A factor mixture model for analyzing heterogeneity and cognitive structure of dementia

The Health and Retirement Study (HRS) is funded by the National Institute on Aging of US with the aim of investigating the health, social and economic implications of the aging of the American population. The participants of the study receive a thorough in-home clinical and neuropsychological assessment leading to a diagnosis of normal, cognitive impairment but not demented, or dementia. Due to the heterogeneity of the participants into three classes, we analyze some overall cognitive functioning responses through a factor mixture analysis model. The model extends recent proposals developed for binary and continuous data to general mixed data and to the situation of observed heterogeneity, typical of the HRS study.     

DESCRIBING DISABILITY THROUGH INDIVIDUAL-LEVEL MIXTURE MODELS FOR MULTIVARIATE BINARY DATA

Data on functional disability are of widespread policy interest in the United States, especially with respect to planning for Medicare and Social Security for a growing population of elderly adults. We consider an extract of functional disability data from the National Long Term Care Survey (NLTCS) and attempt to develop disability profiles using variations of the Grade of Membership (GoM) model. We first describe GoM as an individual-level mixture model that allows individuals to have partial membership in several mixture components simultaneously. We then prove the equivalence between individual-level and population-level mixture models, and use this property to develop a Markov Chain Monte Carlo algorithm for Bayesian estimation of the model. We use our approach to analyze functional disability data from the NLTCS.     

Combining census and registration data to estimate detailed elderly migration flows in England and Wales

Summary.  A log-linear model is developed to estimate detailed elderly migration flows by combining data from the 2001 UK census and National Health Services patient register. After showing that the census and National Health Service migration flows can be reasonably combined, elderly migration flows between groupings of local authority districts by age, sex and health status for the 2000–2001 and 2003–2004 periods are estimated and then analysed to show how the patterns have changed. By combining registration data with census data, we can provide recent estimates of detailed elderly migration flows, which can be used for improvements in social planning or policy.     

Mixture of latent trait analyzers for model-based clustering of categorical data

Model-based clustering methods for continuous data are well established and commonly used in a wide range of applications. However, model-based clustering methods for categorical data are less standard. Latent class analysis is a commonly used method for model-based clustering of binary data and/or categorical data, but due to an assumed local independence structure there may not be a correspondence between the estimated latent classes and groups in the population of interest. The mixture of latent trait analyzers model extends latent class analysis by assuming a model for the categorical response variables that depends on both a categorical latent class and a continuous latent trait variable; the discrete latent class accommodates group structure and the continuous latent trait accommodates dependence within these groups. Fitting the mixture of latent trait analyzers model is potentially difficult because the likelihood function involves an integral that cannot be evaluated analytically. We develop a variational approach for fitting the mixture of latent trait models and this provides an efficient model fitting strategy. The mixture of latent trait analyzers model is demonstrated on the analysis of data from the National Long Term Care Survey (NLTCS) and voting in the U.S. Congress. The model is shown to yield intuitive clustering results and it gives a much better fit than either latent class analysis or latent trait analysis alone.     

Combining information from multiple surveys for assessing health disparities

Despite advances in public health practice and medical technology, the disparities in health among the various racial/ethnic and socioeconomic groups remain a concern which has prompted the Department of Human and Health Services to designate the elimination of disparities in health as an overarching goal of Healthy People 2010. To assess the progress towards this goal, suitable measures are needed at the population level that can be tracked over time; Statistical inferential procedures have to be developed for these population level measures; and the data sources have to be identified to allow for such inferences to be conducted. Popular data sources for health disparities research are large surveys such the National Health and Interview Survey (NHIS) or the Behavior Risk Factor Surveillance System (BRFSS). The self-report disease status collected in these surveys may be inaccurate and the errors may be correlated with variables used in defining the groups. This article uses the National Health and Nutritional Examination Survey (NHANES) 99-00 to assess the extent of error in the self-report disease status; uses a Bayesian framework develop corrections for the self-report disease status in the National Health Interview Survey (NHIS) 99-00; and compares inferences about various measures of health disparities, with and without correcting for measurement error. The methodology is illustrated using the disease outcome hypertension, a common risk factor for cardiovascular disease. JEL classification C1 (C11, C13, C15), C4 (C42) and I3 (I31, I38)     

Latent class models for longitudinal studies of the elderly with data missing at random

The elderly population in the USA is expected to double in size by the year 2025, making longitudinal health studies of this population of increasing importance. The degree of loss to follow-up in studies of the elderly, which is often because elderly people cannot remain in the study, enter a nursing home or die, make longitudinal studies of this population problematic. We propose a latent class model for analysing multiple longitudinal binary health outcomes with multiple-cause non-response when the data are missing at random and a non-likelihood-based analysis is performed. We extend the estimating equations approach of Robins and co-workers to latent class models by reweighting the multiple binary longitudinal outcomes by the inverse probability of being observed. This results in consistent parameter estimates when the probability of non-response depends on observed outcomes and covariates (missing at random) assuming that the model for non-response is correctly specified. We extend the non-response model so that institutionalization, death and missingness due to failure to locate, refusal or incomplete data each have their own set of non-response probabilities. Robust variance estimates are derived which account for the use of a possibly misspecified covariance matrix, estimation of missing data weights and estimation of latent class measurement parameters. This approach is then applied to a study of lower body function among a subsample of the elderly participating in the 6-year Longitudinal Study of Aging.     

Block diagrams and splitting criteria for classification trees

Various aspects of the classification tree methodology of Breiman et al., (1984) are discussed. A method of displaying classification trees, called block diagrams, is developed. Block diagrams give a clear presentation of the classification, and are useful both to point out features of the particular data set under consideration and also to highlight deficiencies in the classification method being used. Various splitting criteria are discussed; the usual Gini-Simpson criterion presents difficulties when there is a relatively large number of classes and improved splitting criteria are obtained. One particular improvement is the introduction of adaptive anti-end-cut factors that take advantage of highly asymmetrical splits where appropriate. They use the number and mix of classes in the current node of the tree to identify whether or not it is likely to be advantageous to create a very small offspring node. A number of data sets are used as examples.     

A Class of Multidimensional Latent Class IRT Models for Ordinal Polytomous Item Responses

We propose a class of multidimensional Item Response Theory models for polytomously-scored items with ordinal response categories. This class extends an existing class of multidimensional models for dichotomously-scored items in which the latent abilities are represented by a random vector assumed to have a discrete distribution, with support points corresponding to different latent classes in the population. In the proposed approach, we allow for different parameterizations for the conditional distribution of the response variables given the latent traits, which depend on the type of link function and the constraints imposed on the item parameters. Moreover, we suggest a strategy for model selection that is based on a series of steps consisting of selecting specific features, such as the dimension of the model (number of latent traits), the number of latent classes, and the specific parameterization. In order to illustrate the proposed approach, we analyze a dataset from a study on anxiety and depression on a sample of oncological patients.     

A Multiple State Model for Disability Using the Decomposition of Death Probabilities and Cross-Sectional Data

ABSTRACT

We split the components corresponding to the disability-free survival probability, and the disability survival probability. Our analysis is conducted for men and women separately, for age groups over 64 years. We discuss the estimation of a multiple state model under several scenarios when only a single survey of cross-sectional data is available. The conclusions are used to discuss the disability level of the Spanish elderly population and are helpful to develop welfare programs and insurance products.     

Latent class models for financial data analysis: some statistical developments

I exploit the potential of latent class models for proposing an innovative framework for financial data analysis. By stressing the latent nature of the most important financial variables, expected return and risk, I am able to introduce a new methodological dimension in the analysis of financial phenomena. In my proposal, (i) I provide innovative measures of expected return and risk, (ii) I suggest a financial data classification consistent with the latent risk-return profile, and (iii) I propose a set of statistical methods for detecting and testing the number of groups of the new data classification. The results lead to an improvement in both risk measurement theory and practice and, if compared to traditional methods, allow for new insights into the analysis of financial data. Finally, I illustrate the potentiality of my proposal by investigating the European stock market and detailing the steps for the appropriate choice of a financial portfolio.     

Parametric estimation of the number of classes in a population

This paper deals with the well-studied problem of how best to estimate the number of mutually exclusive and exhaustive classes in a population, based on a sample from it. Haas & Stokes review and provide non-parametric approaches, but there are associated difficulties especially for small sampling fractions and/or widely varying population class sizes. Sichel provided 'GIGP' methodology, for this problem and for other purposes; this paper utilizes the three-parameter GIGP distribution for this problem, and also for the estimation of the number of classes of size 1, as an alternative to the non-parametric approaches. Methodological and computational issues are considered, and examples indicate the potential for GIGP.     

Analyzing dependence in incidence of diabetes and heart problem using generalized bivariate geometric models with covariates

For analyzing incidence data on diabetes and health problems, the bivariate geometric probability distribution is a natural choice but remained unexplored largely due to lack of models linking covariates with the probabilities of bivariate incidence of correlated outcomes. In this paper, bivariate geometric models are proposed for two correlated incidence outcomes. The extended generalized linear models are developed to take into account covariate dependence of the bivariate probabilities of correlated incidence outcomes for diabetes and heart diseases for the elderly population. The estimation and test procedures are illustrated using the Health and Retirement Study data. Two models are shown in this paper, one based on conditional-marginal approach and the other one based on the joint probability distribution with an association parameter. The joint model with association parameter appears to be a very good choice for analyzing the covariate dependence of the joint incidence of diabetes and heart diseases. Bootstrapping is performed to measure the accuracy of estimates and the results indicate very small bias.     

Bayesian inference and model selection in latent class logit models with parameter constraints: an application to market segmentation

Latent class models have recently drawn considerable attention among many researchers and practitioners as a class of useful tools for capturing heterogeneity across different segments in a target market or population. In this paper, we consider a latent class logit model with parameter constraints and deal with two important issues in the latent class models--parameter estimation and selection of an appropriate number of classes--within a Bayesian framework. A simple Gibbs sampling algorithm is proposed for sample generation from the posterior distribution of unknown parameters. Using the Gibbs output, we propose a method for determining an appropriate number of the latent classes. A real-world marketing example as an application for market segmentation is provided to illustrate the proposed method.     

Nonparametric estimation of waiting time distributions in a Markov model based on current status data

We construct nonparametric estimators of state waiting time distribution functions in a Markov multistate model using current status data. This is a particularly difficult problem since neither the entry nor the exit times of a given state are directly observed. These estimators are obtained, using the Markov property, from estimators of counting processes of state entry and exit times, as well as, the size of “at risk” sets of state entry and transitions out of that state. Consistency of our estimators is established. Finite-sample behavior of our estimators is studied by simulation, in which we show that our estimators based on current status data compare well with those based on complete data. We also illustrate our method using a pubertal development data set obtained from the NHANES III [1997. NHANES III Reference Manuals and Reports (CD-ROM). Analytic and Reporting Guidelines: The Third National Health and Nutrition Examination Survey (1988–94). National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD] study.     

Evaluating subject-level incremental values of new markers for risk classification rule

Suppose that we need to classify a population of subjects into several well-defined ordered risk categories for disease prevention or management with their “baseline” risk factors/markers. In this article, we present a systematic approach to identify subjects using their conventional risk factors/markers who would benefit from a new set of risk markers for more accurate classification. Specifically for each subgroup of individuals with the same conventional risk estimate, we present inference procedures for the reclassification and the corresponding correct re-categorization rates with the new markers. We then apply these new tools to analyze the data from the Cardiovascular Health Study sponsored by the US National Heart, Lung, and Blood Institute. We used Framingham risk factors plus the information of baseline anti-hypertensive drug usage to identify adult American women who may benefit from the measurement of a new blood biomarker, CRP, for better risk classification in order to intensify prevention of coronary heart disease for the subsequent 10 years.     

A Latent-Variable Model of Quality Determination

Because of data difficulties, there has been little empirical work analyzing the determination of the quality of a firm's output. This article constructs a latent variable model for this problem that uses easily obtainable data. The model is developed from the relationship between the firm's input demand functions and reduced-form output functions, and it has a novel multiple indicator multiple cause (MIMIC) interpretation. The model also allows identification of an intercept, implying that an index of quality that is comparable across samples can be constructed. As an example, a latent variable model of nursing-home quality is estimated.     

Sieve Estimation of Time-Varying Panel Data Models With Latent Structures

We propose a heterogeneous time-varying panel data model with a latent group structure that allows the coefficients to vary over both individuals and time. We assume that the coefficients change smoothly over time and form different unobserved groups. When treated as smooth functions of time, the individual functional coefficients are heterogeneous across groups but homogeneous within a group. We propose a penalized-sieve-estimation-based classifier-Lasso (C-Lasso) procedure to identify the individuals’ membership and to estimate the group-specific functional coefficients in a single step. The classification exhibits the desirable property of uniform consistency. The C-Lasso estimators and their post-Lasso versions achieve the oracle property so that the group-specific functional coefficients can be estimated as well as if the individuals’ membership were known. Several extensions are discussed. Simulations demonstrate excellent finite sample performance of the approach in both classification and estimation. We apply our method to study the heterogeneous trending behavior of GDP per capita across 91 countries for the period 1960–2012 and find four latent groups.     

Nonparametric Bayes Stochastically Ordered Latent Class Models

Latent class models (LCMs) are used increasingly for addressing a broad variety of problems, including sparse modeling of multivariate and longitudinal data, model-based clustering, and flexible inferences on predictor effects. Typical frequentist LCMs require estimation of a single finite number of classes, which does not increase with the sample size, and have a well-known sensitivity to parametric assumptions on the distributions within a class. Bayesian nonparametric methods have been developed to allow an infinite number of classes in the general population, with the number represented in a sample increasing with sample size. In this article, we propose a new nonparametric Bayes model that allows predictors to flexibly impact the allocation to latent classes, while limiting sensitivity to parametric assumptions by allowing class-specific distributions to be unknown subject to a stochastic ordering constraint. An efficient MCMC algorithm is developed for posterior computation. The methods are validated using simulation studies and applied to the problem of ranking medical procedures in terms of the distribution of patient morbidity.     

Ehrenberg law-like relationship and anthropometry

Summary. Ehrenberg presented the simple law-like relationship log( w )=0.8 h  + 0.4 ± 0.04 between the weight and height of children aged 5–13 years. Several researchers have confirmed that this relationship holds, irrespective of the child's ethnic, racial, gender and social class. In anthropometry, a weight–height relationship is used to measure the nutritional status of children. For this purpose, the World Health Organization have adopted the National Center for Health Statistics population as the international reference population. The relationship between the World Health Organization–National Center for Health Statistics anthropometric standards and Ehrenberg law-like relationship is examined. Differences between the weight-for-height relationship in anthropometry and the law-like relationship between weight and height for children are small and can be attributable to functional differences. It is found that an Ehrenberg law-like relationship can be extended to include children who are under 5 years old. Criteria for using the law-like relationship to assess the nutritional status of these children are thus suggested. The criteria are evaluated using anthropometric data of a sample of 513 children from a rural district of Botswana. The results indicate that the proposed method of using the law-like relationship to assess nutritional status is much simpler and at least as reliable as the existing methods in anthropometry.