17 research outputs found

    Simulation Approach to Assess the Precision of Estimates Derived from Linking Survey and Administrative Records

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    Probabilistic record linkage implies that there is some level of uncertainty related to the classification of pairs as links or non-links vis-à-vis their true match status. As record linkage is usually performed as a preliminary step to developing statistical estimates, the question then is how does this linkage uncertainty propagate to them? In this paper, we develop an approach to estimate the impact of linkage uncertainty on derived estimates by using a re-sampling approach. For each iteration of the re-sampling, pairs are classified as links or non-links by Monte-Carlo assignment to model estimated true match probabilities. By looking at the range of estimates produced in a series of re-samples, we can estimate the distribution of derived statistics under the prevailing incidence of linkage uncertainty. For this analysis we use the results of linking the 2014 National Hospital Care Survey to the National Death Index performed at the National Center for Health Statistics. We assess the precision of hospital-level death rate estimates

    Nonsampling errors and their implication for estimates of current cancer treatment using the Medical Expenditure Panel Survey

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    Survey nonsampling errors refer to the components of total survey error (TSE) that result from failures in data collection and processing procedures. Evaluating nonsampling errors can lead to a better understanding of their sources, which in turn, can inform survey inference and assist in the design of future surveys. Data collected via supplemental questionnaires can provide a means for evaluating nonsampling errors because it may provide additional information on survey nonrespondents and/or measurements of the same concept over repeated trials on the same sampling unit. We used a supplemental questionnaire administered to cancer survivors to explore potential nonsampling errors, focusing primarily on nonresponse and measurement/specification errors. We discuss the implications of our findings in the context of the TSE paradigm and identify areas for future research

    Blood Lead Levels and Death from All Causes, Cardiovascular Disease, and Cancer: Results from the NHANES III Mortality Study

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    BACKGROUND: Analyses of mortality data for participants examined in 1976–1980 in the second National Health and Nutrition Examination Survey (NHANES II) suggested an increased risk of mortality at blood lead levels > 20 μg/dL. Blood lead levels have decreased markedly since the late 1970s. In NHANES III, conducted during 1988–1994, few adults had levels > 20 μg/dL. OBJECTIVE: Our objective in this study was to determine the risk of mortality in relation to lower blood lead levels observed for adult participants of NHANES III. METHODS: We analyzed mortality information for 9,757 participants who had a blood lead measurement and who were ≥ 40 years of age at the baseline examination. Using blood lead levels categorized as < 5, 5 to < 10, and ≥ 10 μg/dL, we determined the relative risk of mortality from all causes, cancer, and cardiovascular disease through Cox proportional hazard regression analysis. RESULTS: Using blood lead levels < 5 μg/dL as the referent, we determined that the relative risk of mortality from all causes was 1.24 [95% confidence interval (CI), 1.05–1.48] for those with blood levels of 5–9 μg/dL and 1.59 (95% CI, 1.28–1.98) for those with blood levels ≥ 10 μg/dL (p for trend < 0.001). The magnitude of risk was similar for deaths due to cardiovascular disease and cancer, and tests for trend were statistically significant (p < 0.01) for both causes of death. CONCLUSION: In a nationally representative sample of the U.S. population, blood lead levels as low as 5–9 μg/dL were associated with an increased risk of death from all causes, cardiovascular disease, and cancer

    Placental Malaria Diminishes Development of Antibody Responses to Plasmodium falciparum Epitopes in Infants Residing in an Area of Western Kenya Where P. falciparum Is Endemic

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    To determine the effect of placental malaria (PM) infection on the development of antibody responses to malaria in infants, we measured immunoglobulin G levels to seven different Plasmodium falciparum epitopes by using plasma samples collected at monthly intervals from infants born to mothers with and without PM. Overall, PM was associated with diminished antibody levels to all of the epitopes tested, especially with infants aged ≥4 to 12 months, and the difference was statistically significant for four of the seven epitopes (P < 0.0035). These findings suggest that PM can negatively influence the development of immune responses to malaria in infants
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