The main goal of disease mapping is to estimate disease risk and identify high-risk areas. Such analyses are hampered by the limited geographical resolution of the available data. Typically the available data are counts per spatial unit and the common approach is the Besag--York--Molli{é} (BYM) model. When precise geocodes are available, it is more natural to use Log-Gaussian Cox processes (LGCPs). In a simulation study mimicking childhood leukaemia incidence using actual residential locations of all children in the canton of Zürich, Switzerland, we compare the ability of these models to recover risk surfaces and identify high-risk areas. We then apply both approaches to actual data on childhood leukaemia incidence in the canton of Zürich during 1985-2015. We found that LGCPs outperform BYM models in almost all scenarios considered. Our findings suggest that there are important gains to be made from the use of LGCPs in spatial epidemiology.
Survival competing risks models are very useful for studying the incidence of diseases whose occurrence competes with other possible diseases or health conditions. These models perform properly when working with terminal events, such as death, that imply the conclusion of the corresponding study. But they do not allow the treatment of scenarios with non-terminal competing events that may occur sequentially. Multi-state models are complex survival models. They focus on pathways defined by the temporal and sequential occurrence of numerous events of interest and thus they are suitable for connec…
Disaggregation regression has become an important tool in spatial disease mapping for making fine-scale predictions of disease risk from aggregated response data. By including high resolution covariate information and modelling the data generating process on a fine scale, it is hoped that these models can accurately learn the relationships between covariates and response at a fine spatial scale. However, validating these high resolution predictions can be a challenge, as often there is no data observed at this spatial scale. In this study, disaggregation regression was performed on simulated d…
Parkinson's disease (PD) is a chronic, degenerative neurological disorder. PD cannot be prevented, slowed or cured as of today but highly effective symptomatic treatments are available. We consider relevant estimands and treatment effect estimators for randomized trials of a novel treatment which aims to slow down disease progression versus placebo in early, untreated PD. A commonly used endpoint in PD trials is the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), which is longitudinally assessed at scheduled visits. The most important intercurrent events (ICEs) which affect the inter…
The US Census Bureau will implement a new privacy-preserving disclosure avoidance system (DAS), which includes application of differential privacy, on the public-release 2020 census data. There are concerns that the DAS may bias small-area and demographically-stratified population counts, which play a critical role in public health research and policy, serving as denominators in estimation of disease/mortality rates. Employing three DAS demonstration products, we quantify errors attributable to reliance on DAS-protected denominators in standard small-area disease mapping models for characteriz…
University of Zurich（苏黎世大学）；University Hospital of Zurich（苏黎世大学医院）；Yale University（耶鲁大学）；Lister Hill National Center for Biomedical Communications（利斯特希尔国家生物医学通信中心）；National Library of Medicine（美国国家医学图书馆）；Yale School of Medicine（耶鲁医学院）
Heart failure (HF) is one of the leading causes of hospital admissions in the US. Readmission within 30 days after a HF hospitalization is both a recognized indicator for disease progression and a source of considerable financial burden to the healthcare system. Consequently, the identification of patients at risk for readmission is a key step in improving disease management and patient outcome. In this work, we used a large administrative claims dataset to (1)explore the systematic application of neural network-based models versus logistic regression for predicting 30 days all-cause readmissi…
The emergence of Covid-19 requires new effective tools for epidemiological surveillance. Spatio-temporal disease mapping models, which allow dealing with highly disaggregated spatial and temporal units of analysis, are a priority in this sense. Spatio-temporal models provide a geographically detailed and temporally updated overview of the current state of the pandemics, making public health interventions to be more effective. Moreover, the use of spatio-temporal disease mapping models in the new Covid-19 epidemic context, facilitates estimating newly demanded epidemiological indicators, such a…
Alzheimer's disease is a progressive form of dementia that results in problems with memory, thinking, and behavior. It often starts with abnormal aggregation and deposition of beta amyloid and tau, followed by neuronal damage such as atrophy of the hippocampi, leading to Alzheimer's Disease (AD). The aim of this paper is to map the genetic-imaging-clinical pathway for AD in order to delineate the genetically regulated brain changes that drive disease progression based on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. We develop a novel two-step approach to delineate the associ…
Electronic health records (EHRs) have become a platform for data-driven surveillance on a granular level in recent years. In this paper, we make use of EHRs for early prevention of childhood obesity. The proposed method simultaneously provides smooth disease mapping and outlier information for obesity prevalence, which are useful for raising public awareness and facilitating targeted intervention. More precisely, we consider a penalized multilevel generalized linear model. We decompose regional contribution into smooth and sparse signals, which are automatically identified by a combination of …
Integrating Temporal Disaggregation and Distributed Lag Nonlinear Models for Bayesian Spatio-Temporal Disease Mapping with High-Resolution Environmental Exposures
KU Leuven（荷语鲁汶大学）；Hasselt University（哈瑟尔特大学）；Clinton Health Access Initiative（克林顿健康准入倡议）；National Malaria Control Program, Ministry of Health（卫生部国家疟疾控制项目）；University of Birmingham（伯明翰大学）
Comparing Methods of Expert Elicitation for Treatment Effect or Borrowing Parameters in Standard and Rare Disease Clinical Trials: A Systematic Mapping Study
Multiple diagnostic tests are often used due to limited resources or because they provide complementary information on the epidemiology of a disease under investigation. Existing statistical methods to combine prevalence data from multiple diagnostics ignore the potential over-dispersion induced by the spatial correlations in the data. To address this issue, we develop a geostatistical framework that allows for joint modelling of data from multiple diagnostics by considering two main classes of inferential problems: (1) to predict prevalence for a gold-standard diagnostic using low-cost and po…
When analyzing spatially referenced event data, the criteria for declaring rates as "reliable" is still a matter of dispute. What these varying criteria have in common, however, is that they are rarely satisfied for crude estimates in small area analysis settings, prompting the use of spatial models to improve reliability. While reasonable, recent work has quantified the extent to which popular models from the spatial statistics literature can overwhelm the information contained in the data, leading to oversmoothing. Here, we begin by providing a definition for a "reliable" estimate for event …
Modern disease mapping draws upon a wealth of high resolution spatial data products reflecting environmental and/or socioeconomic factors as covariates, or `features', within a geostatistical framework to improve predictions of disease risk. Feature selection is an important step in building these models, helping to reduce overfitting and computational complexity, and to improve model interpretability. Selecting only features that have a causal relationship with the response variable could potentially improve predictions and generalisability, but identifying these causal features from non-inte…
