Yule-Simpson\u27s Paradox in Research

Yule (1903) and Simpson (1951) described a statistical paradox that occurs when data is aggregated. In such situations, aggregated data may reveal a trend that directly contrasts those of sub-groups trends. In fact, the aggregate data trends may even be opposite in direction of sub-group trends. To reveal Yule-Simpson’s paradox (YSP)-type occurrences, researchers must simultaneously consider the effect of an intervention at specific levels and on the overall model to ensure datasets are accurately analyzed and research findings are appropriately interpreted. The primary objectives of this manuscript are to: (1) examine the history of YSP; (2) describe necessary and sufficient causes for YSP occurrences; (3) provide examples of YSP in research and explain YSP’s relationship to multi-level modeling including Hierarchical Linear Modeling (HLM); and (4) discuss YSP’s implications for researchers. Accessed 11,204 times on https://pareonline.net from October 18, 2010 to December 31, 2019. For downloads from January 1, 2020 forward, please click on the PlumX Metrics link to the right

Correlates of chronic disease and patientprovider discussions among middle-aged and older adult males: Implications for successful aging and sexuality

Objective: Effective erectile dysfunction (ED) treatments and cardiovascular disease (CVD) and diabetes risk assessments are available, but require patientprovider communication. The present study explored this issue using 2010 National Social Life, Health and Aging Project data for males age 57 years and older (n=1011).Methods: Multinomial logistic regression was performed to compare factors associated with being without CVD/diabetes (39.9%), being diagnosed with CVD only (43.1%), and having comorbid CVD/diabetes (CVD 17.0%). Logistic regression compared factors associated with having ever discussed sexual issues with physicians.Results: CVD-only participants were more likely to be ≥75 years (p=0.004) and smoke (p=0.019); CVD&D participants were more likely to report activity limitations (p\u3c0.001) and less likely to have sex within the previous year (p=0.014). Compared to CVD-only, men with CVD&D were more likely to be minorities, obese, have daily activity limitations, and report erectile difficulties (all p\u3c0.05). Males discussing sexual issues with physicians were more likely to report higher education [OR=1.68, p=0.001], have sex in previous year [OR1.73, p=0.006], and have erectile difficulties [OR2.26, p\u3c0.001].Discussion: Increased patient and provider awareness and communication are needed to lifestyle behaviors, promote self-care practices, and improve health care utilization among male patients affected by chronic disease and ED. © 2012 Informa UK, Ltd

Correlates of CVD and discussing sexual issues with physicians among male military veterans

Purpose This study aims to identify socio-demographic and health behavior factors associated with cardiovascular disease (CVD) diagnosis and patient-physician communication concerning sexual issues among older Veterans. Methods Cross-sectional data were collected from 635 male Veterans over age 55 years as part of the 2010 National Social Life, Health and Aging Project, a nationally-representative, population-based study of community-dwelling older Americans. Two independent logistic regression analyses were performed. Results Over 33% of Veterans were aged 75 years or older. Over one-half of participants reported having a CVD diagnosis (58%) and sexual intercourse within the previous year (58%); over one-third (37%) reported having one or more sexual dysfunctions and discussing sexual issues with their physician (42%). Veterans diagnosed with CVD were significantly more likely to self-identify as racial/ethnic minorities (OR = 1.89, P = 0.021), have more chronic disease comorbidities (OR = 1.23, P = 0.041), and have more sexual dysfunctions (OR = 1.19, P = 0.028). Veterans diagnosed with CVD were significantly less likely to report having sex within the previous year (OR = 0.53, P = 0.005). Veterans who reported discussing sexual issues with a physician were significantly more likely to be ≥75 years (OR = 1.79, P = 0.010), and report more than a high school education (OR = 1.62, P = 0.016), CVD diagnosis (OR = 1.59, P = 0.015), sex within the previous year (OR = 1.69, P = 0.033), and trouble achieving/maintaining an erection (OR = 3.39, P \u3c 0.001). Implications These findings suggest older male Veterans, particularly racial/ethnic minorities and those less-educated, may benefit from VA and community-based aging and sexual health/counseling services. These services should promote increased patient-physician communication as well as referrals between physicians and sex health/counseling specialists