64th ISI World Statistics Congress - Ottawa, Canada

64th ISI World Statistics Congress - Ottawa, Canada

IPS 376 - Statistical Methods for Complex Data Obtained from Administrative Health Databases

Category: IPS
Wednesday 19 July 2 p.m. - 3:40 p.m. (Canada/Eastern) (Expired) Room 207

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Access to administrative health databases provides immense opportunity to study longitudinal patient health outcomes, drug usage, and disease surveillance, among others. These databases are becoming more complex due to the increasing volume of patients and their encounters with the healthcare system, the integration of imaging and genetic data, and different coding standards in different systems. Most databases were not built for research purposes, and due to the complex nature of the data, proper statistical methods are needed to answer specific research questions.

In this session, we invited five speakers from various career stages with a strong record of research in methods for complex data obtained from administrative health data. Professor Joan Hu from the Department of Statistics at Simon Fraser University will present the analysis of zero-truncated recurrent events data applied to mental health related emergency department visits. Dr. Eleanor Pullenayegum, Senior Scientist at SickKids Research Institute, will present approaches to handling the informative visit process observed in electronic health records of newborns. Assistant Professor Kuan Liu from the Institute of Health Policy, Management and Evaluation at the University of Toronto will present Bayesian sensitivity analysis that models time-dependent unmeasured confounders applied to multi-centre pediatric disease registry. Assistant Professor Zihang Lu from the Department of Public Health Sciences at Queens University will present a joint modeling approach for clustering multiple longitudinal traits using administrative data with complex structures. Assistant Professor Aya Mitani from the Division of Biostatistics at the University of Toronto will present a multistate modeling approach for clustered interval censored data obtained from an administrative oral health database. Professor Wendy Lou from the University of Toronto will chair the session.

The purpose of the session is three-fold: to bring together researchers with recent works on analyzing complex administrative health data to present their methodological advances and applications; to provide an opportunity to bridge gaps and foster collaborations within the ISI community who work with administrative databases; and to give a larger audience access to these developments and applications by promoting interaction and networking among researchers and trainees.

JH: There has been increasing interest in utilizing administrative health data to achieve various scientific goals. Truncation issues arising from analysis of administrative health records are particularly challenging. We present our recent projects on tackling a zero-truncation issue by integrating zero-truncated recurrent events data with available population-based demographic information. We employ the mental health related emergency department visits generated from an administrative cohort to motivate and illustrate the statistical analysis under loosely structured models. This presentation is based on joint work with Angela Chen (Simon Fraser University), Rhonda Rosychuk (University of Alberta), and Yi Xiong (University of Manitoba).

EP: Longitudinal data collected as part of usual healthcare delivery are becoming increasingly available for research through electronic health records. However, a common feature of these data is that they are collected more frequently when patients are unwell. For example, newborns who are slow to regain their birthweight will require more frequent monitoring and will consequently have more weight measurements than their typically growing counterparts. Failing to account for this would lead to underestimation of the rate of growth of the population of newborns as a whole. I will discuss approaches to handling the informative nature of the observation, including recent developments to handle other data complexities such as clustering, causal inference, and variable selection. 

KL: Although administrative data are rich in information, key confounders might not be captured. Several Bayesian sensitivity analyses for unmeasured confounding have been developed that use bias parameters to capture the effect of unobserved confounders. However, these methods do not consider time-dependent unmeasured confounders. We will develop a parametric Bayesian sensitivity analysis that models time-dependent unmeasured confounders. We will formally define sequential ignorability assumption given the unobserved confounders and discuss identifiability of our model. We will apply our approach to study the effectiveness of oral vancomycin for pediatric primary sclerosing cholangitis using a multi-centre pediatric disease registry. 

ZL: Identifying disease phenotypes based on longitudinal traits is a common goal in biomedical study. Compared to clustering a single longitudinal trait, integrating multiple longitudinal traits allows additional information to be incorporated into the clustering process, which reveals co-existing longitudinal patterns and generates deeper biological insight. This talk will discuss a joint modeling approach for clustering multiple longitudinal traits using administrative data with complex structures. Results from analyzing real and simulated data will be presented and discussed. 

AM: Patients with periodontitis visit dental clinics routinely and multiple markers on each tooth are recorded at each visit. To characterize the progression of periodontal markers on each tooth, we extend the multistate model framework to account for informative cluster size by incorporating the within-cluster resampling method and cluster-weighted score function, from which we can obtain the marginal inference about the association of time to disease progression with subject-level covariates. We assess the performance of the proposed methods through simulation studies and apply them to the longitudinal data obtained from the Canadian Armed Forces Oral Health Database.

 

JH: There has been increasing interest in utilizing administrative health data to achieve various scientific goals. Truncation issues arising from analysis of administrative health records are particularly challenging. We present our recent projects on tackling a zero-truncation issue by integrating zero-truncated recurrent events data with available population-based demographic information. We employ the mental health related emergency department visits generated from an administrative cohort to motivate and illustrate the statistical analysis under loosely structured models. This presentation is based on joint work with Angela Chen (Simon Fraser University), Rhonda Rosychuk (University of Alberta), and Yi Xiong (University of Manitoba).

EP: Longitudinal data collected as part of usual healthcare delivery are becoming increasingly available for research through electronic health records. However, a common feature of these data is that they are collected more frequently when patients are unwell. For example, newborns who are slow to regain their birthweight will require more frequent monitoring and will consequently have more weight measurements than their typically growing counterparts. Failing to account for this would lead to underestimation of the rate of growth of the population of newborns as a whole. I will discuss approaches to handling the informative nature of the observation, including recent developments to handle other data complexities such as clustering, causal inference, and variable selection. 

KL: Although administrative data are rich in information, key confounders might not be captured. Several Bayesian sensitivity analyses for unmeasured confounding have been developed that use bias parameters to capture the effect of unobserved confounders. However, these methods do not consider time-dependent unmeasured confounders. We will develop a parametric Bayesian sensitivity analysis that models time-dependent unmeasured confounders. We will formally define sequential ignorability assumption given the unobserved confounders and discuss identifiability of our model. We will apply our approach to study the effectiveness of oral vancomycin for pediatric primary sclerosing cholangitis using a multi-centre pediatric disease registry. 

ZL: Identifying disease phenotypes based on longitudinal traits is a common goal in biomedical study. Compared to clustering a single longitudinal trait, integrating multiple longitudinal traits allows additional information to be incorporated into the clustering process, which reveals co-existing longitudinal patterns and generates deeper biological insight. This talk will discuss a joint modeling approach for clustering multiple longitudinal traits using administrative data with complex structures. Results from analyzing real and simulated data will be presented and discussed. 

AM: Patients with periodontitis visit dental clinics routinely and multiple markers on each tooth are recorded at each visit. To characterize the progression of periodontal markers on each tooth, we extend the multistate model framework to account for informative cluster size by incorporating the within-cluster resampling method and cluster-weighted score function, from which we can obtain the marginal inference about the association of time to disease progression with subject-level covariates. We assess the performance of the proposed methods through simulation studies and apply them to the longitudinal data obtained from the Canadian Armed Forces Oral Health Database.

Organiser: Aya Mitani 

Chair: Prof. Wendy Lou 

Speaker: Joan Hu 

Speaker: Eleanor Pullenayegum 

Speaker: Kuan Liu 

Speaker: Zihang Lu 

Speaker:  Aya Mitani 

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