Vital and Health Statistics Commons^™

Health And Healthcare: Designing For The Social Determinants Of Health And Blue Zones In North Nashville, Rebecca Tonguis, Honor Thomas, Olivia Hobbs

Belmont University Research Symposium (BURS)

Owned by North Nashville’s First Community Church, a now empty site in the Osage-North Fisk neighborhood of North Nashville has been identified as a potential site for a new location of The Store, in addition to a community-centric architectural development based on the social determinants of health and informed by the principles behind Blue Zones, the locations with the highest lifespans in the world. Opened by Brad Paisley and Kimberly Williams-Paisley, The Store is a free grocery store that “allow[s] people to shop for their basic needs in a way that protects dignity and fosters hope”, for which North Nashville …

Formulating An Efficient Statistical Test Using The Goodness Of Fit Approach With Applications To Real-Life Data, S. A. Qaid, S. E. Abo Youssef Prof., Mahmoud Mansour

Basic Science Engineering

Statistical tests are very important for researchers to make decisions. In particular, when the tests are non-parametric, they are of greater importance because they can be applied to a wide range of data sets regardless of knowing the distribution of these data. Researchers are therefore racing to obtain efficient tests for making good decisions based on the results of these tests. In this study, NBU (2)L was used based on the goodness of fit approach to present an efficient statistical test. The efficiency of the proposed test was computed, and the results were compared to those of other tests. Critical …

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 …

Medical Marijuana And Opioids (Memo) Study: Protocol Of A Longitudinal Cohort Study To Examine If Medical Cannabis Reduces Opioid Use Among Adults With Chronic Pain, Chinazo O. Cunningham, Joanna L. Starrels, Chenshu Zhang, Marcus A. Bachhuber, Nancy L. Sohler, Frances R. Levin, Haruka Minami, Deepika E. Slawek, Julia H. Arnsten

School of Medicine Faculty Publications

Introduction In the USA, opioid analgesic use and overdoses have increased dramatically. One rapidly expanding strategy to manage chronic pain in the context of this epidemic is medical cannabis. Cannabis has analgesic effects, but it also has potential adverse effects. Further, its impact on opioid analgesic use is not well studied. Managing pain in people living with HIV is particularly challenging, given the high prevalence of opioid analgesic and cannabis use. This study's overarching goal is to understand how medical cannabis use affects opioid analgesic use, with attention to Δ9-tetrahydrocannabinol and cannabidiol content, HIV outcomes and adverse events. Methods and …

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 …

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. …

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 …

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 …

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 …

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

Department of Animal Science: Faculty Publications

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 …

Economic Burden, Mortality, And Institutionalization In Patients Newly Diagnosed With Alzheimer’S Disease, Christopher M. Black, Howard Fillit, Lin Xie, Xiaohan Hu, M. Furaha Kariburyo, Baishali M. Ambegaonkar, Onur Baser, Huseyin Yuce, Rezaul K. Khandker

Publications and Research

Background: Current information is scarce regarding comorbid conditions, treatment, survival, institutionalization, and health care utilization for Alzheimer’s disease (AD) patients.

Objectives: Compare all-cause mortality, rate of institutionalization, and economic burden between treated and untreated newly-diagnosed AD patients.

Methods: Patients aged 65–100 years with ≥1 primary or ≥2 secondary AD diagnoses (ICD-9-CM:331.0] with continuous medical and pharmacy benefits for ≥12 months pre-index and ≥6 months post-index date (first AD diagnosis date) were identified from Medicare fee-for-service claims 01JAN2011–30JUN2014. Patients with AD treatment claims or AD/ADrelated dementia diagnosis during the pre-index period were excluded. Patients were assigned to treated and untreated cohorts …

Burden Of Atopic Dermatitis In The United States: Analysis Of Healthcare Claims Data In The Commercial, Medicare, And Medi-Cal Databases, Sulena Shrestha, Raymond Miao, Li Wang, Jingdong Chao, Huseyin Yuce, Wenhui Wei

Publications and Research

Comparative data on the burden of atopic dermatitis (AD) in adults relative to the general population are limited. We performed a large-scale evaluation of the burden of disease among US adults with AD relative to matched non-AD controls, encompassing comorbidities, healthcare resource utilization (HCRU), and costs, using healthcare claims data. The impact of AD disease severity on these outcomes was also evaluated.

Mechanistic Mathematical Models: An Underused Platform For Hpv Research, Marc Ryser, Patti Gravitt, Evan R. Myers

Global Health Faculty Publications

Health economic modeling has become an invaluable methodology for the design and evaluation of clinical and public health interventions against the human papillomavirus (HPV) and associated diseases. At the same time, relatively little attention has been paid to a different yet complementary class of models, namely that of mechanistic mathematical models. The primary focus of mechanistic mathematical models is to better understand the intricate biologic mechanisms and dynamics of disease. Inspired by a long and successful history of mechanistic modeling in other biomedical fields, we highlight several areas of HPV research where mechanistic models have the potential to advance the …

Health Care Resource Utilization And Costs Of California Medicaid Patients With Schizophrenia Treated With Paliperidone Palmitate Once Monthly Or Atypical Oral Antipsychotic Treatment, Jacqueline A. Pesa,, Dilesh Doshi, Li Wang, Huseyin Yuce, Onur Baser

Publications and Research

Objective: To compare all-cause health care utilization and costs between patients with schizophrenia treated with once monthly paliperidone palmitate (PP1M; Invega Sustenna1) and atypical oral antipsychotic therapy (OAT).

Methods: This was a retrospective claims-based analysis among adult California Medicaid (Medi-Cal) patients with schizophrenia having 2 claims for PP1M or OAT from 1 July 2009 to 31 December 2013 and continuous health plan enrollment for 1 year pre- and post-index date (PP1M or OAT initiation date). Baseline characteristics were reported descriptively. Propensity score matching with a 1:1 greedy match method was used to create two matched cohorts. Treatment patterns, all-cause health …

Perspectives On Model Forecasts Of The 2014–2015 Ebola Epidemic In West Africa: Lessons And The Way Forward, Gerardo Chowell, Cecile Viboud, Lone Simonsen, Stefano Merler, Alessandro Vespignani

Global Health Faculty Publications

The unprecedented impact and modeling efforts associated with the 2014–2015 Ebola epidemic in West Africa provides a unique opportunity to document the performances and caveats of forecasting approaches used in near-real time for generating evidence and to guide policy. A number of international academic groups have developed and parameterized mathematical models of disease spread to forecast the trajectory of the outbreak. These modeling efforts often relied on limited epidemiological data to derive key transmission and severity parameters, which are needed to calibrate mechanistic models. Here, we provide a perspective on some of the challenges and lessons drawn from these efforts, …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

Spatiotemporal Meta-Analysis: Reviewing Health Psychology Phenomena Over Space And Time., Blair T. Johnson

CHIP Documents

This supplemental material is meant to support this article:

Johnson, B. T., Crowley, E., & Marrouch, N. Spatiotemporal meta-analysis: Reviewing health psychology phenomena over space and time. Health Psychology Review.

Specifically, it is a database of GDPs per capita for nations in the world between 1800 and 2015. It is archived here to support an online supplement to this article.

GDP per capita

Generalized Confidence Intervals And Fiducial Intervals For Some Epidemiological Measures., Ionut Bebu, G. Luta, T. Mathew, B. K. Agan

GW Biostatistics Center

For binary outcome data from epidemiological studies, this article investigates the interval estimation of several measures of interest in the absence or presence of categorical covariates. When covariates are present, the logistic regression model as well as the log-binomial model are investigated. The measures considered include the common odds ratio (OR) from several studies, the number needed to treat (NNT), and the prevalence ratio. For each parameter, confidence intervals are constructed using the concepts of generalized pivotal quantities and fiducial quantities. Numerical results show that the confidence intervals so obtained exhibit satisfactory performance in terms of maintaining the coverage probabilities …

An Evolutionary Vaccination Game In The Modified Activity Driven Network By Considering The Closeness, Dun Han, Mei Sun

Publications and Research

In this paper, we explore an evolutionary vaccination game in the modified activity driven network by considering the closeness. We set a closeness parameter p which is used to describe the way of connection between two individuals. The simulation results show that the closeness p may have an active role in weakening both the spreading of epidemic and the vaccination. Besides, when vaccination is not allowed, the final recovered density increases with the value of the ratio of the infection rate to the recovery rate λ/μ. However, when vaccination is allowed the final density of recovered individual first increases and …

Variation In Rheumatoid Hand And Wrist Surgery Among Medicare Beneficiaries: A Population-Based Cohort Study, Lin Zhong, Kevin C. Chung, Onur Baser, David A. Fox, Huseyin Yuce, Jennifer F. Waljee

Publications and Research

Objective. To examine the rate and variation in rheumatoid arthritis (RA)-related hand and wrist surgery among Medicare (elderly) beneficiaries in the United States, and to identify the patient and provider factors that influence surgical rates.

Methods. Using the 2006–2010 100% Medicare claims data of beneficiaries with RA diagnosis, we examined rates of rheumatoid hand and wrist arthroplasty, arthrodesis, and hand tendon reconstruction in the United States. We used multivariate logistic regression models to examine variation in receipt of surgery by patient and regional characteristics (density of providers, intensity of use of biologic disease-modifying antirheumatic drugs).

Results. Between 2006 and 2010, …

Should We Love Or Hate Big Data? The Good, The Bad, And The Ugly, Dennis Crossen M.Sc., Mba, Karti Puranam Phd, Madjid Tavana Phd

Explorer Café

No abstract provided.

Using Remote Sensing Data To Predict The Spread Of Mosquito Borne Disease, Mary Ellen O'Donnell, Erika Podest

STAR Program Research Presentations

There is interest in how environmental variables derived from satellite data such as temperature, vegetation cover, and precipitation correlate to vector borne disease occurrence such as malaria and dengue fever. This study will be carried out using a decision tree based open source software called Random Forests to find correlations between the remote sensing variables and mosquito abundance. Software will be written in C# to take large amounts of data from the NASA satellite database and automatically format it for the Random Forest Software input. Correlations found, using Random Forests, between disease incidence and the variables can be used as …

Self-Reported Head Injury And Risk Of Late-Life Impairment And Ad Pathology In An Ad Center Cohort, Erin L. Abner, Peter T. Nelson, Frederick A. Schmitt, Steven R. Browning, David W. Fardo, Lijie Wan, Gregory A. Jicha, Gregory E. Cooper, Charles D. Smith, Allison M. Caban-Holt, Linda J. Van Eldik, Richard J. Kryscio

Sanders-Brown Center on Aging Faculty Publications

Aims: To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes. Methods: Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury. Results: The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.21 and 1.34 …

Computational Model For Survey And Trend Analysis Of Patients With Endometriosis : A Decision Aid Tool For Ebm, Salvo Reina, Vito Reina, Franco Ameglio, Mauro Costa, Alessandro Fasciani

COBRA Preprint Series

Endometriosis is increasingly collecting worldwide attention due to its medical complexity and social impact. The European community has identified this as a “social disease”. A large amount of information comes from scientists, yet several aspects of this pathology and staging criteria need to be clearly defined on a suitable number of individuals. In fact, available studies on endometriosis are not easily comparable due to a lack of standardized criteria to collect patients’ informations and scarce definitions of symptoms. Currently, only retrospective surgical stadiation is used to measure pathology intensity, while the Evidence Based Medicine (EBM) requires shareable methods and correct …

Statistical Inference For Data Adaptive Target Parameters, Mark J. Van Der Laan, Alan E. Hubbard, Sara Kherad Pajouh

U.C. Berkeley Division of Biostatistics Working Paper Series

Consider one observes n i.i.d. copies of a random variable with a probability distribution that is known to be an element of a particular statistical model. In order to define our statistical target we partition the sample in V equal size sub-samples, and use this partitioning to define V splits in estimation-sample (one of the V subsamples) and corresponding complementary parameter-generating sample that is used to generate a target parameter. For each of the V parameter-generating samples, we apply an algorithm that maps the sample in a target parameter mapping which represent the statistical target parameter generated by that parameter-generating …