Analyses of population-based surveys are instrumental to research on prevention and treatment of mental and substance use disorders. Population-based data provides descriptive characteristics of multiple determinants of public health and are typically available to researchers as an annual data release. To provide trends in national estimates or to update the existing ones, a meta-analytical approach to year-by-year data is typically employed with ORs as effect sizes. However, if the estimated ORs exhibit different patterns over time, some normalization of ORs may be warranted. We propose a new normalized measure of effect size and derive an asymptotic distribution for the respective test statistic. The normalization constant is based on the maximum range of the standardized log(OR), for which we establish a connection to the Laplace Limit Constant. Furthermore, we propose to employ standardized log(OR) in a novel way to obtain accurate posterior inference. Through simulation studies, we show that our new statistic is more powerful than the traditional one for testing the hypothesis OR=1. We then applied it to the United States population estimates of co-occurrence of side effect problem-experiences (SEPE) among newly incident cannabis users, based on the the National Survey on Drug Use and Health (NSDUH), 2004-2014.
Classical epidemiology has focused on the control of confounding but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g., an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed acyclic graph (DAG), a collider is the variable in the middle of an inverted fork (i.e., the variable C in A -> C <- Y). Controlling for, or conditioning an analysis on a collider (i.e., through stratification or regression) can introduce a spurious association between its causes. This po…
The odds ratio (OR) is a measure of effect size commonly used in observational research. OR reflects statistical association between a binary outcome, such as the presence of a health condition, and a binary predictor, such as an exposure to a pollutant. Statistical inference and interval estimation for OR are often performed on the logarithmic scale, due to asymptotic convergence of log(OR) to a normal distribution. Here, we propose a new normalized measure of effect size, $γ'$, and derive its asymptotic distribution. We show that the new statistic, based on the $γ'$ distribution, is more pow…
Rich meta-epidemiological data sets have been collected to explore associations between intervention effect estimates and study-level characteristics. Welton et al. proposed models for the analysis of meta-epidemiological data, but these models are restrictive because they force heterogeneity among studies with a particular characteristic to be at least as large as that among studies without the characteristic. In this paper we present alternative models that are invariant to the labels defining the two categories of studies. To exemplify the methods, we use a collection of meta-analyses in wh…
This paper discusses different needs and approaches to establishing ``causation'' that are relevant in legal cases involving statistical input based on epidemiological (or more generally observational or population-based) information. We distinguish between three versions of ``cause'': the first involves negligence in providing or allowing exposure, the second involves ``cause'' as it is shown through a scientifically proved increased risk of an outcome from the exposure in a population, and the third considers ``cause'' as it might apply to an individual plaintiff based on the first two. The …
We develop a functional proportional hazards mixture cure (FPHMC) model with scalar and functional covariates measured at the baseline. The mixture cure model, useful in studying populations with a cure fraction of a particular event of interest is extended to functional data. We employ the EM algorithm and develop a semiparametric penalized spline-based approach to estimate the dynamic functional coefficients of the incidence and the latency part. The proposed method is computationally efficient and simultaneously incorporates smoothness in the estimated functional coefficients via roughness …
The odds ratio (OR) is a widely used measure of the effect size in observational research. ORs reflect statistical association between a binary outcome, such as the presence of a health condition, and a binary predictor, such as an exposure to a pollutant. Statistical significance and interval estimates are often computed for the logarithm of OR, ln(OR), and depend on the asymptotic standard error of ln(OR). For a sample of size N, the standard error can be written as a ratio of sigma over square root of N, where sigma is the population standard deviation of ln(OR). The ratio of ln(OR) over si…
The classical multilevel model fails to capture the proximity effect in epidemiological studies, where subjects are nested within geographical units. Multilevel Conditional Autoregressive models are alternatives to help explain the spatial effect better. They have been developed for cross-sectional studies but not for longitudinal studies so far. This paper has two goals. Firstly, it further develops the multilevel (growth) models for longitudinal data by adding existing area level random effect terms with CAR prior specification, whose structure is changing over time. We name these models MLM…
The attributable risk, often called the population attributable risk, is in many epidemiological contexts a more relevant measure of exposure-disease association than the excess risk, relative risk, or odds ratio. When estimating attributable risk with case-control data and a rare disease, we present a simple correction to the standard approach making it essentially unbiased, and also less noisy. As with analogous corrections given in Jewell (1986) for other measures of association, the adjustment often won't make a substantial difference unless the sample size is very small or point estimates…
It is emphasised that for epidemiological studies where disease incidence is rare, results from conventional proportional hazards models can often correctly estimate causal associations. The well-known "backdoor criteria" from causal-inference is applied to the common epidemiological study of rare diseases with a proportional hazards model, providing an example of when and how estimates from conventional proportional hazards studies can be used. A similar study with the "frontdoor criteria", that allows studies with unmeasured confounders, finds similar results to conventional mediation analys…
In this paper, we propose a novel association measure for longitudinal studies based on the traditional definition of relative risk. In a Markovian fashion, such a proposal takes into account the information content regarding the previous time. We derive its corresponding confidence interval by means of the Delta method having in mind the crude association between factor and event. Also, we study the properties of our uncertainty quantification scheme through an exhaustive simulation study. Our findings show that the coverage probability is quite close to the level of confidence. Finally, our …
Many epidemiological questions concern potential interventions to alter the pathways presumed to mediate an association. For example, we consider a study that investigates the benefit of interventions in young adulthood for ameliorating the poorer mid-life psychosocial outcomes of adolescent self-harmers relative to their healthy peers. Two methodological challenges arise. Firstly, mediation methods have hitherto mostly focused on the elusive task of discovering pathways, rather than on the evaluation of mediator interventions. Secondly, the complexity of such questions is invariably such that…
Institute for Biomedical Informatics（生物医学信息学研究所）；University of Pennsylvania（宾夕法尼亚大学）；Biostatistics and Bioinformatics Facility（生物统计学与生物信息学中心）；Fox Chase Cancer Center（福克斯蔡斯癌症中心）；Division of Cancer Epidemiology and Genetics（癌症流行病学与遗传学部门）；National Cancer Institute（美国国家癌症研究所）；Cancer Prevention and Control（癌症预防与控制部门）
Machine learning (ML) offers a collection of powerful approaches for detecting and modeling associations, often applied to data having a large number of features and/or complex associations. Currently, there are many tools to facilitate implementing custom ML analyses (e.g. scikit-learn). Interest is also increasing in automated ML packages, which can make it easier for non-experts to apply ML and have the potential to improve model performance. ML permeates most subfields of biomedical research with varying levels of rigor and correct usage. Tremendous opportunities offered by ML are frequent…
In epidemiological cohort studies, the relative risk (also known as risk ratio) is a major measure of association to summarize the results of two treatments or exposures. Generally, it measures the relative change in disease risk as a result of treatment application. Standard approaches to estimating relative risk available in common software packages may produce biased inference when applied to correlated binary data collected from longitudinal or clustered studies. In recent years, several methods for estimating the risk ratio for correlated binary data have been published, some of which mai…
Hierarchical Bayesian Modeling of Dengue in Recife, Brazil (2015-2024): The Role of Spatial Granularity and Data Quality for Epidemiological Risk Mapping
The population-attributable fraction (PAF) is a popular epidemiological measure for the burden of a harmful exposure within a population. It is often interpreted causally as proportion of preventable cases after an elimination of exposure. Originally, the PAF has been defined for cohort studies of fixed length with a baseline exposure or cross-sectional studies. An extension of the definition to complex time-to-event data is not straightforward. We revise the proposed approaches in literature and provide a clear concept of the PAF for these data situations. The conceptualization is achieved by…
Epidemiological research supports an association between maternal exposure to air pollution during pregnancy and adverse children's health outcomes. Advances in exposure assessment and statistics allow for estimation of both critical windows of vulnerability and exposure effect heterogeneity. Simultaneous estimation of windows of vulnerability and effect heterogeneity can be accomplished by fitting a distributed lag model (DLM) stratified by subgroup. However, this can provide an incomplete picture of how effects vary across subgroups because it does not allow for subgroups to have the same wi…
