National Survey on Drug Use and Health (NSDUH) public use files (PUFs) have been produced using a statistical disclosure control technique named MASSC, which stands for Micro Agglomeration, Substitution, Subsampling, and Calibration, to protect confidentiality and quality of data. To inform researchers that NSDUH PUFs maintain high data quality and comparability with NSDUH restricted-use files (RUFs), about 300 NSDUH published tables (based on RUF data) of substance use and mental health were selected and reproduced using PUF data. Key estimates and their respective standard errors (SEs) produced from the two sets of 2014 to 2019 data files were compared. Summary statistics of ratios of the estimates and ratios of their SEs from PUF and RUF data were produced. Out of 22,000 estimates compared, average ratios for estimated percentages across years were within the 0.99 to 1.01 range, and the average increase in SEs for the estimates produced from PUFs across years was about 7–11

The National Survey on Drug Use and Health (NSDUH), an annual survey of the U.S. civilian, noninstitutionalized population aged 12 or older, is a major source of substance use and mental illness data. The 2010 estimates were produced using weights poststratified to 2010 population control totals (intercensal estimates) derived from the 2000 decennial census; however, the 2011 estimates were produced using weights poststratified to 2011 population control totals derived from the 2010 decennial census. This study was done to determine whether the change in the source of the control totals had an effect on the level of change observed between the 2010 and the 2011 estimates. To examine this "census effect," 2010 estimates were also produced using weights poststratified to 2010 population control totals derived from the 2010 decennial census, resulting in two sets of weights for use on the 2010 data. NSDUH estimates were compared using both sets of 2010 estimates along with the 2011 estimates. Substance use estimates were more affected by the census effect than were mental illness estimates, and they were more notable for estimated totals compared with rates.

Gemcitabine is a commonly used chemotherapy for biliary tree carcinomas, achieving response rates of 10% to 60%. Preclinical studies indicate that fixed dose rate infusion optimizes accumulation of gemcitabine triphosphate and may enhance the clinical activity of gemcitabine. We conducted a phase II study of fixed dose rate gemcitabine in 15 chemotherapy-naive patients with advanced cholangiocarcinoma and gallbladder carcinoma. Gemcitabine was administered at a dose of 1500 mg/m2 over 150 minutes weekly for 3 weeks every 28 days. Fourteen patients were evaluable for response. No complete or partial responses were observed. Two patients (13%) had stable disease lasting a median of 9 weeks. The median time to progression was 9 weeks; median survival was 20 weeks. There was considerable grade 3/4 hematologic toxicity, including neutropenia in 49% of patients, leukopenia in 40%, anemia in 27%, and thrombocytopenia in 27%. Grade 3/4 nonhematologic toxicities were minimal. We conclude that fixed dose rate gemcitabine results in significant myelosuppression and has minimal activity in patients with biliary tree carcinoma.

To examine fluctuations in women's cigarette smoking during pregnancy and implications for the design of clinical interventions for pregnant smokers and research on the effects of fetal exposure to cigarettes. We examined changes in absolute smoking status in 1426 women who reportedly smoked during their last pregnancy in the National Health Interview Survey 1991 Pregnancy and Smoking Supplement and fluctuations in amount smoked in 60 pregnant smokers in the Family Health and Development Project. In the National Health Interview Survey 1991 Pregnancy and Smoking Supplement, a substantial proportion of women exhibited a pattern of repeated cessation and relapse. In multivariable logistic regression models, having more than a high school education was significantly associated with being an intermittent versus a continuous smoker (odds ratio = 1.55, P <.01) and with successful quitting versus continuously smoking or relapsing (odds ratio = 1.74, P <.01). Fluctuations in smoking intensity in the Family Health and Development Project were also substantial and, although 48% quit or reduced their smoking upon learning of their pregnancy, over half changed smoking intensity multiple times. We conclude that smoking during pregnancy is a complex and variable behavior for many women. Simple measures of smoking may lead to under-estimation of the impact of smoking on the fetus, and brief smoking cessation interventions early in pregnancy are likely to be inadequate for many smokers during pregnancy.

OBJECTIVES:To determine whether an education program on prostate cancer could improve awareness and knowledge among African-American men. African-American men have the world's highest incidence of prostate cancer and more than twice the mortality compared with white men. Screening programs for prostate cancer have not been successful in attracting African-American participation. One explanation is a poor awareness and knowledge about the disease among this high-risk population.METHODS:We surveyed 900 African-American adults attending prostate cancer education seminars in community settings throughout Illinois between March 1998 and January 2001. Participants were asked to complete a multiple-choice questionnaire on topics related to prostate cancer. The main outcome measures were a change in awareness and knowledge of prostate cancer after the 1-hour educational seminar.RESULTS:The mean survey score improved from 26.0% before the seminar to 73.3% after it (P <0.0001). Every multiple-choice question was answered correctly more often after the seminar than before it. Increasing levels of education and income were associated with higher before and after scores (P <0.001). Men achieved a significantly greater score improvement (mean 48.1%) compared with women (mean 41.1%; P = 0.006). Previous screening for prostate cancer was reported by 23% of the participants. Using logistic regression analyses, higher levels of education and income correlated with higher rates of screening. After the seminar, 63.1% stated the intention to undergo screening.CONCLUSIONS:Our results demonstrate that prostate cancer awareness and knowledge can improve dramatically after a 1-hour seminar on the topic. Additional studies to evaluate the long-term retention of knowledge and impact on behavior are warranted.

Object. In this retrospective study the authors examined the aspect ratio (AR; the maximum dimension of the dome/width of the neck of an aneurysm) and compared the distribution of this ratio in a group of ruptured and unruptured aneurysms. A similar comparison was performed in relation to the maximum dimension of the aneurysm alone. The authors sought to evaluate the utility of these measures for differentiating ruptured and unruptured aneurysms. Methods. Measurements were made of 774 aneurysms in 532 patients at three medical centers. One hundred twenty-seven patients harbored only unruptured lesions, 290 only ruptured lesions, and 115 both ruptured and unruptured lesions. Cases were included if angiograms were available for measurement and the status of the individual patient's aneurysm(s) was known. The odds of a lesion falling in the ruptured aneurysm group increased with both the lesion's maximum size and the AR. The odds ratio for rupture rose progressively only for the AR. The distribution curves showed that ruptured aneurysms were larger and had greater ARs. The mean size of unruptured aneurysms was 7 mm and that of ruptured ones was 8 mm; the corresponding mean ARs were 1.8 and 3.4, respectively. The odds of rupture were 20-fold greater when the AR was larger than 3.47 compared with an AR less than or equal to 1.38. Only 7% of ruptured aneurysms had an AR less than 1.38 compared with 45% of unruptured lesions. Conclusions. The AR is probably a useful index to calculate. A high AR might reasonably influence the decision to treat actively an unruptured aneurysm independent of its maximum size. Prospective studies are warranted.

Purpose: Patients with cancer are increasingly incorporating complementary therapies into the overall treatment. We determine the prevalence and patterns of use of complementary therapies among patients with prostate cancer.Materials and Methods: Patients attending 6 urology institutions for prostate cancer management completed a self-administered questionnaire on complementary therapy. All men diagnosed with prostate cancer were eligible, regardless of age, stage of disease or treatment.Results: A total of 1,099 patients returned the questionnaire. The overall response rate was 78.5%. Complementary therapies had previously been or were currently being used by 23.5% (258) and 18.2% (200) of patients, respectively. Higher levels of education and income were associated with greater use of complementary therapy (p <0.002 by logistic regression). Patients with progressive disease or those primarily treated with hormones were most likely to use complementary therapy. Among the patients using complementary therapy 90% believed that it would help them live longer and improve quality of life, 60% believed it would relieve symptoms and 47% expected it to cure disease.Conclusions: Complementary therapies are used by a large number of patients with prostate cancer, particularly those with progressive disease or who have undergone multiple treatments. Health care providers need to recognize this growing pattern of use of complementary therapy. Among patients who use complementary therapy the perception of benefit is much greater than that supported by scientific data. Future research should aim to unravel the complex psychosocial dynamics that influence the decision to use complementary therapy by men with prostate cancer and to educate patients about the efficacy of such therapies.

The process of public-use micro-data files creation involves a number of components. One of its key elements is RTI International's innovative MASSC methodology. However, there are other major components in this process such as treatment of non-core identifying variables and extreme outcomes for extra protection. The statistical disclosure limitation is designed to counter both inside and outside intrusion. The components of the process are accordingly designed.