When one depends on the other: reporting of interaction in case-control and cohort studies

BACKGROUND: Interaction refers to the situation in which the effect of 1 exposure on an outcome differs across strata of another exposure. We did a survey of epidemiologic studies published in leading journals to examine how interaction is assessed and reported. METHODS: We selected 150 case-control and 75 cohort studies published between May 2001 and May 2007 in leading general medicine, epidemiology, and clinical specialist journals. Two reviewers independently extracted data on study characteristics. RESULTS: Of the 225 studies, 138 (61%) addressed interaction. Among these, 25 (18%) presented no data or only a P value or a statement of statistical significance; 40 (29%) presented stratum-specific effect estimates but no meaningful comparison of these estimates; and 58 (42%) presented stratum-specific estimates and appropriate tests for interaction. Fifteen articles (11%) presented the individual effects of both exposures and also their joint effect or a product term, providing sufficient information to interpret interaction on an additive and multiplicative scale. Reporting was poorest in articles published in clinical specialist articles and most adequate in articles published in general medicine journals, with epidemiology journals in an intermediate position. CONCLUSIONS: A majority of articles reporting cohort and case-control studies address possible interactions between exposures. However, in about half of these, the information provided was unsatisfactory, and only 1 in 10 studies reported data that allowed readers to interpret interaction effects on an additive and multiplicative scale.

‘Idolatry’ and Religious Diversity: Thinking about the Other in Early Modern Europe

Idolatry is a key concept in the history of Western thinking about religion, as an all-encompassing category in which all religions more or less alien to the Christian tradition could be subsumed. From Late Antiquity to the Modern period, we can follow how the notion was put to work within Christian discourse to think about the religious “other. ” In fact, the word is almost ubiquitous in pre-modern debates on religion and the origins of religion. Theories on the nature and causes of “idolatry” framed much of the issue of “Religion” vs. the “religions,” and largely provided the conceptual space, in early modern Europe, in which religious anthropology would emerge. The present paper will investigate some aspects of the early modern discourse on idolatry, and its place in early modern discussions on the “diversity” of religions.

Religious Diversity and Religious Vitality: New Measuring Strategies and Empirical Evidence

Quantitative studies of the conditions and consequences of religious diversity are based mostly on indices that measure the variety of religious membership in a particular region. However, this line of research has become stagnant, and the question of whether diversity affects religious vitality remains unanswered. This article attempts to shed new light on the discussion by measuring religious diversity differently and capturing religious vitality independently of membership figures. In particular, it contrasts the Herfindahl-Hirschman Index based on membership proportions with a second measure of diversity: an index of organizational diversity. Conversely, the dependent variable religious vitality is measured not by using rates of participation in religious organizations but via the Centrality of Religion Scale. Based on ecological and individual level data of forty-three local regions in Finland, Germany, and Slovenia and using multilevel analysis, our results suggest that religious diversity is related to religious vitality. However, the nature of this association differs across subgroups.

Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine

BACKGROUND: In clinical practice a diagnosis is based on a combination of clinical history, physical examination and additional diagnostic tests. At present, studies on diagnostic research often report the accuracy of tests without taking into account the information already known from history and examination. Due to this lack of information, together with variations in design and quality of studies, conventional meta-analyses based on these studies will not show the accuracy of the tests in real practice. By using individual patient data (IPD) to perform meta-analyses, the accuracy of tests can be assessed in relation to other patient characteristics and allows the development or evaluation of diagnostic algorithms for individual patients. In this study we will examine these potential benefits in four clinical diagnostic problems in the field of gynaecology, obstetrics and reproductive medicine. METHODS/DESIGN: Based on earlier systematic reviews for each of the four clinical problems, studies are considered for inclusion. The first authors of the included studies will be invited to participate and share their original data. After assessment of validity and completeness the acquired datasets are merged. Based on these data, a series of analyses will be performed, including a systematic comparison of the results of the IPD meta-analysis with those of a conventional meta-analysis, development of multivariable models for clinical history alone and for the combination of history, physical examination and relevant diagnostic tests and development of clinical prediction rules for the individual patients. These will be made accessible for clinicians. DISCUSSION: The use of IPD meta-analysis will allow evaluating accuracy of diagnostic tests in relation to other relevant information. Ultimately, this could increase the efficiency of the diagnostic work-up, e.g. by reducing the need for invasive tests and/or improving the accuracy of the diagnostic workup. This study will assess whether these benefits of IPD meta-analysis over conventional meta-analysis can be exploited and will provide a framework for future IPD meta-analyses in diagnostic and prognostic research.

Valuing the Health States Associated with Chlamydia trachomatis Infections and Their Sequelae: A Systematic Review of Economic Evaluations and Primary Studies

OBJECTIVES Economic evaluations of interventions to prevent and control sexually transmitted infections such as Chlamydia trachomatis are increasingly required to present their outcomes in terms of quality-adjusted life-years using preference-based measurements of relevant health states. The objectives of this study were to critically evaluate how published cost-effectiveness studies have conceptualized and valued health states associated with chlamydia and to examine the primary evidence available to inform health state utility values (HSUVs). METHODS A systematic review was conducted, with searches of six electronic databases up to December 2012. Data on study characteristics, methods, and main results were extracted by using a standard template. RESULTS Nineteen economic evaluations of relevant interventions were included. Individual studies considered different health states and assigned different values and durations. Eleven studies cited the same source for HSUVs. Only five primary studies valued relevant health states. The methods and viewpoints adopted varied, and different values for health states were generated. CONCLUSIONS Limitations in the information available about HSUVs associated with chlamydia and its complications have implications for the robustness of economic evaluations in this area. None of the primary studies could be used without reservation to inform cost-effectiveness analyses in the United Kingdom. Future debate should consider appropriate methods for valuing health states for infectious diseases, because recommended approaches may not be suitable. Unless we adequately tackle the challenges associated with measuring and valuing health-related quality of life for patients with chlamydia and other infectious diseases, evaluating the cost-effectiveness of interventions in this area will remain problematic.

Identity, Philosophy, and the Problem of Armenian History in the Sixth Century

History and Identity in the Late Antique Near East gathers together the work of distinguished historians and early career scholars with a broad range of expertise to investigate the significance of newly emerged, or recently resurrected, ethnic identities on the borders of the eastern Mediterranean world. It focuses on the "long late antiquity" from the eve of the Arab conquest of the Roman East to the formation of the Abbasid caliphate. The first half of the book offers papers on the Christian Orient on the cusp of the Islamic invasions. These papers discuss how Christians negotiated the end of Roman power, whether in the selective use of the patristic past to create confessional divisions or the emphasis of the shared philosophical legacy of the Greco-Roman world. The second half of the book considers Muslim attempts to negotiate the pasts of the conquered lands of the Near East, where the Christian histories of Hira or Egypt were used to create distinctive regional identities for Arab settlers. Like the first half, this section investigates the redeployment of a shared history, this time the historical imagination of the Qu'ran and the era of the first caliphs. All the papers in the volume bring together studies of the invention of the past across traditional divides between disciplines, placing the re-assessment of the past as a central feature of the long late antiquity. As a whole, History and Identity in the Late Antique Near East represents a distinctive contribution to recent writing on late antiquity, due to its cultural breadth, its interdisciplinary focus, and its novel definition of late antiquity itself.

Gender in Theology and Religion: a Success Story?! Report from a Conference

In January 2011 some fifty scholars from different parts of Europe met in Groningen, the Netherlands for an expert meeting entitled Gender in theology and religion: a success story?! to analyze the factors that contribute to the successful mainstreaming of gender in a theological discipline and to reflect on the future of gender studies in theology and religious studies. Different speakers highlighted the many successes of gender studies in theology and religious studies: its power to 'trouble' the disciplines and their heuristic categories; its contribution to the development of other disciplines such as queer studies and postcolonial studies; the many PhD studies produced; the number of significant publications that had appeared over the last years. All indicate that gender studies in theology and religious studies have matured. But the participants also pointed towards the ambiguity of the success of gender studies in the academy: the indeterminacy of the institutional position and positions of gender studies in the theological disciplines in seminaries, departments faculties and universities; the lack of male scholars’ engagement in gender studies, which is expressed by their absence in these studies and/or the low reception of gender studies publications in their disciplines. Both ambiguities represent a danger for the future of gender studies, according to the participants in the meeting. In order to further the success of gender in theology and religion they formulated the following recommendations: to analyze the position of these studies in their institutions from the perspective of the implied audience (church, academy, ordinary theologians); engage men in gender studies; embrace the cultural turn in religious studies; develop interdisciplinary cooperations with gender studies in the humanities; engage creatively with the changing role of religion in contemporary society; analyze whose perspective one follows and authorizes in the perception of theology, religious studies and gender studies themselves; record the history of women’s and gender studies in theology and religion, and honor and celebrate the successes.