Interrupted Time Series Analysis in Clinical Research

2003 ◽  
Vol 37 (7-8) ◽  
pp. 1110-1116 ◽  
Author(s):  
Lloyd K Matowe ◽  
Cathie A Leister ◽  
Concetta Crivera ◽  
Joan M Korth-Bradley

OBJECTIVE: To demonstrate the usefulness of interrupted time series analysis in clinical trial design. METHODS: A safety data set of electrocardiographic (ECG) information was simulated from actual data that had been collected in a Phase I study. Simulated data on 18 healthy volunteers based on a study performed in a contract research facility were collected based on single doses of an experimental medication that may affect ECG parameters. Serial ECGs were collected before and during treatment with the experimental medication. Data from 7 real subjects receiving placebo were used to simulate the pretreatment phase of time series; data from 18 real subjects receiving active treatment were used to simulate the treatment phase of the time series. Visual inspection of data was performed, followed by tests for trend, seasonality, and autocorrelation by use of SAS. RESULTS: There was no evidence of trend, seasonality, or autocorrelation. In 11 of 18 simulated individuals, statistically significant changes in QTc intervals were observed following treatment with the experimental medication. A significant time of day and treatment interaction was observed in 4 simulated patients. CONCLUSIONS: Interrupted time series analysis techniques offer an additional tool for the study of clinical situations in which patients must act as their own controls and where serial data can be collected at evenly distributed intervals.

Author(s):  
Yulin Hswen ◽  
Alyssa J. Moran ◽  
Siona Prasad ◽  
Anna Li ◽  
Denise Simon ◽  
...  

Public awareness of calories in food sold in retail establishments is a primary objective of the menu labeling law. This study explores the extent to which we can use social media and internet search queries to understand whether the federal calorie labeling law increased awareness of calories. To evaluate the association of the federal menu labeling law with tweeting about calories we retrieved tweets that contained the term “calorie(s)” from the CompEpi Geo Twitter Database from 1 January through 31 December in 2016 and 2018. Within the same time period, we also retrieved time-series data for search queries related to calories via Google Trends (GT). Interrupted time-series analysis was used to test whether the federal menu labeling law was associated with a change in mentions of “calorie(s)” on Twitter and relative search queries to calories on GT. Before the implementation of the federal calorie labeling law on 7 May 2018, there was a significant decrease in the baseline trend of 4.37 × 10−8 (SE = 1.25 × 10−8, p < 0.001) mean daily ratio of calorie(s) tweets. A significant increase in post-implementation slope of 3.19 × 10−8 (SE = 1.34 × 10−8, p < 0.018) mean daily ratio of calorie(s) tweets was seen compared to the pre-implementation slope. An interrupted time-series (ITS) analysis showed a small, statistically significant upward trend of 0.0043 (SE = 0.036, p < 0.001) weekly search queries for calories pre-implementation, with no significant level change post-implementation. There was a decrease in trend of 1.22 (SE = 0.27, p < 0.001) in search queries for calories post-implementation. The federal calorie labeling law was associated with a 173% relative increase in the trend of mean daily ratio of tweets and a −28381% relative change in trend for search queries for calories. Twitter results demonstrate an increase in awareness of calories because of the addition of menu labels. Google Trends results imply that fewer people are searching for the calorie content of their meal, which may no longer be needed since calorie information is provided at point of purchase. Given our findings, discussions online about calories may provide a signal of an increased awareness in the implementation of calorie labels.


2018 ◽  
Vol 3 (1) ◽  
pp. 19-39 ◽  
Author(s):  
Yaşar Tonta

Abstract Purpose One of the main indicators of scientific production is the number of papers published in scholarly journals. Turkey ranks 18th place in the world based on the number of scholarly publications. The objective of this paper is to find out if the monetary support program initiated in 1993 by the Turkish Scientific and Technological Research Council (TÜBİTAK) to incentivize researchers and increase the number, impact, and quality of international publications has been effective in doing so. Design/methodology/approach We analyzed some 390,000 publications with Turkish affiliations listed in the Web of Science (WoS) database between 1976 and 2015 along with about 157,000 supported ones between 1997 and 2015. We used the interrupted time series (ITS) analysis technique (also known as “quasi-experimental time series analysis” or “intervention analysis”) to test if TÜBİTAK’s support program helped increase the number of publications. We defined ARIMA (1,1,0) model for ITS data and observed the impact of TÜBİTAK’s support program in 1994, 1997, and 2003 (after one, four and 10 years of its start, respectively). The majority of publications (93%) were full papers (articles), which were used as the experimental group while other types of contributions functioned as the control group. We also carried out a multiple regression analysis. Findings TÜBİTAK’s support program has had negligible effect on the increase of the number of papers with Turkish affiliations. Yet, the number of other types of contributions continued to increase even though they were not well supported, suggesting that TÜBİTAK’s support program is probably not the main factor causing the increase in the number of papers with Turkish affiliations. Research limitations Interrupted time series analysis shows if the “intervention” has had any significant effect on the dependent variable but it does not explain what caused the increase in the number of papers if it was not the intervention. Moreover, except the “intervention”, other “event(s)” that might affect the time series data (e.g., increase in the number of research personnel over the years) should not occur during the period of analysis, a prerequisite that is beyond the control of the researcher. Practical implications TÜBİTAK’s “cash-for-publication” program did not seem to have direct impact on the increase of the number of papers published by Turkish authors, suggesting that small amounts of payments are not much of an incentive for authors to publish more. It might perhaps be a better strategy to concentrate limited resources on a few high impact projects rather than to disperse them to thousands of authors as “micropayments.” Originality/value Based on 25 years’ worth of payments data, this is perhaps one of the first large-scale studies showing that “cash-for-publication” policies or “piece rates” paid to researchers tend to have little or no effect on the increase of researchers’ productivity. The main finding of this paper has some implications for countries wherein publication subsidies are used as an incentive to increase the number and quality of papers published in international journals. They should be prepared to consider reviewing their existing support programs (based usually on bibliometric measures such as journal impact factors) and revising their reward policies.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanne Martin ◽  
Edwin Amalraj Raja ◽  
Steve Turner

Abstract Background Service reconfiguration of inpatient services in a hospital includes complete and partial closure of all emergency inpatient facilities. The “natural experiment” of service reconfiguration may give insight into drivers for emergency admissions to hospital. This study addressed the question does the prevalence of emergency admission to hospital for children change after reconfiguration of inpatient services? Methods There were five service reconfigurations in Scottish hospitals between 2004 and 2018 where emergency admissions to one “reconfigured” hospital were halted (permanently or temporarily) and directed to a second “adjacent” hospital. The number of emergency admissions (standardised to /1000 children in the regional population) per month to the “reconfigured” and “adjacent” hospitals was obtained for five years prior to reconfiguration and up to five years afterwards. An interrupted time series analysis considered the association between reconfiguration and admissions across pairs comprised of “reconfigured” and “adjacent” hospitals, with adjustment for seasonality and an overall rising trend in admissions. Results Of the five episodes of reconfiguration, two were immediate closure, two involved closure only to overnight admissions and one with overnight closure for a period and then closure. In “reconfigured” hospitals there was an average fall of 117 admissions/month [95% CI 78, 156] in the year after reconfiguration compared to the year before, and in “adjacent” hospitals admissions rose by 82/month [32, 131]. Across paired reconfigured and adjacent hospitals, in the months post reconfiguration, the overall number of admissions to one hospital pair slowed, in another pair admissions accelerated, and admission prevalence was unchanged in three pairs. After reconfiguration in one hospital, there was a rise in admissions to a third hospital which was closer than the named “adjacent” hospital. Conclusions There are diverse outcomes for the number of emergency admissions post reconfiguration of inpatient facilities. Factors including resources placed in the community after local reconfiguration, distance to the “adjacent” hospital and local deprivation may be important drivers for admission pathways after reconfiguration. Policy makers considering reconfiguration might consider a number of factors which may be important determinants of admissions post reconfiguration.


2021 ◽  
pp. 140349482110132
Author(s):  
Agnieszka Konieczna ◽  
Sarah Grube Jakobsen ◽  
Christina Petrea Larsen ◽  
Erik Christiansen

Aim: The aim of this study is to analyse the potential impact from the financial crisis (onset in 2009) on suicide rates in Denmark. The hypothesis is that the global financial crisis raised unemployment which leads to raising the suicide rate in Denmark and that the impact is most prominent in men. Method: This study used an ecological study design, including register data from 2001 until 2016 on unemployment, suicide, gender and calendar time which was analysed using Poisson regression models and interrupted time series analysis. Results: The correlation between unemployment and suicide rates was positive in the period and statistically significant for all, but at a moderate level. A dichotomised version of time (calendar year) showed a significant reduction in the suicide rate for women (incidence rate ratio 0.87, P=0.002). Interrupted time series analysis showed a significant decreasing trend for the overall suicide rate and for men in the pre-recession period, which in both cases stagnated after the onset of recession in 2009. The difference between the genders’ suicide rate changed significantly at the onset of recession, as the rate for men increased and the rate for women decreased. Discussion: The Danish social welfare model might have prevented social disintegration and suicide among unemployed, and suicide prevention programmes might have prevented deaths among unemployed and mentally ill individuals. Conclusions: We found some indications for gender-specific differences from the impact of the financial crises on the suicide rate. We recommend that men should be specifically targeted for appropriate prevention programmes during periods of economic downturn.


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