The Effect of Community Socioeconomic Context on High School Attendance in China: A Generalized Propensity Score Approach

Many developing countries have experienced increasing spatial inequality, but little is known about the effect of community disadvantages on educational attainment in these societies. Using data from the China Family Panel Studies (2010–2016), I examine the effect of community socioeconomic status (SES) on the transition into high school in urban and rural China, and I explore several mechanisms explaining the community effects. I adopt the generalized propensity score method to estimate the potential probability of high school entrance at different levels of community SES. Results show that community SES is positively associated with high school attendance in both urban and rural China, and the relationship is stronger in more disadvantaged communities in both contexts. In urban areas, the effect of community SES is partly attributable to collective socialization and children’s academic performance. In rural areas, spatial accessibility to high schools and children’s academic performance are the salient mechanisms.

Early mortality in elderly patients with isolated C2 odontoid fracture treated by halo-vest immobilization, anterior spinal fixation, or posterior spinal fixation: A generalized propensity score-based analysis using a nationwide database

Purpose To compare in-hospital mortality of three procedures in the treatment of elderly patients with isolated C2 odontoid fracture: halo-vest immobilization, anterior spinal fixation (ASF), and posterior spinal fixation (PSF). Methods We extracted data for elderly patients who were admitted with C2 odontoid fracture and treated with at least one of the three procedures (halo-vest immobilization, ASF, or PSF) during hospitalization. We conducted a generalized propensity score-based matching weight analysis to compare in-hospital mortality among the three procedures. We further investigated independent risk factors for in-hospital death. Results The study involved 891 patients (halo-vest, n = 463; ASF, n = 74; and PSF, n = 354) with a mean age of 78 years. In-hospital death occurred in 45 (5.1%) patients. Treatment type was not significantly associated with in-hospital mortality. Male sex (odds ratio, 2.98; 95% confidence interval, 1.32–6.73; p = 0.009) and a Charlson comorbidity index of ≥ 3 (odds ratio, 9.18; 95% confidence interval, 3.25–25.92; p < 0.001) were independent risk factors for in-hospital mortality. Conclusions Treatment type (halo-vest immobilization, ASF, or PSF) was not significantly associated with in-hospital mortality in elderly patients with isolated C2 odontoid fracture. Halo-vest immobilization can help to avoid adverse events in patients with C2 odontoid fracture who are considered less suitable for surgical treatment.

Adjuvant Therapy in Resected Nonmetastatic Stage II–IV Gallbladder Cancer: A Generalized Propensity Score Analysis

<b><i>Background:</i></b> The clinical benefits and efficacies of adjuvant therapies for gallbladder cancer (GBC) have not been verified due to insufficient clinical evidence. <b><i>Methods:</i></b> Patients with resected nonmetastatic stage II–IV GBC were selected from the Surveillance, Epidemiology, and End Results database and distributed into nonchemotherapy and chemoradiotherapy (NCRT), chemotherapy (CT), and chemoradiotherapy (CRT) groups. Generalized propensity score and inverse probability of treatment weighting (IPTW) were used to reduce the imbalances between groups. <b><i>Results:</i></b> A total of 2,689 patients were enrolled, among whom 1,193 (44.4%) were classified as stage II, 1,371 (51.0%) as stage III, and 125 (4.6%) as stage IV GBC. A total of 1,703, 444, and 542 patients were placed in the NCRT, CT, and CRT groups, respectively. After the IPTW, there were no significant differences in overall survival (OS) between the 3 treatment groups (<i>p &#x3e;</i> 0.05) in stage II GBC patients. In patients with stage III–IV GBC, the CT group exhibited a superior OS compared to the NCRT group (<i>p &#x3c;</i> 0.001). In addition, the CRT group exhibited a superior OS compared to the CT (<i>p &#x3c;</i> 0.001) and NCRT (<i>p &#x3c;</i> 0.001) groups. For patients with stage III–IV tumors, a nomogram was constructed to predict the survival benefits of adjuvant therapies. <b><i>Conclusion:</i></b> Patients with stage II GBC may not benefit from adjuvant therapy, while patients with stage III–IV GBC were shown to benefit from chemotherapy and chemoradiotherapy. Furthermore, chemoradiotherapy exhibited a superior OS. Nevertheless, the results need to be explained in the context of retrospective studies.

Adjuvant therapy in the treatment of resected nonmetastatic gallbladder cancer of stage II-IV: A generalized propensity score analysis.

471 Background: The benefit of adjuvant therapy for gallbladder cancer (GBC) remains controversial due to the limited evidence. The current study was aimed to explore the efficacy of adjuvant therapy in patients with resected non-metastatic GBC and to establish a prognosis model to predict the survival benefit of GCB patients with different adjuvant therapies. Methods: Patients with resected non-metastatic GBC of stage II-IV were selected from the Surveillance, Epidemiology, and End Results database and divided into non-radiotherapy and chemotherapy (NCRT) group, chemotherapy (CT) group, and chemoradiotherapy (CRT) group. Generalized propensity score (GPS) and inverse probability of treatment weighting (IPTW) was used to reduce the imbalances between groups. Nomogram was constructed based on Cox proportional hazard model, and the model was validated for discrimination and calibration. Results: Among the 2689 enrolled patients, 1193 (44.4%) patients were classified as stage II, 1371 (51.0%) as stage III, and 125 (4.6%) as stage IV according to the 8th American Joint Commotion Cancer staging manual. Patients in NCRT, CT, and CRT groups were 1703, 444, and 542 respectively. After the IPTW, absolute standardized differences of baseline characteristics were less than 0.1 both in patients with stage II tumors and with stage III-IV tumors. In patients with GBC of stage II, no significant difference in OS was observed between the three treatment groups (P > 0.05). In patients with GBC of stage III-IV, CT group has a superior OS compared with the NCRT group (P < 0.001), and CRT group has a superior OS compared with the CT(P < 0.001) and NCRT (P < 0.001) group. Sensitivity analysis showed consistent results. A nomogram was constructed for patients with stage III-IV tumors to predict the survival benefit of adjuvant therapies. The C-index was 0.673 (95% CI: 0.654-0.692) in the validation using the training set (diagnosed at 2004-2012) and was 0.707 (95% CI: 0.677-0·739) in the internal validation using the validation set (diagnosed at 2013-2015). The calibration curves indicated that the predicted probability closely corresponded to the actual observation OS. Conclusions: Patients with GBC of stage II could not benefit from adjuvant therapy. Patients with GBC of stage III-IV could benefit from chemotherapy and chemoradiotherapy while chemoradiotherapy provide a superior OS. A nomogram was built to predict the survival benefit of different adjuvant therapies in patients with GBC of stage III-IV.

A practical generalized propensity-score estimator for quantile continuous treatment effects

In this article, we present a new command, qcte, that implements several methods for estimation and inference for quantile treatment-effects models with a continuous treatment. We propose a semiparametric two-step estimator, where the first step is based on a flexible Box–Cox model, as the default model of the command. We develop practical statistical inference procedures using bootstrap. We implement some simulations to show that the proposed methods perform well. Finally, we apply qcte to a survey of Massachusetts lottery winners to estimate the unconditional quantile effects of the prize amount, as a proxy of nonlabor income changes, on subsequent labor earnings from U.S. Social Security records. The empirical results reveal strong heterogeneity across unconditional quantiles.