scholarly journals Mixed-effects models for the evaluation of long-term trends in exposure levels with an example from the nickel industry

2001 ◽  
Keyword(s):  
Mixed Effects ◽  
Mixed Effects Models ◽  
Long Term Trends ◽  
Exposure Levels ◽  
Nickel Industry

Multi-site Pain Is Associated with Long-term Patient-Reported Outcomes in Older Adults with Persistent Back Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 1898-1906 ◽  
Author(s):  
Sean D Rundell ◽  
Kushang V Patel ◽  
Melissa A Krook ◽  
Patrick J Heagerty ◽  
Pradeep Suri ◽  
...  
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Pain Intensity ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Widespread Pain ◽  
Pain Site ◽  
Multisite Pain ◽  
Persistent Back Pain

AbstractObjectiveTo estimate the prevalence of co-occurring pain sites among older adults with persistent back pain and associations of multisite pain with longitudinal outcomes.DesignSecondary analysis of a cohort study.SettingThree integrated health systems in the United States.SubjectsEight hundred ninety-nine older adults with persistent back pain.MethodsParticipants reported pain in the following sites: stomach, arms/legs/joints, headaches, neck, pelvis/groin, and widespread pain. Over 18 months, we measured back-related disability (Roland Morris, scored 0–24), pain intensity (11-point numerical rating scale), health-related quality of life (EuroQol-5D [EQ-5D], utility from 0–1), and falls in the past three weeks. We used mixed-effects models to test the association of number and type of pain sites with each outcome.ResultsNearly all (N = 839, 93%) respondents reported at least one additional pain site. There were 216 (24%) with one additional site and 623 (69%) with multiple additional sites. The most prevalent comorbid pain site was the arms/legs/joints (N = 801, 89.1%). Adjusted mixed-effects models showed that for every additional pain site, RMDQ worsened by 0.65 points (95% confidence interval [CI] = 0.43 to 0.86), back pain intensity increased by 0.14 points (95% CI = 0.07 to 0.22), EQ-5D worsened by 0.012 points (95% CI = –0.018 to –0.006), and the odds of falling increased by 27% (odds ratio = 1.27, 95% CI = 1.12 to 1.43). Some specific pain sites (extremity pain, widespread pain, and pelvis/groin pain) were associated with greater long-term disability.ConclusionsMultisite pain is common among older adults with persistent back pain. Number of pain sites was associated with all outcomes; individual pain sites were less consistently associated with outcomes.

Abstract P203: Demographic Predictors of Long-term Weight Loss Beginning One-Year After Bariatric Surgery at Two Medical Centers

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Laura Rasmussen-Torvik ◽  
Abigail Baldridge ◽  
Jennifer Pacheco ◽  
Sharon Aufox ◽  
Kwang-Young Kim ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Post Surgery ◽  
Percentage Weight

Objective: Existing studies of predictors of weight loss after bariatric surgery suffer from simplistic statistical methods and relatively short follow-up. We sought to determine predictors of long-term weight loss up to 9.6 years after bariatric surgery using data extracted from two electronic health records (EHR) systems and linear mixed effects models. Methods: Participants were selected from patients enrolled in the NUgene biorepository at either Northwestern Memorial HealthCare or NorthShore University HealthSystem. Individuals who had undergone Roux-en-Y gastric bypass (RNY) were identified through billing or surgical history procedure codes in the electronic health records (EHRs). All available weight measurements and dates were extracted from the EHR as well as surgery date. Sex, race/ethnicity, education, marital status, and height were taken from the NUgene intake questionnaire. SAS PROC MIXED was used to create linear mixed effects models to examine weight loss from 1- 9.6 years post-surgery. To examine overall weight loss and slope of weight regain, covariates and covariate interactions with time post-surgery were included in the mixed effects models. Results: 119 individuals from Northwestern and 43 individuals from NorthShore had undergone gastric bypass and had at least 1 weight measurement 1 year post-surgery. There were 3071 weight measurements which occurred at least 1 year post-surgery in the dataset; the median number of observations per person was 10 and the median weight loss represented by these measurements was 32.7% from pre-surgical weight. The regression model indicated that, on average, individuals experienced slight weight regain of about 0.8% of pre-surgical weight per year after their first year post-surgery. Over the 1- 10 years of follow up African Americans lost nearly 5 percentage points less weight than whites ( p =.0025) . People who were older and taller also experienced less percentage weight loss, and people with higher initial weights experienced a higher percentage weight loss (all p <.05), Older age was associated with significantly (p<0.05) slower weight regain after 1 year post-surgery. Discussion: EHR records from multiple institutions can be integrated to study outcomes after bariatric surgery. Demographic factors predict overall weight loss and a rate of weight regain after 1 year post RNY surgery. This information may be useful for both surgeons and prospective patients.

scholarly journals The Importance of the Baby Boom Cohort and the Great Recession in Understanding Age, Period, and Cohort Patterns in Happiness

2017 ◽  
Vol 8 (3) ◽  
pp. 341-350 ◽  
Author(s):  
Anthony R. Bardo ◽  
Scott M. Lynch ◽  
Kenneth C. Land
Keyword(s):  
Great Recession ◽  
Data Aggregation ◽  
Baby Boom ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Period Effect ◽  
Trend Analyses ◽  
Mature Adults ◽  
The Great Recession

Twenge, Sherman, and Lyubomirsky (TSL) claim that long-term cultural changes have increased young adults’ happiness while reducing mature adults’ happiness. To establish their conclusion, TSL use trend analyses, as well as more sophisticated mixed-effects models, but their analyses are problematic. In particular, TSL’s trend analyses ignore a crucial cohort effect: well-known lower happiness among baby boomers. Furthermore, their data aggregation obscures the ephemerality of a recent period effect: the Great Recession. Finally, TSL overlook a key finding of their mixed-effects models that both pre- and post-Boomer cohorts became happier as they aged from young to mature adults. Our reanalyses of the data establish that the Baby Boomer cohort, the short-lived Great Recession, and unfortunate data aggregation account for TSL’s results. The well-established, long-term relationship between age and happiness remains as it has been for decades despite any cultural shifts that may have occurred disfavoring mature adults.

scholarly journals Causal modelling of variation in clinical practice and long-term outcomes of ADHD using Norwegian registry data: the ADHD controversy project

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041698
Author(s):  
Arnstein Mykletun ◽  
Tarjei Widding-Havneraas ◽  
Ashmita Chaulagain ◽  
Ingvild Lyhmann ◽  
Ingvar Bjelland ◽  
...  
Keyword(s):  
Public Sector ◽  
Child And Adolescent ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Outpatient Clinics ◽  
Long Term Outcomes ◽  
Link Type ◽  
Psychiatric Outpatient ◽  
Open Access Journals

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is among the most common mental disorders in children and adolescents, and it is a strong risk factor for several adverse psychosocial outcomes over the lifespan. There are large between-country and within-country variations in diagnosis and medication rates. Due to ethical and practical considerations, a few studies have examined the effects of receiving a diagnosis, and there is a lack of research on effects of medication on long-term outcomes.Our project has four aims organised in four work packages: (WP1) To examine the prognosis of ADHD (with and without medication) compared with patients with other psychiatric diagnoses, patients in contact with public sector child and adolescent psychiatric outpatient clinics (without diagnosis) and the general population; (WP2) Examine within-country variation in ADHD diagnoses and medication rates by clinics’ catchment area; and(WP3) Identify causal effects of being diagnosed with ADHD and (WP4) ADHD medication on long-term outcomes.Method and analysisOur project links several nationwide Norwegian registries. The patient sample is all persons aged 5–18 years that were in contact with public sector child and adolescent psychiatric outpatient clinics in 2009–2011. Our comparative analysis of prognosis will be based on survival analysis and mixed-effects models. Our analysis of variation will apply mixed-effects models and generalised linear models. We have two identification strategies for the effect of being diagnosed with ADHD and of receiving medication on long-term outcomes. Both strategies rely on using preference-based instrumental variables, which in our project are based on provider preferences for ADHD diagnosis and medication.Ethics and disseminationThe project is approved by the Regional Ethics Committee, Norway (REC number 2017/2150/REC south-east D). All papers will be published in open-access journals and results will be presented in national and international conferences.Trial registration numbersISRCTN11573246 and ISRCTN11891971.

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