Public Health Commons^™

A Hybrid Model For Reducing Ecological Bias, Ruth Salway, Jon Wakefield

UW Biostatistics Working Paper Series

A major drawback of epidemiological ecological studies, in which the association between area-level summaries of risk and exposure are used to make inference about individual risk, is the difficulty in characterising within-area variability in exposure and confounder variables. To avoid ecological bias, samples of individual exposure/confounder data within each area are required. Unfortunately these may be difficult or expensive to obtain, particularly if large samples are required. In this paper we propose a new approach suitable for use with small samples. We combine a Bayesian non-parametric Dirichlet process prior with an estimating functions approach, and show that this model gives …

Health-Exposure Modelling And The Ecological Fallacy, Jon Wakefield, Gavin Shaddick

UW Biostatistics Working Paper Series

Recently there has been increased interest in modelling the association between aggregate disease counts and environmental exposures measured, for example via air pollution monitors, at point locations. This paper has two aims: first we develop a model for such data in order to avoid ecological bias; second we illustrate that modelling the exposure surface and estimating exposures may lead to bias in estimation of health effects. Design issues are also briefly considered, in particular the loss of information in moving from individual to ecological data, and the at-risk populations to consider in relation to the pollution monitor locations. The approach …

Is The Number Of Sick Persons In A Cohort Constant Over Time?, Paula Diehr, Ann Derleth, Anne Newman, Liming Cai

UW Biostatistics Working Paper Series

Objectives: To estimate the number of persons in a cohort who are sick, over time.

Methods: We calculated the number of sick persons in the Cardiovascular Health Study (CHS), a cohort study of older adults followed up to 14 years, using eight definitions of “healthy” and “sick”. We projected the number in each health state over time for a birth cohort.

Results: The number of sick persons in CHS was approximately constant for 14 years, for all definitions of “sick”. The estimated number of sick persons in the birth cohort was approximately constant from ages 55-75, after which it decreased. …