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Exact inference for the Youden index to discriminate individuals using two-parameter exponentially distributed pooled samples 使用双参数指数分布的混合样本对约登指数进行区分个体的精确推断
Q3 Medicine Pub Date : 2019-01-01 DOI: 10.1080/24709360.2019.1587264
Sumith Gunasekera, Lakmali Weerasena, Aruna Saram, O. Ajumobi
It has become increasingly common in epidemiological studies to pool specimens across subjects as a useful cot-cutting technique to achieve accurate quantification of biomarkers and certain environmental chemicals. The data collected from these pooled samples can then be utilized to estimate the Youden Index, which measures biomarker's effectiveness and aids in the selection of an optimal threshold value, as a summary measure of the Receiver Operating Characteristic curve. The aim of this paper is to make use of generalized approach to estimate and testing of the Youden index. This goal is accomplished by the comparison of classical and generalized procedures for the Youden Index with the aid of pooled samples from the shifted-exponentially distributed biomarkers for the low-risk and high-risk patients. These are juxtaposed using confidence intervals, p-values, power of the test, size of the test, and coverage probability with a wide-ranging simulation study featuring a selection of various scenarios. In order to demonstrate the advantages of the proposed generalized procedures over its classical counterpart, an illustrative example is discussed using the Duchenne Muscular Dystrophy data available at http://biostat.mc.vanderbilt.edu/wiki/Main/DataSets or http://lib.stat.cmu.edu/datasets/.
在流行病学研究中,将不同对象的标本汇集起来作为一种有用的裁剪技术,以实现生物标志物和某些环境化学物质的准确定量,这已经变得越来越普遍。然后,从这些汇集的样本中收集的数据可用于估计约登指数,该指数测量生物标志物的有效性,并有助于选择最佳阈值,作为接受者工作特征曲线的汇总测量。本文的目的是利用广义方法来估计和检验约登指数。这一目标是通过比较约登指数的经典和通用程序,并借助于低风险和高风险患者的指数分布生物标志物的汇集样本来实现的。这些并置使用置信区间,p值,测试的能力,测试的大小和覆盖概率与广泛的模拟研究,以选择各种场景为特征。为了证明所提出的广义程序相对于其经典对应程序的优势,使用可在http://biostat.mc.vanderbilt.edu/wiki/Main/DataSets或http://lib.stat.cmu.edu/datasets/上获得的杜氏肌营养不良症数据讨论了一个示例。
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引用次数: 1
Effect of modeling a multilevel structure on the Indian population to identify the factors influencing HIV infection 对印度人口进行多层次结构建模以确定影响HIV感染的因素的效果
Q3 Medicine Pub Date : 2019-01-01 DOI: 10.1080/24709360.2019.1671096
Nidhiya Menon, Binukumar Bhaskarapillai, A. Richardson
ABSTRACT Many studies have addressed the factors associated with HIV in the Indian population. Some of these studies have used sampling weights for the risk estimation of factors associated with HIV, but few studies have adjusted for the multilevel structure of survey data. The National Family Health Survey 3 collected data across India between 2005 and 2006. 38,715 females and 66,212 males with complete information were analyzed. To account for the correlations within clusters, a three-level model was employed. Bivariate and multivariable mixed effect logistic regression analysis were performed to identify factors associated with HIV. Intracluster correlation coefficients were used to assess the relatedness of each pair of variables within clusters. Variables pertaining to no knowledge of contraceptive methods, age at first marriage, wealth index and noncoverage of PSUs by Anganwadis were significant risk factors for HIV when the multileveled model was used for analysis. This study has identified the risk profile for HIV infection using an appropriate modeling strategy and has highlighted the consequences of ignoring the structure of the data. It offers a methodological guide towards an applied approach to the identification of future risk and the need to customize intervention to address HIV infection in the Indian population.
摘要许多研究都探讨了印度人群中与艾滋病毒相关的因素。其中一些研究使用了抽样权重来估计与艾滋病毒相关的因素的风险,但很少有研究对调查数据的多级结构进行了调整。全国家庭健康调查3收集了2005年至2006年间印度各地的数据。对38715名女性和66212名信息完整的男性进行了分析。为了说明集群内的相关性,采用了一个三级模型。进行双变量和多变量混合效应逻辑回归分析,以确定与HIV相关的因素。聚类内相关系数用于评估聚类内每对变量的相关性。当使用多层次模型进行分析时,与不了解避孕方法、初婚年龄、财富指数和Anganwadis的PSU非平均值有关的变量是感染HIV的重要风险因素。这项研究使用适当的建模策略确定了艾滋病毒感染的风险状况,并强调了忽视数据结构的后果。它为确定未来风险的应用方法以及为解决印度人口中的艾滋病毒感染而定制干预措施的必要性提供了方法指南。
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引用次数: 0
The 9-criteria evaluation framework for perceptions survey: the case of VA’s Learners’ Perceptions Survey 认知调查的9项标准评估框架——以弗吉尼亚大学学生认知调查为例
Q3 Medicine Pub Date : 2018-12-16 DOI: 10.1080/24709360.2018.1553362
T. Kashner, Christopher Clarke, D. Aron, John M. Byrne, G. Cannon, D. Deemer, S. Gilman, C. Kaminetzky, L. Loo, Sophia Li, Annie B. Wicker, S. Keitz
ABSTRACT For its clinical, epidemiologic, educational, and health services research, evaluation, administrative, regulatory, and accreditation purposes, the perceptions survey is a data collection tool that asks observers to describe perceptions of their experiences with a defined phenomenon of interest. In practice, these surveys are often subject to criticism for not having been thoroughly evaluated before its first application using a consistent and comprehensive set of criteria for validity and reliability. This paper introduces a 9-criteria framework to assess perceptions surveys that integrates criteria from multiple evaluation sources. The 9-criteria framework was applied to data from the Department of Veterans Affairs’ Learners’ Perceptions Survey (LPS) that had been administered to national and local samples, and from findings obtained through a literature review involving LPS survey data. We show that the LPS is a robust tool that may serve as a model for design and validation of other perceptions surveys. Findings underscore the importance of using all nine criteria to validate perceptions survey data.
为了临床、流行病学、教育和卫生服务研究、评估、行政、监管和认证的目的,感知调查是一种数据收集工具,要求观察者用感兴趣的定义现象描述他们对经验的感知。在实践中,这些调查经常受到批评,因为在首次应用之前没有使用一套一致和全面的有效性和可靠性标准进行彻底评估。本文介绍了一个9个标准框架来评估来自多个评估来源的综合标准的感知调查。9个标准框架应用于退伍军人事务部学习者感知调查(LPS)的数据,该调查已对国家和地方样本进行了管理,并从涉及LPS调查数据的文献综述中获得的结果。我们表明,LPS是一个强大的工具,可以作为设计和验证其他感知调查的模型。调查结果强调了使用所有九个标准来验证感知调查数据的重要性。
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引用次数: 3
An introduction to the why and how of risk adjustment 介绍风险调整的原因和方法
Q3 Medicine Pub Date : 2018-09-17 DOI: 10.1080/24709360.2018.1519990
W. B. Vogel, Guoqing Chen
Department of Veterans Affairs (VA) health services researchers often adjust for the differing risk profiles of selected patient populations for a variety of purposes. This paper explains the major reasons to conduct risk adjustment and provides a high level overview of what risk adjustment actually does and how the results of risk adjustment can be used in different ways for different purposes. The paper also discusses choosing a diagnostic classification system and describes some of the systems commonly used in risk adjustment along with comorbidity/severity indices and individual disease taxonomies. The factors influencing the choice of diagnostic classification systems and other commonly used risk adjustors are also presented along with a discussion of data requirements. Statistical approaches to risk adjustment are also briefly discussed. The paper concludes with some recommendations concerning risk adjustment that should be considering when developing research proposals.
退伍军人事务部(VA)的健康服务研究人员经常调整不同的风险概况选定的病人群体为各种目的。本文解释了进行风险调整的主要原因,并对风险调整的实际作用以及风险调整的结果如何以不同的方式用于不同的目的提供了高层次的概述。本文还讨论了诊断分类系统的选择,并描述了一些在风险调整中常用的系统,以及合并症/严重程度指数和个体疾病分类。影响选择诊断分类系统和其他常用风险调节器的因素也被提出,并讨论了数据要求。本文还简要讨论了风险调整的统计方法。本文最后提出了一些在制定研究建议时应考虑的风险调整建议。
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引用次数: 2
Clinical trials design and conduct 临床试验的设计和实施
Q3 Medicine Pub Date : 2018-06-07 DOI: 10.1080/24709360.2018.1477467
W. Henderson
ABSTRACT This article attempts to outline the most important aspects to consider when planning a randomized controlled clinical trial (RCT) and writing a proposal for the RCT. RCTs are generally formulated by a planning committee that should be comprised of members with expertise in the different important features of the trial. Important considerations include background, objectives/hypotheses, experimental design, patient population and recruitment/retention plan, stratification/randomization, experimental treatment, control or comparison treatment, blinding, primary and secondary outcomes, patient follow-up, data to be collected, capture of data and confidentiality, handling of adverse events, sample size/statistical power and feasibility, statistical analysis, ethical issues, and governance of the trial. Real world examples, mostly drawn from the US Department of Veterans Affairs Cooperative Studies Program, are used to illustrate the various important considerations.
摘要本文试图概述在规划随机对照临床试验(RCT)和编写随机对照临床实验建议时需要考虑的最重要方面。随机对照试验通常由一个规划委员会制定,该委员会应由具有试验不同重要特征专业知识的成员组成。重要考虑因素包括背景、目标/假设、实验设计、患者群体和招募/保留计划、分层/随机化、实验治疗、对照或比较治疗、致盲、主要和次要结果、患者随访、待收集数据、数据采集和保密性、不良事件处理、,样本量/统计能力和可行性、统计分析、伦理问题和试验管理。现实世界中的例子大多来自美国退伍军人事务部合作研究项目,用于说明各种重要的考虑因素。
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引用次数: 0
Quasi-experimental design 准实验设计
Q3 Medicine Pub Date : 2018-06-07 DOI: 10.1080/24709360.2018.1477468
M. Maciejewski
ABSTRACT Quasi-experiments are similar to randomized controlled trials in many respects, but there are many challenges in designing and conducting a quasi-experiment when internal validity threats are introduced from the absence of randomization. This paper outlines design, measurement and statistical issues that must be considered prior to the conduct of a quasi-experimental evaluation. We discuss challenges for the internal validity of quasi-experimental designs, inclusion/exclusion criteria, treatment and comparator cohort definitions, and the five types of explanatory variables that one must classify prior to analysis. We discuss data collection and confidentiality, statistical power and conclude with analytic issues that one must consider.
摘要准实验在许多方面与随机对照试验相似,但当由于缺乏随机化而引入内部有效性威胁时,在设计和进行准实验方面存在许多挑战。本文概述了在进行准实验评估之前必须考虑的设计、测量和统计问题。我们讨论了准实验设计的内部有效性、纳入/排除标准、治疗和对照队列定义以及分析前必须分类的五种解释变量的挑战。我们讨论了数据收集和保密性、统计能力,并以必须考虑的分析问题作为结论。
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引用次数: 31
Epidemiological characteristics of severe cases of hand, foot, and mouth disease in Guangdong, China 广东省严重手足口病病例流行病学特征分析
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1080/24709360.2018.1469809
Zhicheng Du, Wangjian Zhang, Dingmei Zhang, Shicheng Yu, Y. Hao
ABSTRACT Hand, foot, and mouth disease (HFMD) has become a major public health issue in China, especially in Guangdong. The burden of severe cases deserves further attention. We hereby explored the epidemiological features of severe HFMD in Guangdong. Patients who were from rural areas (OR = 2.03, 95% CI: 1.86–2.21), males (OR = 1.17, 1.07–1.28), aged ≤3 years old (2.48, 1.68–3.68, and 1.63, 1.10–2.41, for ≤1 and 2–3 years, respectively), and/or infected with EV71 (6.69, 5.98–7.49) tended to progress to severe status. Cases from rural areas tended to have a longer interval from onset to diagnosis (p < .001; i.e. the proportions of each interval (≤1, ∼2, ∼3, ∼4, and >4 days) for rural and urban areas in 2009 were 14%, 13%, 14%, 8%, 51%, and 21%, 21%, 15%, 11%, 31%, respectively). The spatial pattern of the epidemics clarified by the flexible scan statistic showed that the clusters of severe cases were observed to be expanding from the Pearl River Delta Region to the Eastern Region and the Mountainous Region. Overall, the relative risk of the most likely clusters ranged from 5.548 to 15.558 (all p < .001). Our results were particularly practical and important for developing severe HFMD-targeted control programs in the context of disease surveillance. Abbreviations: CA16: Coxsackievirus A16; EV71: enterovirus 71; GDP: gross domestic product; HFMD: hand; foot and mouth disease.
摘要手足口病(HFMD)已成为中国特别是广东省的一个重大公共卫生问题。严重病例的负担值得进一步关注。探讨广东地区重型手足口病的流行病学特征。来自农村地区的患者(OR = 2.03,95%CI:1.86-2.21),男性(OR=1.17,1.07-1.28),年龄≤3岁(分别为2.48,1.68–3.68和1.63,1.10–2.41,≤1年和2-3年),和/或感染EV71(6.69,5.98–7.49)倾向于发展为严重状态。来自农村地区的病例从发病到确诊的时间间隔往往较长(p 4天)分别为14%、13%、14%、8%、51%和21%、21%、15%、11%、31%)。灵活扫描统计数据阐明的疫情空间格局表明,重症病例集群正在从珠三角地区向东部地区和山区扩展。总体而言,最有可能的集群的相对风险在5.548至15.558之间(均p < .001)。我们的研究结果对于在疾病监测的背景下制定严重手足口病靶向控制计划特别实用和重要。缩写:CA16:柯萨奇病毒A16;EV71:肠道病毒71;国内生产总值:国内生产总值;手足口病:手;口蹄疫。
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引用次数: 7
On two-step residual inclusion estimator for instrument variable additive hazards model 仪器变量加性危害模型的两步残差包含估计
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1080/24709360.2017.1406567
Binyan Jiang, Jialiang Li, J. Fine
ABSTRACT Instrumental variable (IV) methods are popular in non-experimental settings to estimate the causal effects of scientific interventions. These approaches allow for the consistent estimation of treatment effects even if major confounders are unavailable. There have been some extensions of IV methods to survival analysis recently. We specifically consider the two-step residual inclusion (2SRI) estimator proposed recently in the literature for the additive hazards regression model in this paper. Assuming linear structural equation models for the hazard function, we may attain a closed-form, two-stage estimator for the causal effect in the additive hazards model. The main contribution of this paper is to provide theoretical works for the 2SRI approach. The asymptotic properties of the estimators are rigorously established and the resulting inferences are shown to perform well in numerical studies.
工具变量(IV)方法在非实验环境中很流行,用于估计科学干预的因果效应。这些方法允许对治疗效果进行一致的估计,即使主要混杂因素不可用。近年来有一些将静脉注射方法扩展到生存分析。我们特别考虑了文献中最近提出的两步残差包含(2SRI)估计量用于本文的加性危害回归模型。假设危害函数为线性结构方程模型,我们可以得到加性危害模型中因果效应的一个封闭的两阶段估计。本文的主要贡献是为2SRI方法提供理论工作。严格地建立了估计量的渐近性质,由此得到的推论在数值研究中表现良好。
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引用次数: 7
Goodness-of-fit test for the parametric proportional hazard regression model with interval-censored data 区间截尾数据的参数比例风险回归模型的拟合优度检验
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1080/24709360.2018.1529347
R. Sakurai, S. Hattori
ABSTRACT Interval-censored data are common in medical research. Fully parametric models provide simple and efficient inference for the estimation of survival functions using interval-censored observations. Inference based on a parametric regression model requires the complete specification of the probability density function, and therefore, correctly specifying the model is crucial, while the regression diagnostic is a very important step. However, regression diagnostic methods for use with the interval-censored data have not been completely developed. Here, we developed a model-checking procedure based on the cumulative martingale residuals for the interval-censored observations. We employed the conditional expectation of residuals for the diagnostics, because the data showing the exact failure time cannot be obtained for the interval-censoring analyses, and developed the formal resampling-based supremum-type test and graphical model-checking techniques. A simulation study demonstrated an excellent performance of the proposed method during the detection of a misspecified functional form of covariates in the finite sample. Furthermore, we used this method for the analysis of the medical checkup data obtained in Japan.
摘要区间截尾数据在医学研究中很常见。全参数模型为使用区间截尾观测的生存函数估计提供了简单有效的推断。基于参数回归模型的推理需要完全指定概率密度函数,因此,正确指定模型至关重要,而回归诊断是非常重要的一步。然而,用于区间截尾数据的回归诊断方法还没有完全开发出来。在这里,我们为区间截尾观测开发了一个基于累积鞅残差的模型检查程序。由于区间截尾分析无法获得显示确切故障时间的数据,我们在诊断中采用了残差的条件期望,并开发了基于形式重采样的上确界类型检验和图形模型检验技术。一项模拟研究表明,在有限样本中检测到错误指定的协变函数形式时,所提出的方法具有良好的性能。此外,我们将该方法用于分析在日本获得的体检数据。
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引用次数: 0
Recent developments in statistical methods for GWAS and high-throughput sequencing association studies of complex traits GWAS统计方法和复杂性状高通量测序关联研究的最新进展
Q3 Medicine Pub Date : 2018-01-01 DOI: 10.1080/24709360.2018.1529346
Duo Jiang, Miaoyan Wang
ABSTRACT The advent of large-scale genetic studies has helped bring a new era of biomedical research on dissecting the genetic architecture of complex human disease. Genome-wide association studies (GWASs) and next-generation sequencing studies are two popular tools for identifying genetic variants that are associated with complex traits. This article overviews some of the most important statistical tools for analyzing data from these two types of studies, with an emphasis on single-SNP tests for common variants and region-based tests for rare variants. We compare various statistical methods for common and rare variants in humans, and describe some critical considerations to guide the choice of an analysis method. Also discussed are the related topics of sample ascertainment, missing heritability, and multiple testing correction, as well as some remaining analytical challenges presented by complex trait association mapping using genomic data obtained via high-throughput technologies.
大规模基因研究的出现为解剖复杂人类疾病的遗传结构带来了生物医学研究的新时代。全基因组关联研究(GWASs)和下一代测序研究是鉴定与复杂性状相关的遗传变异的两种常用工具。本文概述了用于分析这两类研究数据的一些最重要的统计工具,重点是针对常见变异的单snp检测和针对罕见变异的基于区域的检测。我们比较了人类常见和罕见变异的各种统计方法,并描述了指导分析方法选择的一些关键考虑因素。还讨论了样本确定、缺失遗传性和多重测试校正等相关主题,以及利用高通量技术获得的基因组数据进行复杂性状关联映射所带来的一些剩余分析挑战。
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引用次数: 5
期刊
Biostatistics and Epidemiology
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