIONS | Brigham and Women's Hospital |
| ORCID | 0000-0002-0697-8996 |
| VERIFIED | Yes |
| TOTAL WORKS | 18 |
| TOTAL CITATIONS | 34 |
| AUTHOR COUNT | 18 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1981 |
| LATEST PUBLICATION YEAR | 2014 |
| H-INDEX | 3 |
Time-Dependent Propensity Score for Assessing the Effect of Vaccine Exposure on Pregnancy Outcomes through Pregnancy Exposure Cohort Studies
Women are advised to be vaccinated for influenza during pregnancy and may receive vaccine at any time during their pregnancy. In observational studies evaluating vaccine safety in pregnancy, to account for such time-varying vaccine exposure, a time-dependent predictor can be used in a proportional hazards model setting for outcomes such as spontaneous abortion or preterm delivery. Also, due to the observational nature of pregnancy exposure cohort…
Burden of smoking on cause-specific mortality: Application to the Nurses' Health Study
The risks of smoking and the benefits from quitting are greater than previously reported, when utilising repeated measures of smoking data collected during follow-up, and vary by cause of death. Focused efforts to communicate the benefits of quitting to smokers and to prevent smoking initiation among children and youths should remain top public health priorities to reduce the worldwide mortality burden caused by smoking
Confounding Control in Healthcare Database Research: Challenges and Potential Approaches
Epidemiologic studies are increasingly used to investigate the safety and effectiveness of medical products and interventions. Appropriate adjustment for confounding in such studies is challenging because exposure is determined by a complex interaction of patient, physician, and healthcare system factors. The challenges of confounding control are particularly acute in studies using healthcare utilization databases where information on many potent…
Effects of Prescription Coinsurance and Income-Based Deductibles on Net Health Plan Spending for Older Users of Inhaled Medications
BACKGROUND: Health plans that increase prescription cost-sharing for their patients may increase overall plan costs. We analyzed the impact on health plan spending of a switch in public drug insurance from full coverage to a prescription copayment (copay), and then to income-based deductibles plus coinsurance (IBD). METHODS: We studied British Columbia residents 65 years of age or older who were dispensed inhaled steroids, beta2 agonists or antic…
Design of Cluster-Randomized Trials of Quality Improvement Interventions Aimed at Medical Care Providers
BACKGROUND: Randomized trials aimed at improving the quality of medical care often randomize the provider. Such trials are frequently embedded in health care systems with available automated records, which can be used to enhance the design of the trial. METHODS: We consider how available information from automated records can address each of the following concerns in the design of a trial: whether to randomize individual providers or practices; c…
Increasing Levels of Restriction in Pharmacoepidemiologic Database Studies of Elderly and Comparison With Randomized Trial Results
BACKGROUND: The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates. OBJECTIVES: This article describes increasing levels of restrictions for use in pharmacoepidemiology and examines to what extent they change rate ratio estimates and reduce bias in a study of statin treatment and 1-year mortality. METHODS: : The s…
Adjustments for Unmeasured Confounders in Pharmacoepidemiologic Database Studies Using External Information
BACKGROUND: Nonexperimental studies of drug effects in large automated databases can provide timely assessment of real-life drug use, but are prone to confounding by variables that are not contained in these databases and thus cannot be controlled. OBJECTIVES: To describe how information on additional confounders from validation studies can help address the problem of unmeasured confounding in the main study. RESEARCH DESIGN: Review types of vali…
Variable Selection for Propensity Score Models
Despite the growing popularity of propensity score (PS) methods in epidemiology, relatively little has been written in the epidemiologic literature about the problem of variable selection for PS models. The authors present the results of two simulation studies designed to help epidemiologists gain insight into the variable selection problem in a PS analysis. The simulation studies illustrate how the choice of variables that are included in a PS m…
Characteristics Associated with Differences in Reported Versus Measured Total CholesterolAmong Male Physicians
Demographic Predictors of Eye Care Utilization Among Women
BACKGROUND: Visual impairment may be preventable or treatable with timely intervention. Differences in the use of eye care services may play a role in fostering the racial and socioeconomic gap in the burden of visual impairment in the United States. OBJECTIVE: The objective of this study was to examine the frequency of eye examinations in women and how this varies with age, race, marital status, geographic region, profession, education, and inco…
Patient Noncompliance in the Managed Care Setting: The Case of Medical Therapy for Glaucoma
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
A Short Physical Performance Battery Assessing Lower Extremity Function: Association With Self-Reported Disability and Prediction of Mortality and Nursing Home Admission
BACKGROUND: A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. METHODS: Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. RESULTS: A…
The use of vitamin supplements and the risk of cataract among US male physicians
OBJECTIVES. The purpose of this study was to examine prospectively the association between reported use of vitamin supplements and risk of cataract and cataract extraction. METHODS. The study population consisted of 17,744 participants in the Physicians' Health Study, a randomized trial of aspirin therapy and beta-carotene among US male physicians 40 to 84 years of age in 1982 who did not report cataract at baseline and provided complete informat…
Treatment for glaucoma: Adherence by the elderly
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Left-handedness and mortality
We examined mortality associated with handedness in two ways. A simulation using national data suggests that lower mean age at death among left-handed persons, previously offered as evidence of higher mortality, can be explained exclusively by the age distribution of laterality. Second, empiric evidence from a 6-year cohort study of 3774 older adults from East Boston, Massachusetts, demonstrates that left-handedness is not associated with mortali…
Aging and generational effects on drinking behaviors in men: Results from the normative aging study
The effects of aging on alcohol consumption behaviors are unclear because of confounding with period and cohort effects. In 1973, 1,859 male participants in the Normative Aging Study, born between 1892 and 1945, described their drinking behaviors by responding to a mailed questionnaire. In 1982, 1,713 of the participants in this study responded to a similar questionnaire. We used multivariate techniques, adjusting regression coefficients for the …
Smoking Cessation in a Prospective Study of Healthy Adult Males: Effects of Age, Time Period, and Amount Smoked
The present study examined effects on smoking cessation of three variables—chronological age, time period, and amount smoked—in 637 healthy male smokers aged 22-69 at baseline. Subjects were followed from 1962-1975 using life table procedures. Age was not significantly related to quitting rates (p = .150). The amount smoked effect approached significance (p = .096) with rates of quitting progressively lower at higher consumption levels. Powerful …
Relationship between cigarette smoking, chest size and body size in health-screened adult males
Previous investigations have shown that chest dimensions and pulmonary function are positively correlated in healthy individuals. It is not known, however, whether the pulmonary effects of cigarette smoking may modify chest size during adulthood. The present study used cross-sectional data from 1557 healthy male participants in the Normative Aging Study of the Veterans Administration Outpatient Clinic, Boston. Because elastic recoil of the lung i…
The use of vitamin supplements and the risk of cataract among US male physicians
OBJECTIVES. The purpose of this study was to examine prospectively the association between reported use of vitamin supplements and risk of cataract and cataract extraction. METHODS. The study population consisted of 17,744 participants in the Physicians' Health Study, a randomized trial of aspirin therapy and beta-carotene among US male physicians 40 to 84 years of age in 1982 who did not report cataract at baseline and provided complete informat…
Treatment for glaucoma: Adherence by the elderly
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Aging and generational effects on drinking behaviors in men: Results from the normative aging study
The effects of aging on alcohol consumption behaviors are unclear because of confounding with period and cohort effects. In 1973, 1,859 male participants in the Normative Aging Study, born between 1892 and 1945, described their drinking behaviors by responding to a mailed questionnaire. In 1982, 1,713 of the participants in this study responded to a similar questionnaire. We used multivariate techniques, adjusting regression coefficients for the …
Smoking Cessation in a Prospective Study of Healthy Adult Males: Effects of Age, Time Period, and Amount Smoked
The present study examined effects on smoking cessation of three variables—chronological age, time period, and amount smoked—in 637 healthy male smokers aged 22-69 at baseline. Subjects were followed from 1962-1975 using life table procedures. Age was not significantly related to quitting rates (p = .150). The amount smoked effect approached significance (p = .096) with rates of quitting progressively lower at higher consumption levels. Powerful …
Left-handedness and mortality
We examined mortality associated with handedness in two ways. A simulation using national data suggests that lower mean age at death among left-handed persons, previously offered as evidence of higher mortality, can be explained exclusively by the age distribution of laterality. Second, empiric evidence from a 6-year cohort study of 3774 older adults from East Boston, Massachusetts, demonstrates that left-handedness is not associated with mortali…
Relationship between cigarette smoking, chest size and body size in health-screened adult males
Previous investigations have shown that chest dimensions and pulmonary function are positively correlated in healthy individuals. It is not known, however, whether the pulmonary effects of cigarette smoking may modify chest size during adulthood. The present study used cross-sectional data from 1557 healthy male participants in the Normative Aging Study of the Veterans Administration Outpatient Clinic, Boston. Because elastic recoil of the lung i…
Smoking Cessation in a Prospective Study of Healthy Adult Males: Effects of Age, Time Period, and Amount Smoked
The present study examined effects on smoking cessation of three variables—chronological age, time period, and amount smoked—in 637 healthy male smokers aged 22-69 at baseline. Subjects were followed from 1962-1975 using life table procedures. Age was not significantly related to quitting rates (p = .150). The amount smoked effect approached significance (p = .096) with rates of quitting progressively lower at higher consumption levels. Powerful …
Aging and generational effects on drinking behaviors in men: Results from the normative aging study
The effects of aging on alcohol consumption behaviors are unclear because of confounding with period and cohort effects. In 1973, 1,859 male participants in the Normative Aging Study, born between 1892 and 1945, described their drinking behaviors by responding to a mailed questionnaire. In 1982, 1,713 of the participants in this study responded to a similar questionnaire. We used multivariate techniques, adjusting regression coefficients for the …
Treatment for glaucoma: Adherence by the elderly
OBJECTIVES. The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS. This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma…
Left-handedness and mortality
We examined mortality associated with handedness in two ways. A simulation using national data suggests that lower mean age at death among left-handed persons, previously offered as evidence of higher mortality, can be explained exclusively by the age distribution of laterality. Second, empiric evidence from a 6-year cohort study of 3774 older adults from East Boston, Massachusetts, demonstrates that left-handedness is not associated with mortali…
A Short Physical Performance Battery Assessing Lower Extremity Function: Association With Self-Reported Disability and Prediction of Mortality and Nursing Home Admission
BACKGROUND: A short battery of physical performance tests was used to assess lower extremity function in more than 5,000 persons age 71 years and older in three communities. METHODS: Balance, gait, strength, and endurance were evaluated by examining ability to stand with the feet together in the side-by-side, semi-tandem, and tandem positions, time to walk 8 feet, and time to rise from a chair and return to the seated position 5 times. RESULTS: A…
The use of vitamin supplements and the risk of cataract among US male physicians
OBJECTIVES. The purpose of this study was to examine prospectively the association between reported use of vitamin supplements and risk of cataract and cataract extraction. METHODS. The study population consisted of 17,744 participants in the Physicians' Health Study, a randomized trial of aspirin therapy and beta-carotene among US male physicians 40 to 84 years of age in 1982 who did not report cataract at baseline and provided complete informat…
Patient Noncompliance in the Managed Care Setting: The Case of Medical Therapy for Glaucoma
OBJECTIVES: The authors identify demographic and clinical characteristics associated with noncompliance in patients beginning medical therapy for the treatment of glaucoma in a managed care setting. METHODS: The authors describe a retrospective cohort study in a group-model health maintenance organization in Massachusetts. Patients were members of the health maintenance organization who were newly initiated on topical drug therapy to treat open-a…
Demographic Predictors of Eye Care Utilization Among Women
BACKGROUND: Visual impairment may be preventable or treatable with timely intervention. Differences in the use of eye care services may play a role in fostering the racial and socioeconomic gap in the burden of visual impairment in the United States. OBJECTIVE: The objective of this study was to examine the frequency of eye examinations in women and how this varies with age, race, marital status, geographic region, profession, education, and inco…
Characteristics Associated with Differences in Reported Versus Measured Total CholesterolAmong Male Physicians
Variable Selection for Propensity Score Models
Despite the growing popularity of propensity score (PS) methods in epidemiology, relatively little has been written in the epidemiologic literature about the problem of variable selection for PS models. The authors present the results of two simulation studies designed to help epidemiologists gain insight into the variable selection problem in a PS analysis. The simulation studies illustrate how the choice of variables that are included in a PS m…
Design of Cluster-Randomized Trials of Quality Improvement Interventions Aimed at Medical Care Providers
BACKGROUND: Randomized trials aimed at improving the quality of medical care often randomize the provider. Such trials are frequently embedded in health care systems with available automated records, which can be used to enhance the design of the trial. METHODS: We consider how available information from automated records can address each of the following concerns in the design of a trial: whether to randomize individual providers or practices; c…
Increasing Levels of Restriction in Pharmacoepidemiologic Database Studies of Elderly and Comparison With Randomized Trial Results
BACKGROUND: The goal of restricting study populations is to make patients more homogeneous regarding potential confounding factors and treatment effects and thereby achieve less biased effect estimates. OBJECTIVES: This article describes increasing levels of restrictions for use in pharmacoepidemiology and examines to what extent they change rate ratio estimates and reduce bias in a study of statin treatment and 1-year mortality. METHODS: : The s…
Adjustments for Unmeasured Confounders in Pharmacoepidemiologic Database Studies Using External Information
BACKGROUND: Nonexperimental studies of drug effects in large automated databases can provide timely assessment of real-life drug use, but are prone to confounding by variables that are not contained in these databases and thus cannot be controlled. OBJECTIVES: To describe how information on additional confounders from validation studies can help address the problem of unmeasured confounding in the main study. RESEARCH DESIGN: Review types of vali…
Effects of Prescription Coinsurance and Income-Based Deductibles on Net Health Plan Spending for Older Users of Inhaled Medications
BACKGROUND: Health plans that increase prescription cost-sharing for their patients may increase overall plan costs. We analyzed the impact on health plan spending of a switch in public drug insurance from full coverage to a prescription copayment (copay), and then to income-based deductibles plus coinsurance (IBD). METHODS: We studied British Columbia residents 65 years of age or older who were dispensed inhaled steroids, beta2 agonists or antic…
Burden of smoking on cause-specific mortality: Application to the Nurses' Health Study
The risks of smoking and the benefits from quitting are greater than previously reported, when utilising repeated measures of smoking data collected during follow-up, and vary by cause of death. Focused efforts to communicate the benefits of quitting to smokers and to prevent smoking initiation among children and youths should remain top public health priorities to reduce the worldwide mortality burden caused by smoking
Confounding Control in Healthcare Database Research: Challenges and Potential Approaches
Epidemiologic studies are increasingly used to investigate the safety and effectiveness of medical products and interventions. Appropriate adjustment for confounding in such studies is challenging because exposure is determined by a complex interaction of patient, physician, and healthcare system factors. The challenges of confounding control are particularly acute in studies using healthcare utilization databases where information on many potent…
Time-Dependent Propensity Score for Assessing the Effect of Vaccine Exposure on Pregnancy Outcomes through Pregnancy Exposure Cohort Studies
Women are advised to be vaccinated for influenza during pregnancy and may receive vaccine at any time during their pregnancy. In observational studies evaluating vaccine safety in pregnancy, to account for such time-varying vaccine exposure, a time-dependent predictor can be used in a proportional hazards model setting for outcomes such as spontaneous abortion or preterm delivery. Also, due to the observational nature of pregnancy exposure cohort…
Medicine (18 works) · Internal Medicine (9 works) · Demography (8 works) · Advanced Causal Inference Techniques (6 works) · Cohort (6 works) · Cohort study (6 works) · Confounding (6 works) · Environmental health (6 works) · Gerontology (6 works) · Gerontology (6 works)