Reduced admissions for acute myocardial infarction associated with a public smoking ban: matched controlled study

There has been no research linking implementation of a public smoking ban and reduced incidence of acute myocardial infarction (AMI) among nonsmoking patients. An ex post facto matched control group study was conducted to determine whether there was a change in hospital admissions for AMI among nonsmoking patients after a public smoking ban was implemented in Monroe County compared with Delaware County, Indiana without such a ban. Poisson analysis was conducted for 44 months of hospital admissions. A significant drop occurred in the number of admissions among nonsmoking patients in Monroe County after the ban whereas a nonsignificant decrease in the number of admissions occurred in Delaware County. The changes in the number of smoking-patient admissions before and after the ban were not significant.     

Stress-strength reliability of exponentiated Fréchet distributions based on Type-II censored data

In this paper, we consider inference of the stress-strength parameter, R, based on two independent Type-II censored samples from exponentiated Fréchet populations with different index parameters. The maximum likelihood and uniformly minimum variance unbiased estimators, exact and asymptotic confidence intervals and hypotheses testing for R are obtained. We conduct a Monte Carlo simulation study to evaluate the performance of these estimators and confidence intervals. Finally, two real data sets are analysed for illustrative purposes.     

Pseudo-empirical Bayes estimation of small area means under a nested error linear regression model with functional measurement errors

Small area estimation is studied under a nested error linear regression model with area level covariate subject to measurement error. Ghosh and Sinha (2007) obtained a pseudo-Bayes (PB) predictor of a small area mean and a corresponding pseudo-empirical Bayes (PEB) predictor, using the sample means of the observed covariate values to estimate the true covariate values. In this paper, we first derive an efficient PB predictor by using all the available data to estimate true covariate values. We then obtain a corresponding PEB predictor and show that it is asymptotically “optimal”. In addition, we employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator. Our results show that the proposed PEB predictor can lead to significant gain in efficiency over the previously proposed PEB predictor. Area level models are also studied.     

Copula-based predictions in small area estimation

Unit-level regression models are commonly used in small area estimation (SAE) to obtain an empirical best linear unbiased prediction of small area characteristics. The underlying assumptions of these models, however, may be unrealistic in some applications. Previous work developed a copula-based SAE model where the empirical Kendall's tau was used to estimate the dependence between two units from the same area. In this article, we propose a likelihood framework to estimate the intra-class dependence of the multivariate exchangeable copula for the empirical best unbiased prediction (EBUP) of small area means. One appeal of the proposed approach lies in its accommodation of both parametric and semi-parametric estimation approaches. Under each estimation method, we further propose a bootstrap approach to obtain a nearly unbiased estimator of the mean squared prediction error of the EBUP of small area means. The performance of the proposed methods is evaluated through simulation studies and also by a real data application.     

Likelihood ratio tests for fuzzy hypotheses testing

In hypotheses testing, such as other statistical problems, we may confront imprecise concepts. One case is a situation in which hypotheses are imprecise. In this paper, we recall and redefine some concepts about fuzzy hypotheses testing, and then we introduce the likelihood ratio test for fuzzy hypotheses testing. Finally, we give some applied examples.     

Spatio‐temporal modelling of disease mapping of rates

This paper studies generalized linear mixed models (GLMMs) for the analysis of geographic and temporal variability of disease rates. This class of models adopts spatially correlated random effects and random temporal components. Spatio‐temporal models that use conditional autoregressive smoothing across the spatial dimension and autoregressive smoothing over the temporal dimension are developed. The model also accommodates the interaction between space and time. However, the effect of seasonal factors has not been previously addressed and in some applications (e.g., health conditions), these effects may not be negligible. The authors incorporate the seasonal effects of month and possibly year as part of the proposed model and estimate model parameters through generalized estimating equations. The model provides smoothed maps of disease risk and eliminates the instability of estimates in low‐population areas while maintaining geographic resolution. They illustrate the approach using a monthly data set of the number of asthma presentations made by children to Emergency Departments (EDs) in the province of Alberta, Canada, during the period 2001–2004. The Canadian Journal of Statistics 38: 698–715; 2010 © 2010 Statistical Society of Canada     

The impact of in-vehicle cell-phone use on accidents or near-accidents among college students

With in-vehicle use of cell phones rapidly increasing, the safety of young drivers, who represent 14% of licensed drivers but 26% of drivers involved in fatal crashes, may be disproportionately threatened. The authors used a questionnaire to examine the association between in-vehicle cell-phone use and accidents or near-accidents among 1,291 conveniently recruited college students in 4 states. Of the 1,185 respondents who were drivers, 87% had a cell phone, and 86% of the cell-phone owners reported talking while driving at least occasionally. Of the 762 reported accidents or near-accidents, 21% (n = 159) involved at least 1 of the drivers talking while driving. Chi-square tests and logistic regression analyses showed that the frequency, not the duration, of drivers talking while driving was related to experiencing accidents or near-accidents. Differences between drivers who used cell phones and nonusers in unsafe driving behaviors and attitudes were also examined, and target groups for intervention efforts against talking on a cell phone while driving are suggested.     

Ice‐Breaker vs. Standalone: Comparing Alternative Workflow Modes of Mid‐level Care Providers

Capitalizing on the operational concept of division‐of‐labor, clinics often reduce physician service time by off‐loading some of his/her clinical activities to lower‐cost personnel. These personnel, such as nurse practitioners and physician assistants, are often collectively referred to as “mid‐level providers” (MLPs) and can perform many patient‐consultation tasks. The common rationale is that using an MLP allows the physician to serve more patients, increase patients’ access to care, and, due to MLPs’ lower salaries, improve the clinic's financial performance. An MLP is typically integrated into the outpatient clinic process in one of two modes: as an “ice‐breaker,” seeing each patient before the physician, or as a “standalone” provider, a substitute for the physician for the entirety of some patients’ visits. Despite both of these modes being widely used in practice, we find no research that identifies the circumstances under which either one is preferable. This study examines these two modes’ effects on operational performance, such as patient flow and throughput, as well as on financial measures. Using queueing and bottleneck analysis, discrete‐event simulation, and profit modeling, we compare these two deployment modes and identify the optimal policies for deploying MLPs as either ice‐breakers or as standalone providers. Interestingly, we also find there exists a range of scenarios where not hiring an MLP at all (i.e., the physician works alone) is likely to be most profitable for the clinic. Implications for practice are discussed.     

SMALL AREA ESTIMATION USING SURVEY WEIGHTS WITH FUNCTIONAL MEASUREMENT ERROR IN THE COVARIATE

Nested error linear regression models using survey weights have been studied in small area estimation to obtain efficient model‐based and design‐consistent estimators of small area means. The covariates in these nested error linear regression models are not subject to measurement errors. In practical applications, however, there are many situations in which the covariates are subject to measurement errors. In this paper, we develop a nested error linear regression model with an area‐level covariate subject to functional measurement error. In particular, we propose a pseudo‐empirical Bayes (PEB) predictor to estimate small area means. This predictor borrows strength across areas through the model and makes use of the survey weights to preserve the design consistency as the area sample size increases. We also employ a jackknife method to estimate the mean squared prediction error (MSPE) of the PEB predictor. Finally, we report the results of a simulation study on the performance of our PEB predictor and associated jackknife MSPE estimator.     

Hierarchical Bayesian bivariate disease mapping: analysis of children and adults asthma visits to hospital

In spatial epidemiology, detecting areas with high ratio of disease is important as it may lead to identifying risk factors associated with disease. This in turn may lead to further epidemiological investigations into the nature of disease. Disease mapping studies have been widely performed with considering only one disease in the estimated models. Simultaneous modelling of different diseases can also be a valuable tool both from the epidemiological and also from the statistical point of view. In particular, when we have several measurements recorded at each spatial location, one can consider multivariate models in order to handle the dependence among the multivariate components and the spatial dependence between locations. In this paper, spatial models that use multivariate conditionally autoregressive smoothing across the spatial dimension are considered. We study the patterns of incidence ratios and identify areas with consistently high ratio estimates as areas for further investigation. A hierarchical Bayesian approach using Markov chain Monte Carlo techniques is employed to simultaneously examine spatial trends of asthma visits by children and adults to hospital in the province of Manitoba, Canada, during 2000–2010.