Assessing uncertainty in the American Indian Trust Fund

Fiscal year-end balances of the Individual Indian Money System (a part of the Indian Trust) were constructed from data related to money collected in the system and disbursed by the system from 1887 to 2007. The data set of fiscal year accounting information had a high proportion of missing values, and much of the available data did not satisfy basic accounting relationships. Instead of just calculating a single estimate and arguing to the Court that the assumptions needed for the computation were reasonable, a distribution of calculated balances was developed using multiple imputation and time series models. These provided information to assess the uncertainty of the estimate due to missing and questionable data.Comment: Published in at http://dx.doi.org/10.1214/09-AOAS274 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

What Protects the Autonomy of the Federal Statistical Agencies? An Assessment of the Procedures in Place to Protect the Independence and Objectivity of Official U.S. Statistics

AbstractWe assess the professional autonomy of the 13 principal U.S. federal statistical agencies. We define six components or measures of such autonomy and evaluate each of the 13 principal statistical agencies according to each measure. Our assessment yields three main findings: (a) Challenges to the objectivity, credibility, and utility of federal statistics arise largely as a consequence of insufficient autonomy. (b) There is remarkable variation in autonomy protections and a surprising lack of statutory protections for many agencies for many of the proposed measures. (c) Many existing autonomy rules and guidelines are weakened by unclear or unactionable language. We conclude that a lack of professional autonomy unduly exposes the principal federal statistical agencies to efforts to undermine the objectivity of their products and that agencies cannot completely rebuff these efforts. Our main recommendations are to strengthen the role of the OMB Chief Statistician and to legislate new statutory autonomy protections, including explicit authorization for the principal federal statistical agencies that currently have no recognition in statute. We also recommend periodic assessments of the health of the federal statistical system, including not only autonomy protections and resources, but also how well agencies are satisfying data needs for the public good and using best methods to do so

The effect of hypertension and hyperchlosterolemia screening with subsequent intervention letter on the use of blood pressure and lipid lowering drugs

AIM: To evaluate the effect of a letter intervention that was send to both the participants of a population screening and their general practitioners. We also tested what predicting variables influenced the GP to actually prescribe blood pressure lowering drugs (BPLD) or lipid lowering drugs (LLD). METHOD: The study design was cross sectional, in the PREVEND outpatient clinic in Groningen University Hospital, the Netherlands. We used the clinical data of the 8592 subjects that participated in the first screening of the PREVEND study. Data on drug use was collected from community pharmacies. Drug use was measured the year before and after the screening with the subsequent intervention letter. As control population without intervention, we used the data from the InterAction DataBase (IADB) standardized for the population characteristics of the intervention group. The letter intervention was sent to participants who had shown after screening to have either an elevated blood pressure or plasma cholesterol, and the letter contained the advice to use a BPLD or LLD. Main outcome measures were proportion of patients prescribed BPLD and/or LLD in the year before and after the intervention, and variables that influence the GP to prescribe BPLD and LLD. RESULTS: Data from the community pharmacy were available from 7567 (88%) subjects. 397 participants (5.2%) received a letter with advice to start a BPLD, and 326 participants (4.3%) received a letter with advice to start a LLD. The prevalence of patients who were using BPLD and LLD before the intervention was not significantly different between the intervention and control group, 16.6 (CI 95% 15.8 –17.5) vs 16.0 and 4.8 (4.4–5.3) vs 4.6, respectively. After the letter intervention, the prevalence of BPLD use was higher in the intervention group compared with the control group (19.4 [18, 5–20, 3]vs 17.0%), as was the prevalence of LLD use (7.1[6.5–7.7) vs 5.4%). The same held true for the incidence of BPLD (3.4[3.0–3.8]vs 2.5%) and LLD use (2.1 [1, 6–2, 4]vs 1.0%), respectively, in the year after the intervention. Univariate and multivariate analysis showed that a higher blood pressure and cholesterol level, but not the presence of other cardiovascular risk factors, were associated to with a greater percentage use of a BPLD and a LLD. CONCLUSION: A population survey followed by a letter of intervention to both the patient and GP are effective to improve the use of blood pressure and lipid lowering drugs as a primary prevention in patients with hypertension and hyperlipidemia. Our therapeutic advice however, was followed only in about one of the three subjects with hypertension and one of the four subjects with hyperlipidemia. The levels of blood pressure and plasma total cholesterol are important variables influencing the GP to prescribe a BPLD and/or LLD