Biostatistics Commons^™

Methods For Dealing With Death And Missing Data, And For Standardizing Different Health Variables In Longitudinal Datasets: The Cardiovascular Health Study, Paula Diehr

UW Biostatistics Working Paper Series

Longitudinal studies of older adults usually need to account for deaths and missing data. The study databases often include multiple health-related variables, whose trends over time are hard to compare because they were measured on different scales. Here we present a unified approach to these three problems that was developed and used in the Cardiovascular Health Study. Data were first transformed to a new scale that had integer/ratio properties, and on which “dead” logically takes the value zero. Missing data were then imputed on this new scale, using each person’s own data over time. Imputation could thus be informed by …

Power And Sample Size Calculations For Interval-Censored Survival Analysis, Hae-Young Kim, John M. Williamson, Hung-Mo Lin

NYMC Faculty Publications

We propose a method for calculating power and sample size for studies involving interval-censored failure time data that only involves standard software required for fitting the appropriate parametric survival model. We use the framework of a longitudinal study where patients are assessed periodically for a response and the only resultant information available to the investigators is the failure window: the time between the last negative and first positive test results. The survival model is fit to an expanded data set using easily computed weights. We illustrate with a Weibull survival model and a two-group comparison. The investigator can specify a …

Data-Adaptive Inference Of The Optimal Treatment Rule And Its Mean Reward. The Masked Bandit, Antoine Chambaz, Wenjing Zheng, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

This article studies the data-adaptive inference of an optimal treatment rule. A treatment rule is an individualized treatment strategy in which treatment assignment for a patient is based on her measured baseline covariates. Eventually, a reward is measured on the patient. We also infer the mean reward under the optimal treatment rule. We do so in the so called non-exceptional case, i.e., assuming that there is no stratum of the baseline covariates where treatment is neither beneficial nor harmful, and under a companion margin assumption.

Our pivotal estimator, whose definition hinges on the targeted minimum loss estimation (TMLE) principle, actually …

A Weighted Instrumental Variable Estimator To Control For Instrument-Outcome Confounders, Douglas Lehmann, Yun Li, Rajiv Saran, Yi Li

The University of Michigan Department of Biostatistics Working Paper Series

No abstract provided.

Recommendation To Use Exact P-Values In Biomarker Discovery Research, Margaret Sullivan Pepe, Matthew F. Buas, Christopher I. Li, Garnet L. Anderson

UW Biostatistics Working Paper Series

Background: In biomarker discovery studies, markers are ranked for validation using P-values. Standard P-value calculations use normal approximations that may not be valid for small P-values and small sample sizes common in discovery research.

Methods: We compared exact P-values, valid by definition, with normal and logit-normal approximations in a simulated study of 40 cases and 160 controls. The key measure of biomarker performance was sensitivity at 90% specificity. Data for 3000 uninformative markers and 30 true markers were generated randomly, with 10 replications of the simulation. We also analyzed real data on 2371 antibody array markers …

Is Metabolism Goal-Directed? Investigating The Validity Of Modeling Biological Systems With Cybernetic Control Via Omic Data, Frank T. Devilbiss

Open Access Dissertations

Cybernetic models are uniquely juxtaposed to other metabolic modeling frameworks in that they describe the time-dependent regulation of cellular reactions in terms of dynamic "metabolic goals." This approach contrasts starkly with purely mechanistic descriptions of metabolic regulation which seek to explain metabolic processes in high resolution — a clearly daunting undertaking. Over a span of three decades, cybernetic models have been used to predict metabolic phenomena ranging from resource consumption in mixed-substrate environments to intracellular reaction fluxes of intricate metabolic networks. While the cybernetic approach has been validated in its utility for the prediction of metabolic phenomena, its central feature, …

Uncovering Local Trends In Genetic Effects Of Multiple Phenotypes Via Functional Linear Models, Olga A. Vsevolozhskaya, Dmitri V. Zaykin, David A. Barondess, Xiaoren Tong, Sneha Jadhav, Qing Lu

Biostatistics Faculty Publications

Recent technological advances equipped researchers with capabilities that go beyond traditional genotyping of loci known to be polymorphic in a general population. Genetic sequences of study participants can now be assessed directly. This capability removed technology-driven bias toward scoring predominantly common polymorphisms and let researchers reveal a wealth of rare and sample-specific variants. Although the relative contributions of rare and common polymorphisms to trait variation are being debated, researchers are faced with the need for new statistical tools for simultaneous evaluation of all variants within a region. Several research groups demonstrated flexibility and good statistical power of the functional linear …

One-Step Targeted Minimum Loss-Based Estimation Based On Universal Least Favorable One-Dimensional Submodels, Mark J. Van Der Laan, Susan Gruber

U.C. Berkeley Division of Biostatistics Working Paper Series

Consider a study in which one observes n independent and identically distributed random variables whose probability distribution is known to be an element of a particular statistical model, and one is concerned with estimation of a particular real valued pathwise differentiable target parameter of this data probability distribution. The targeted maximum likelihood estimator (TMLE) is an asymptotically efficient substitution estimator obtained by constructing a so called least favorable parametric submodel through an initial estimator with score, at zero fluctuation of the initial estimator, that spans the efficient influence curve, and iteratively maximizing the corresponding parametric likelihood till no more updates …

Modeling And Survival Analysis Of Breast Cancer: A Statistical, Artificial Neural Network, And Decision Tree Approach, Venkateswara Rao Mudunuru

USF Tampa Graduate Theses and Dissertations

Survival analysis today is widely implemented in the fields of medical and biological sciences, social sciences, econometrics, and engineering. The basic principle behind the survival analysis implies to a statistical approach designed to take into account the amount of time utilized for a study period, or the study of time between entry into observation and a subsequent event. The event of interest pertains to death and the analysis consists of following the subject until death. Events or outcomes are defined by a transition from one discrete state to another at an instantaneous moment in time. In the recent years, research …

Maximum Likelihood Based Analysis Of Equally Spaced Longitudinal Count Data With Specified Marginal Means, First-Order Antedependence, And Linear Conditional Expectations, Victoria Gamerman, Matthew Guerra, Justine Shults

UPenn Biostatistics Working Papers

This manuscript implements a maximum likelihood based approach that is appropriate for equally spaced longitudinal count data with over-dispersion, so that the variance of the outcome variable is larger than expected for the assumed Poisson distribution. We implement the proposed method in the analysis of two data sets and make comparisons with the semi-parametric generalized estimating equations (GEE) approach that incorrectly ignores the over-dispersion. The simulations demonstrate that the proposed method has better small sample efficiency than GEE. We also provide code in R that can be used to recreate the analysis results that we provide in this manuscript.

Marginal Structural Models With Counterfactual Effect Modifiers, Wenjing Zheng, Zhehui Luo, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

In health and social sciences, research questions often involve systematic assessment of the modification of treatment causal effect by patient characteristics, in longitudinal settings with time-varying or post-intervention effect modifiers of interest. In this work, we investigate the robust and efficient estimation of the so-called Counterfactual-History-Adjusted Marginal Structural Model (van der Laan and Petersen (2007)), which models the conditional intervention-specific mean outcome given modifier history in an ideal experiment where, possible contrary to fact, the subject was assigned the intervention of interest, including the treatment sequence in the conditioning history. We establish the semiparametric efficiency theory for these models, and …

Conditional Screening For Ultra-High Dimensional Covariates With Survival Outcomes, Hyokyoung Grace Hong, Jian Kang, Yi Li

The University of Michigan Department of Biostatistics Working Paper Series

Identifying important biomarkers that are predictive for cancer patients' prognosis is key in gaining better insights into the biological influences on the disease and has become a critical component of precision medicine. The emergence of large-scale biomedical survival studies, which typically involve excessive number of biomarkers, has brought high demand in designing efficient screening tools for selecting predictive biomarkers. The vast amount of biomarkers defies any existing variable selection methods via regularization. The recently developed variable screening methods, though powerful in many practical setting, fail to incorporate prior information on the importance of each biomarker and are less powerful in …

Correlation Of Maximal Inspiratory Pressure To Transdiaphragmatic Twitch Pressure In Intensive Care Unit Patients, Gerald S. Supinski, Philip M. Westgate, Leigh Ann Callahan

Internal Medicine Faculty Publications

Background: Respiratory muscle weakness contributes to respiratory failure in ICU patients. Unfortunately, assessment of weakness is difficult since the most objective test, transdiaphragmatic pressure in response to phrenic nerve stimulation (PdiTw), is difficult to perform. While most clinicians utilize maximum inspiratory pressure (Pimax) to assess strength, the relationship of this index to PdiTw has not been evaluated in a large ICU population. The purpose of the present study was to assess both PdiTw and Pimax in ICU patients to determine how these indices correlate with each other, what factors influence these indices, and how well these indices predict outcomes.

Methods: …

On The Dynamics Of Boolean Gene Regulatory Networks With Stochasticity, Yuezhe Li

Theses and Dissertations

Genes are responsible for producing proteins that are essential to the construction of complex biological systems. The mechanisms by which this production is regulated have long been the center of wide spread research efforts. Deterministic Boolean gene regulatory models have been a particularly effective avenue of research in this field. However these models fall short of accounting for variations in the gene functionality due to the uncertain internal or external environmental conditions. One of the recent attempts to overcome this weakness is by (Murrugarra, 2012), in which a probabilistic component is introduced as the fixed activation/degradation propensities at the cellular …

Simulating Longer Vectors Of Correlated Binary Random Variables Via Multinomial Sampling, Justine Shults

UPenn Biostatistics Working Papers

The ability to simulate correlated binary data is important for sample size calculation and comparison of methods for analysis of clustered and longitudinal data with dichotomous outcomes. One available approach for simulating length n vectors of dichotomous random variables is to sample from the multinomial distribution of all possible length n permutations of zeros and ones. However, the multinomial sampling method has only been implemented in general form (without first making restrictive assumptions) for vectors of length 2 and 3, because specifying the multinomial distribution is very challenging for longer vectors. I overcome this difficulty by presenting an algorithm for …

Strengthening Instrumental Variables Through Weighting, Douglas Lehmann, Yun Li, Rajiv Saran, Yi Li

The University of Michigan Department of Biostatistics Working Paper Series

Instrumental variable (IV) methods are widely used to deal with the issue of unmeasured confounding and are becoming popular in health and medical research. IV models are able to obtain consistent estimates in the presence of unmeasured confounding, but rely on assumptions that are hard to verify and often criticized. An instrument is a variable that influences or encourages individuals toward a particular treatment without directly affecting the outcome. Estimates obtained using instruments with a weak influence over the treatment are known to have larger small-sample bias and to be less robust to the critical IV assumption that the instrument …

Motorcycle Helmet Effectiveness In Reducing Head, Face And Brain Injuries By State And Helmet Law, Cody S. Olsen, Andrea M. Thomas, Michael Singleton, Anna M. Gaichas, Tracy J. Smith, Gary A. Smith, Justin Peng, Michael J. Bauer, Ming Qu, Denise Yeager, Timothy Kerns, Cynthia Burch, Lawrence J. Cook

Biostatistics Faculty Publications

Background: Despite evidence that motorcycle helmets reduce morbidity and mortality, helmet laws and rates of helmet use vary by state in the U.S.

Methods: We pooled data from eleven states: five with universal laws requiring all motorcyclists to wear a helmet, and six with partial laws requiring only a subset of motorcyclists to wear a helmet. Data were combined in the Crash Outcome Data Evaluation System's General Use Model and included motorcycle crash records probabilistically linked to emergency department and inpatient discharges for years 2005-2008. Medical outcomes were compared between partial and universal helmet law settings. We estimated adjusted relative …

Evaluating The Impact Of A Hiv Low-Risk Express Care Task-Shifting Program: A Case Study Of The Targeted Learning Roadmap, Linh Tran, Constantin T. Yiannoutsos, Beverly S. Musick, Kara K. Wools-Kaloustian, Abraham Siika, Sylvester Kimaiyo, Mark J. Van Der Laan, Maya L. Petersen

U.C. Berkeley Division of Biostatistics Working Paper Series

In conducting studies on an exposure of interest, a systematic roadmap should be applied for translating causal questions into statistical analyses and interpreting the results. In this paper we describe an application of one such roadmap applied to estimating the joint effect of both time to availability of a nurse-based triage system (low risk express care (LREC)) and individual enrollment in the program among HIV patients in East Africa. Our study population is comprised of 16;513 subjects found eligible for this task-shifting program within 15 clinics in Kenya between 2006 and 2009, with each clinic starting the LREC program between …

Progression Of Electrocardiographic Abnormalities In Type 1 Diabetes During 16 Years Of Follow‐Up: The Epidemiology Of Diabetes Interventions And Complications (Edic) Study, Elsayed Soliman, Jye-Yu Backlund, Ionut Bebu, Yabing Li, Zhu-Ming Zhang, Patricia A. Cleary, John M. Lachin

GW Biostatistics Center

Background The electrocardiogram (ECG) is an objective tool for cardiovascular disease (CVD) risk assessment.

Methods and Results We evaluated distribution of ECG abnormalities and risk factors for developing new abnormalities in 1314 patients with type 1 diabetes (T1D) from the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Annual ECGs were centrally read. ECG abnormalities were classified as major and minor according to the Minnesota ECG Classification. At EDIC year 1 (baseline), 356 (27.1%) of the participants had at least 1 ECG abnormality (major or minor) whereas 26 (2%) had at least one major abnormality. During 16 years of follow‐up, …

Knowledge And Behavior Change Of People Living With Hiv Through Nutrition Education And Counseling, Fitri Hudayani, Ratu Ayu Dewi Sartika

Kesmas

HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan …