Some links between conditional and coregionalized multivariate Gaussian Markov random fields

Multivariate disease mapping models are attracting considerable attention. Many modeling proposals have been made in this area, which could be grouped into three large sets: coregionalization, multivariate conditional and univariate conditional models. In this work we establish some links between these three groups of proposals. Specifically, we explore the equivalence between the two conditional approaches and show that an important class of coregionalization models can be seen as a large subclass of the conditional approaches. Additionally, we propose an extension to the current set of coregionalization models with some new unexplored proposals. This extension is able to reproduce asymmetric cross-spatial covariances for different diseases. This shows that the previously accepted belief that coregionalization was not able to reproduce models with asymmetric cross-covariances was wrong

On the use of adaptive spatial weight matrices from disease mapping multivariate analyses

Conditional autoregressive distributions are commonly used to model spatial dependence between nearby geographic units in disease mapping studies. These distributions induce spatial dependence by means of a spatial weights matrix that quantifies the strength of dependence between any two neighboring spatial units. The most common procedure for defining that spatial weights matrix is using an adjacency criterion. In that case, all pairs of spatial units with adjacent borders are given the same weight (typically 1) and the remaining non-adjacent units are assigned a weight of 0. However, assuming all spatial neighbors in a model to be equally influential could be possibly a too rigid or inappropriate assumption. In this paper, we propose several adaptive conditional autoregressive distributions in which the spatial weights for adjacent areas are random variables, and we discuss their use in spatial disease mapping models. We will introduce our proposal in a multivariate context so that the spatial dependence structure between spatial units is shared and estimated from a sufficiently large set of mortality causes. As we will see, this is a key aspect for making inference on the spatial dependence structure. We show that our adaptive modeling proposal provides more flexible and accurate mortality risk estimates than traditional proposals in which spatial weights for neighboring areas are fixed to a common value

Bayesian modeling of spatial ordinal data from health surveys

Health surveys allow exploring health indicators that are of great value from a public health point of view and that cannot normally be studied from regular health registries. These indicators are usually coded as ordinal variables and may depend on covariates associated with individuals. In this paper, we propose a Bayesian individual-level model for small-area estimation of survey-based health indicators. A categorical likelihood is used at the first level of the model hierarchy to describe the ordinal data, and spatial dependence among small areas is taken into account by using a conditional autoregressive (CAR) distribution. Post-stratification of the results of the proposed individual-level model allows extrapolating the results to any administrative areal division, even for small areas. We apply this methodology to the analysis of the Health Survey of the Region of Valencia (Spain) of 2016 to describe the geographical distribution of a self-perceived health indicator of interest in this region

On the convenience of heteroscedasticity in highly multivariate disease mapping

Highly multivariate disease mapping has recently been proposed as an enhancement of traditional multivariate studies, making it possible to perform the joint analysis of a large number of diseases. This line of research has an important potential since it integrates the information of many diseases into a single model yielding richer and more accurate risk maps. In this paper we show how some of the proposals already put forward in this area display some particular problems when applied to small regions of study. Specifically, the homoscedasticity of these proposals may produce evident misfits and distorted risk maps. In this paper we propose two new models to deal with the variance-adaptivity problem in multivariate disease mapping studies and give some theoretical insights on their interpretation

Some findings on zero-inflated and hurdle Poisson models for disease mapping

Zero excess in the study of geographically referenced mortality data sets has been the focus of considerable attention in the literature, with zero-inflation being the most common procedure to handle this lack of fit. Although hurdle models have also been used in disease mapping studies, their use is more rare. We show in this paper that models using particular treatments of zero excesses are often required for achieving appropriate fits in regular mortality studies since, otherwise, geographical units with low expected counts are oversmoothed. However, as also shown, an indiscriminate treatment of zero excess may be unnecessary and has a problematic implementation. In this regard, we find that naive zero-inflation and hurdle models, without an explicit modeling of the probabilities of zeroes do not fix zero excesses problems well enough and are clearly unsatisfactory. Results sharply suggest the need for an explicit modeling of the probabilities that should vary across areal units. Unfortunately, these more flexible modeling strategies can easily lead to improper posterior distributions as we prove in several theoretical results. Those procedures have been repeatedly used in the disease mapping literature and one should bear these issues in mind in order to propose valid models. We finally propose several valid modeling alternatives according to the results mentioned that are suitable for fitting zero excesses. We show that those proposals fix zero excesses problems and correct the mentioned oversmoothing of risks in low populated units depicting geographic patterns more suited to the data

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics

<p>Abstract</p> <p>Background</p> <p>The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software.</p> <p>Results</p> <p>In this paper, we introduce <monospace>FluDetWeb</monospace>, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (ℝ and WinBUGS), a web server environment for Java code (<it>Tomcat</it>) and a software module created by us (<it>Rdp</it>) responsible for managing internal tasks; the software package <it>MySQL </it>has been used to construct the database management system. The implementation is available on-line from: <url>http://www.geeitema.org/meviepi/fludetweb/</url>.</p> <p>Conclusion</p> <p>The ease of use of <monospace>FluDetWeb</monospace> and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.</p

A Multilevel Regression Model for Geographical Studies in Sets of Non-Adjacent Cities

<div><p>In recent years, small-area-based ecological regression analyses have been published that study the association between a health outcome and a covariate in several cities. These analyses have usually been performed independently for each city and have therefore yielded unrelated estimates for the cities considered, even though the same process has been studied in all of them. In this study, we propose a joint ecological regression model for multiple cities that accounts for spatial structure both within and between cities and explore the advantages of this model. The proposed model merges both disease mapping and geostatistical ideas. Our proposal is compared with two alternatives, one that models the association for each city as fixed effects and another that treats them as independent and identically distributed random effects. The proposed model allows us to estimate the association (and assess its significance) at locations with no available data. Our proposal is illustrated by an example of the association between unemployment (as a deprivation surrogate) and lung cancer mortality among men in 31 Spanish cities. In this example, the associations found were far more accurate for the proposed model than those from the fixed effects model. Our main conclusion is that ecological regression analyses can be markedly improved by performing joint analyses at several locations that share information among them. This finding should be taken into consideration in the design of future epidemiological studies.</p></div

Posterior standard deviations (SD) of the predicted relative risks between lung cancer mortality in men and unemployment throughout peninsular Spain, 2002–2007.

<p>Posterior standard deviations (SD) of the predicted relative risks between lung cancer mortality in men and unemployment throughout peninsular Spain, 2002–2007.</p

Comparative model with respect to city specific relative risks (RR) between mortality and unemployment and their 95% credible intervals (95%CI), 2002–2007.

<p>Comparative model with respect to city specific relative risks (RR) between mortality and unemployment and their 95% credible intervals (95%CI), 2002–2007.</p