Introduction: In various practical applications, neighbouring small area data have spatial correlation. More recently, an extension of the Fay–Herriot model through the spatial (exponential) has been considered. This spatial area-level model like the fundamental area-level model (was first suggested by Fay III and Herriot) has a powerful assumption of known sampling variance. Several methods have been suggested for smoothing of sampling variance and there is no unique method for sampling variance estimation, more studies need. Methods: This research examines four techniques for sampling variance estimates including of Direct, Probability Distribution, Bayes and Bootstrap methods. We used households’ food expenditures (HFE) data 2013 and other socio-economic ancillary data to fit the read model and at last conduct a simulation study based on this data to compare the effects of four variance estimation methods on precision of small area estimates. Results: The best model on real data showed that the lowest and the highest HFE belonged to Pishva district (in Tehran province) with 26,707 thousand rials (TRs) and Omidiyeh (in Khouzestan province) with 101,961 TRs, respectively. Accordingly on simulation study, the probability distribution and direct methods, respectively and approximately had the smallest and the highest Root Average Mean Square Errors (RAMSE) for all conditions. Conclusion: The results showed the best fitting with direct method in real data and best precision with Probability Distribution method in simulation study.
{"title":"Sampling Variance Estimation Method and Precision of Small Area Estimation in the Exponential Spatial Structure","authors":"Y. Mehrabi, A. Kavousi, M. Soltani-Kermanshahi","doi":"10.18502/jbe.v8i3.12287","DOIUrl":"https://doi.org/10.18502/jbe.v8i3.12287","url":null,"abstract":"Introduction: In various practical applications, neighbouring small area data have spatial correlation. More recently, an extension of the Fay–Herriot model through the spatial (exponential) has been considered. This spatial area-level model like the fundamental area-level model (was first suggested by Fay III and Herriot) has a powerful assumption of known sampling variance. Several methods have been suggested for smoothing of sampling variance and there is no unique method for sampling variance estimation, more studies need. \u0000Methods: This research examines four techniques for sampling variance estimates including of Direct, Probability Distribution, Bayes and Bootstrap methods. We used households’ food expenditures (HFE) data 2013 and other socio-economic ancillary data to fit the read model and at last conduct a simulation study based on this data to compare the effects of four variance estimation methods on precision of small area estimates. \u0000Results: The best model on real data showed that the lowest and the highest HFE belonged to Pishva district (in Tehran province) with 26,707 thousand rials (TRs) and Omidiyeh (in Khouzestan province) with 101,961 TRs, respectively. Accordingly on simulation study, the probability distribution and direct methods, respectively and approximately had the smallest and the highest Root Average Mean Square Errors (RAMSE) for all conditions. \u0000Conclusion: The results showed the best fitting with direct method in real data and best precision with Probability Distribution method in simulation study.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43494748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Indu Kebede Gebre, Shimels Kebede Gebre, Melkamu A Zeru
Introduction: Birth weight and gestational age are important determinants of an infant’s survival and future development. Low birth weight can be caused by preterm birth or by small gestational age. The main objective of this research was to identify the determinants of birth weight and gestational age simultaneously based on Ethiopia's demographic health survey in 2016 which implemented in a statistical package R. Methods: Cross-sectional study design was used from Ethiopia's demographic health survey in 2016. The bi-variate linear regression model was used to identify factors of birth weight and gestational age simultaneously which had small standard errors as compared to a separate model. Results: Bi-variate models of birth weight and gestational age determined the effect of predictors. Therefore, the model shows that the number of tetanus injections before pregnancy, educational level of a husband, desire for more children, drink alcohol, and region are statistically significant at 5% level of significance for gestational age in Ethiopia. Similarly, the size or height of a child at birth, preferred waiting time to another birth or birth interval, the number of tetanus injections before pregnancy was statistically associated with birth weight at 5% level of significance Conclusion: From our finding, we concluded that the number of tetanus injections before pregnancy, educational level of a husband, desire for more children, alcohol drink, size or height of a child at birth, preferred waiting time or birth interval for another birth and region were significant predictors of birth weight and gestational age simultaneously at 5% level of significance. Hence, special care should be given to the pregnant during prenatal care for minimizing the risk of low birth weight and small gestational age.
{"title":"Application of Bivariate Multiple Linear Regression on Weight of Children at Birth and Duration of Pregnancy in Ethiopia","authors":"Indu Kebede Gebre, Shimels Kebede Gebre, Melkamu A Zeru","doi":"10.18502/jbe.v8i3.12280","DOIUrl":"https://doi.org/10.18502/jbe.v8i3.12280","url":null,"abstract":"Introduction: Birth weight and gestational age are important determinants of an infant’s survival and future development. Low birth weight can be caused by preterm birth or by small gestational age. The main objective of this research was to identify the determinants of birth weight and gestational age simultaneously based on Ethiopia's demographic health survey in 2016 which implemented in a statistical package R. \u0000Methods: Cross-sectional study design was used from Ethiopia's demographic health survey in 2016. The bi-variate linear regression model was used to identify factors of birth weight and gestational age simultaneously which had small standard errors as compared to a separate model. \u0000Results: Bi-variate models of birth weight and gestational age determined the effect of predictors. Therefore, the model shows that the number of tetanus injections before pregnancy, educational level of a husband, desire for more children, drink alcohol, and region are statistically significant at 5% level of significance for gestational age in Ethiopia. Similarly, the size or height of a child at birth, preferred waiting time to another birth or birth interval, the number of tetanus injections before pregnancy was statistically associated with birth weight at 5% level of significance \u0000Conclusion: From our finding, we concluded that the number of tetanus injections before pregnancy, educational level of a husband, desire for more children, alcohol drink, size or height of a child at birth, preferred waiting time or birth interval for another birth and region were significant predictors of birth weight and gestational age simultaneously at 5% level of significance. Hence, special care should be given to the pregnant during prenatal care for minimizing the risk of low birth weight and small gestational age.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46581364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Solmaz Norouzi, M. Asghari jafarabadi, S. Shamshirgaran, Farshid Farzipoor, R. Fallah
Introduction: In the presence of competing risks, patients with brain stroke (BS) experience death by various causes, such as diabetes, and heart disease, and other causes in the follow-up. This study aimed to model the survival in patients with BS in the presence of these competing risk of death using cumulative incidence function (CIF) and cause-specific hazard (CSH) models. Methods: In the study, 332 patients with the definitive diagnosis of BS were followed up for 10 years, and their mortality status due to BS or other causes was evaluated. In addition, significance tests and parameters were estimated by using STATA 14 software by considering the CIF and CSH model. Results: The median follow-up time was 20.68 months for patients who died due to BS and 68.50 months for patients who died due to other causes. In the CIF model, Sex [BS: cumulative incidence hazard ratio (SHR) = 2.35, 90% confidence interval (CI) = (1.76-3.14)], Employment status [BS: 2.04(1.50-2.75)], History of blood pressure[BS: 1.64(1.25-2.14)], Heart disease[BS: 1.47(1.13-1.94)], Cerebrovascular accident type[BS: 0.77(0.69-0.87)]; age [Other case: 59-68 years, 2.61 (1.13-6.06) and ≥76 years: 3.03 (1.32-6.92)] were directly related to hazard of death. The CSH model resulted in similar estimates except for age [BS: 69-75 years; 1.31(1.18-1.45), ≥76 years; 1.37(1.23-1.53); other case: age 59-68 years 1.91 (1.22-2.99) and 69-75 years; 1.89 (1.21-2.96) and ≥76 years: 2.14 (1.36-3.37)], Sex[BS: 1.38(1.07-1.79)], History of blood pressure [BS: 1.57(1.20-2.05)], Heart disease [BS:1.44(1.09-1.91)] were directly related to hazard of death. Conclusion: The estimation of CIF analysis, along with CSH one for the competing risks, is suggested to provide more precise information about patients’ status in order to support adopted clinical decisions when aiming at assessing health related to a specific cause economically and determining the probability of occurring an intended event among other causes.
{"title":"Competing Risks and Analysis of Patients with Brain Stroke: Cumulative Incidence Function and Cause-Specific Hazard Approach","authors":"Solmaz Norouzi, M. Asghari jafarabadi, S. Shamshirgaran, Farshid Farzipoor, R. Fallah","doi":"10.18502/jbe.v8i3.12286","DOIUrl":"https://doi.org/10.18502/jbe.v8i3.12286","url":null,"abstract":"Introduction: In the presence of competing risks, patients with brain stroke (BS) experience death by various causes, such as diabetes, and heart disease, and other causes in the follow-up. This study aimed to model the survival in patients with BS in the presence of these competing risk of death using cumulative incidence function (CIF) and cause-specific hazard (CSH) models. \u0000Methods: In the study, 332 patients with the definitive diagnosis of BS were followed up for 10 years, and their mortality status due to BS or other causes was evaluated. In addition, significance tests and parameters were estimated by using STATA 14 software by considering the CIF and CSH model. \u0000Results: The median follow-up time was 20.68 months for patients who died due to BS and 68.50 months for patients who died due to other causes. In the CIF model, Sex [BS: cumulative incidence hazard ratio (SHR) = 2.35, 90% confidence interval (CI) = (1.76-3.14)], Employment status [BS: 2.04(1.50-2.75)], History of blood pressure[BS: 1.64(1.25-2.14)], Heart disease[BS: 1.47(1.13-1.94)], Cerebrovascular accident type[BS: 0.77(0.69-0.87)]; age [Other case: 59-68 years, 2.61 (1.13-6.06) and ≥76 years: 3.03 (1.32-6.92)] were directly related to hazard of death. The CSH model resulted in similar estimates except for age [BS: 69-75 years; 1.31(1.18-1.45), ≥76 years; 1.37(1.23-1.53); other case: age 59-68 years 1.91 (1.22-2.99) and 69-75 years; 1.89 (1.21-2.96) and ≥76 years: 2.14 (1.36-3.37)], Sex[BS: 1.38(1.07-1.79)], History of blood pressure [BS: 1.57(1.20-2.05)], Heart disease [BS:1.44(1.09-1.91)] were directly related to hazard of death. \u0000Conclusion: The estimation of CIF analysis, along with CSH one for the competing risks, is suggested to provide more precise information about patients’ status in order to support adopted clinical decisions when aiming at assessing health related to a specific cause economically and determining the probability of occurring an intended event among other causes.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49253349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Receiver Operating Characteristic (ROC) curve is one of the widely used supervised classification technique to allocate/classify the individuals and also instrumental in comparing diagnostic tests. Generally, to deal with classification problems we need to have knowledge on class labels. In most of the medical scenarios, most of data sets exhibit multi-model patterns in class labels which leads to multi-class classification problems. The main aim of this study is to address on the issue of constructing ROC models when there exists multimodel patterns in the class labels further, to classify the individuals for better diagnosis and also to reduce the complexity of graphical representation of ROC curves in such classification problems. Methods: A new version of univariate and multivariate ROC models are proposed in the framework of Finite Mixtures, due to the flexibility of identifying and modelling the subcomponents in the heterogeneous populations. Results: Oral Glucose Tolerance Test and Disk Hernia datasets are used and simulation studies are also performed. Results show that the proposed models possess better accuracy when compared with Bi-Normal and MROC models with reasonable low 1-Specificity and higher Sensitivity. The ROC curves are depicted in a 2D space rather than higher dimension for multi-class classification problem. Conclusion: It is suggested that before one proceeds to model ROC curves, it is better to take a look at the density patterns of the study variable(s), which in turn help in explaining the true information between the classes and also provides good amount of “true” accuracy.
{"title":"Multi-Class Classification using Mixtures of Univariate and Multivariate ROC Curves","authors":"Siva Gajjalavari, V. Rudravaram","doi":"10.18502/jbe.v8i2.10418","DOIUrl":"https://doi.org/10.18502/jbe.v8i2.10418","url":null,"abstract":"Introduction: Receiver Operating Characteristic (ROC) curve is one of the widely used supervised classification technique to allocate/classify the individuals and also instrumental in comparing diagnostic tests. Generally, to deal with classification problems we need to have knowledge on class labels. In most of the medical scenarios, most of data sets exhibit multi-model patterns in class labels which leads to multi-class classification problems. The main aim of this study is to address on the issue of constructing ROC models when there exists multimodel patterns in the class labels further, to classify the individuals for better diagnosis and also to reduce the complexity of graphical representation of ROC curves in such classification problems. \u0000Methods: A new version of univariate and multivariate ROC models are proposed in the framework of Finite Mixtures, due to the flexibility of identifying and modelling the subcomponents in the heterogeneous populations. \u0000Results: Oral Glucose Tolerance Test and Disk Hernia datasets are used and simulation studies are also performed. Results show that the proposed models possess better accuracy when compared with Bi-Normal and MROC models with reasonable low 1-Specificity and higher Sensitivity. The ROC curves are depicted in a 2D space rather than higher dimension for multi-class classification problem. \u0000Conclusion: It is suggested that before one proceeds to model ROC curves, it is better to take a look at the density patterns of the study variable(s), which in turn help in explaining the true information between the classes and also provides good amount of “true” accuracy.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48761291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dinka Fikadu Gamtesa, H. Tola, Gadissa Gutema, Biniyam Dagne, Bira Bejiga Bedassa
Introduction: Level of knowledge, Attitude and Practice (KAP) of the community towards corona virus disease 2019 (COVID-19) is important to prevent and control the disease . In Ethiopia there are some studies that assess the KAP’s of different segments of the community and reported different results. However, there is limited review evidence that pooled the proportion of KAP of the community to wards COVID-19 prevention and control of the disease in Ethiopia. The aim of this systematic review and meta-analysis was to summarize and pool the proportion of KAP towards COVID-19 prevention and control in general community. Methods: A systematic review and meta-analysis study was conducted to estimate the pooled proportion of Knowledge, Attitude and Practice towards COVID-19 prevention and control in general community. Electronic databases such as PubMed, Google Scholar and Science Direct were searched for studies reported in English language without restricting publication year. The search strategy was used by combining the keywords: “Knowledge”, “Attitude”, “Practice”, “COVID-19”, and “Ethiopia” both in Medical Subject Heading (MeSH) and free text terms. Data was analyzed using STATA version 14. Random effects model meta-analysis was employed to estimate pooled proportion of KAP’s towards COVID-19 in general community Results: Data on 12391 participants which retrived from 26 studies included into this review .The study was pooled to estimate the pooled proportion of knowledge, attitude and practice towards COVID-19 prevention and control in the community. Our meta-analysis revealed that the pooled proportion of good knowledge was 62% (95% CI: 54%-71%), while favorable attitude 64 %( 95% CI: 58%-71%) and prevention practice 44% (95% CI: 32%-56%). Conclusion: Our review indicated that the knowledge, attitude and practice towards COVID-19 prevention and control in general community were considerably insufficient. There are several different factors that affects the level of practice towards COVID-19 prevention. Therefore, collaborative efforts should be made by the government, partners and the media to improve the knowledge,attitude and practice of the general community towards COVID-19 preventive practices.
{"title":"Knowledge, attitude and practice towards Coronavirus disease 2019 prevention in Ethiopia: Systematic review and meta-analysis","authors":"Dinka Fikadu Gamtesa, H. Tola, Gadissa Gutema, Biniyam Dagne, Bira Bejiga Bedassa","doi":"10.18502/jbe.v7i4.10392","DOIUrl":"https://doi.org/10.18502/jbe.v7i4.10392","url":null,"abstract":"Introduction: Level of knowledge, Attitude and Practice (KAP) of the community towards corona virus disease 2019 (COVID-19) is important to prevent and control the disease . In Ethiopia there are some studies that assess the KAP’s of different segments of the community and reported different results. However, there is limited review evidence that pooled the proportion of KAP of the community to wards COVID-19 prevention and control of the disease in Ethiopia. The aim of this systematic review and meta-analysis was to summarize and pool the proportion of KAP towards COVID-19 prevention and control in general community. \u0000Methods: A systematic review and meta-analysis study was conducted to estimate the pooled proportion of Knowledge, Attitude and Practice towards COVID-19 prevention and control in general community. Electronic databases such as PubMed, Google Scholar and Science Direct were searched for studies reported in English language without restricting publication year. The search strategy was used by combining the keywords: “Knowledge”, “Attitude”, “Practice”, “COVID-19”, and “Ethiopia” both in Medical Subject Heading (MeSH) and free text terms. Data was analyzed using STATA version 14. Random effects model meta-analysis was employed to estimate pooled proportion of KAP’s towards COVID-19 in general community \u0000Results: Data on 12391 participants which retrived from 26 studies included into this review .The study was pooled to estimate the pooled proportion of knowledge, attitude and practice towards COVID-19 prevention and control in the community. Our meta-analysis revealed that the pooled proportion of good knowledge was 62% (95% CI: 54%-71%), while favorable attitude 64 %( 95% CI: 58%-71%) and prevention practice 44% (95% CI: 32%-56%). \u0000Conclusion: Our review indicated that the knowledge, attitude and practice towards COVID-19 prevention and control in general community were considerably insufficient. There are several different factors that affects the level of practice towards COVID-19 prevention. Therefore, collaborative efforts should be made by the government, partners and the media to improve the knowledge,attitude and practice of the general community towards COVID-19 preventive practices.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45684229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Abdi, Rezvaneh Alvandi, B. Haghdoost, S. Sazgarnejad, E. Ahmadnezhad, Behzad Nadjafi, I. Harirchi
Introduction: One of the most important 2015-post agendas of countries’ health systems is achieving Universal Health Coverage (UHC), so countries should monitor the activities carried out. The present study aimed to investigate the UHC status two years after Health Transformation Plan (HTP) in Iran. Methods: This is a secondary analysis of the national household income and expenditure survey (with close 40,000 households as the survey sample). The survey was used to estimate financial protection indicators (out-of-pocket payment, catastrophic and impoverishment health expenditure) in 2016. Estimation for service coverage index provided by international databases was applied at the country level. Indicators of financial protection and service coverage were evaluated in relation to each other using the World Health Organization joint levels assessment method, which indicates UHC attainment in terms of a plot with four zones. The relationship was estimated for the entire population, first quintile, and fifth quintile in 2000, 2017, and 2030. Results: The average per capita of OOP annually was 1,940,613 Rials (162.415 PPP int $). About 15.85% of households endured catastrophic health expenditures at the 10% threshold. The impoverishment health expenditure is about 0.6. Accordingly, Iran is on the border between zones 1 and 2 in 2017 in terms of achieving UHC and will move to zone 1 in 2030 with the current trend. Conclusion: According to the results of this study, universal health coverage has not been achieved even despite the implementation of the HTP. Even with improved service coverage, achieving UHC by 2030 may seem impossible with the current trends.
导言:各国卫生系统最重要的2015年后议程之一是实现全民健康覆盖，因此各国应监测开展的活动。本研究旨在调查卫生转型计划(HTP)实施两年后伊朗全民健康覆盖状况。方法:对全国家庭收支调查(以近4万户为调查样本)进行二次分析。该调查用于估计2016年的财务保护指标(自付费用、灾难性和贫困医疗支出)。在国家一级采用了国际数据库提供的服务覆盖指数的估计。使用世界卫生组织联合水平评估方法对财务保护和服务覆盖率指标进行了相互关联的评估，该方法表明在四个区域的地块上实现了全民健康覆盖。在2000年、2017年和2030年对整个人口、第一五分之一和第五五分之一的人口进行了这种关系的估计。结果:年人均OOP为1,940,613里亚尔(162.415 PPP int $)。大约15.85%的家庭在10%的门槛上承受了灾难性的医疗支出。贫困化卫生支出约为0.6。因此，在实现全民健康覆盖方面，伊朗在2017年处于第1区和第2区之间，按照目前的趋势，到2030年将向第1区移动。结论:根据本研究的结果，尽管实施了卫生计划，但全民健康覆盖仍未实现。即使改善了服务覆盖面，按照目前的趋势，到2030年实现全民健康覆盖似乎也是不可能的。
{"title":"Measuring Progress toward Universal Health Coverage in Iran: Two Years after the Implementation of the Health Transformation Plan","authors":"Z. Abdi, Rezvaneh Alvandi, B. Haghdoost, S. Sazgarnejad, E. Ahmadnezhad, Behzad Nadjafi, I. Harirchi","doi":"10.18502/jbe.v8i2.10415","DOIUrl":"https://doi.org/10.18502/jbe.v8i2.10415","url":null,"abstract":"Introduction: One of the most important 2015-post agendas of countries’ health systems is achieving Universal Health Coverage (UHC), so countries should monitor the activities carried out. The present study aimed to investigate the UHC status two years after Health Transformation Plan (HTP) in Iran. \u0000Methods: This is a secondary analysis of the national household income and expenditure survey (with close 40,000 households as the survey sample). The survey was used to estimate financial protection indicators (out-of-pocket payment, catastrophic and impoverishment health expenditure) in 2016. Estimation for service coverage index provided by international databases was applied at the country level. Indicators of financial protection and service coverage were evaluated in relation to each other using the World Health Organization joint levels assessment method, which indicates UHC attainment in terms of a plot with four zones. The relationship was estimated for the entire population, first quintile, and fifth quintile in 2000, 2017, and 2030. \u0000Results: The average per capita of OOP annually was 1,940,613 Rials (162.415 PPP int $). About 15.85% of households endured catastrophic health expenditures at the 10% threshold. The impoverishment health expenditure is about 0.6. Accordingly, Iran is on the border between zones 1 and 2 in 2017 in terms of achieving UHC and will move to zone 1 in 2030 with the current trend. \u0000Conclusion: According to the results of this study, universal health coverage has not been achieved even despite the implementation of the HTP. Even with improved service coverage, achieving UHC by 2030 may seem impossible with the current trends.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43393234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Logistic regression is one of the most common models used to predict and classify binary and multiple state responses in medicine. Genetic algorithms search techniques inspired by biology have recently been used successfully as a predictive model. The aim of present study was to use the genetic algorithm and logistic regression models in diagnosing and predicting factors affecting breast cancer mortality. Methods: Data of 2836 people with breast cancer during the years 2014-2018 were examined. Information was registered in the cancer registration system of Kerman University of Medical Sciences. Death status was considered as the dependent variable, while age, morphology, tumor differentiation (grad), residence status, and place of residence were considered as independent variables. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curve were used to compare the models. Results: The logistic regression model determined factors affecting the breast cancer mortality rate, (with sensitivity (0.60), specificity (0.80), area under the ROC curve (0.70), and accuracy (0.77)), and also genetic algorithm model (with sensitivity (0.21), specificity (0.96), area under the ROC curve (0.58) and accuracy (0.87)) did so. Conclusion: The sensitivity and area under the ROC curve of the logistic regression model were higher than those of the genetic algorithm, but the specificity and accuracy of the genetic algorithm were higher than those of the logistic regression. According to the purpose of the study, two models can be used simultaneously.
{"title":"Prediction of the breast cancer mortality rate and its effective factors using genetic algorithm and logistic regression","authors":"Mahdieh Mirzaie, Y. Jahani, A. Bahrampour","doi":"10.18502/jbe.v8i1.10403","DOIUrl":"https://doi.org/10.18502/jbe.v8i1.10403","url":null,"abstract":"Introduction: Logistic regression is one of the most common models used to predict and classify binary and multiple state responses in medicine. Genetic algorithms search techniques inspired by biology have recently been used successfully as a predictive model. The aim of present study was to use the genetic algorithm and logistic regression models in diagnosing and predicting factors affecting breast cancer mortality. \u0000Methods: Data of 2836 people with breast cancer during the years 2014-2018 were examined. Information was registered in the cancer registration system of Kerman University of Medical Sciences. Death status was considered as the dependent variable, while age, morphology, tumor differentiation (grad), residence status, and place of residence were considered as independent variables. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curve were used to compare the models. \u0000Results: The logistic regression model determined factors affecting the breast cancer mortality rate, (with sensitivity (0.60), specificity (0.80), area under the ROC curve (0.70), and accuracy (0.77)), and also genetic algorithm model (with sensitivity (0.21), specificity (0.96), area under the ROC curve (0.58) and accuracy (0.87)) did so. \u0000Conclusion: The sensitivity and area under the ROC curve of the logistic regression model were higher than those of the genetic algorithm, but the specificity and accuracy of the genetic algorithm were higher than those of the logistic regression. According to the purpose of the study, two models can be used simultaneously.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46849836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sevda Riyahifar, Mahboobeh Rasouli, J. Abolghasemi, Moein Yoosefi, A. Azarkeivan, A. Ashouri
Introduction: Thalassemia major is an important health problem in Mediterranean countries that causes many psychological and economic problems. This study aimed to evaluate the effective factors on long- and short-term survival of thalassemia major patients using mixture and non-mixture cure survival models based on Generalized Gompertz distribution. The Generalized Gompertz distribution has flexible curve of failure rate that may be appropriate for different situation of survival analysis. Methods: In this retrospective cohort study, medical records of 300 thalassemia major patients referring to Zafar's thalassemia clinic during 1994-2017 in Tehran, Iran were reviewed. Mixture and non-mixture cure survival models based on Gompertz and Generalized Gompertz distributions were performed to estimate the effective factors on long- term and short- term survival of Thalassemia Major Patients. The Akaike Information Criteria (AIC) was used to compare the models. Analysis was performed using SAS software version 9.4. Results: The mean (±SD) survival time was 32.21 (±7.47) years. The censorship rate was 78.30%. In both of the mixture and non-mixture cure models, Generalized Gompertz distribution, as compared to the standard Gompertz had the lower Akaike criteria that was 200.8. Based on this model, iron deposition in liver at mild and moderate levels had a significant effect on the long-term survival of these patients. Conclusion: Based on Akaike Information criteria, considering the Generalized Gompertz mixture cure model has the best fit for the data of thalassemia major disease in which patients are long-term survivors. In order to analyze the survival of patients with thalassemia major, since iron deposition in liver at mild and moderate levels had a significant effect on the long-term survival of these patients; it is recommended to apply a regular iron chelation therapy for extra iron excretion.
重度地中海贫血是地中海国家的一个重要健康问题，它会引起许多心理和经济问题。本研究旨在采用基于广义Gompertz分布的混合和非混合治疗生存模型，评价影响地中海贫血重症患者长期和短期生存的有效因素。广义Gompertz分布具有灵活的故障率曲线，可适用于不同的生存分析情况。方法:回顾性分析1994-2017年在伊朗德黑兰扎法尔地中海贫血诊所就诊的300例地中海贫血重症患者的病历。采用基于Gompertz和广义Gompertz分布的混合和非混合治疗生存模型来估计影响地中海贫血重症患者长期和短期生存的有效因素。采用赤池信息标准(Akaike Information Criteria, AIC)对模型进行比较。采用SAS软件9.4进行分析。结果:平均(±SD)生存时间为32.21(±7.47)年。审查率为78.30%。在混合和非混合固化模型中，广义Gompertz分布与标准Gompertz相比具有较低的Akaike准则，为200.8。基于该模型，轻度和中度水平的肝脏铁沉积对这些患者的长期生存有显著影响。结论:基于赤池信息标准，考虑广义Gompertz混合治疗模型最适合地中海贫血重症患者长期存活的数据。为了分析重度地中海贫血患者的生存，由于轻度和中度水平的肝脏铁沉积对这些患者的长期生存有显著影响;建议定期进行铁螯合治疗，以减少多余的铁排泄。
{"title":"Contribution Factors on Long- term and Short- term Survival of Thalassemia Major Patients","authors":"Sevda Riyahifar, Mahboobeh Rasouli, J. Abolghasemi, Moein Yoosefi, A. Azarkeivan, A. Ashouri","doi":"10.18502/jbe.v7i4.10394","DOIUrl":"https://doi.org/10.18502/jbe.v7i4.10394","url":null,"abstract":"Introduction: Thalassemia major is an important health problem in Mediterranean countries that causes many psychological and economic problems. This study aimed to evaluate the effective factors on long- and short-term survival of thalassemia major patients using mixture and non-mixture cure survival models based on Generalized Gompertz distribution. The Generalized Gompertz distribution has flexible curve of failure rate that may be appropriate for different situation of survival analysis. \u0000Methods: In this retrospective cohort study, medical records of 300 thalassemia major patients referring to Zafar's thalassemia clinic during 1994-2017 in Tehran, Iran were reviewed. Mixture and non-mixture cure survival models based on Gompertz and Generalized Gompertz distributions were performed to estimate the effective factors on long- term and short- term survival of Thalassemia Major Patients. The Akaike Information Criteria (AIC) was used to compare the models. Analysis was performed using SAS software version 9.4. \u0000Results: The mean (±SD) survival time was 32.21 (±7.47) years. The censorship rate was 78.30%. In both of the mixture and non-mixture cure models, Generalized Gompertz distribution, as compared to the standard Gompertz had the lower Akaike criteria that was 200.8. Based on this model, iron deposition in liver at mild and moderate levels had a significant effect on the long-term survival of these patients. \u0000Conclusion: Based on Akaike Information criteria, considering the Generalized Gompertz mixture cure model has the best fit for the data of thalassemia major disease in which patients are long-term survivors. In order to analyze the survival of patients with thalassemia major, since iron deposition in liver at mild and moderate levels had a significant effect on the long-term survival of these patients; it is recommended to apply a regular iron chelation therapy for extra iron excretion.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68130086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Cuschieri, Amy Carabott, R. Caruana, M. Farrugia, Anthea Ferrigi, E. Grech, A. Pace, T. Attard Mallia, Nicole Attard, Nathalie Attard, Emma Camilleri, Jeanelle Calleja, Martina Baldacchino, Davide Magrì, Neriah Mangion, A. Cuschieri
Introduction: COVID-19 spread globally, including across the Balkans, resulting in different morbidity and mortality outcomes in different countries. The aim of this study was to review the impact of COVID-19 over 17 months with regards to pandemic progression, implemented mitigation strategies, and COVID-19 vaccination programs across the Balkan countries, while identifying any valuable pieces of information acquired serendipitously throughout the pandemic that can be implemented in future action plans. Methods: A longitudinal ecological study was conducted across the Balkan countries from the onset of COVID-19 in these countries up until 1st August 2021. Epidemiological data was obtained from Our World in Data databases, while Ministry of Health websites for each respective country as well as local newspapers were utilized to review COVID-19-related mitigation and vaccination strategies. Comparisons of vaccination coverage, incident cases and mortality were made across neighboring countries, by converting the respective data to rates per 100,000 population for each country using Microsoft® Excel for mac (Version 16.59). Results: More than 10 million positive COVID-19 cases and 164,470 deaths were observed across the Balkan countries up until 1st August 2021. Trends in COVID morbidity and mortality outcomes were evident across neighbouring countries. A staggered vaccination rollout was observed, with various rollout speeds, although gradual decline in both morbidity and mortality occurred. Conclusion: Results obtained from this study strongly indicate that COVID-19 outcome for a particular country is not only dependent on the country’s own level of viral transmission, mitigations, and vaccination rates but also on neighbouring countries’ COVID-19 situation. Hence, cross-border governance action and recovery plans are recommended along with targeting vaccination hesitance.
简介：新冠肺炎在全球范围内传播，包括在巴尔干半岛，导致不同国家的发病率和死亡率不同。本研究的目的是审查新冠肺炎在17个月内对巴尔干国家的大流行进展、实施的缓解策略和新冠肺炎疫苗接种计划的影响，同时确定在大流行期间意外获得的任何有价值的信息，这些信息可以在未来的行动计划中实施。方法：从新冠肺炎爆发到2021年8月1日，在巴尔干国家进行了一项纵向生态研究。流行病学数据来自Our World in data数据库，同时利用每个国家的卫生部网站以及当地报纸来审查与COVID-19相关的缓解和疫苗接种策略。通过使用Microsoft®Excel for mac（16.59版）将各自的数据转换为每个国家每10万人口的接种率，对邻国的疫苗接种覆盖率、事件病例和死亡率进行了比较。结果：截至2021年8月1日，巴尔干国家共观察到超过1000万例新冠肺炎阳性病例和164470例死亡病例。新冠肺炎发病率和死亡率的趋势在邻国都很明显。尽管发病率和死亡率逐渐下降，但观察到疫苗接种的时间错开，接种速度各不相同。结论：这项研究的结果有力地表明，特定国家的新冠肺炎结果不仅取决于该国自身的病毒传播水平、缓解措施和疫苗接种率，还取决于邻国的新冠肺炎情况。因此，建议在针对疫苗接种犹豫的同时采取跨境治理行动和恢复计划。
{"title":"Making the Case for Cross-Border Public Health Strategies: A comparativie Assessment of Covid-19 Epidemiological Trends in the Balkan Countries Across 17 Months","authors":"S. Cuschieri, Amy Carabott, R. Caruana, M. Farrugia, Anthea Ferrigi, E. Grech, A. Pace, T. Attard Mallia, Nicole Attard, Nathalie Attard, Emma Camilleri, Jeanelle Calleja, Martina Baldacchino, Davide Magrì, Neriah Mangion, A. Cuschieri","doi":"10.18502/jbe.v8i2.10416","DOIUrl":"https://doi.org/10.18502/jbe.v8i2.10416","url":null,"abstract":"Introduction: COVID-19 spread globally, including across the Balkans, resulting in different morbidity and mortality outcomes in different countries. The aim of this study was to review the impact of COVID-19 over 17 months with regards to pandemic progression, implemented mitigation strategies, and COVID-19 vaccination programs across the Balkan countries, while identifying any valuable pieces of information acquired serendipitously throughout the pandemic that can be implemented in future action plans. \u0000Methods: A longitudinal ecological study was conducted across the Balkan countries from the onset of COVID-19 in these countries up until 1st August 2021. Epidemiological data was obtained from Our World in Data databases, while Ministry of Health websites for each respective country as well as local newspapers were utilized to review COVID-19-related mitigation and vaccination strategies. Comparisons of vaccination coverage, incident cases and mortality were made across neighboring countries, by converting the respective data to rates per 100,000 population for each country using Microsoft® Excel for mac (Version 16.59). \u0000Results: More than 10 million positive COVID-19 cases and 164,470 deaths were observed across the Balkan countries up until 1st August 2021. Trends in COVID morbidity and mortality outcomes were evident across neighbouring countries. A staggered vaccination rollout was observed, with various rollout speeds, although gradual decline in both morbidity and mortality occurred. \u0000Conclusion: Results obtained from this study strongly indicate that COVID-19 outcome for a particular country is not only dependent on the country’s own level of viral transmission, mitigations, and vaccination rates but also on neighbouring countries’ COVID-19 situation. Hence, cross-border governance action and recovery plans are recommended along with targeting vaccination hesitance.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42900428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: An essential concept in assessing the extent to which an infectious outbreak spread is the concept of basic reproductive number (R0 ). The current systematic review and meta-analysis aimed to estimate the R0 of the Delta variant of SARS-CoV-2 based on studies published from 1 January 2021 to 23 September 2021. Methods: International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched using keywords: "Basic reproduction number, R0 , COVID-19, SARS-COV-2, Severe Acute Respiratory Syndrome Coronavirus, NCOV, 2019 NCOV, coronavirus, Delta variant, B.1.617.2". Due to significant heterogeneity, DerSimonian-Laird random-effects model was used to estimate the pooled value of R0 . Results: A total of 245 reports were identified. After assessing the inclusion criteria, three studies were selected. The pooled R0 for the Delta variant was estimated as 5.10 (95% CI, 3.04 to 7.17), (I2 =86.77%, T2 :2.68, p-value from the chi-square test for heterogeneity was<0.001). Conclusion: Considering the estimated value of R0 for the Delta variant of SARS-CoV-2, the amount of vaccine coverage required to achieve herd immunity appears to be higher than previous variants of the virus.
{"title":"Estimate of the Basic Reproduction Number for Delta variant of SARS-CoV-2: A Systematic Review and Meta-analysis","authors":"M. Sepandi, Y. Alimohamadi, Firooz Esmaeilzadeh","doi":"10.18502/jbe.v8i1.10400","DOIUrl":"https://doi.org/10.18502/jbe.v8i1.10400","url":null,"abstract":"Introduction: An essential concept in assessing the extent to which an infectious outbreak spread is the concept of basic reproductive number (R0 ). The current systematic review and meta-analysis aimed to estimate the R0 of the Delta variant of SARS-CoV-2 based on studies published from 1 January 2021 to 23 September 2021. \u0000Methods: International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched using keywords: \"Basic reproduction number, R0 , COVID-19, SARS-COV-2, Severe Acute Respiratory Syndrome Coronavirus, NCOV, 2019 NCOV, coronavirus, Delta variant, B.1.617.2\". Due to significant heterogeneity, DerSimonian-Laird random-effects model was used to estimate the pooled value of R0 . \u0000Results: A total of 245 reports were identified. After assessing the inclusion criteria, three studies were selected. The pooled R0 for the Delta variant was estimated as 5.10 (95% CI, 3.04 to 7.17), (I2 =86.77%, T2 :2.68, p-value from the chi-square test for heterogeneity was<0.001). \u0000Conclusion: Considering the estimated value of R0 for the Delta variant of SARS-CoV-2, the amount of vaccine coverage required to achieve herd immunity appears to be higher than previous variants of the virus.","PeriodicalId":34310,"journal":{"name":"Journal of Biostatistics and Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45914928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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