COVID-19 data are messy: analytic methods for rigorous impact analyses with imperfect data

Abstract Background In Germany a new reimbursement system for psychiatric clinics was proposed in 2009 based on the § 17d KHG Psych-Entgeltsystem. The system can be voluntary implemented by clinics since 2013 but therapists are frequently afraid it might affect treatment negatively. Objectives To evaluate whether the new system has a negative impact on treatment success by analysing routinely collected data in a Bavarian clinic. Material and methods Aggregated data of 1760 patients treated in the years 2007–2016 was analysed with segmented regression analysis of interrupted time series to assess the effects of the system on treatment success, operationalized with three outcome variables. A negative change in level after a lag period was hypothesized. The robustness of results was tested by sensitivity analyses. Results The percentage of patients with treatment success tends to increase after the new system but no significant change in level was observed. The sensitivity analyses corroborate results for 2 outcomes but when the intervention point was shifted, the positive change in level for the third outcome became significant. Conclusions Our initial hypothesis is not supported. However, the sensitivity analyses disclosed uncertainties and our study has limitations, such as a short observation time post intervention. Results are not generalizable as data of a single clinic was analysed. Nevertheless, we show the importance of collecting and analysing routine data to assess the impact of policy changes on patient outcomes.

Download Full-text

Effectiveness of pre-operative anaemia screening and increased Tranexamic acid dose on outcomes following unilateral primary, elective total hip or knee replacement: a statistical analysis plan for an interrupted time series and regression discontinuity study

F1000Research ◽

10.12688/f1000research.22962.1 ◽

2020 ◽

Vol 9 ◽

pp. 224

Author(s):

Ashley B. Scrimshire ◽

Caroline Fairhurst ◽

Catriona McDaid ◽

David J. Torgerson

Keyword(s):

Time Series ◽

Statistical Analysis ◽

Blood Transfusion ◽

Knee Replacement ◽

Regression Discontinuity ◽

Interrupted Time Series ◽

Statistical Analysis Plan ◽

Study Designs ◽

The Impact ◽

Perioperative Blood Transfusion

Perioperative blood transfusion is associated with poorer postoperative outcomes following hip and knee replacement surgery. Evidence for the effectiveness of some measures aimed at reducing blood transfusions in this setting are limited and often rely on weak pre-post study designs. Quasi-experimental study designs such as interrupted time series (ITS) and regression discontinuity design (RDD) address many of the weaknesses of the pre-post study design. In addition, a priori publication of statistical analysis plans for such studies increases their transparency and likely validity, as readers are able to distinguish between pre-planned and exploratory analyses. As such, this article, written prospective of any analysis, provides the statistical analysis plan for an ITS and RDD study based on a data set of 20,772 primary elective hip and knee replacement patients in a single English NHS Trust. The primary aim is to evaluate the impact of a preoperative anaemia optimisation service on perioperative blood transfusion (within 7 days of surgery) using both ITS and RDD methods. A secondary aim is to evaluate the impact of a policy of increased tranexamic acid dose given at the time of surgery, using ITS methods.

Download Full-text

Effect of newborn screening for critical CHD on healthcare utilisation

Cardiology in the Young ◽

10.1017/s1047951120001742 ◽

2020 ◽

Vol 30 (8) ◽

pp. 1157-1164

Author(s):

Rie Sakai-Bizmark ◽

Hiraku Kumamaru ◽

Eliza J. Webber ◽

Dennys Estevez ◽

Laurie A. Mena ◽

...

Keyword(s):

Pulse Oximetry ◽

Incidence Rate ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Healthcare Utilisation ◽

Interrupted Time Series ◽

Sensitivity Analyses ◽

Health Issues ◽

Increasing Trend ◽

The Impact

AbstractObjective:To evaluate the impact of state-mandated policies for pulse oximetry screening on healthcare utilisation, with a focus on use of echocardiograms.Data sources/study setting:Healthcare Cost and Utilisation Project, Statewide Inpatient Databases from 2008 to 2014 from six states.Methods:We defined pre- and post-mandate cohorts based on dates when pulse oximetry became mandated in each state. Linear segmented regression models for interrupted time series assessed associations between implementation of the screening and changes in rate of newborns with Critical CHD-negative echocardiogram results. We also evaluated the changes in rate of newborns who underwent echocardiogram but were not diagnosed with any health issues that could cause hypoxemia.Results:We identified 5967 critical CHD-negative echocardiograms (2847 and 3120 in the pre- and post-mandate periods, respectively). Our models detected a statistically significant increasing trend in rate of critical CHD-negative echocardiograms in the pre-mandate period (Incidence Rate Ratio: 1.08, p = 0.02), but did not detect any statistical differences in changes between pre- and post-mandate periods (Incidence Rate Ratio: 0.93, p = 0.14). Among non-Whites, an increasing trend of Critical CHD-negative echocardiogram during the pre-mandate period was detected (Incidence Rate Ratio 1.12, p < 0.01) and was attenuated during the post-mandate period (Incidence Rate Ratio 0.89, p = 0.02). Similar results were observed in the sensitivity analyses among both Whites and non-Whites.Conclusions:Results suggest that mandatory state screening policies are associated with reductions in false-positive screening rates for hypoxemic conditions, with reductions primarily attributed to trends among non-Whites.

Download Full-text

Effectiveness of pre-operative anaemia screening and increased Tranexamic acid dose policies on outcomes following unilateral primary, elective total hip or knee replacement: a statistical analysis plan for an interrupted time series and regression discontinuity study

F1000Research ◽

10.12688/f1000research.22962.2 ◽

2021 ◽

Vol 9 ◽

pp. 224

Author(s):

Ashley B. Scrimshire ◽

Caroline Fairhurst ◽

Catriona McDaid ◽

David J. Torgerson

Keyword(s):

Time Series ◽

Statistical Analysis ◽

Blood Transfusion ◽

Knee Replacement ◽

Regression Discontinuity ◽

Interrupted Time Series ◽

Statistical Analysis Plan ◽

Study Designs ◽

The Impact ◽

Perioperative Blood Transfusion

Perioperative blood transfusion is associated with poorer postoperative outcomes following hip and knee replacement surgery. Evidence for the effectiveness of some measures aimed at reducing blood transfusions in this setting are limited and often rely on weak pre-post study designs. Quasi-experimental study designs such as interrupted time series (ITS) and regression discontinuity design (RDD) address many of the weaknesses of the pre-post study design. In addition, a priori publication of statistical analysis plans for such studies increases their transparency and likely validity, as readers are able to distinguish between pre-planned and exploratory analyses. As such, this article, written prospective of any analysis, provides the statistical analysis plan for an ITS and RDD study based on a data set of 20,772 primary elective hip and knee replacement patients in a single English NHS Trust. The primary aim is to evaluate the impact of a preoperative anaemia optimisation service on perioperative blood transfusion (within 7 days of surgery) using both ITS and RDD methods. A secondary aim is to evaluate the impact of a policy of increased tranexamic acid dose given at the time of surgery, using ITS methods.

Download Full-text

Did England's Teenage Pregnancy Strategy reduce pregnancy rates in England? A Natural Experiment study

10.1101/2020.05.12.20099002 ◽

2020 ◽

Author(s):

Andrew J Baxter ◽

Ruth Dundas ◽

Frank Popham ◽

Peter Craig

Keyword(s):

Time Series ◽

Teenage Pregnancy ◽

Interrupted Time Series ◽

Pregnancy Rates ◽

Control Population ◽

Sensitivity Analyses ◽

Synthetic Control ◽

Birth Rates ◽

Time Series Analyses ◽

The Impact

Objective To re-evaluate the impact of England's Teenage Pregnancy Strategy (1999 to 2010) on pregnancy and birth rates. Hailed as a unique, nation-wide, comprehensive, evidence-based intervention, the strategy has been promoted as a reproducible model for other countries with high teenage pregnancy rates. Design Controlled interrupted time series and synthetic control analyses using routinely collected data on births and abortions in 16 countries. Setting The Strategy was published in July 1999 and implemented from 2000-2010, with increased investment in areas with higher rates of under-18 pregnancies from 2006 onwards. Participants Women aged under 20 living in England during the intervention period were considered to be the target population. Women in Scotland and Wales were the control population in our interrupted time series analyses. Women from European and English-speaking high-income countries were the control population in our synthetic control analyses. Main outcome measures The pregnancy rate among women aged under-18 was our primary outcome, as this was the target of the Strategy. We used under-18 births and under-20 pregnancies as secondary outcomes. Results In the controlled interrupted time series analyses, trends in rates of teenage pregnancy in England were similar to Scotland (0.08 fewer pregnancies per 1,000 women per year in England; -0.74 to 0.59) and Wales (0.14 more pregnancies per 1,000 women per year in England; -0.48 to 0.76). In synthetic control analyses, under-18 birth rates were very similar in England and the synthetic control. Under-20 pregnancy rates were marginally higher in England than in the synthetic control. Placebo testing and other sensitivity analyses supported the finding of no observable effect. Conclusion Although teenage pregnancies and births in England fell following implementation of the Teenage Pregnancy Strategy, comparisons with other countries suggest the strategy had little, if any, effect. The strategy should not be used as a model for future public health interventions in England or in other countries. The protocol for the analysis was published online at https://osf.io/tdbr8/

Download Full-text

FUNDAMENTAL AND APPLIED SCIENTIFIC RESEARCH: сб.науч.тр./ OEAPS Inc.; редкол.: Флора Бертран (отв.ред.) [и др.]. - Берлин, Германия : OEAPS Inc., 2018. - 58 С.

10.31219/osf.io/hj4yf ◽

2018 ◽

Author(s):

Мария Григорьевна Алпатова ◽

Мария Игоревна Щеглова ◽

Elmira Kalybaevna Adil’bekova ◽

Nuradin Alibaev ◽

Arunas Svitojus

Keyword(s):

Service Sector ◽

Applied Research ◽

Point Of View ◽

Scientific Quality ◽

Final Decision ◽

Main Criterion ◽

The Public ◽

Peer Reviewers ◽

Verification Process

The conference is a major international forum for analyzing and discussing trends and approaches in research in the field of basic science and applied research. We provide a platform for discussions on innovative, theoretical and empirical research. The form of the conference: in absentia, without specifying the form in the collection of articles. Working languages: Russian, English Doctors and candidates of science, scientists, specialists of various profiles and directions, applicants for academic degrees, teachers, graduate students, undergraduates, students are invited to participate in the conference. There is one blind verification process in the journal. All articles will be initially evaluated by the editor for compliance with the journal. Manuscripts that are considered appropriate are then usually sent to at least two independent peer reviewers to assess the scientific quality of the article. The editor is responsible for the final decision on whether to accept or reject the article. The editor's decision is final. The main criterion used in assessing the manuscript submitted to the journal is: uniqueness or innovation in the work from the point of view of the methodology being developed and / or its application to a problem of particular importance in the public sector or service sector and / or the setting in which the efforts, for example, in the developing region of the world. That is, the very model / methodology, application and context of problems, at least one of them must be unique and important. Additional criteria considered in the consideration of the submitted document are its accuracy, organization / presentation (ie logical flow) and recording quality.

Download Full-text

FUNDAMENTAL AND APPLIED SCIENTIFIC RESEARCH April 2019: сб.науч.тр./ OEAPS Inc.; редкол.: Флора Бертран (отв.ред.) [и др.]. - Берлин, Германия : OEAPS Inc., 2019. - 98 C.

10.31219/osf.io/qmrey ◽

2019 ◽

Author(s):

Изабелла Станиславовна Чибисова ◽

Диана Ильгизаровна Шарипова ◽

Альфия Галиевна Зулькарнаева ◽

Ксения Александровна Дулова ◽

Садег Амирзадеган ◽

...

Keyword(s):

Service Sector ◽

Applied Research ◽

Point Of View ◽

Scientific Quality ◽

Final Decision ◽

Main Criterion ◽

The Public ◽

Peer Reviewers ◽

Verification Process

The conference is a major international forum for analyzing and discussing trends and approaches in research in the field of basic science and applied research. We provide a platform for discussions on innovative, theoretical and empirical research. The form of the conference: in absentia, without specifying the form in the collection of articles. Working languages: Russian, English Doctors and candidates of science, scientists, specialists of various profiles and directions, applicants for academic degrees, teachers, graduate students, undergraduates, students are invited to participate in the conference. There is one blind verification process in the journal. All articles will be initially evaluated by the editor for compliance with the journal. Manuscripts that are considered appropriate are then usually sent to at least two independent peer reviewers to assess the scientific quality of the article. The editor is responsible for the final decision on whether to accept or reject the article. The editor's decision is final. The main criterion used in assessing the manuscript submitted to the journal is: uniqueness or innovation in the work from the point of view of the methodology being developed and / or its application to a problem of particular importance in the public sector or service sector and / or the setting in which the efforts, for example, in the developing region of the world. That is, the very model / methodology, application and context of problems, at least one of them must be unique and important. Additional criteria considered in the consideration of the submitted document are its accuracy, organization / presentation (ie logical flow) and recording quality.

Download Full-text

Academy Journal No.3(15), 2019/ Chief Editors Susan Belih & Jaak Järv /OEAPS Inc.(Open European Academy of Public Sciences) & Estonian Academy of Sciences. Tallinn, Estonia. 09.03.2019: OEAPS Inc., 2019. - 88 P. ISBN: 9781797440507 ISSN 1736-7530 (electronic)

10.31219/osf.io/u5yxe ◽

2019 ◽

Author(s):

Inc. OEAPS

Keyword(s):

Service Sector ◽

Point Of View ◽

Scientific Quality ◽

Final Decision ◽

Research Subjects ◽

Wide Range ◽

Peer Reviewers ◽

Verification Process ◽

Scientific Research Articles ◽

Monthly Journal

"Academy Journal" is an international, peer-reviewed monthly journal. It is devoted to the publication of original scientific research articles dealing with various academic disciplines.Articles that may be of interest to a wide range of researchers are welcome, and not limited to those who work on specific research subjects."Academy Journal" has an open archive, according to which published articles are available immediately after publication, excluding embargoes.Expert reviewThere is one blind verification process in the journal. All articles will be initially evaluated by the editor for compliance with the journal. Manuscripts that are considered appropriate are then usually sent to at least two independent peer reviewers to assess the scientific quality of the article. The editor is responsible for the final decision on whether to accept or reject the article. The editor's decision is final.The main criterion used in assessing the manuscript submitted to the journal is: uniqueness or innovation in the work from the point of view of the methodology being developed and / or its application to a problem of particular importance in the public sector or service sector and / or the setting in which the efforts, for example, in the developing region of the world. That is, the very model / methodology, application and context of problems, at least one of them must be unique and important.Additional criteria considered in the consideration of the submitted document are its accuracy, organization / presentation (ie logical flow) and recording quality.

Download Full-text