Biostatistics Commons^™

Prediction Models For Descreasing Visual Acuity In Wig Makers, Nur Ulfah, Siti Harwanti, Ngadiman Ngadiman

Kesmas

One of the occupational diseases that can arise for workers with high accuracy is a decrease in their visual acuity. Therefore, it is necessary to study the risk factors of decreasing visual acuity in workers with high accuracy, such as in wig makers. This study aimed to examine the correlation between age, working period, lighting intensity, fatigue, and nutritional status with visual acuity, and to observe the main risk factors that can be used as a reference for predicting decreasing visual acuity. This study was an observational study that used a cross-sectional design. The population number for this study was …

Evaluating Trajectories Of Episodic Memory In Normal Cognition And Mild Cognitive Impairment: Results From Adni, Xiuhua Ding, Richard J. Charnigo, Frederick A. Schmitt, Richard J. Kryscio, Erin L. Abner, Alzheimer’S Disease Neuroimaging Initiative

Statistics Faculty Publications

BACKGROUND: Memory assessment is a key factor for the diagnosis of cognitive impairment. However, memory performance over time may be quite heterogeneous within diagnostic groups.

METHOD: To identify latent trajectories in memory performance and their associated risk factors, we analyzed data from Alzheimer's Disease Neuroimaging Initiative (ADNI) participants who were classified either as cognitively normal or as Mild Cognitive Impairment (MCI) at baseline and were administered the Rey Auditory Verbal Learning test (RAVLT) for up to 9 years. Group-based trajectory modeling on the 30-minute RAVLT delayed recall score was applied separately to the two baseline diagnostic groups.

RESULTS: There were …

Impact Of The Affordable Care Act On Colorectal Cancer Screening, Incidence, And Survival In Kentucky, Tong Gan, Heather F. Sinner, Samuel C. Walling, Quan Chen, Bin Huang, Thomas C. Tucker, Jitesh A. Patel, B. Mark Evers, Avinash S. Bhakta

Surgery Faculty Publications

Background

Kentucky ranks first in the US in cancer incidence and mortality. Compounded by high poverty levels and a high rate of medically uninsured, cancer rates are even worse in Appalachian Kentucky. Being one of the first states to adopt the Affordable Care Act (ACA) Medicaid expansion, insurance coverage markedly increased for Kentucky residents. The purpose of our study was to determine the impact of Medicaid expansion on colorectal cancer (CRC) screening, diagnosis, and survival in Kentucky.

Study Design

The Kentucky Cabinet for Health and Family Services and the Kentucky Cancer Registry were queried for individuals (≥20 years) undergoing CRC …

Opioids And Cerebral Physiology In The Acute Management Of Traumatic Brain Injury: A Systematic Review, Joshua Weiner, Amanda Mcintyre, Shannon Janzen, Magdalena Mirkowski, Heather M. Mackenzie, Robert Teasell

Epidemiology and Biostatistics Publications

Background: Following traumatic brain injury (TBI), optimization of cerebral physiology is recommended to promote more favourable patient outcomes. Accompanying pain and agitation are commonly treated with sedative and analgesic agents, such as opioids. However, the impact of opioids on certain aspects of cerebral physiology is not well established.

Objective: To conduct a systematic review of the evidence on the effect of opioids on cerebral physiology in TBI during acute care.

Methods: A comprehensive literature search was conducted in five electronic databases for articles published in English up to November 2017. Studies were included if: (1) the study sample was human …

Gene Co-Expression Networks Analysis Reveal Novel Molecular Endotypes In Alpha-1 Antitrypsin Deficiency, Jen-Hwa Chu, Wenlan Zang

Yale Day of Data

Rationale:Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that predisposes to early onset pulmonary emphysema and airways obstruction. The exact mechanism through which AATD leads to lung disease is incompletely understood.

Objectives: To investigate the effect of AAT genotype and augmentation therapy on bronchoalveolar lavage (BAL) and peripheral blood mononuclear cells (PBMC) transcriptome, while examining the link between gene expression profiles, and clinical features of AATD.

Methods: We performed RNA-Seq on RNA extracted from BAL and PBMC on samples obtained from 89 AATD patients enrolled in the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study. Differential …

A Novel Pathway-Based Distance Score Enhances Assessment Of Disease Heterogeneity In Gene Expression, Yunqing Liu, Xiting Yan

Yale Day of Data

Distance-based unsupervised clustering of gene expression data is commonly used to identify heterogeneity in biologic samples. However, high noise levels in gene expression data and the relatively high correlation between genes are often encountered, so traditional distances such as Euclidean distance may not be effective at discriminating the biological differences between samples. In this study, we developed a novel computational method to assess the biological differences based on pathways by assuming that ontologically defined biological pathways in biologically similar samples have similar behavior. Application of this distance score results in more accurate, robust, and biologically meaningful clustering results in both …

Variance Estimation In Inverse Probability Weighted Cox Models, Di Shu, Jessica G. Young, Sengwee Toh, Rui Wang

Harvard University Biostatistics Working Paper Series

Inverse probability weighted Cox models can be used to estimate marginal hazard ratios under different treatments interventions in observational studies. To obtain variance estimates, the robust sandwich variance estimator is often recommended to account for the induced correlation among weighted observations. However, this estimator does not incorporate the uncertainty in estimating the weights and tends to overestimate the variance, leading to inefficient inference. Here we propose a new variance estimator that combines the estimation procedures for the hazard ratio and weights using stacked estimating equations, with additional adjustments for the sum of non-independent and identically distributed terms in a Cox …

General Approach Of Causal Mediation Analysis With Causally Ordered Multiple Mediators And Survival Outcome, An-Shun Tai, Pei-Hsuan Lin, Yen-Tsung Huang, Sheng-Hsuan Lin

Harvard University Biostatistics Working Paper Series

Causal mediation analysis with multiple mediators (causal multi-mediation analysis) is critical in understanding why an intervention works, especially in medical research. Deriving the path-specific effects (PSEs) of exposure on the outcome through a certain set of mediators can detail the causal mechanism of interest. However, the existing models of causal multi-mediation analysis are usually restricted to partial decomposition, which can only evaluate the cumulative effect of several paths. Moreover, the general form of PSEs for an arbitrary number of mediators has not been proposed. In this study, we provide a generalized definition of PSE for partial decomposition (partPSE) and for …

Comparison Of Long-Term Survival Of Patients With Early-Stage Non–Small Cell Lung Cancer After Surgery Vs Stereotactic Body Radiotherapy, Alexander Chi, Wei Fang, Yeping Sun, Sinjin Wen

Faculty & Staff Scholarship

IMPORTANCE Previous comparisons of surgery and stereotactic body radiotherapy (SBRT) for early-stage (ES) non–small cell lung cancer (NSCLC) did not account for the extent of regional lymph node examination (LNE) during surgery. OBJECTIVE To compare long-term overall survival (OS) of patients with ES NSCLC after surgery vs SBRT when the extent of regional LNE in patients undergoing surgery is thoroughly considered. DESIGN, SETTING, AND PARTICIPANTS Cohort study with survival comparisons using the multivariable Cox proportional hazards model and after propensity score matching. Data from the National Cancer Database were analyzed from October 28, 2018, through April 18, 2019. Patients with …

Controlling For Confounding Via Propensity Score Methods Can Result In Biased Estimation Of The Conditional Auc: A Simulation Study, Hadiza I. Galadima, Donna K. Mcclish

Community & Environmental Health Faculty Publications

In the medical literature, there has been an increased interest in evaluating association between exposure and outcomes using nonrandomized observational studies. However, because assignments to exposure are not random in observational studies, comparisons of outcomes between exposed and nonexposed subjects must account for the effect of confounders. Propensity score methods have been widely used to control for confounding, when estimating exposure effect. Previous studies have shown that conditioning on the propensity score results in biased estimation of conditional odds ratio and hazard ratio. However, research is lacking on the performance of propensity score methods for covariate adjustment when estimating the …

An Information Theory-Based Approach To Assessing Spatial Patterns In Complex Systems, Tarsha Eason, Wen Ching-Chuang, Shana Sundstrom, Heriberto Cabezas

School of Natural Resources: Faculty Publications

Given the intensity and frequency of environmental change, the linked and cross-scale nature of social-ecological systems, and the proliferation of big data, methods that can help synthesize complex system behavior over a geographical area are of great value. Fisher information evaluates order in data and has been established as a robust and effective tool for capturing changes in system dynamics, including the detection of regimes and regime shifts. The methods developed to compute Fisher information can accommodate multivariate data of various types and requires no a priori decisions about system drivers, making it a unique and powerful tool. However, the …

Saturated Fat Intake Is Associated With Lung Function In Individuals With Airflow Obstruction: Results From Nhanes 2007⁻2012, Kasey Cornell, Morshed Alam, Elizabeth Lyden, Lisa Wood, Tricia D. Levan, Tara M. Nordgren, Kristina L. Bailey, Corrine K. Hanson

Journal Articles: Biostatistics

Nutritional status is a well-recognized prognostic indicator in chronic obstructive pulmonary disease (COPD); however, very little is known about the relationship between lung function and saturated fat intake. We used data from the cross-sectional National Health and Nutrition Examination Surveys (NHANES) to assess the relationship between saturated fatty acid (SFA) intake and lung function in the general US adult population. Adults in NHANES (2007⁻2012) with pre-bronchodilator spirometry measurements and dietary SFA intake were included. Primary outcomes were lung function including forced expiratory volume in one second (FEV₁)

Stretching Hiv Treatment: A Replication Study Of Task Shifting In South Africa, Baojiang Chen, Morshed Alam

Journal Articles: Biostatistics

The Streamlining Tasks & Roles to Expand Treatment and Care for HIV (STRETCH) program was developed to increase the reach of antiretroviral therapy (ART) for HIV/AIDS patients in Sub-Saharan Africa by training nurses to prescribe, initiate, and maintain ART. Fairall and colleagues conducted a cluster-randomized trial to determine the effects/impact of STRETCH on patient health outcomes in South Africa between 2008 and 2010. The purpose of our replication study is to evaluate Fairall and colleagues' findings. We conducted push button and pure replication studies and measurement and estimation analyses (MEA). Our MEA validates the original findings: (1) overall, time to …

Use Of Complementary And Alternative Medicine Among People With Cardiovascular Diseases In Southeast Georgia, Chimuanya Okoli, Stacy Carswell, Sewuese Akuse, Kelly L. Sullivan

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Background: Heart disease is a leading cause of death in the United States. Proper treatment of patients with cardiovascular disease is essential and can be challenged by non-disclosed use of complementary or alternative treatments. The objective of this study was to assess which demographics were associated with complementary and alternative medicine (CAM) use and if education affects the use of CAM.

Methods: A cross-sectional survey was conducted among a stratified random sample of residents of Southeastern Georgia. Sampling was stratified by urban/rural residence in order to reach sufficient rural residents. Participants that indicated they had been diagnosed with hypertension or …

Quasi-Likelihood Ratio Tests For Homoscedasticity Of Variance In Linear Regression, Lili Yu, Varadan Sevilimedu, Robert Vogel, Hani Samawi

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Two quasi-likelihood ratio tests are proposed for the homoscedasticity assumption in the linear regression models. They require few assumptions than the existing tests. The properties of the tests are investigated through simulation studies. An example is provided to illustrate the usefulness of the new proposed tests.

Safety Constraint Optimization Of Combination Drug Therapy In Hypertension Clinical Trials, Victor Chukwu

College of Graduate Studies: Theses & Dissertations

In Clinical Practice, combination drug therapy has become common in treating many disease conditions. The purpose of these combinations is often to ensure optimal efficacy and to reduce adverse effects that may arise from monotherapy. Clinical trials have also been conducted to ensure efficacy and safety of these combinations before they are introduced into the market. However, adverse effects still occur with combination therapies. The objective of this study is to (1) To determine a region of optimum doses of Drug A and Drug B in combination while focusing on efficacy alone (2) To determine a region of optimum doses …

Variable Selection In Accelerated Failure Time (Aft) Frailty Models: An Application Of Penalized Quasi-Likelihood, Sarbesh R. Pandeya

College of Graduate Studies: Theses & Dissertations

Variable selection is one of the standard ways of selecting models in large scale datasets. It has applications in many fields of research study, especially in large multi-center clinical trials. One of the prominent methods in variable selection is the penalized likelihood, which is both consistent and efficient. However, the penalized selection is significantly challenging under the influence of random (frailty) covariates. It is even more complicated when there is involvement of censoring as it may not have a closed-form solution for the marginal log-likelihood. Therefore, we applied the penalized quasi-likelihood (PQL) approach that approximates the solution for such a …

Bayesian Nonparametric Analysis Of Longitudinal Data With Non-Ignorable Non-Monotone Missingness, Yu Cao

Theses and Dissertations

In longitudinal studies, outcomes are measured repeatedly over time, but in reality clinical studies are full of missing data points of monotone and non-monotone nature. Often this missingness is related to the unobserved data so that it is non-ignorable. In such context, pattern-mixture model (PMM) is one popular tool to analyze the joint distribution of outcome and missingness patterns. Then the unobserved outcomes are imputed using the distribution of observed outcomes, conditioned on missing patterns. However, the existing methods suffer from model identification issues if data is sparse in specific missing patterns, which is very likely to happen with a …

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …