Clinical Epidemiology Commons^™

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Net Reclassification Index: A Misleading Measure Of Prediction Improvement, Margaret Sullivan Pepe, Holly Janes, Kathleen F. Kerr, Bruce M. Psaty

UW Biostatistics Working Paper Series

The evaluation of biomarkers to improve risk prediction is a common theme in modern research. Since its introduction in 2008, the net reclassification index (NRI) (Pencina et al. 2008, Pencina et al. 2011) has gained widespread use as a measure of prediction performance with over 1,200 citations as of June 30, 2013. The NRI is considered by some to be more sensitive to clinically important changes in risk than the traditional change in the AUC (Delta AUC) statistic (Hlatky et al. 2009). Recent statistical research has raised questions, however, about the validity of conclusions based on the NRI. (Hilden and …

Net Reclassification Indices For Evaluating Risk Prediction Instruments: A Critical Review, Kathleen F. Kerr, Zheyu Wang, Holly Janes, Robyn Mcclelland, Bruce M. Psaty, Margaret S. Pepe

UW Biostatistics Working Paper Series

Background Net Reclassification Indices (NRI) have recently become popular statistics for measuring the prediction increment of new biomarkers.

Methods In this review, we examine the various types of NRI statistics and their correct interpretations. We evaluate the advantages and disadvantages of the NRI approach. For pre-defined risk categories, we relate NRI to existing measures of the prediction increment. We also consider statistical methodology for constructing confidence intervals for NRI statistics and evaluate the merits of NRI-based hypothesis testing.

Conclusions Investigators using NRI statistics should report them separately for events (cases) and nonevents (controls). When there are two risk categories, the …

Maribel Gamon - Multidrug-Resistant Tuberculosis In India: Solving A Problem By Reconstructing The Public Health Infrastructure, Maribel Gamon

Ronald E. McNair Scholars Program 2013

Mycobacterium tuberculosis, commonly referred to as TB, is responsible for causing about 630,000 cases per year of infectious diseases worldwide. Recently, multidrug resistant tuberculosis (MDR-TB) has become an alarming public health concern. In addition, many developing countries lack effective treatment programs. India is one of those countries with a high prevalence of TB, seemingly affected by disconnectedness in their public health infrastructure. India, although a developing country, is still burdened with both chronic and infectious diseases, and there is a reactive public health system that must place focus on long-term effects of emerging resistant strains of TB. It is important …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

The Net Reclassification Index (Nri): A Misleading Measure Of Prediction Improvement With Miscalibrated Or Overfit Models, Margaret Pepe, Jin Fang, Ziding Feng, Thomas Gerds, Jorgen Hilden

UW Biostatistics Working Paper Series

The Net Reclassification Index (NRI) is a very popular measure for evaluating the improvement in prediction performance gained by adding a marker to a set of baseline predictors. However, the statistical properties of this novel measure have not been explored in depth. We demonstrate the alarming result that the NRI statistic calculated on a large test dataset using risk models derived from a training set is likely to be positive even when the new marker has no predictive information. A related theoretical example is provided in which a miscalibrated risk model that includes an uninformative marker is proven to erroneously …

Comparing Two-Year Community College And Four-Year University Student Social And Behavioral Sexually Transmitted Infection Risk Factors, Oswald M. Attin

Faculty Dissertations

Sexually transmitted infections (STIs) could cause ectopic, cervical cancer, infertility, and organ damage to the heart, kidneys, and brain. This study compared several behavioral risk factors of STIs (condom use, number of sexual partners, type of sex (anal or vaginal) and drinking habits) between two distinct educational settings and their association with socioeconomic risk factors such as low income and parent’s lower level of education that are known to increase the incidence of STIs among college-aged students. This study was based on the precautionary-health-behavior model, where individuals act regardless of consequences, and the health-behavior-change model, where individual behaviors either increase …

Social And Behavioral Sti Risk Factors: Comparing A Two-Year Community College Setting To A Four-Year University Setting, Oswald M. Attin

Faculty Publications and Presentations

No abstract provided.