A Biostatistics Toolbox for Data Analysis
Abstract
This sophisticated package of statistical methods is for advanced master's (MPH) and PhD students in public health and epidemiology who are involved in the analysis of data. It makes the link from statistical theory to data analysis, focusing on the methods and data types most common in public health and related fields. Like most toolboxes, the statistical tools in this book are organized into sections with similar objectives. Unlike most toolboxes, however, these tools are accompanied by complete instructions, explanations, detailed examples, and advice on relevant issues and potential pitfalls - conveying skills, intuition, and experience. The only prerequisite is a first-year statistics course and familiarity with a computing package such as R, Stata, SPSS, or SAS. Though the book is not tied to a particular computing language, its figures and analyses were all created using R. Relevant R code, data sets, and links to public data sets are available from www.cambridge.org/9781107113084.
... Descriptive statistics and Mann-Whitney U tests were performed to compare group median scores for parent and teacher reported outcomes. Group medians and interquartile ranges (IQR) showing the 25th and 75th percentiles are reported to indicate the distribution of data and to provide a reliable representation of central tendency (51). Score distributions of the controls were used to define clinically significant impairment (using a worst 10% cut-point). ...
Background: Increasing evidence suggests potential lifetime effects following mild traumatic brain injury (TBI) in childhood. Few studies have examined medium-term outcomes among hospitalized and non-hospitalized samples. Study aims were to describe children's behavioral and emotional adjustment, executive function (EF), quality of life, and participation at 7-years following mild TBI using parents' and teachers' reports.
Methods: Nested case control study of 86 children (68% male, mean age at assessment = 11.27 years; range 7–17 years) who sustained a mild TBI 7-years previously, identified from a prospective, population-based study. They were compared to 69 children free from TBI (61% male, mean age at assessment = 11.12 years; range 5–17 years). In addition to parent-reported socio-demographic details, parents (mild TBI n = 86, non-TBI n = 69) completed age-appropriate standardized questionnaires about children's health-related quality of life, behavioral and emotional adjustment, EF, and social participation. Parents own mood was assessed using the Hospital Anxiety and Depression Scale. Teachers (mild TBI n = 53, non-TBI n = 42) completed questionnaires about children's behavioral and emotional adjustment, and EF.
Results: Parent reports showed median group-level scores for cases were statistically significantly greater than controls for emotional symptoms, conduct problems, hyperactivity/inattention, total behavioral difficulties, inhibitory control, shifting, planning/organizing, and Global Executive Composite (total) EF difficulties (p-values 0.001–0.029). Parent reports of child quality of life and social participation were similar, as were teacher reports of child behavioral and emotional adjustment, and EF (p > 0.05). When examining clinical cut-offs, compared to controls, cases had a higher risk of parent-reported total EF difficulties (odds ratio = 3.00) and, to a lesser extent, total behavior problems (odds ratio = 2.51).
Conclusions: As a group, children with a history of mild TBI may be at elevated risk for clinically significant everyday EF difficulties in the medium-term compared to non-TBI controls, as judged by their parents. Further multi-informant longitudinal research is required, following larger samples. Aspects requiring particular attention include pre-injury characteristics, such as sleep disturbances and comorbidities (e.g., headaches), that may act as potential confounders influencing the association between mild TBI and child behavioral problems.
... Al the date was expressed as μg formazan/g biological material. The data were statistically interpreted with the Student t test and the Pearson correlation coefficient (r), in order to determine whether there is an association between the two variables (pH and oxidoreductases activity) and how strong this association is [18] ...
Dehydrogenases are enzymes that catalyzes the electron transfer reactions and act according to their redox potential (rH) from negative rH values to the highest positive ones. Depending on the chemical nature of the substrate which donates hydrogen, dehydrogenase bear appropriate names: α-ketoglutarate glucoso 6-fosfat dehidrogenase, isocitrate dehydrogenase, malate dehydrogenase, etc. The paper presents the influence of pH against the dehydrogenase activity, both if the mycelium and culture liquid, at 21 and 28 days from the inoculation.
... The imputation was based on the missing at random assumption. The distribution of the observed data (see Table 1) was used to estimate multiple values of missing baseline BMI that reflect the uncertainty around the true value [21,22]. We generated 25 complete datasets with imputed data using all available information from the patients which also included (see Table 1). ...
Objective:
To examine whether fulfilment of process performance measures reflecting national guidelines is associated with in-hospital costs among hip fracture patients.
Design:
Nationwide, population-based follow-up study.
Setting:
Public hospitals in Denmark.
Participants:
A total of 20 458 patients 65 years or older admitted with a hip fracture between 2010 and 2013.
Intervention:
Quality of care defined as fulfilment of process performance measures reflecting recommendations from national clinical guidelines, which previously have been shown to be associated with lower mortality and readmission risk. The measures included systematic pain assessment; mobilisation within 24 h post-operatively; assessment of basic mobility before admission and discharge; and receiving a rehabilitation programme before discharge, anti-osteoporotic medication and fall prevention.
Main outcome measures:
Total costs defined as the sum of hospital costs used for treating the individual patients according to the Danish Reference Cost Database.
Results:
Within the index admission, fulfilling 50 to >75% of the performance measures was associated with lower adjusted costs (EUR 2643) than was fulfilling 0-50% of these measures (EUR 3544). The lower costs were mainly due to savings on further treatment and fewer bed days. Mobilisation within 24 h after surgery and assessment for need of anti-osteoporotic medication were associated with the largest cost differences, corresponding to adjusted cost differences of EUR 3030 and EUR 3538, respectively. The cost difference was lower when all costs related to hospitalisation within the first year were considered.
Conclusions:
These findings indicate that high quality of care does not imply higher hospital spending and may be associated with cost savings.
Background
Few individuals (<2%) who experience a stroke or transient ischemic attack (TIA) participate in secondary prevention lifestyle programs. Novel approaches that leverage digital health technology may provide a viable alternative to traditional interventions that support secondary prevention in people living with stroke or TIA. To be successful, these strategies should focus on user needs and preferences and be acceptable to clinicians and people living with stroke or TIA.
Objective
This study aims to co-design, with people with lived experience of stroke or TIA (referred to as consumers) and clinicians, a multicomponent digital technology support program for secondary prevention of stroke.
Methods
A consumer user needs survey (108 items) was distributed through the Australian Stroke Clinical Registry and the Stroke Association of Victoria. An invitation to a user needs survey (135 items) for clinicians was circulated via web-based professional forums and national organizations (eg, the Stroke Telehealth Community of Practice Microsoft Teams Channel) and the authors’ research networks using Twitter (subsequently rebranded X, X Corp) and LinkedIn (LinkedIn Corp). Following the surveys, 2 rounds of user experience workshops (design and usability testing workshops) were completed with representatives from each end user group (consumers and clinicians). Feedback gathered after each round informed the final design of the digital health program.
Results
Overall, 112 consumers (male individuals: n=63, 56.3%) and 54 clinicians (female individuals: n=43, 80%) responded to the survey; all items were completed by 75.8% (n=85) of consumers and 78% (n=42) of clinicians. Most clinicians (46/49, 94%) indicated the importance of monitoring health and lifestyle measures more frequently than current practice, particularly physical activity, weight, and sleep. Most consumers (87/96, 90%) and clinicians (41/49, 84%) agreed that providing alerts about potential deterioration in an individual’s condition were important functions for a digital program. Intention to use a digital program for stroke prevention and discussing the data collected during face-to-face consultations was high (consumers: 79/99, 80%; clinicians 36/42, 86%). In addition, 7 consumers (male individuals: n=5, 71%) and 9 clinicians (female individuals: n=6, 67%) took part in the user experience workshops. Participants endorsed using a digital health program to help consumers manage stroke or TIA and discussed preferred functions and health measures in a digital solution for secondary prevention of stroke. They also noted the need for a mobile app that is easy to use. Clinician feedback highlighted the need for a customizable clinician portal that captures individual consumer goals.
Conclusions
Following an iterative co-design process, supported by evidence from user needs surveys and user experience workshops, a consumer-facing app that integrates wearable activity trackers and a clinician web portal were designed and developed to support secondary prevention of stroke. Feasibility testing is currently in progress to assess acceptability and use.
Número completo de la revista Odontología Activa Volumen 4 número 1
Resumen El objetivo de este trabajo, es realizar una contribución didáctica docente que revise los contenidos necesarios y suficientes para la ejecución del planteamiento de las variables en la elaboración de un proyecto de investigación. Se explican los pasos para la construcción de una tabla de operacionalización de variables, desarrolla contenidos y ejemplos con casos concretos aplicados en odontología y profesiones afines. Palabras clave: Indicadores de Salud, Indicadores (Estadística), Tesis Académicas.
Abstract The aim of this article is to guide our fellow teachers on how to properly present the variables when preparing a research proposal. It contains some important definitions and several examples taken from the dentistry field that help understanding operationalization of variables. The aim of this paper, is to make a contribution didactic teacher to review the necessary and sufficient for the implementation of the approach of the variables in the development of a research project contents. Develops content and examples that help understanding the operationalization of the variables, concrete cases related to the field of dentistry. Las características fundamentales del método científico son la validez (capacidad de medir lo que se plantea medir) y la confiabilidad (capacidad de repetir una medida en las mismas condiciones). 1 Plantear adecuadamente las variables ayuda a garantizar la validez y confiabilidad de un estudio. Las variables son características medibles u observables de las unidades de estudio y que pueden asumir distintos va-lores. 2, 3 Son el eje central de la investigación del enfoque cuantitativo, debido a que traducen la información que ob-tiene el investigador en valores, los cuales pueden ser de tipo cuantitativo (expresados en números susceptibles de ser em-pleados en operaciones aritméticas) o cualitativo (expresados en categorías o características). 4 Existe discrepancia entre las cátedras de investigación de diferentes universidades, respecto a la ubicación del cuadro de la operacionalización de variables en el contexto de un proyecto de investigación (o tesis): algunas abogan por presentarlo en el Planteamiento Teórico del proyecto de investigación, mientras que otras proponen ubicarlo en el capítulo de Materiales y Métodos. En la Cátedra de Investigación Científica de la carrera de Odontología de la Universidad Católica de Cuenca, creemos que este cuadro debe ser parte del planteamiento teórico, debido a que aclara la forma en la que se plantea el problema (relación de variables), el rol que desempeñan las variables y la definición teórica de cada una de ellas. Este trabajo fue motivado por la gran cantidad de veces que hemos observado confusiones de términos en los proyectos de tesis de nuestros estudiantes de pregrado (por ejemplo: dimensión-indicador,
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