Protective estimation of mixed-effects logistic regression when data are not missing at random

Abstract Objective The study sought to evaluate if peer input on outpatient cases impacted diagnostic confidence. Materials and Methods This randomized trial of a peer input intervention occurred among 28 clinicians with case-level randomization. Encounters with diagnostic uncertainty were entered onto a digital platform to collect input from ≥5 clinicians. The primary outcome was diagnostic confidence. We used mixed-effects logistic regression analyses to assess for intervention impact on diagnostic confidence. Results Among the 509 cases (255 control; 254 intervention), the intervention did not impact confidence (odds ratio [OR], 1.46; 95% confidence interval [CI], 0.999-2.12), but after adjusting for clinician and case traits, the intervention was associated with higher confidence (OR, 1.53; 95% CI, 1.01-2.32). The intervention impact was greater in cases with high uncertainty (OR, 3.23; 95% CI, 1.09- 9.52). Conclusions Peer input increased diagnostic confidence primarily in high-uncertainty cases, consistent with findings that clinicians desire input primarily in cases with continued uncertainty.

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Surgical Site Infection Trend Analysis Following Abdominal Hysterectomy, National Healthcare Safety Network, 2009–2018

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1039 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s396-s397

Author(s):

Qunna Li ◽

Minn Soe ◽

Allan Nkwata ◽

Victoria Russo ◽

Margaret Dudeck ◽

...

Keyword(s):

Logistic Regression ◽

Trend Analysis ◽

Primary Closure ◽

Abdominal Hysterectomy ◽

Incidence Rates ◽

Mixed Effects ◽

Mandatory Reporting ◽

Hospital Inpatient ◽

Quality Reporting ◽

Reporting Requirement

Background: Surveillance data for surgical site infections (SSIs) following abdominal hysterectomy (HYST) have been reported to the CDC NHSN since 2005. Beginning in 2012, HYST SSI surveillance coverage expanded substantially as a result of a CMS mandatory reporting requirement as part of the Hospital Inpatient Quality Reporting Program. A trend analysis of HYST SSI using data submitted to the NHSN has not been previously reported. To estimate the overall trend of HYST SSI incidence rates, we analyzed data reported from acute-care hospitals with surgery performed between January 1, 2009, and December 31, 2018. Methods: We analyzed inpatient adult HYST procedures with primary closure resulting deep incisional primary and organ-space SSIs detected during the same hospitalization or rehospitalization to the same hospital. SSIs reported as infection present at time of surgery (PATOS) were included in the analysis. Due to the surveillance definition changes for primary closure in 2013 and 2015, these were tested separately as interruptions to HYST SSI outcome using an interrupted time-series model with a mixed-effects logistic regression. Because the previously described changes were not significantly associated with changes in HYST SSI risk, mixed-effects logistic regression was used to estimate the annual change in the log odds of HYST SSI. The estimates were adjusted for the following covariates: hospital bed size, general anesthesia, scope, ASA score, wound classification, medical school affiliation type, procedure duration and age. Results: The number of hospitals and procedures reported to NHSN for HYST increased and then stabilized after 2012 (Table 1). The unadjusted annual SSI incidence rates ranged from 0.60% to 0.81%. Based on the model, we estimate a 2.58% decrease in the odds of having a HYST SSI annually after controlling for variables mentioned above (Table 2). Conclusions: The volume of hospitals and procedures for HYST reported to NHSN increased substantially because of the CMS reporting requirement implemented in 2012. The overall adjusted HYST SSI odds ratio decreased annually over 2009–2018, which indicates progress in preventing HYST SSIs.Funding: NoneDisclosures: None

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Evaluating working conditions in the informal economy: Evidence from the 2015 European Working Conditions Survey

International Sociology ◽

10.1177/0268580919836666 ◽

2019 ◽

Vol 34 (3) ◽

pp. 281-306 ◽

Cited By ~ 6

Author(s):

Colin C Williams ◽

Ioana Alexandra Horodnic

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Working Conditions ◽

Logistic Regression Analysis ◽

Informal Economy ◽

Mixed Effects ◽

Policy Implications ◽

Formal Economy ◽

European Working ◽

European Working Conditions Survey

Although it is widely held that working conditions in the informal economy are worse than in the formal economy, little evidence has been so far provided. The aim of this article is to fill this lacuna by comparing the working conditions of informal employees with formal employees using the 2015 European Working Conditions Survey. Multilevel mixed-effects logistic regression analysis provides a nuanced and variegated appreciation of which working conditions are worse for informal employees, which are no different, and which are better for informal than formal employees. The article concludes by discussing the theoretical and policy implications.

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Relationship between childhood obesity and socioeconomic status among primary school children in Costa Rica

Public Health Nutrition ◽

10.1017/s1368980021002032 ◽

2021 ◽

pp. 1-24

Author(s):

Tatiana Gamboa-Gamboa ◽

Romain Fantin ◽

Jeancarlo Cordoba ◽

Ivannia Caravaca ◽

Ingrid Gómez-Duarte

Keyword(s):

Socioeconomic Status ◽

Logistic Regression ◽

Childhood Obesity ◽

Costa Rica ◽

Regression Model ◽

Primary Schools ◽

Logistic Regression Model ◽

Mixed Effects ◽

Overweight And Obesity ◽

Public And Private

Abstract Objective: This article analyzes the relationship between socioeconomic status and the prevalence of overweight and obesity in the primary school population in Costa Rica. Design: A National School Weight/Height Census was disseminated across Costa Rica in 2016. The percentage of children who were overweight or obese was calculated by sex, age, and socioeconomic indicators (type of institution: private, public, mix; type of geographic location: rural, urban; and the level of development of the district of residence: quartiles). A mixed effects multinomial logistic regression model and mixed effects logistic regression model were used to analyze the association between the prevalence of being overweight or obese and district socioeconomic status. Setting: The survey was carried out in public and private primary schools across Costa Rica in 2016. Participants: 347,366 students from 6 to 12 years old, enrolled in public and private primary schools. Results: The prevalence of overweight and obesity among children was 34.0%. Children in private schools were more likely to be overweight or obese than students in public schools (OR=1.10 [1.07, 1.13]). Additionally, children were less likely to be overweight or obese if attending a school in a district of the lowest socioeconomic quartile compared to the highest socioeconomic quartile (OR=0.79 [0.75, 0.83]), and in a rural area compared to the urban area (OR=0.92 [0.87, 0.97]). Conclusions: Childhood obesity in Costa Rica continues to be a public health problem. Prevalence of overweight and obesity in children was associated with indicators of higher socioeconomic status.

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Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

American Journal of Perinatology ◽

10.1055/s-0041-1733782 ◽

2021 ◽

Author(s):

Danielle LoRe ◽

Christopher Mattson ◽

Dalia M. Feltman ◽

Jessica T. Fry ◽

Kathleen G. Brennan ◽

...

Keyword(s):

Quality Of Life ◽

Logistic Regression ◽

Regression Models ◽

Mixed Effects ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Comfort Care ◽

Logistic Regression Models ◽

Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

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Is Medicaid expansion associated with increases in palliative treatments for metastatic cancer?

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0178 ◽

2021 ◽

Author(s):

Alexander P Cole ◽

Stuart R Lipsitz ◽

Adam S Kibel ◽

Brandon A Mahal ◽

Nelya Melnitchouk ◽

...

Keyword(s):

Logistic Regression ◽

Affordable Care Act ◽

Odds Ratio ◽

Metastatic Cancer ◽

Mixed Effects ◽

Rate Of Change ◽

Medicaid Expansion ◽

Demographic Differences ◽

Men And Women ◽

Lower Baseline

Background: Medicaid expansion following the 2010 Affordable Care Act has an unknown impact on palliative treatments. Materials & methods: This registry-based study of individuals with metastatic cancer from 2010 to 2016 identified men and women with metastatic cancer in expansion and non-expansion states who received palliative treatments. A mixed effects logistic regression compared trends in expansion and non-expansion states and generated risk-adjusted probabilities or receiving palliative treatments each year. Results: Despite lower baseline use of palliative treatments, the rate of change was more rapid in expansion states (odds ratio [OR]: 1.02; 95% CI: 1.01–1.03; p < 0.001). The adjusted probability of receiving palliative treatments rose from 21.3 to 26.0% in non-expansion states, and from 19.7 to 26.9% in expansion states. Conclusion: Use of palliative treatments among metastatic cancer patients increased from 2010 to 2016 with a significantly greater increase in Medicaid expansion states, even when adjusting for demographic differences between states.

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Prevalence of Internet Addiction and Its Relationship With Combinations of Physical Activity and Screen-Based Sedentary Behavior Among Adolescents in China

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0512 ◽

2021 ◽

pp. 1-8

Author(s):

Gengyu Han ◽

Jingshu Zhang ◽

Shang Ma ◽

Ruoran Lu ◽

Jiali Duan ◽

...

Keyword(s):

Physical Activity ◽

Logistic Regression ◽

Sedentary Behavior ◽

Internet Addiction ◽

Cross Sectional Study ◽

Mixed Effects ◽

Chi Square ◽

Cross Sectional ◽

Other Information ◽

Chi Square Test

Background: Given the widespread prevalence and serious nature of Internet addiction (IA), this study aimed to estimate the prevalence of IA and assess the relationships between IA and combinations of physical activity (PA) and screen-based sedentary behavior (SB) among adolescents in China. Methods: This cross-sectional study surveyed 31,954 adolescents in grades 7 to 12 in Beijing. IA, PA, screen-based SB, and other information were obtained from a self-administrated questionnaire. The chi-square test and mixed-effects logistic regression model were applied to estimate the relationship between IA and combinations of PA and screen-based SB. Results: 6.2% of the surveyed adolescents reported IA and the prevalence of low PA/high screen-based SB, high PA/high screen-based SB, low PA/low screen-based SB, and high PA/low screen-based SB were 53.7%, 19.5%, 18.8%, and 8.0%, respectively. Mixed-effects logistic regression analysis showed that adolescents with low PA/high screen-based SB were 1.99 (95% confidence interval, 1.62–2.44, P < .001) times more likely to prefer IA than those with high PA/low screen-based SB. Conclusions: The prevalence of IA among Chinese adolescents is still high. Intervention programs like maintaining sufficient PA and reducing screen-based SB might contribute to reducing their IA.

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The alternative negative constructions in spoken and written Korean: Logistic regression analysis

Corpus Linguistics and Linguistic Theory ◽

10.1515/cllt-2016-0021 ◽

2019 ◽

Vol 15 (2) ◽

pp. 419-442

Author(s):

Beom-mo Kang

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Mixed Effects ◽

Written Language ◽

Regression Analyses ◽

Relevant Factor ◽

Factors Influencing ◽

Frequency Of Use ◽

Relevant Factors

AbstractAdopting quantitative corpus-based methods, this paper focuses on the alternative negative constructions in Korean, [anV] and [Vanhda]. Logistic regression analyses for a mixed-effects model were carried out on data drawn from the Sejong Korean Corpus. Certain features of the verb or adjective in negative constructions significantly affect the use of the two negative constructions. A relevant factor is register/medium (spoken or written), among other significant interactions of factors. Furthermore, the fact that frequency is consistent with other relevant factors, together with certain diachronic facts of Korean, supports the claim that frequency of use plays an important role in linguistic changes. Another finding is that, notwithstanding noticeable differences between spoken and written language, the factors influencing the use of the two negative constructions in Korean are largely similar in the spoken and written registers.

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