Evidence map›Paper›PMID 39342237›Full record

ArticleBMC public health2024

Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts.

Janet L Peacock, Susana Diaz Coto, Judy R Rees, Odile Sauzet, Elizabeth T Jensen, Raina Fichorova, Anne L Dunlop, Nigel Paneth, Amy Padula, Tracey Woodruff and 37 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Making Statistics Clinically Meaningful.Clinical epidemiology · 2026
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Janet L PeacockDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA. janet.l.peacock@dartmouth.edu.
Susana Diaz CotoDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA.
Judy R ReesDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA.
Odile SauzetBielefeld School of Public Health and Department of Economy and Business Administration, Bielefeld University, Bielefeld, Germany.
Elizabeth T JensenDepartment of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Raina FichorovaDepartment of Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA, USA.
Anne L DunlopEmory University School of Medicine, Atlanta, GA, USA.
Nigel PanethDepartment of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Amy PadulaDepartment of Reproductive Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Tracey WoodruffDepartment of Reproductive Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Rachel Morello-FroschDepartment of Environmental Health Sciences, University of California, Berkeley, CA, USA.
Jessica TrowbridgeDepartment of Reproductive Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Dana GoinChildren's Environmental Health Center, University of Illinois, Urbana, IL, USA.
Luis E MaldonadoDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Zhongzheng NiuDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Akhgar GhassabianHarvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Leonardo TransandeDepartment of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA.
Assiamira FerraraKaiser Permanente Northern California Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Lisa A CroenKaiser Permanente Northern California Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Stacey AlexeeffKaiser Permanente Northern California Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Carrie BretonDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Augusto LitonjuaUniversity of Rochester Medical Center, Rochester, NY, USA.
Thomas G O'ConnorUniversity of Rochester Medical Center, Rochester, NY, USA.
Kristen LyallAJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
Heather VolkJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Akram AlshawabkehDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
Justin ManjouridesDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Dana DabeleaLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Christine W HockettAvera Research Institute, Sioux Falls, SD, USA.
Casper G BendixsenNational Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, USA.
Irva Hertz-PicciottoDepartment of Public Health Sciences, School of Medicine, The MIND Institute, University of California Davis, Davis, CA, USA.
Rebecca J SchmidtDepartment of Public Health Sciences, School of Medicine, The MIND Institute, University of California Davis, Davis, CA, USA.
Alison E HipwellDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Kate KeenanUniversity of Chicago, Chicago, IL, USA.
Catherine KarrDepartment of Pediatrics, University of Washington, Seatle, WA, USA.
Kaja Z LeWinnDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
Barry LesterPsychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Brown University, Providence, RI, USA.
Marie CamerotaPsychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Brown University, Providence, RI, USA.
Jody GanibanGeorge Washington University, Washington, DC, USA.
Cynthia McEvoyDepartment of Pediatrics, School of Medicine, Oregan Health and Science University, Portland, OR, USA.
Michael R ElliottUniversity of Michigan School of Public Health and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Sheela SathyanarayanaDepartment of Pediatrics, Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA.
Nan JiDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Joseph M BraunWarren Alpert Medical School of Brown University, Brown University, Providence, RI, USA.
Margaret R KaragasDepartment of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, 03756, USA.
Program Collaborators for Environmental influences on Child Health Outcomes

Funding

Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9M
ECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4M
Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-UpUH3OD023282 · OD · UNIVERSITY OF WISCONSIN-MADISON · PI James E. Gern · 2018 to 2026
$64.8M
The NYU Children’s Health & Environment Study: an ECHO CohortUH3OD023305 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Akhgar Ghassabian, Leonardo Trasande · 2018 to 2026
$59.5M
Mount Sinai ECHO site for Perinatal Environment and Development StudiesUH3OD023337 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KECIA Nicole CARROLL, Robert O Wright · 2018 to 2026
$54.1M
A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · OD · DARTMOUTH COLLEGE · PI MARGARET Rita KARAGAS, Juliette Madan · 2018 to 2026
$44.3M
The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7M
VISUAL INDICES OF NEUROTOXICITYP30ES001247 · NIEHS · UNIVERSITY OF ROCHESTER · PI Martha Susiarjo · 1985 to 2026
$42.8M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3M
Environmental Influences on Childhood Outcomes in the Northern Plains Safe Passage Study CohortsUH3OD023279 · OD · AVERA MCKENNAN · PI Amy J Elliott, Christine W Hockett · 2018 to 2026
$31.7M
Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4M
Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and NeurodevelopmentUH3OD023289 · OD · KAISER FOUNDATION RESEARCH INSTITUTE · PI ASSIAMIRA FERRARA, Monique Marie Hedderson · 2018 to 2026
$25.1M
NIEHS NIH HHS P30 ES001247NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U2C OD023375NIH HHS UG3 OD023271NIH HHS UG3 OD023282NIH HHS UG3 OD035528NIH HHS UH3 OD023244NIH HHS UH3 OD023248NIH HHS UH3 OD023249NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023279NIH HHS UH3 OD023282NIH HHS UH3 OD023285NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023288NIH HHS UH3 OD023289NIH HHS UH3 OD023290NIH HHS UH3 OD023305NIH HHS UH3 OD023313NIH HHS UH3 OD023318NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023337NIH HHS UH3 OD023342NIH HHS UH3 OD023349NIH HHS UH3 OD023365NIH HHS UH3 OD023389
6 · The paper itself

Abstract

backgroundA major challenge in epidemiology is knowing when an exposure effect is large enough to be clinically important, in particular how to interpret a difference in mean outcome in unexposed/exposed groups. Where it can be calculated, the proportion/percentage beyond a suitable cut-point is useful in defining individuals at high risk to give a more meaningful outcome. In this simulation study we compute differences in outcome means and proportions that arise from hypothetical small effects in vulnerable sub-populations.

methodsData from over 28,000 mother/child pairs belonging to the Environmental influences on Child Health Outcomes Program were used to examine the impact of hypothetical environmental exposures on mean birthweight, and low birthweight (LBW) (birthweight < 2500g). We computed mean birthweight in unexposed/exposed groups by sociodemographic categories (maternal education, health insurance, race, ethnicity) using a range of hypothetical exposure effect sizes. We compared the difference in mean birthweight and the percentage LBW, calculated using a distributional approach.

resultsWhen the hypothetical mean exposure effect was fixed (at 50, 125, 167 or 250g), the absolute difference in % LBW (risk difference) was not constant but varied by socioeconomic categories. The risk differences were greater in sub-populations with the highest baseline percentages LBW: ranging from 3.1-5.3 percentage points for exposure effect of 125g. Similar patterns were seen for other mean exposure sizes simulated.

conclusionsVulnerable sub-populations with greater baseline percentages at high risk fare worse when exposed to a small insult compared to the general population. This illustrates another facet of health disparity in vulnerable individuals.

Indexed as

Birth WeightChild HealthInfant, Low Birth WeightVulnerable PopulationsAdultCohort StudiesEnvironmental ExposureFemaleHumansInfant, NewbornMalePregnancySocioeconomic FactorsChild health outcomeEnvironmental exposureHealth disparitiesPregnancy outcomesSocial determinants of health

Identifiers

PMID39342237
PMCPMC11438038

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.