Joint coverage probability in a simulation study on continuous-time Markov chain parameter estimation

Parameter dependency within data sets in simulation studies is common, especially in models such as continuous-time Markov chains (CTMCs). Additionally, the literature lacks a comprehensive examination of estimation performance for the likelihood-based general multi-state CTMC. Among studies attempting to assess the estimation, none have accounted for dependency among parameter estimates. The purpose of this research is twofold: (1) to develop a multivariate approach for assessing accuracy and precision for simulation studies (2) to add to the literature a comprehensive examination of the estimation of a general 3-state CTMC model. Simulation studies are conducted to analyze longitudinal data with a trinomial outcome using a CTMC with and without covariates. Measures of performance including bias, component-wise coverage probabilities, and joint coverage probabilities are calculated. An application is presented using Alzheimer's disease caregiver stress levels. Comparisons of joint and component-wise parameter estimates yield conflicting inferential results in simulations from models with and without covariates. In conclusion, caution should be taken when conducting simulation studies aiming to assess performance and choice of inference should properly reflect the purpose of the simulation.     

Working with an executive search firm: Part I--The candidate's perspective

This article is the first in a two-part series on how to work with executive search firms. Part one describes how the physician executive can build an effective relationship with an executive search firm as a candidate or potential candidate. Part two will cover how the physician executive can work with an executive search firm--either as a client or as a member of an executive search committee--to attract high-quality management talent.     

Utilizing Spiritual Lifemaps with LDS Clients: Enhancing Cultural Competence in Social Work Practice

Few people realize that the Latter-day Saints (LDS) or Mormon Church currently ranks as the fourth largest religious denomination in the United States. Although spirituality and religion play a central role in the beliefs, lifestyle, and culture, of many LDS clients, very few spiritual assessment tools have been validated with this population. Utilizing a mixed method design, this study modified an existing spiritual assessment tool—spiritual lifemaps—that may be particularly congruent with LDS client populations. A sample of recognized experts in LDS culture (N = 100) examined how consistent the spiritual lifemap assessment tool was with LDS culture, and how consistent the four sample question sets were with LDS culture. Overall, results indicate that the spiritual lifemap assessment tool is consistent with LDS clients’ beliefs, lifestyle, and culture. This study represents an important step at providing more culturally competent practice with LDS clients.