Public Health Commons^™

Estimating Weighted Panel Sizes For Primary Care Providers: An Assessment Of Clustering And Novel Methods Of Panel Size Estimation On Electronic Medical Records, Martin A. Lavallee

Theses and Dissertations

Primary Care is on the frontlines of healthcare, thus they see the most diverse set of patients. In order to achieve high functioning primary care, a practice must establish empanelment, the pairing of patients to providers. Enumeration of empanelment, or estimating panel sizes, helps ensure that the demands of the patients demand the supply of providers and optimize the balance of primary care resources to improve quality of care. Further we can adjust panel sizes by using patient-level data on healthcare utilization and complexity extracted from the electronic medial record to determine the amount of care or burden of work …

Factors Influencing Intent To Take A Covid-19 Test In The United States, Sheila Rutto

Theses and Dissertations

In 2020, COVID-19 became the first pandemic in the world’s history that brought the entire world to an abrupt and unexpected halt. Since the first reported case of the disease to date, the novel coronavirus has been able to wreak havoc in literary every corner of the globe and left an ever-growing number of unprecedented fatalities. The normal way of life has been disrupted, and the level of uncertainty about the end of this pandemic continues to manifest to many. Due to the urgency to bring this pandemic under control, medical officers have been able to recommend actions that people …

Machine-Learning-Based Prediction Of Sepsis Events From Vertical Clinical Trial Data: A Naïve Approach, Tyler Michael Gaddis

Theses and Dissertations

Sepsis is a potentially life-threatening condition characterized by a dysregulated, disproportionate immune response to infection by which the afflicted body attacks its own tissues, sometimes to the point of organ failure, and in the worst cases, death. According to the Centers for Disease Control and Prevention (CDC) Sepsis is reported to kill upwards of 270,000 Americans annually, though this figure may be greater given certain ambiguities in the current accepted diagnostic framework of the disease.

This study attempted to first establish an understanding of past definitions of sepsis, and to then recommend use of machine learning as integral in an …

Infant Mortality In The United States: Socioeconomic Factors Predicting Infant Survival In Late Neo-Natal And Post Neo-Natal Infants From Birth Certificate Data, Mark Brunk-Grady

Theses and Dissertations

According to the Centers for Disease Control and Prevention, the infant mortality rate in the United States in 2018 was 5.6 deaths per 1000 live births. Infant mortality is defined as a child being born alive but dying before their first birthday. This study aimed to determine if adding socioeconomic factors to traditional predictive survival models improved the predictive power in terms of survival for late and post neonatal infants. Secondly, this study looked to develop a risk score to and predict which mothers would be classified as “High” or “Low” risk for infant death.

Data were analyzed from a …

Network Analysis Of Scientific Collaboration And Co-Authorship Of The Trifecta Of Malaria, Tuberculosis And Hiv/Aids In Benin., Gbedegnon Roseric Azondekon

Theses and Dissertations

Despite the international mobilization and increase in research funding, Malaria, Tuberculosis and HIV/AIDS are three infectious diseases that have claimed more lives in sub Saharan Africa than any other place in the World. Consortia, research network and research centers both in Africa and around the world team up in a multidisciplinary and transdisciplinary approach to boost efforts to curb these diseases. Despite the progress in research, very little is known about the dynamics of research collaboration in the fight of these Infectious Diseases in Africa resulting in a lack of information on the relationship between African research collaborators. This dissertation …

Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry

Theses and Dissertations

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and …

Marginal Structural Cox Model For Survival Data With Treatment-Confounder Feedback, Yanan Zhang

Theses and Dissertations

In an observational longitudinal study, there can be time-varying exposure/treatment and time-varying confounders. When the confounders affect the exposure and prior exposure also has an impact on levels of confounders, there is treatment confounder feedback. To admit estimation of unbiased causal effects, these conditions need to be hold, exchangeability, positivity, consistency. The traditional method of conditioning on potential confounders does not meet these 3 conditions. Therefore, parameter estimates from traditional Cox model are biased casual effect estimates when the treatment confounder feedback exists. The marginal structural Cox model can be used to address this issue. By calculating and including inverse …

Provision Of Hospital-Based Palliative Care And The Impact On Organizational And Patient Outcomes, Marisa L. Roczen

Theses and Dissertations

Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit …

Spatio-Temporal Analysis Of The Occupational Fatal Victimization Of Law Enforcement Officers In The Us, Xueyi Xing

Theses and Dissertations

The models with constant coefficients of the covariates across space and time are commonly used in spatio-temporal analyses. However, the associations between risk factors and the outcome could have locally differential temporal trends in many cases. In this study, a Bayesian latent cluster modeling strategy is employed to identify potential spatial clusters in which locally specific sets of temporally varying coefficients of covariates are allowed. A state-level panel data of police officers occupational fatal victimization for the years 1979-2010 is used. To accommodate overdisperson and excess zeros, a negative binomial model and zero-inflated Poisson/negative binomial models are also utilized. A …

Simulation Based Evaluation Of Multiscale Small Area Health Models, Purbasha Dasgupta

Theses and Dissertations

The effects of scale on the analysis of spatial data, often referred to as the modifiable areal unit problem in spatial studies, is one of the issues often encountered in small area health models. These spatial effects of scale are also seen in the areas of disease mapping where data are usually available in counts. Often there is a need to consider the different scales of aggregation that exist within count data, since inferences based on analyses can vary if we change the definition of the unit of analysis. This thesis provides a framework that describes the distribution of relative …

An Efficient Methodology For Learning Bayesian Networks, Emmanuel Owusu Asante-Asamani

Theses and Dissertations

Statistics from the National Cancer Institute indicate that 1 in 8 women will develop Breast cancer in their lifetime. Researchers have developed numerous statistical models to predict breast cancer risk however physicians are hesitant to use these models because of disparities in the predictions they produce. In an effort to reduce these disparities, we use Bayesian networks to capture the joint distribution of risk factors, and simulate artificial patient populations (clinical avatars) for interrogating the existing risk prediction models. The challenge in this effort has been to produce a Bayesian network whose dependencies agree with literature and are good estimates …