2025
Factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 in primary healthcare settings in Nepal: a cross-sectional study
Timalsena D, Nakarmi C, Mali S, Dhakal A, Bharati A, Bishwokarma A, Adhikari A, Poudel B, Kulung B, Baral P, Bhattarai S, Dixit L, Pokharel Y, Rhodes E, Xu D, Spiegelman D, Shrestha A. Factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 in primary healthcare settings in Nepal: a cross-sectional study. BMJ Open 2025, 15: e090923. PMID: 40935428, DOI: 10.1136/bmjopen-2024-090923.Peer-Reviewed Original ResearchConceptsWHO packageNon-communicable diseasesPrimary healthcareBody mass indexCardiovascular disease risk-prediction chartsHealthcare workersCardiovascular diseaseRisk prediction chartsPrimary healthcare settingsPrimary healthcare facilitiesPrimary healthcare centresBlood glucose screeningCardiovascular disease riskLow-resource settingsCross-sectional studyAssociated with accessBMI assessmentHealthcare settingsSystemic barriersProvider motivationBlood pressure measurementsAvailability of metforminRisk chartsPrediction chartsHealthcare facilitiesBarriers and facilitators to patient utilization of noncommunicable disease services in primary healthcare facilities in Nepal: a qualitative study
Mali S, Rhodes E, Nakarmi C, Shrestha S, Dhakal A, Bharati A, Bishwokarma A, Adhikari A, Poudel B, Rai B, Manandhar S, KC S, Timalsena D, Silwal S, Dhimal M, Baral P, Teufel F, Bhattarai S, Spiegelman D, Shrestha A. Barriers and facilitators to patient utilization of noncommunicable disease services in primary healthcare facilities in Nepal: a qualitative study. BMC Health Services Research 2025, 25: 863. PMID: 40598095, PMCID: PMC12217986, DOI: 10.1186/s12913-025-13050-8.Peer-Reviewed Original ResearchNon-communicable diseasesPrimary healthcare facilitiesPatient utilizationNon-communicable disease interventionsHealthcare facilitiesWorld Health OrganizationPurposive sample of patientsQualitative studyPurposive samplingNoncommunicable disease servicesCardiovascular diseaseNCD servicesChronic respiratory diseasesSample of patientsDisease servicesHealth OrganizationDisease interventionRespiratory diseaseFacilitationServicesFacilitiesBarriersNepalInterventionDiseaseCorrecting for bias due to mismeasured exposure in mediation analysis with a survival outcome
Cheng C, Spiegelman D, Li F. Correcting for bias due to mismeasured exposure in mediation analysis with a survival outcome. Journal Of The Royal Statistical Society Series C (Applied Statistics) 2025, 74: 969-993. PMID: 40837827, PMCID: PMC12364547, DOI: 10.1093/jrsssc/qlaf010.Peer-Reviewed Original ResearchExposure-mediator interactionProtective effect of physical activityHealth Professionals Follow-up StudyEffects of physical activityReduced body mass indexExposure measurement errorRisk of cardiovascular diseaseBody mass indexPhysical activityMismeasured exposureMass indexRare outcomesFollow-up studyCardiovascular diseaseMediation analysisCox regressionOutcomesBias formulaSurvival outcomesHealthPower and Sample Size Calculations for Cluster Randomized Hybrid Type 2 Effectiveness‐Implementation Studies
Owen M, Curran G, Smith J, Tedla Y, Cheng C, Spiegelman D. Power and Sample Size Calculations for Cluster Randomized Hybrid Type 2 Effectiveness‐Implementation Studies. Statistics In Medicine 2025, 44: e70015. PMID: 39930740, DOI: 10.1002/sim.70015.Peer-Reviewed Original ResearchConceptsHybrid type 2 effectiveness-implementation studySample size calculationCluster randomized trialCluster randomized designSize calculationImplementation research outcomesReduce cardiovascular diseaseIssue of multiple testingEffective outcomesImplementation outcomesCommunity interventionsControl blood pressureBinary outcomesOutcomes approachLiterature searchMultiple testingCardiovascular diseaseInterventionRandomized trialsStandard statistical methodsBlood pressureOutcomesType 2 studies
2024
Causal Selection of Covariates in Regression Calibration for Mismeasured Continuous Exposure
Tang W, Spiegelman D, Liao X, Wang M. Causal Selection of Covariates in Regression Calibration for Mismeasured Continuous Exposure. Epidemiology 2024, 35: 320-328. PMID: 38630507, PMCID: PMC12337126, DOI: 10.1097/ede.0000000000001706.Peer-Reviewed Original ResearchConceptsMismeasured exposureOutcome modelRegression calibrationMeasurement error modelSelection of covariatesNonparametric settingEffect modificationCovariate adjustmentFiber intakeMeasurement errorCardiovascular diseaseEffects of fiber intakeStudy datasetOutcomesCovariatesComprehensive guidanceError modelRegressionHealthEfficiency lossErrorRosnerWillettExposureAdjustment
2023
Mediation analysis in the presence of continuous exposure measurement error
Cheng C, Spiegelman D, Li F. Mediation analysis in the presence of continuous exposure measurement error. Statistics In Medicine 2023, 42: 1669-1686. PMID: 36869626, PMCID: PMC11320713, DOI: 10.1002/sim.9693.Peer-Reviewed Original ResearchConceptsBody mass indexExposure measurement errorPhysical activityMediation proportionHealth Professionals FollowCardiovascular disease incidenceProfessionals FollowMediation analysisMass indexCardiovascular diseaseLower riskStudy designEffect estimatesValidation study designContinuous exposureBiased effect estimatesTrue exposureMediatorsExposureValidation studyBinary outcomesHealth science studiesOutcomesRiskDisease incidence
2022
Effect modification by sex for associations of fine particulate matter (PM2.5) with cardiovascular mortality, hospitalization, and emergency room visits: systematic review and meta-analysis
Heo S, Son JY, Lim CC, Fong KC, Choi HM, Hernandez-Ramirez RU, Nyhan K, Dhillon PK, Kapoor S, Prabhakaran D, Spiegelman D, Bell ML. Effect modification by sex for associations of fine particulate matter (PM2.5) with cardiovascular mortality, hospitalization, and emergency room visits: systematic review and meta-analysis. Environmental Research Letters 2022, 17: 053006. PMID: 35662857, PMCID: PMC9162078, DOI: 10.1088/1748-9326/ac6cfb.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsCardiovascular diseaseRisk ratioCVD mortalityEffect modificationObservational studyLong-term exposureSystematic reviewIschemic heart diseaseAcute myocardial infarctionQuality of evidenceMeeting inclusion criteriaDifferent risksLong-term PMShort-term PMEffects of PMCurrent observational studyRecommendations AssessmentCardiovascular mortalityCardiovascular riskCVD outcomesCVD riskHeart failureCardiac arrestMyocardial infarctionSubgroup analysis
2021
Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa
Brault MA, Vermund SH, Aliyu MH, Omer SB, Clark D, Spiegelman D. Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa. International Journal Of Environmental Research And Public Health 2021, 18: 10751. PMID: 34682492, PMCID: PMC8535610, DOI: 10.3390/ijerph182010751.Peer-Reviewed Original ResearchConceptsNon-communicable diseasesNon-communicable disease careInfectious diseasesHIV care infrastructureTropical infectious diseasesHIV/AIDS epidemicIntegrated service delivery modelCOVID-19Future pandemic threatsLow-cost interventionMinistry of HealthDisease careChronic diseasesCardiovascular diseaseSuch careIntegrated careAIDS ReliefHealth systemSub-Saharan AfricaDiseaseService delivery modelsPandemic threatAIDS epidemicCare infrastructureHealthcare model
2020
The Moderate Alcohol and Cardiovascular Health Trial (MACH15): Design and methods for a randomized trial of moderate alcohol consumption and cardiometabolic risk
Spiegelman D, Lovato LC, Khudyakov P, Wilkens TL, Adebamowo CA, Adebamowo SN, Appel LJ, Beulens JW, Coughlin JW, Dragsted LO, Edenberg HJ, Eriksen JN, Estruch R, Grobbee DE, Gulayin PE, Irazola V, Krystal JH, Lazo M, Murray MM, Rimm EB, Schrieks IC, Williamson JD, Mukamal KJ. The Moderate Alcohol and Cardiovascular Health Trial (MACH15): Design and methods for a randomized trial of moderate alcohol consumption and cardiometabolic risk. European Journal Of Preventive Cardiology 2020, 27: 1967-1982. PMID: 32250171, PMCID: PMC7541556, DOI: 10.1177/2047487320912376.Peer-Reviewed Original ResearchConceptsModerate alcohol consumptionCardiovascular Health TrialAlcohol consumptionHealth trialsCardiovascular diseaseModerate alcoholNon-fatal ischemic strokeNon-fatal myocardial infarctionPrimary composite endpointCongestive heart failureCoronary heart diseaseModerate alcohol consumersAdults 50 yearsPublic health guidelinesAlcohol use disorderPreferred alcoholic beverageCardiometabolic effectsCardiometabolic riskCarotid revascularizationIschemic strokeSecondary outcomesComposite endpointHeart failurePrimary outcomeMyocardial infarctionCardiovascular disease trends in Nepal – An analysis of global burden of disease data 2017
Bhattarai S, Aryal A, Pyakurel M, Bajracharya S, Baral P, Citrin D, Cox H, Dhimal M, Fitzpatrick A, Jha AK, Jha N, Karmacharya BM, Koju R, Maharjan R, Oli N, Pyakurel P, Sapkota BP, Shrestha R, Shrestha S, Spiegelman D, Vaidya A, Shrestha A. Cardiovascular disease trends in Nepal – An analysis of global burden of disease data 2017. IJC Heart & Vasculature 2020, 30: 100602. PMID: 32775605, PMCID: PMC7399110, DOI: 10.1016/j.ijcha.2020.100602.Peer-Reviewed Original ResearchBurden of CVDCardiovascular diseaseGlobal burdenBlood pressureTotal DALYsRisk factorsDiet lowTotal deathsHigh low-density lipoprotein cholesterolHigher systolic blood pressureLow-density lipoprotein cholesterolMajor public health problemCardiovascular disease trendsPredominant cardiovascular diseasesCardiovascular disease incidenceDensity lipoprotein cholesterolSystolic blood pressureHigh blood pressureIschemic heart diseaseBody mass indexEvaluation's Global BurdenPublic health problemOlder age groupsLipoprotein cholesterolMiddle-income countries
2019
Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal
Archana S, Karmacharya BM, Rashmi M, Abhinav V, Meghnath D, Natalia O, Rajeev S, Prajjwal P, Annette F, David C, Swornim B, Roman XD, Donna S, Rajendra K. Stakeholder Engagement in Planning the Design of a National Needs Assessment for Cardiovascular Disease Prevention and Management in Nepal. Global Heart 2019, 14: 181-189. PMID: 31324373, PMCID: PMC7003959, DOI: 10.1016/j.gheart.2019.05.002.Peer-Reviewed Original Research
2018
Much room for optimism on measuring diet, preventing cancer and cardiovascular disease, and correcting for measurement error – discussion of the paper by R. L. Prentice and Y. Huang
Spiegelman D. Much room for optimism on measuring diet, preventing cancer and cardiovascular disease, and correcting for measurement error – discussion of the paper by R. L. Prentice and Y. Huang. Statistical Theory And Related Fields 2018, 2: 14-20. DOI: 10.1080/24754269.2018.1493632.Peer-Reviewed Original ResearchCardiovascular diseaseCashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial
Mohan V, Gayathri R, Jaacks LM, Lakshmipriya N, Anjana RM, Spiegelman D, Jeevan RG, Balasubramaniam KK, Shobana S, Jayanthan M, Gopinath V, Divya S, Kavitha V, Vijayalakshmi P, Bai R M, Unnikrishnan R, Sudha V, Krishnaswamy K, Salas-Salvadó J, Willett WC. Cashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial. Journal Of Nutrition 2018, 148: 63-69. PMID: 29378038, DOI: 10.1093/jn/nxx001.Peer-Reviewed Original ResearchConceptsSystolic blood pressureBlood pressureNut consumptionBody weightAsian IndiansHDL cholesterolDiabetic dietNut supplementationSelf-reported dietary intakeStandard diabetic dietClinical Trials RegistryHDL cholesterol concentrationsPlasma HDL cholesterolType 2 diabetesCashew nut consumptionBlood lipidsControlled TrialsTrials RegistryGlycemic variablesLipid variablesDietary intakeIntervention groupLipid profileCardiovascular diseaseRobust variance estimation
2011
Socio-economic status, urbanization, and cardiometabolic risk factors among middle-aged adults in Tanzania.
Njelekela MA, Liu E, Mpembeni R, Muhihi A, Mligiliche N, Spiegelman D, Finkelstein JL, Fawzi WW, Willett WC, Mtabaji J. Socio-economic status, urbanization, and cardiometabolic risk factors among middle-aged adults in Tanzania. East African Journal Of Public Health 2011, 8: 216-23. PMID: 23120960.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesCross-Sectional StudiesDietExerciseFemaleHealth BehaviorHumansLife StyleLipidsLogistic ModelsMaleMetabolic SyndromeMiddle AgedObesityResidence CharacteristicsRisk FactorsSocioeconomic FactorsSurveys and QuestionnairesTanzaniaUrban HealthUrbanizationWaist CircumferenceConceptsCardiometabolic risk factorsPoorer lipid profileHigher socioeconomic statusRisk factorsLipid profileSocioeconomic statusUrban residenceCardio-metabolic risk factorsWorld Health Organization criteriaHigher total cholesterolHigh waist circumferenceRisk of obesityHealth screening strategiesMiddle-aged adultsMetabolic syndromeTotal cholesterolWaist circumferenceLDL cholesterolHigher BMIPrimary preventionLower triglyceridesOrganization criteriaDietary factorsCardiovascular diseaseGlucose levels
2004
Fruit and Vegetable Intake and Risk of Major Chronic Disease
Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D, Willett WC. Fruit and Vegetable Intake and Risk of Major Chronic Disease. Journal Of The National Cancer Institute 2004, 96: 1577-1584. PMID: 15523086, DOI: 10.1093/jnci/djh296.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalysis of VarianceCardiovascular DiseasesCause of DeathChronic DiseaseConfidence IntervalsConfounding Factors, EpidemiologicDiet SurveysFeeding BehaviorFemaleFollow-Up StudiesFruitHealth PersonnelHumansIncidenceMaleMiddle AgedNeoplasmsProportional Hazards ModelsProspective StudiesResearch DesignRisk AssessmentRisk FactorsSurveys and QuestionnairesUnited StatesVegetablesConceptsMajor chronic diseasesVegetable intakeCardiovascular diseaseChronic diseasesRelative riskHealth StudyVegetable consumptionGreen leafy vegetable intakeSemiquantitative food frequency questionnaireCox proportional hazards analysisOverall cancer incidenceTotal fruitNurses' Health StudyFood frequency questionnaireProportional hazards analysisStrong inverse associationProspective cohortGreen leafy vegetablesHighest quintileInverse associationCancer incidenceFood groupsHealth professionalsOverall healthDietary information
2003
Dietary Fiber Reduces Peripheral Arterial Disease Risk in Men
Merchant AT, Hu FB, Spiegelman D, Willett WC, Rimm EB, Ascherio A. Dietary Fiber Reduces Peripheral Arterial Disease Risk in Men. Journal Of Nutrition 2003, 133: 3658-3663. PMID: 14608090, DOI: 10.1093/jn/133.11.3658.Peer-Reviewed Original ResearchConceptsPeripheral arterial disease riskCereal fiber intakeArterial disease riskPAD riskFiber intakeInverse associationDisease riskEarly coronary heart diseaseIncident PAD casesFood frequency questionnaireCoronary heart diseaseTotal fiber intakeOverall inverse associationDisease QuestionnaireFrequency questionnaireLowest quintileHeart diseaseCardiovascular diseaseFamily historyPhysical activityPAD casesAlcohol consumptionEnergy intakeIntakeRiskJoint Association of Alcohol and Folate Intake with Risk of Major Chronic Disease in Women
Jiang R, Hu FB, Giovannucci EL, Rimm EB, Stampfer MJ, Spiegelman D, Rosner BA, Willett WC. Joint Association of Alcohol and Folate Intake with Risk of Major Chronic Disease in Women. American Journal Of Epidemiology 2003, 158: 760-771. PMID: 14561666, DOI: 10.1093/aje/kwg221.Peer-Reviewed Original ResearchConceptsMajor chronic diseasesFolate intakeChronic diseasesCardiovascular diseaseLower total folate intakeJoint associationsMultivariate relative riskNonfatal cardiovascular diseaseTotal folate intakeHigh folate intakeAdequate folate intakeAge 60 yearsLow folate intakePrimary preventionNontraumatic deathsRelative riskHigh riskPrevious historyDietary dataHeavy drinkersNew casesYoung womenDiseaseHeavy drinkingIntakeThe Use of B Vitamin Supplements and Peripheral Arterial Disease Risk in Men Are Inversely Related
Merchant AT, Hu FB, Spiegelman D, Willett WC, Rimm EB, Ascherio A. The Use of B Vitamin Supplements and Peripheral Arterial Disease Risk in Men Are Inversely Related. Journal Of Nutrition 2003, 133: 2863-2867. PMID: 12949378, DOI: 10.1093/jn/133.9.2863.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseasePAD riskFolate intakePrevention of PADPeripheral arterial disease riskVitamin BArterial disease riskIncident PAD casesU.S. health professionalsB vitamin intakeVitamin supplement useB-vitamin supplementsCoronary heart diseaseWeak inverse associationMultivariate adjustmentArterial diseaseVitamin intakeSupplement useHeart diseaseInverse associationCardiovascular diseaseD incrementStudy populationVitamin supplementsDietary folateAdipose Tissue α-Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica
Baylin A, Kabagambe EK, Ascherio A, Spiegelman D, Campos H. Adipose Tissue α-Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica. Circulation 2003, 107: 1586-1591. PMID: 12668490, DOI: 10.1161/01.cir.0000058165.81208.c6.Peer-Reviewed Original ResearchConceptsNonfatal acute myocardial infarctionAcute myocardial infarctionAdipose tissue alpha-linolenic acidAlpha-linolenic acidMyocardial infarctionCardiovascular diseaseFirst nonfatal acute myocardial infarctionMultivariate conditional logistic regression modelPopulation-based case-control studyConditional logistic regression modelsTissue linoleic acidMI risk factorsPopulation control subjectsCase-control studyAdipose tissue samplesArea of residenceLogistic regression modelsTrans fatty acidsΑ-Linolenic AcidCase patientsFatty acidsControl subjectsLowest quintileInverse associationRisk factors
2002
Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance 1 , 2 , 3
McCullough ML, Feskanich D, Stampfer MJ, Giovannucci EL, Rimm EB, Hu FB, Spiegelman D, Hunter DJ, Colditz GA, Willett WC. Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance 1 , 2 , 3. American Journal Of Clinical Nutrition 2002, 76: 1261-1271. PMID: 12450892, DOI: 10.1093/ajcn/76.6.1261.Peer-Reviewed Original ResearchConceptsAlternate Healthy Eating IndexRecommended Food ScoreHealthy Eating IndexChronic disease riskMajor chronic diseasesMajor chronic disease riskCardiovascular diseaseChronic diseasesDisease riskDietary guidelinesHealth StudyDiet qualityChronic disease risk reductionAgriculture Healthy Eating IndexHigher AHEI scoreNurses' Health StudyDisease risk reductionStrong inverse associationDietary questionnaireAHEI scoreLowest quintileNontraumatic deathsFood ScoreInverse associationHealth professionals
This site is protected by hCaptcha and its Privacy Policy and Terms of Service apply