Vital and Health Statistics Commons^™

Dynamic Prediction For Alternating Recurrent Events Using A Semiparametric Joint Frailty Model, Jaehyeon Yun

Statistical Science Theses and Dissertations

Alternating recurrent events data arise commonly in health research; examples include hospital admissions and discharges of diabetes patients; exacerbations and remissions of chronic bronchitis; and quitting and restarting smoking. Recent work has involved formulating and estimating joint models for the recurrent event times considering non-negligible event durations. However, prediction models for transition between recurrent events are lacking. We consider the development and evaluation of methods for predicting future events within these models. Specifically, we propose a tool for dynamically predicting transition between alternating recurrent events in real time. Under a flexible joint frailty model, we derive the predictive probability of …

Concerns With Taking The Covid-19 Vaccine, Kaela Bellamy, Robert S. Keyser

The Kennesaw Journal of Undergraduate Research

This IRB-approved descriptive study provides an overview of the concerns associated with receiving a COVID-19 vaccination within the Kennesaw State University community, an R2 university with over 41,000 students, and uses a survey to provide insight into how students, faculty, staff, and administrators are responding to the vaccinations for COVID-19, both available and unavailable, and their preferences. Our research findings indicate that: 1) Most of the population at Kennesaw State University intends to receive the vaccine, regardless of their concerns; 2) The majority of the participants who are either employed or provided an education by Kennesaw State University plan to …

Intervention Time Series Analysis Of Organ Donor Transplants In The Us, Supraja Malladi

Biology and Medicine Through Mathematics Conference

No abstract provided.

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Modeling Covid-19 Spread In Small Colleges, Riti Bahl, Nicole Eikmeier, Alexandra Fraser, Matthew Junge, Felicia Keesing, Kukai Nakahata, Lily Reeves

Publications and Research

We develop an agent-based model on a network meant to capture features unique to COVID-19 spread through a small residential college. We find that a safe reopening requires strong policy from administrators combined with cautious behavior from students. Strong policy includes weekly screening tests with quick turnaround and halving the campus population. Cautious behavior from students means wearing facemasks, socializing less, and showing up for COVID-19 testing. We also find that comprehensive testing and facemasks are the most effective single interventions, building closures can lead to infection spikes in other areas depending on student behavior, and faster return of test …

Em Estimation For Zero- And K-Inflated Poisson Regression Model, Monika Arora, N. Rao Chaganty

Mathematics & Statistics Faculty Publications

Count data with excessive zeros are ubiquitous in healthcare, medical, and scientific studies. There are numerous articles that show how to fit Poisson and other models which account for the excessive zeros. However, in many situations, besides zero, the frequency of another count k tends to be higher in the data. The zero- and k-inflated Poisson distribution model (ZkIP) is appropriate in such situations The ZkIP distribution essentially is a mixture distribution of Poisson and degenerate distributions at points zero and k. In this article, we study the fundamental properties of this mixture distribution. Using stochastic representation, we …

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3.26 …

Improving The Quality And Design Of Retrospective Clinical Outcome Studies That Utilize Electronic Health Records, Oliwier Dziadkowiec, Jeffery Durbin, Vignesh Jayaraman Muralidharan, Megan Novak, Brendon Cornett

HCA Healthcare Journal of Medicine

Electronic health records (EHRs) are an excellent source for secondary data analysis. Studies based on EHR-derived data, if designed properly, can answer previously unanswerable clinical research questions. In this paper we will highlight the benefits of large retrospective studies from secondary sources such as EHRs, examine retrospective cohort and case-control study design challenges, as well as methodological and statistical adjustment that can be made to overcome some of the inherent design limitations, in order to increase the generalizability, validity and reliability of the results obtained from these studies.

Pattern Of Health Behavior And Its Association With Self-Rated Health: Evidence From The 2018 Behavioral Risk Factor Surveillance System In The United States, Linh Nguyen, Mamunur Rashid, M. Mazharul Islam

Student Research

Aim: To improve public health services, we need to keep policymakers updated with health-related issues. This study (1) examines the recent pattern of physical activities, smoking, alcohol consumption, and SRH, and (2) investigates the association between the behaviors and SRH status among US citizens.

Method: We extracted data from the latest state-based survey of the 2018 Behavioral Risk Factor Surveillance System (BRFSS), which provides a nationally representative sample of 437,436 American adults. We analyzed the data, mainly employing chi-square tests and logistic regression models.

Results: Physical inactivity and smoking are more common among participants with lower education and household income. …

Life And Death: Quantifying The Risk Of Heart Disease With Machine Learning, Jack Scott Glienke

Honors Program Theses

Coronary heart disease has long been a key area of focus in the discussion of public health. As such, numerous studies have been conducted throughout history with the sole intention of identifying risk factors leading to the onset of cardiovascular conditions. A plethora of statistical procedures can be used to identify an individual’s risk of developing heart disease, yet regression models tend to be the default tool used by researchers. Using the data obtained from the most influential cardiovascular study to date, the Framingham Heart Study, this analysis uses machine learning techniques to generate and test the predictive power of …

Personal Foul: How Head Trauma And The Insurance Industry Are Threatening Sports, Zachary Cooler

Senior Honors Theses

This thesis will investigate the growing problem of head trauma in contact sports like football, hockey, and soccer through medical studies, implications to the insurance industry, and ongoing litigation. The thesis will investigate medical studies that are finding more evidence to support the claim that contact sports players are more likely to receive head trauma symptoms such as memory loss, mood swings, and even Lou Gehrig’s disease in extreme cases. The thesis will also demonstrate that these medical symptoms and monetary losses from medical claims are convincing insurance companies to withdraw insurance coverage for sports leagues, which they are justifying …

Bayesian Methods For The Assessment Of Reporting Errors For Data-Sparse Population-Periods With Applications To Estimating Mortality, Emily Peterson

Doctoral Dissertations

Population level mortality data is often subject to substantial reporting errors due to misclassification of cause of death, misclassification of death status, or age reporting errors. Accuracy of error-prone data sources can be assessed by comparing such data to gold standard data for the same population-period. We present Bayesian methods for assessing the extent of reporting errors across different population-periods and generalizing those to settings where gold-standard data are lacking. Firstly, we investigate misclassification errors of maternal cause of death reporting in civil registration vital statistics data. We use a Bayesian hierarchical bivariate random-walk model to estimate country-year specific sensitivity …

Measuring Change: Prediction Of Early Onset Sepsis, Aric Schadler

Theses and Dissertations--Statistics

Sepsis occurs in a patient when an infection enters into the blood stream and spreads throughout the body causing a cascading response from the immune system. Sepsis is one of the leading causes of morbidity and mortality in today’s hospitals. This is despite published and accepted guidelines for timely and appropriate interventions for septic patients. The largest barrier to applying these interventions is the early identification of septic patients. Early identification and treatment leads to better outcomes, shorter lengths of stay, and financial savings for healthcare institutions. In order to increase the lead time in recognizing patients trending towards septicemia …

The Experiences Of Ncaa Student-Athletes With An Eating Disorder Or Disordered Eating, Rachel E. Taylor

Electronic Theses and Dissertations

The purpose of this study was to explore the experiences of student-athletes who had an eating disorder or disordered eating (ED/DE) while competing for the National Collegiate Athletic Association (NCAA). Integrating criticism and connoisseurship and critical evocative portraiture, four post-collegiate women who participated in cross country and track, who were either clinically diagnosed with an ED/DE or who self-diagnosed, participated in two interviews to describe their experiences with and the impact of ED/DE on their athletic pursuits, academic pursuits, as well as their relationships with coaches, teammates, and family. The analysis of these interviews showed the complexity of this topic. …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

A Mathematical Model For Malaria With Age-Heterogeneous Biting Rate, Sho Kawakami

All Graduate Theses, Dissertations, and Other Capstone Projects

We propose a mathematical model for malaria with age-heterogeneous biting rate from mosquitos. The existence of the model, the local behavior of the disease free equilibrium are explored. Furthermore the model is extended to an optimal control problem and the corresponding adjoint equations and optimality conditions are derived. Age dependent parameter values are estimated and numerical simulations are carried out for the model. The new model better accounts for difference in biting rates of mosquitos to different age groups, and improvements in stability to the explicit algorithm. The optimal control is also shown to depend on the age distribution of …

Detecting Differentially Co-Expressed Gene Modules Via The Edge-Count Test, Anne Gratius Lin

Graduate Theses and Dissertations

Background

Gene expression profiling by microarray has been used to uncover molecular variations in many different diseases. Complementary to conventional differential expression analysis, differential co-expression analysis can identify gene markers from the systematic and granular level. There are three aspects for differential co-expression network analysis, including the network global topological comparison, differential co-expression cluster identification, and differential co-expressed genes and gene pair identification. To date, most of the methods available still rely on Pearson’s correlation coefficient despite its nonlinear insensitivity.

Results

Here we present an approach that is robust to nonlinearity by using the edge-count test for differential co-expression analysis. …

Identifying Risk Factors Related To Premature Birth Through Binary Logistic And Proportional Odds Ordinal Logistic Regression, Clayton Elwood

Electronic Theses and Dissertations

Premature birth has been identified as the single greatest cause of death worldwide in children under the age of five. This thesis will implement binary logistic regression and proportional odds ordinal logistic regression to predict different levels of premature birth and identify associated risk factors. The models will be built from the Center for Disease Control and Prevention's 2014 Vital Statistics Natality Birth Data containing nearly 4 million live births within the United States. Odds ratios and confidence intervals on risk factors were produced utilizing binary logistic regression.

Sickle Cell Disease Complications: Prevalence And Resource Utilization, Nirmish Shah, Menaka Bhor, Lin Xi, Jincy Paulose, Huseyin Yuce

Publications and Research

Objectives: This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.

Methods: The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for .6 months baseline and .12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC …

Comparative Clinical Outcomes Between Direct Oral Anticoagulants And Warfarin Among Elderly Patients With Non-Valvular Atrial Fibrillation In The Cms Medicare Population, Alpesh Amin, Oluwaseyi Dina, Allison Keshishian, Amol Dhamane, Anagha Nadkarni, Eric Carda, Cristina Russ, Lisa Rosenblatt, Jack Mardekian, Huseyin Yuce, Christine L. Baker

Publications and Research

Atrial fibrillation (AF) prevalence increases with age; > 80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs) vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfarin cohorts. Cox proportional hazards models estimated the risk of stroke/SE, MB, NCO, and MACE. 37,525 …

Statistical Modeling Of Influenza-Like-Illness In Montana Using Spatial And Temporal Methods, Benjamin A. Stark

Graduate Student Theses, Dissertations, & Professional Papers

Studying air pollution and public health has been a historically important question in science. It has long been hypothesized that severe air pollution conditions lead to negative implications in basic human health. Primarily, areas thats are prone to severe degrees of human pollution are the focus of such studies. Such research relating to less populated areas are scarce, and this scarcity raises the question of how such pollution dynamics (human-made and natural) influence human health in more rural areas.

The aim of this study is to explore this hole in research; in particular we explore possible links between air pollution …

Real-Time Dengue Forecasting In Thailand: A Comparison Of Penalized Regression Approaches Using Internet Search Data, Caroline Kusiak

Masters Theses

Dengue fever affects over 390 million people annually worldwide and is of particu- lar concern in Southeast Asia where it is one of the leading causes of hospitalization. Modeling trends in dengue occurrence can provide valuable information to Public Health officials, however many challenges arise depending on the data available. In Thailand, reporting of dengue cases is often delayed by more than 6 weeks, and a small fraction of cases may not be reported until over 11 months after they occurred. This study shows that incorporating data on Google Search trends can improve dis- ease predictions in settings with severely …

The Relationship Between Stryd Power And Running Economy In Well-Trained Distance Runners 2018, Casey Austin

Master's Theses

A novel running wearable called the Stryd Summit footpod attaches to a runner’s right or left shoe and measures running power output. The developers of the product purport that the footpod’s power and form power measures may correlate with metabolic data gathered in a lab. PURPOSE: Explore the relationship between power output and running economy at threshold pace. METHODS: Seventeen well-trained distance runners, 9 males and 8 females, completed a running protocol at threshold pace. Participants ran two discontinuous four-minute stages: one with their self-selected cadence (SS), and one with cadence lowered by 10% (LC). Metabolic data, power, and form …

Analysis Of Episodes Of Care In Medicare Beneficiaries Newly Diagnosed With Alzheimer’S Disease, Rezaul K. Khandker, Christopher Black, Lin Xie, M. Furaha Kariburyo, Baishali M. Ambegaonkar, Onur Baser, Huseyin Yuce, Howard Fillit

Publications and Research

OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer’s disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD.

DESIGN: A retrospective observational cohort study.

SETTING: United States.

PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331.0) were identified from the Medicare database between January 1, 2011, and June 30, 2014. This analysis identified individuals …

Burden Of Rheumatoid Arthritis Among Us Medicare Population: Co-Morbidities, Health-Care Resource Utilization And Costs, Chieh-I Chen, Li Wang, Wenhui Wei, Huseyin Yuce, Kristine Phillips

Publications and Research

Objectives. The study aimed to assess the burden of RA among the US Medicare population (aged 65 years) by comparing co-morbidities, health-care resource utilization (HCRU) and costs against matched non-RA Medicare patients.

Methods. Data were obtained from the Medicare fee-for-service claims database from 2010 to 2013. RA Medicare patients were identically matched with Medicare patients without RA (controls) based on demographics. Bivariate analyses were conducted to examine differences between cohorts for comorbidities, HCRU and costs. A generalized linear model was used to test relationships between patient-level characteristics, HCRU and costs.

Results. The study population included 115 867 RA patients and …

Multi-State Modeling Of Hospital Frequent Users, Yu Liang

Major Papers

The top 1% of frequent users account for 34% of public health system expenditures in Ontario, while the top 5% account for 66%. In this paper, we explore the efficacy of an intervention aimed at reducing hospital utilization for a group of patients defined as frequent users, by using Multi-state modeling. We employ time-homogeneous, time-inhomogeneous, parametric and semi-parametric Markov processes to study the transitions of the patients between hospital, ER and outside during a follow up period of one year. The results do not indicate any strong evidence that the intervention was beneficial.

Systematic Review And Meta-Analysis: Tuberculosis, Tnfα Inhibitors, And Crohn's Disease, Brent L. Cao

Honors Undergraduate Theses

Inflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs inhibiting tumor necrosis factor alpha (TNFα) is serious infection, including tuberculosis (TB).

Anti-TNFα therapy is used to treat patients with Crohn’s disease, for which the risk of tuberculosis may be …

The Impact Of Truncating Data On The Predictive Ability For Single-Step Genomic Best Linear Unbiased Prediction, Jeremy T. Howard, Thomas A. Rathje, Caitlyn E. Bruns, Danielle F. Wilson-Wells, Stephen D. Kachman, Matthew L. Spangler

Faculty Papers and Publications in Animal Science

Simulated and swine industry data sets were utilized to assess the impact of removing older data on the predictive ability of selection candidate estimated breeding values (EBV) when using single-step genomic best linear unbiased prediction (ssGBLUP). Simulated data included thirty replicates designed to mimic the structure of swine data sets. For the simulated data, varying amounts of data were truncated based on the number of ancestral generations back from the selection candidates. The swine data sets consisted of phenotypic and genotypic records for three traits across two breeds on animals born from 2003 to 2017. Phenotypes and genotypes were iteratively …

Long-Term Outcomes After Elective Sterilization Procedures — A Comparative Retrospective Cohort Study Of Medicaid Patients, Rachel Steward, Patricia Carney, Amy Law, Lin Xie, Yuexi Wang, Huseyin Yuce

Publications and Research

Objectives: The objectives were to compare the long-termoutcomes, including hysterectomy, chronic pelvic pain (CPP) and abnormal uterine bleeding (AUB), in women post hysteroscopic sterilization (HS) and laparoscopic tubal ligation (TL) in the Medicaid population.

Study design: This was a retrospective observational cohort analysis using data from the US Medicaid Analytic Extracts Encounters database.Women aged 18 to 49 years with at least one claimfor HS (n=3929) or TL (n=10,875) between July 1, 2009, through December 31, 2010, were included. Main outcome measures were hysterectomy, CPP or AUB in the 24 months poststerilization. Propensity score matching was used to control for patient …

Some Dimension Reduction Strategies For The Analysis Of Survey Data, Jiaying Weng, Derek S. Young

Statistics Faculty Publications

In the era of big data, researchers interested in developing statistical models are challenged with how to achieve parsimony. Usually, some sort of dimension reduction strategy is employed. Classic strategies are often in the form of traditional inference procedures, such as hypothesis testing; however, the increase in computing capabilities has led to the development of more sophisticated methods. In particular, sufficient dimension reduction has emerged as an area of broad and current interest. While these types of dimension reduction strategies have been employed for numerous data problems, they are scantly discussed in the context of analyzing survey data. This …