Statistics and Probability Commons^™

Establishing A Public Health Surveillance System For The Opioid Crisis: The Experience Of The Healing Communities Study, Bridget Freisthler, Daniel J. Feaster, Charles Knott, Marc Larochelle, John Mccarthy, Svetla Slavova, Sharon L. Walsh, Jennifer Villani

Biostatistics Faculty Publications

Introduction: Efforts to reduce opioid overdose deaths in the United States have been stymied by the lack of timely and standardized population-level data for local, state, and national levels. The U.S. has a strong national need for linking opioid and other drug overdose surveillance data to service utilization data for overdose prevention and treatment to inform resource allocation and response planning.

Methods: We provide insight on the challenges of identifying, obtaining, and harmonizing administrative outcome data across four states using the collective experience from the HEALing Communities Study to test a community-engaged, data-driven, population-level intervention to reduce opioid overdose deaths. …

Using Camera-Based Unmarked Spatial Capture-Recapture Modeling To Estimate Reintroduced Elk (Cervus Canadensis) Population Parameters And Distribution In Southeastern Kentucky, Claire Marie Muia

Theses and Dissertations--Forestry and Natural Resources

Estimation of population parameters is important for wildlife management decisions. Elk reintroduced to southeastern Kentucky experienced early irruptive population growth and are currently monitored using a statewide harvest-based statistical population reconstruction model (SPR) across the Kentucky Elk Restoration Zone (KERZ). Because the SPR model is spatially coarse and difficult to scale to the smaller management units comprising the KERZ, we conducted a spatially explicit capture-recapture study using a clustered camera-trapping array deployed for 10 weeks from June–August 2024 to estimate elk population parameters within Management Unit 4. Due to a lack of resights of GPS-marked elk, population parameters were estimated …

Feasibility, Acceptability, And Preliminary Efficacy Of A Pilot Study To Integrate Buprenorphine Into A Harm-Reduction Drop-In-Center In Kampala, Uganda, Julia Dickson-Gomez, Sergey Tarima, Wamala Twaibu, Dan Katende, Latifah Kyeswa, Laura Glasman, Arthur Kiconco, Sarah Krechel, Bryan Johnston, Moses Ogwal, Brian Byamah Mutamba, Peter Mudiope, Stella Alamo, Rhoda Wanyenze, Geofrey Musinguzi

Biostatistics Faculty Publications

Illicit drug use has been increasing rapidly in Sub-Saharan Africa in the past decade. However, until recently HIV prevention has largely ignored people who inject drugs and medications to treat opioid use disorder (MOUD) were largely absent. This paper reports results of a pilot intervention that integrated buprenorphine into a harm-reduction drop-in-center for people with opioid use disorder (OUD) in Kampala, Uganda. We collected implementation outcomes and changes in self-reported drug use after buprenorphine initiation. We conducted qualitative interviews with a subset of 14 participants who had initiated buprenorphine. Sixty-two participants were screened for OUD, of whom 57 were eligible …

Artificial Intelligence In Biomedical Team Science: Perceptions, Practices, And Training Needs, Emily Slade, Kelsey N. Karnik, Caitline Phan, Megan E. Hall, Yana Feygin, Kristen J. Mcquerry

Biostatistics Faculty Publications

Introduction: Artificial intelligence (AI) is increasingly used in biomedical research, yet limited empirical work has described how researchers use AI tools on collaborative research teams and how they view their role within team-based research. This study examines researchers’ experience with and attitudes toward AI use in collaborative research environments.

Methods: A cross-sectional survey was administered to 178 investigators engaged in collaborative research at the University of Kentucky. Questions assessed AI use across research and communication tasks, team-related decision-making practices, perceived benefits and concerns, and preferences for training and frameworks.

Results: Thirty-nine participants responded (22%). AI use was heterogeneous: 26% had …

Enhancing Team Science By Training Collaborative Biostatisticians To Have A Strong Statistical Voice, Gina-Maria Pomann, Steven C. Grambow, Marissa C. Ashner, Bibhas Chakraborty, Nan Liu, Megan L. Neely, Sarah Peskoe, Lacey Rende, Emily Slade, Tracy Truong, Lexie Zidanyue Yang, Greg P. Samsa, Jesse D. Troy

Biostatistics Faculty Publications

Strong statistical voice is defined as the ability to advocate and negotiate for good and ethical statistical practices, including integrating and resolving differing scientific approaches. This skill is crucial for biostatisticians who work on biomedical research teams, as it ensures the integrity and accuracy of statistical analyses and fosters productive collaborations with non-statisticians. Despite its importance, new graduates often lack targeted training opportunities. This manuscript presents a scalable training approach through the development of online videos. Preliminary didactic materials focused on two key applications: providing written comments on manuscripts and engaging in study design discussions. To evaluate this training approach, …

Challenges And Applications Of Fine-Grained Temporal Action Understanding: Modeling Temporal Granularity And Data Efficiency, Halil I. Helvaci

Theses and Dissertations--Electrical and Computer Engineering

Fine-grained Temporal Action Segmentation (TAS) has become a cornerstone of video understanding, offering dense frame-level predictions essential for clinical assessment, surgical skill evaluation, and human-computer interaction. While TAS methods have delivered strong results on coarse-grained benchmarks, two fundamental challenges persist: (1) global attention mechanisms dilute boundary information critical for subsecond precision, a phenomenon we term the temporal granularity bottleneck, and (2) dense frame-level annotation remains prohibitively expensive, with most datasets requiring exhaustive labeling of lengthy untrimmed videos. These challenges are particularly pronounced in medical domains, where sub-second primitives define clinical outcomes while expert annotation remains scarce. In this dissertation, we …

Body Mass Index Has No Impact On Complications And Mortality For Patients With Stage Iv Pancreatic Ductal Adenocarcinoma, Ren Bryant, Hannah Darnell, Megan Hall, Kelsey N. Karnik, Kristen J. Mcquerry, Ruben R. Plentz

Biostatistics Faculty Publications

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of United States (USA) cancer death. Overweight and obesity developing into a growing global medical and socio-economic problem, affecting approximately 42% of adults in the USA population. The aim of our analysis was to evaluate the influence of overweight and obesity on complications and clinical outcome in patients with stage IV PDAC.

Methods: We retrospectively reviewed electronic health records of patients diagnosed with stage IV PDAC (n=162) who followed with the University of Kentucky from January 2017–October 2024. Comparisons were based on the body mass index (BMI): low BMI …

Association Between Lifetime Interpersonal Violence And Post– Covid-19 Condition Among Women In Kentucky, 2020-2022, Ayşe Güler, Heather M. Bush, Katie Schill, Nurlan Kussainov, Ann L. Coker

Biostatistics Faculty Publications

Objective: The COVID-19 pandemic increased the risk of interpersonal violence. We investigated the association between lifetime interpersonal violence experience and risk of post–COVID-19 condition (the persistence of symptoms of COVID-19 and severity of health problems associated with COVID-19 that last a few weeks, months, or years) among women with lifetime interpersonal violence experience.   Methods: Women participants aged ≥18 years in Kentucky’s Wellness, Health & You—COVID-19 study completed online quantitative surveys about the impacts of the pandemic, developing COVID-19, and symptoms of post–COVID-19 condition. We conducted cross-sectional analyses estimating rate ratios of developing COVID-19 and symptoms of post–COVID-19 condition during the …

Implementation Of Project-Based Instruction In Statistics Higher Education Courses, Jennifer A. Daddysman

Theses and Dissertations--Education Sciences

Project-based instruction is an instructional methodology based in constructivism that aligns with recommendations from the American Statistical Association for teaching statistics, including incorporating real-world data and examples, collaboration, and scaffolding (GAISE College Report ASA Revision Committee, 2016; GAISE Steering Committee, 2024; Krajcik & Blumenfeld, 2005; Tishkovskaya & Lancaster, 2012). This study examined current use of project-based instruction in United States higher education courses in statistics and the supports for and challenges to implementing this type of instruction.

This study used qualitative research methodology in the integrative pedagogy and diffusion of innovation frameworks. Voluntary response surveys were distributed via two sections …

Understanding The Impact Of The Medicaid Expansion On Hospital Length Of Stay And Emergency Department Use In Kentucky, Cameron Bushling

Theses and Dissertations--Epidemiology and Biostatistics

Three related analyses were performed to try to understand the immediate effects of Medicaid expansion on hospital systems in Kentucky. Medicaid expansion led to a large, sudden increase in the number of individuals eligible for various health care needs. This sudden increase in demand for health services lead to initial hypotheses regarding hospitals’ ability to handle this demand. The first analysis examined hospital average length of stay (LOS) using a linear mixed-effects model. Length of stay was modeled longitudinally between 2013 and 2015 to determine if significant changes in the slope of LOS could be detected after expansion (2014). Separate …

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Comparison Of Machine Learning Models For Colon Cancer Survival: Predictive Modeling Approach, Reuben Adatorwovor, Motolani E. Ogunsanya, Bin Huang, Richard Charnigo, Olufunmilola Abraham

Biostatistics Faculty Publications

Background: Colon cancer is a leading cause of cancer-related deaths worldwide, with survival influenced by risk factors, treatment type, and patient characteristics. Traditional statistical models, such as Kaplan-Meier curves, have been widely used to estimate survival probabilities. However, these models often have difficulty handling complex interactions, covariates, and nonlinear relationships between risk factors. Recently, machine learning (ML) techniques have emerged as promising tools for improving survival prediction by handling large covariates and capturing complex patterns.

Objective: This study compares several ML models to accurately estimate colon cancer survival by leveraging data from the Kentucky Cancer Registry. By identifying key risk …

Disentangling The Inverse Relationship Between Cancer And Alzheimer’S Or Parkinson’S Disease: A Systematic Review On Mendelian Randomization Studies, Khine Zin Aung, Su Su Zin, Xian Wu, Zin W. Myint, Shama D. Karanth, Steven Estus, Christopher M. Norris, Peter T. Nelson, David W. Fardo, Erin L. Abner, Yuriko Katsumata

Biostatistics Faculty Publications

Introduction

Although studies have reported an inverse relationship between cancer and neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), findings remain inconsistent. Observational studies are limited by survival bias and reverse causation. To better understand the relationship, we conducted a systematic review of Mendelian randomization (MR) studies examining both directions—assessing cancer as a risk factor for AD or PD, as well as AD or PD as exposures influencing cancer risk.

Methods

We systematically reviewed MR studies investigating the causal relation between cancer and either AD or PD. Cancer could be specified as either an exposure or an …

Incident Atherosclerotic Cardiovascular Disease Among Veterans By Gender Identity: A Cohort Study, Carl G. Streed Jr., Meredith S. Duncan, Kory R. Heier, T. Elizabeth Workman, Lauren B. Beach, Guneet K. Jasuja, Hill L. Wolfe, Landon D. Hughes, John R. O’Leary, Melissa Skanderson, Joseph L. Goulet

Biostatistics Faculty Publications

Background: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

Objective: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

Design: Cohort study.

Participants: Over 1 million veterans receiving care in the Veterans Health Administration.

Main Measures: Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard …

Adverse Childhood Experiences, Depression And Subjective Cognitive Decline By Gender: A Moderated Mediation Analysis, Monique J. Brown, Darlingtina K. Esiaka, Jaya Viswanathan

Behavioral Science Faculty Publications

Studies assessing depression as a mediating factor between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) are lacking. Therefore, the aims of this study were to: (1) determine the mediating role of depression in the association between ACEs and SCD; and (2) assess the moderating role of gender. Data were obtained from the 2023 Behavioral Risk Factor Surveillance Study (BRFSS) survey (N = 38,600). Crude and adjusted path analyses were used to determine the mediating role of depression between ACEs and SCD. Adjusted analyses controlled for sociodemographic confounders. ACEs were positively associated with depression (B = 0.129, p …

Communities That Heal Intervention And Mortality Including Polysubstance Overdose Deaths: A Randomized Clinical Trial, Bridget Freisthler, Rouba A. Chahine, Jennifer Villani, Redonna Chandler, Daniel J. Feaster, Svetla Slavova, Jolene Defiore-Hyrmer, Alexander Y. Walley, Sarah Kosakowski, Arnie Aldridge, Carolina Barbosa, Sabana Bhatta, Candace Brancato, Carly Bridden, Mia Christopher, Tom Clarke, James David, Lauren D'Costa, Irene Ewing, Soledad Fernandez, Erin Gibson, Louisa Gilbert, Megan E. Hall, Sarah Hargrove, Timothy Hunt, Elizabeth N. Kinnard, Lauren Larochelle, Aaron Macoubray, Shawn R. Nigam, Edward V. Nunes, Carrie B. Oser, Sharon Pagnano, Peter J. Rock, Pamela Salsberry, Aimee Shadwick, Thomas J. Stopka, Sylvia Tan, Jessica L. Taylor, Philip M. Westgate, Elwin Wu, Gary A. Zarkin, Sharon L. Walsh, Nabila El-Bassel, T. John Winhusen, Jeffrey H. Samet, Emmanuel A. Oga

Biostatistics Faculty Publications

IMPORTANCE: The HEALing Communities Study (HCS) evaluated the effectiveness of the Communities That HEAL (CTH) intervention in preventing fatal overdoses amidst the US opioid epidemic.

OBJECTIVE: To evaluate the impact of the CTH intervention on total drug overdose deaths and overdose deaths involving combinations of opioids with psychostimulants or benzodiazepines.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was a parallel-arm, multisite, community-randomized, open, and waitlisted controlled comparison trial of communities in 4 US states between 2020 and 2023. Eligible communities were those reporting high opioid overdose fatality rates in Kentucky, Massachusetts, New York, and Ohio. Covariate constrained randomization stratified …

A Probabilistic Approach To Estimate The Temporal Order Of Pathway Mutations Accounting For Intra-Tumor Heterogeneity, Menghan Wang, Yanqi Xie, Jinpeng Liu, Austin Li, Li Chen, Arnold Stromberg, Susanne Arnold, Chunming Liu, Chi Wang

Markey Cancer Center Faculty Publications

The development of cancer involves the accumulation of somatic mutations in several essential biological pathways. Delineating the temporal order of pathway mutations during tumori- genesis is crucial for comprehending the biological mechanisms underlying cancer development and identifying potential targets for therapeutic intervention. Several computational and statistical methods have been introduced for estimating the order of somatic mutations based on mutation profile data from a cohort of patients. However, one major issue of current methods is that they do not take into account intra-tumor heterogeneity (ITH), which limits their ability to accurately discern the order of pathway mutations. To address this …

A Guide To Successful Management Of Collaborative Partnerships In Quantitative Research: An Illustration Of The Science Of Team Science., Alyssa Platt, Tracy Truong, Mary Boulos, Nichole E Carlson, Manisha Desai, Monica M Elam, Emily Slade, Alexandra L Hanlon, Jillian H Hurst, Maren K Olsen, Laila M Poisson, Lacey Rende, Gina-Maria Pomann

Biostatistics Faculty Publications

Data-intensive research continues to expand with the goal of improving healthcare delivery, clinical decision-making, and patient outcomes. Quantitative scientists, such as biostatisticians, epidemiologists, and informaticists, are tasked with turning data into health knowledge. In academic health centres, quantitative scientists are critical to the missions of biomedical discovery and improvement of health. Many academic health centres have developed centralized Quantitative Science Units which foster dual goals of professional development of quantitative scientists and producing high quality, reproducible domain research. Such units then develop teams of quantitative scientists who can collaborate with researchers. However, existing literature does not provide guidance on how …

Snpaimer: R Package For Evaluating Ancestry Informative Marker Contributions In Non-Model Population Diagnostics, Kim L. Vertacnik, Oksana V. Vernygora, Julian R. Dupuis

Entomology Faculty Publications

Motivation: Single nucleotide polymorphism (SNP) markers are increasingly popular for population genomics and inferring ancestry for individuals of unknown origin. Because large SNP datasets are impractical for rapid and routine analysis, diagnostics rely on panels of highly informative markers. Strategies exist for selecting these markers, however, resources for efficiently evaluating their performance are limited for non-model systems.

Results: snpAIMeR is a user-friendly R package that evaluates the efficacy of genomic markers for the cluster assignment of unknown individuals. It is intended to help minimize panel size and genotyping effort by determining the informativeness of candidate diagnostic markers. Provided genotype data …

Mapping Urban Form Into Local Climate Zones For The Continental Us From 1986–2020, Meng Qi, Chunxue Xu, Wenwen Zhang, Matthias Demuzere, Perry Hystad, Tianjun Lu, Peter James, Benjamin Bechtel, Steve Hankey

Earth and Environmental Sciences Faculty Publications

Urbanization has altered land surface properties driving changes in micro-climates. Urban form influences people’s activities, environmental exposures, and health. Developing detailed and unified longitudinal measures of urban form is essential to quantify these relationships. Local Climate Zones [LCZ] are a culturally-neutral urban form classification scheme. To date, longitudinal LCZ maps at large scales (i.e., national, continental, or global) are not available. We developed an approach to map LCZs for the continental US from 1986 to 2020 at 100 m spatial resolution. We developed lightweight contextual random forest models using a hybrid model development pipeline that leveraged crowdsourced and expert labeling …

A 3-Step, Open-Data, Ride-Hailing Ridership Model With Pricing Applications, Richard A. Mucci

Theses and Dissertations--Civil Engineering

Researchers and practitioners studied the effects ride-hailing had in cities before the covid-19 pandemic. Previous research found ride-hailing to produce negative externalities, such as reducing transit ridership and increasing congestion in various cities. Since the pandemic, ride-hailing ridership has nearly recovered to pre-pandemic levels in Chicago. Ride-hailing ridership has grown steadily since the pandemic while a rider’s willingness to share their trip stagnated. Ride-hailing ridership nearly recovering to pre-covid levels in Chicago suggests that transportation planners, and policy makers, will need to continue assessing the impacts ride-hailing trips have in their cities.

Pickup and drop off locations in the Chicago …

Differential Impacts Of Weather Anomalies On Household Energy Expenditure Shares: A Comparison Of Clustered Panel Analysis Methods, Jordan Champion

Theses and Dissertations--Agricultural Economics

Recent emphasis on environmental justice has highlighted deficiencies in our energy system that produce disparities in accessibility and affordability for the most vulnerable. Meanwhile, the realities of a gradually warming climate and the onset of a global energy crisis (IEA 2022) have coincidently contributed to spikes in both energy prices and demand. These implications threaten to further exacerbate existing disparities for income-constrained and vulnerable populations, enhancing their risk of falling into prolonged insecurity. To ensure our transition to a just, sustainable future, we must first ensure equitable access to affordable and reliable energy for everyone. Combining household-level panel and state-level …

The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam

Theses and Dissertations--Epidemiology and Biostatistics

Opioid misuse is a nationwide epidemic, with Kentucky having one of the highest opioid overdose-related fatality rates across all US states. These rates have increased significantly over the past decade, with particularly large increases during the COVID-19 pandemic. This dissertation aims to study the behavior of these increases and the methods for the marginal modeling of count outcomes related to opioid overdose.

Opioid overdose-related fatality rates in Kentucky increased significantly during the COVID-19 pandemic. In this chapter, we characterize the changes in opioid overdose fatality rates in Kentucky and identify associations between potential factors and fatality rates. County-level opioid overdose …

Variable Selection For High-Dimensional Data With Interaction Effects: Methods, Applications, And Inferences, Leiyue Li

Theses and Dissertations--Statistics

For high-dimensional data where the number of variables greatly exceeds the number of observations, selecting important variables while maintaining the required heredity conditions can be challenging. This dissertation is structured into three interconnected parts. In the first part, we propose a variable selection method by implementing a well-known optimization technique, the Genetic Algorithm. An R package was developed to simplify the implementation and usage of the proposed method. We then propose another variable selection method by extending the study from the Genetic Algorithm to a different but related optimization technique, Simulated Annealing. We consider three different hierarchical structures in both …

High-Dimensional Tests And Projection Methods: Subvector Analysis And Matrix Variate Data, Shouryya Mitra

Theses and Dissertations--Statistics

In this dissertation, we study projection-based methods to testing problems for high-dimensional data. We also investigate inferential methods for matrix variate data with block compound symmetry (BCS) covariance structure. The research reported in dissertation consists of three projects.

The first project addresses power loss and ill-conditioned error covariance estimates commonly faced by multivariate tests in high-dimensional settings. To overcome these challenges, previous approaches avoided correlations in constructing test statistics, but this required strong assumptions about covariance matrices and dependence structures. More recently, some methods have incorporated correlations by employing random projection into a lower-dimensional space. We develop a unified framework …

Estimation And Testing Of Nonparametric Effects Of Incomplete Multivariate And Repeated Measures Data, Swetalina Maity

Theses and Dissertations--Statistics

In this dissertation, we investigate three distinct but interrelated problems in analyzing repeated measure data with missing values.

The first project is on semiparametric methods for analyzing repeated measures designs with missing values. A closed-form estimator for the parameters and their asymptotic covariance are derived using block partitioning based on the missing data pattern. We also derive the asymptotic distribution of the estimators and construct test statistics to test hypothesis formulated as linear contrasts of the mean vector.

In the second project, we focus on purely nonparametric methods. In this setup, nonparametric treatment effects are defined as functionals of the …

From Non-Parametric Methods To Self-Supervised Learning: Applications In Edge Detection And Image Denoising, Jiacheng Xu

Theses and Dissertations--Statistics

This dissertation explores advanced methodologies for edge detection and image denoising through the application of both traditional non-parametric methods and modern self-supervised deep learning techniques. Beginning with non-parametric approaches, we refine surface fitting and jump detection criteria to enhance the detection of discontinuous regression surfaces in grayscale images. These foundational techniques are extended to color images, with analyses across RGB and CIELAB color spaces to improve edge detection accuracy. We then introduce a self-supervised neural network model that integrates Masked Modeling into the Bi-Directional Cascade Network (BDCN) framework. This approach shows the potential of reducing the dependency on annotated data …

Patterns Into Pathways For Improving Safety Culture: Refined Latent Class Analysis Informs Tailored Decision Support For South Carolina Dss Safety Culture Improvements, Michaela Voit

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The rising prevalence of exposures to adverse childhood experiences (ACEs) demands a coordinated public health response, as a significant body of research details the cumulative impact of ACEs on chronic morbidities contributing to reduced life expectancy. Child welfare workers (CWW) are embedded in this public health effort, tasked with preventing and mitigating the impacts of ACEs through family and prevention services. The National Partnership for Child Safety (NPCS) may improve the wellbeing of CWWs and the effectiveness of Child Welfare (CW) services by improving the quality of safety culture within CW organizations. To inform NPCS quality improvement efforts, our project …

A Case Study On Variations In Network Structure And Cross- Sector Alignment In Two Local Systems Serving Pregnant And Parenting Women In Recovery, Liza M. Creel, Yana Feygin, Madeline Shipley, Deborah Winders Davis, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan

Biostatistics Faculty Publications

Objective: To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community.

Data Sources and Study Settings: Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021.

Study Design: Social network analysis measured system collaboration and cross-sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall …

Higher First 30-Day Dose Of Buprenorphine For Opioid Use Disorder Treatment Is Associated With Decreased Mortality, Feitong Lei, Michelle R. Lofwall, Jana Mcanich, Reuben Adatorwovor, Emily Slade, Patricia R. Freeman, Daniela Moga, Nabarun Dasgupta, Sharon L. Walsh, Rachel Vickers-Smith, Svetla Slavova

Biostatistics Faculty Publications

Objective: Buprenorphine is a medication for opioid use disorder that reduces mortality. This study aims to investigate the less well-understood relationship between the dose in the early stages of treatment and the subsequent risk of death.

Methods: We used Kentucky prescription monitoring data to identify adult Kentucky residents initiating transmucosal buprenorphine medication for opioid use disorder (January 2017 to November 2019). Average daily buprenorphine dose for days covered in the first 30 days of treatment was categorized as ≤8 mg, >8 to ≤16 mg, and >16 mg. Patients were followed for 365 days after the first 30 days of buprenorphine …