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Bind, Marie‐Abèle

0000-0002-0422-6651

A5045885520 | I4210087915

Mayo Clinic

Massachusetts General Hospital

Citations 2

Results from the first four regimens of the HEALEY ALS Platform Trial (PL5.004)

Neurology | April 28, 2023 | Volume: 100 | Issue: 17_supplement_2 | Pages: No page available

10.1212/wnl.0000000000204032

The role of body mass index at diagnosis of colorectal cancer on Black–White disparities in survival: a density regression mediation approach

Biostatistics | August 21, 2020 | Volume: 23 | Issue: 2 | Pages: 449-466

10.1093/biostatistics/kxaa034 | PMID 32968805

SummaryThe study of racial/ethnic inequalities in health is important to reduce the uneven burden of disease. In the case of colorectal cancer (CRC), disparities in survival among non-Hispanic Whites and Blacks are well documented, and mechanisms leading to these disparities need to be studied formally. It has also been established that body mass index (BMI) is a risk factor for developing CRC, and recent literature shows BMI at diagnosis of CRC is associated with survival. Since BMI varies by racial/ethnic group, a question that arises is whether differences in BMI are partially responsible for observed racial/ethnic disparities in survival for CRC patients. This article presents new methodology to quantify the impact of the hypothetical intervention that matches the BMI distribution in the Black population to a potentially complex distributional form observed in the White population on racial/ethnic disparities in survival. Our density mediation approach can be utilized to estimate natural direct and indirect effects in the general causal mediation setting under stronger assumptions. We perform a simulation study that shows our proposed Bayesian density regression approach performs as well as or better than current methodology allowing for a shift in the mean of the distribution only, and that standard practice of categorizing BMI leads to large biases when BMI is a mediator variable. When applied to motivating data from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, our approach suggests the proposed intervention is potentially beneficial for elderly and low-income Black patients, yet harmful for young or high-income Black populations.