Vital and Health Statistics Commons^™

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3 ...

Improving The Quality And Design Of Retrospective Clinical Outcome Studies That Utilize Electronic Health Records, Oliwier Dziadkowiec, Jeffery Durbin, Vignesh Jayaraman Muralidharan, Megan Novak, Brendon Cornett

HCA Healthcare Journal of Medicine

Electronic health records (EHRs) are an excellent source for secondary data analysis. Studies based on EHR-derived data, if designed properly, can answer previously unanswerable clinical research questions. In this paper we will highlight the benefits of large retrospective studies from secondary sources such as EHRs, examine retrospective cohort and case-control study design challenges, as well as methodological and statistical adjustment that can be made to overcome some of the inherent design limitations, in order to increase the generalizability, validity and reliability of the results obtained from these studies.

Pattern Of Health Behavior And Its Association With Self-Rated Health: Evidence From The 2018 Behavioral Risk Factor Surveillance System In The United States, Linh Nguyen, Mamunur Rashid, M. Mazharul Islam

Student Research

Aim: To improve public health services, we need to keep policymakers updated with health-related issues. This study (1) examines the recent pattern of physical activities, smoking, alcohol consumption, and SRH, and (2) investigates the association between the behaviors and SRH status among US citizens.

Method: We extracted data from the latest state-based survey of the 2018 Behavioral Risk Factor Surveillance System (BRFSS), which provides a nationally representative sample of 437,436 American adults. We analyzed the data, mainly employing chi-square tests and logistic regression models.

Results: Physical inactivity and smoking are more common among participants with lower education and household ...

Life And Death: Quantifying The Risk Of Heart Disease With Machine Learning, Jack Scott Glienke

Honors Program Theses

Coronary heart disease has long been a key area of focus in the discussion of public health. As such, numerous studies have been conducted throughout history with the sole intention of identifying risk factors leading to the onset of cardiovascular conditions. A plethora of statistical procedures can be used to identify an individual’s risk of developing heart disease, yet regression models tend to be the default tool used by researchers. Using the data obtained from the most influential cardiovascular study to date, the Framingham Heart Study, this analysis uses machine learning techniques to generate and test the predictive power ...

Personal Foul: How Head Trauma And The Insurance Industry Are Threatening Sports, Zachary Cooler

Senior Honors Theses

This thesis will investigate the growing problem of head trauma in contact sports like football, hockey, and soccer through medical studies, implications to the insurance industry, and ongoing litigation. The thesis will investigate medical studies that are finding more evidence to support the claim that contact sports players are more likely to receive head trauma symptoms such as memory loss, mood swings, and even Lou Gehrig’s disease in extreme cases. The thesis will also demonstrate that these medical symptoms and monetary losses from medical claims are convincing insurance companies to withdraw insurance coverage for sports leagues, which they are ...

Bayesian Methods For The Assessment Of Reporting Errors For Data-Sparse Population-Periods With Applications To Estimating Mortality, Emily Peterson

Doctoral Dissertations

Population level mortality data is often subject to substantial reporting errors due to misclassification of cause of death, misclassification of death status, or age reporting errors. Accuracy of error-prone data sources can be assessed by comparing such data to gold standard data for the same population-period. We present Bayesian methods for assessing the extent of reporting errors across different population-periods and generalizing those to settings where gold-standard data are lacking. Firstly, we investigate misclassification errors of maternal cause of death reporting in civil registration vital statistics data. We use a Bayesian hierarchical bivariate random-walk model to estimate country-year specific sensitivity ...

The Experiences Of Ncaa Student-Athletes With An Eating Disorder Or Disordered Eating, Rachel E. Taylor

Electronic Theses and Dissertations

The purpose of this study was to explore the experiences of student-athletes who had an eating disorder or disordered eating (ED/DE) while competing for the National Collegiate Athletic Association (NCAA). Integrating criticism and connoisseurship and critical evocative portraiture, four post-collegiate women who participated in cross country and track, who were either clinically diagnosed with an ED/DE or who self-diagnosed, participated in two interviews to describe their experiences with and the impact of ED/DE on their athletic pursuits, academic pursuits, as well as their relationships with coaches, teammates, and family. The analysis of these interviews showed the complexity ...

Measuring Change: Prediction Of Early Onset Sepsis, Aric Schadler

Theses and Dissertations--Statistics

Sepsis occurs in a patient when an infection enters into the blood stream and spreads throughout the body causing a cascading response from the immune system. Sepsis is one of the leading causes of morbidity and mortality in today’s hospitals. This is despite published and accepted guidelines for timely and appropriate interventions for septic patients. The largest barrier to applying these interventions is the early identification of septic patients. Early identification and treatment leads to better outcomes, shorter lengths of stay, and financial savings for healthcare institutions. In order to increase the lead time in recognizing patients trending towards ...

A Mathematical Model For Malaria With Age-Heterogeneous Biting Rate, Sho Kawakami

All Graduate Theses, Dissertations, and Other Capstone Projects

We propose a mathematical model for malaria with age-heterogeneous biting rate from mosquitos. The existence of the model, the local behavior of the disease free equilibrium are explored. Furthermore the model is extended to an optimal control problem and the corresponding adjoint equations and optimality conditions are derived. Age dependent parameter values are estimated and numerical simulations are carried out for the model. The new model better accounts for difference in biting rates of mosquitos to different age groups, and improvements in stability to the explicit algorithm. The optimal control is also shown to depend on the age distribution of ...

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled ...

Detecting Differentially Co-Expressed Gene Modules Via The Edge-Count Test, Anne Gratius Lin

Theses and Dissertations

Background

Gene expression profiling by microarray has been used to uncover molecular variations in many different diseases. Complementary to conventional differential expression analysis, differential co-expression analysis can identify gene markers from the systematic and granular level. There are three aspects for differential co-expression network analysis, including the network global topological comparison, differential co-expression cluster identification, and differential co-expressed genes and gene pair identification. To date, most of the methods available still rely on Pearson’s correlation coefficient despite its nonlinear insensitivity.

Results

Here we present an approach that is robust to nonlinearity by using the edge-count test for differential co-expression ...

Identifying Risk Factors Related To Premature Birth Through Binary Logistic And Proportional Odds Ordinal Logistic Regression, Clayton Elwood

Electronic Theses and Dissertations

Premature birth has been identified as the single greatest cause of death worldwide in children under the age of five. This thesis will implement binary logistic regression and proportional odds ordinal logistic regression to predict different levels of premature birth and identify associated risk factors. The models will be built from the Center for Disease Control and Prevention's 2014 Vital Statistics Natality Birth Data containing nearly 4 million live births within the United States. Odds ratios and confidence intervals on risk factors were produced utilizing binary logistic regression.

Sickle Cell Disease Complications: Prevalence And Resource Utilization, Nirmish Shah, Menaka Bhor, Lin Xi, Jincy Paulose, Huseyin Yuce

Publications and Research

Objectives: This study evaluated the prevalence rate of vaso-occlusive crisis (VOC) episodes, rates of uncomplicated and complicated VOC episodes, and the primary reasons for emergency room (ER) visits and inpatient admissions for sickle cell disease (SCD) patients.

Methods: The Medicaid Analytic extracts database was used to identify adult SCD patients using claims from 01JUL2009-31DEC2012. The date of the first observed SCD claim was designated as the index date. Patients were required to have continuous medical and pharmacy benefits for .6 months baseline and .12 months follow-up period. Patient demographics, baseline clinical characteristics, the rate of uncomplicated and complicated VOC (VOC ...

Comparative Clinical Outcomes Between Direct Oral Anticoagulants And Warfarin Among Elderly Patients With Non-Valvular Atrial Fibrillation In The Cms Medicare Population, Alpesh Amin, Oluwaseyi Dina, Allison Keshishian, Amol Dhamane, Anagha Nadkarni, Eric Carda, Cristina Russ, Lisa Rosenblatt, Jack Mardekian, Huseyin Yuce, Christine L. Baker

Publications and Research

Atrial fibrillation (AF) prevalence increases with age; > 80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs) vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfarin cohorts. Cox proportional hazards models estimated the risk of stroke/SE, MB, NCO, and MACE. 37 ...

Statistical Modeling Of Influenza-Like-Illness In Montana Using Spatial And Temporal Methods, Benjamin A. Stark

Graduate Student Theses, Dissertations, & Professional Papers

Studying air pollution and public health has been a historically important question in science. It has long been hypothesized that severe air pollution conditions lead to negative implications in basic human health. Primarily, areas thats are prone to severe degrees of human pollution are the focus of such studies. Such research relating to less populated areas are scarce, and this scarcity raises the question of how such pollution dynamics (human-made and natural) influence human health in more rural areas.

The aim of this study is to explore this hole in research; in particular we explore possible links between air pollution ...

Real-Time Dengue Forecasting In Thailand: A Comparison Of Penalized Regression Approaches Using Internet Search Data, Caroline Kusiak

Masters Theses

Dengue fever affects over 390 million people annually worldwide and is of particu- lar concern in Southeast Asia where it is one of the leading causes of hospitalization. Modeling trends in dengue occurrence can provide valuable information to Public Health officials, however many challenges arise depending on the data available. In Thailand, reporting of dengue cases is often delayed by more than 6 weeks, and a small fraction of cases may not be reported until over 11 months after they occurred. This study shows that incorporating data on Google Search trends can improve dis- ease predictions in settings with severely ...

The Relationship Between Stryd Power And Running Economy In Well-Trained Distance Runners, Casey Austin

Master's Theses

A novel running wearable called the Stryd Summit footpod attaches to a runner’s right or left shoe and measures running power output. The developers of the product purport that the footpod’s power and form power measures may correlate with metabolic data gathered in a lab. PURPOSE: Explore the relationship between power output and running economy at threshold pace. METHODS: Seventeen well-trained distance runners, 9 males and 8 females, completed a running protocol at threshold pace. Participants ran two discontinuous four-minute stages: one with their self-selected cadence (SS), and one with cadence lowered by 10% (LC). Metabolic data, power ...

The Test-Retest Reliability Of Erp Components As Assessed By The Brief Neurometric Battery, James D. Cole, Paul Kieffaber

Undergraduate Honors Theses

Electroencephalography (EEG) has been a crucial component of neuropsychological research for nearly a century. Recent applications of the EEG recordings in a clinical setting have demonstrated a range of diagnostic and prognostic uses. Certain changes in event-related potentials (ERP) have been linked to the effects of different neurological conditions and can be accurately used to determine the severity of those conditions. However, in order to assess the stability of these ERP recordings over an extended period of time, one must first establish their statistical test-retest reliability. Using a novel Brief Neurometric Battery we assessed seven different ERP components in twenty ...

Analysis Of Episodes Of Care In Medicare Beneficiaries Newly Diagnosed With Alzheimer’S Disease, Rezaul K. Khandker, Christopher Black, Lin Xie, M. Furaha Kariburyo, Baishali M. Ambegaonkar, Onur Baser, Huseyin Yuce, Howard Fillit

Publications and Research

OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer’s disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD.

DESIGN: A retrospective observational cohort study.

SETTING: United States.

PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331.0) were identified from the Medicare database between January 1, 2011, and June 30, 2014. This ...

Burden Of Rheumatoid Arthritis Among Us Medicare Population: Co-Morbidities, Health-Care Resource Utilization And Costs, Chieh-I Chen, Li Wang, Wenhui Wei, Huseyin Yuce, Kristine Phillips

Publications and Research

Objectives. The study aimed to assess the burden of RA among the US Medicare population (aged 65 years) by comparing co-morbidities, health-care resource utilization (HCRU) and costs against matched non-RA Medicare patients.

Methods. Data were obtained from the Medicare fee-for-service claims database from 2010 to 2013. RA Medicare patients were identically matched with Medicare patients without RA (controls) based on demographics. Bivariate analyses were conducted to examine differences between cohorts for comorbidities, HCRU and costs. A generalized linear model was used to test relationships between patient-level characteristics, HCRU and costs.

Results. The study population included 115 867 RA patients and ...