Health Services and Outcomes Research Methodology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Bayesian analysis of heterogeneous treatment effects for patient-centered outcomes research
AbstractEvaluation of heterogeneity of treatment effect (HTE) is an essential aspect of personalized medicine and patient-centered outcomes research. Our goal in this article is to promote the use of Bayesian methods for subgroup analysis and to lower the barriers to their implementation by describing the ways in which the companion softwarebeanz can facilitate these types of analyses. To advance this goal, we describe several key Bayesian models for investigating HTE and outline the ways in which they are well-suited to address many of the commonly cited challenges in the study of HTE. Topics highlighted include shrinkage...
Source: Health Services and Outcomes Research Methodology - September 19, 2016 Category: Statistics Source Type: research

A comparison of care management delivery models on the trajectories of medical costs among patients with chronic diseases: 4-year follow-up results
In this study, we modeled the unknown form of the time-varying program effects using a spline-based technique in the Bayesian framework, where the number and locations of knots were treated unknown and learned via reversible jump Markov chain Monte Carlo. We also addressed additional modeling challenges from features seen in our healthcare cost data such as highly right-skewed outcomes with non-constant variances and extra zeros. To provide a more robust analysis, we incorporated a follow-up period of up to 4  years that is longer than the most of the published studies on care management. The results of this work demonstr...
Source: Health Services and Outcomes Research Methodology - September 8, 2016 Category: Statistics Source Type: research

Propensity score weighting for a continuous exposure with multilevel data
AbstractPropensity score methods (e.g., matching, weighting, subclassification) provide a statistical approach for balancing dissimilar exposure groups on baseline covariates. These methods were developed in the context of data with no hierarchical structure or clustering. Yet in many applications the data have a clustered structure that is of substantive importance, such as when individuals are nested within healthcare providers or within schools. Recent work has extended propensity score methods to a multilevel setting, primarily focusing on binary exposures. In this paper, we focus on propensity score weighting for a co...
Source: Health Services and Outcomes Research Methodology - August 24, 2016 Category: Statistics Source Type: research

A conversation with Elizabeth A. Stuart
AbstractElizabeth A. Stuart is a Professor in the Departments of Mental Health, Biostatistics, and Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, and Associate Dean for Education at the school. She is a renowned expert in the area of causal inference, including propensity score methods for observational data and the generalizability of randomized trial results, and is also a Fellow of the American Statistical Association. Prior to her appointment to the faculty at Johns Hopkins, Professor Stuart received her Ph.D. in statistics from Harvard University and a bachelor ’s degree in math...
Source: Health Services and Outcomes Research Methodology - August 23, 2016 Category: Statistics Source Type: research

Intraclass correlation coefficients: clearing the air, extending some cautions, and making some requests
AbstractIntraclass correlation coefficients (ICCs) are frequently employed in health science research, often to assess intrarater and interrater reliability. In many cases, insufficient details are provided about these ICCs and there seem to be misunderstandings about their selection and how they should be interpreted. This paper is intended primarily to provide a clear, accessible description of ICCs, including how they should be selected, interpreted, and reported. Emphasis is given to areas where researchers seem to encounter the greatest conceptual difficulties and to exhibit the greatest misconceptions. Two extended e...
Source: Health Services and Outcomes Research Methodology - August 22, 2016 Category: Statistics Source Type: research

Combining non-randomized and randomized data in clinical trials using commensurate priors
AbstractRandomization eliminates selection bias, and attenuates imbalance among study arms with respect to prognostic factors, both known and unknown. Thus, information arising from randomized clinical trials (RCTs) is typically considered the gold standard for comparing therapeutic interventions in confirmatory studies. However, RCTs are limited in contexts wherein patients who are willing to accept a random treatment assignment represent only a subset of the patient population. By contrast, observational studies (OSs) often enroll patient cohorts that better reflect the broader patient population. However, OSs often suff...
Source: Health Services and Outcomes Research Methodology - August 5, 2016 Category: Statistics Source Type: research

A survey on the state of healthcare upcoding fraud analysis and detection
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > From its infancy in the 1910s, healthcare group insurance continues to increase, creating a consistently rising burden on the government and taxpayers. The growing number of people enrolled in healthcare programs such as Medicare, along with the enormous volume of money in the healthcare industry, increases the appeal for and risk of fraudulent activities. One such fraud, known as upcoding, is a means by which a provider can obtain additional reimbursement by coding a certain provided service as a more expensive service than what was actually perfo...
Source: Health Services and Outcomes Research Methodology - July 27, 2016 Category: Statistics Source Type: research

An interview with Don Hedeker
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > Don Hedeker was born in the late 1950s in Chicago, Illinois. He attended public schools in Chicago and did his undergraduate work at the University of Chicago, earning a degree in Economics in 1980. In 1981, he began graduate work in the Department of Behavioral Sciences, Committee on Research Methodology and Quantitative Psychology at the University of Chicago. He completed his dissertation in 1989 under the direction of Darrell Bock. In 1993, Don accepted a faculty position at the University of Illinois at Chicago (UIC) where he was promoted to t...
Source: Health Services and Outcomes Research Methodology - July 22, 2016 Category: Statistics Source Type: research

An analysis of patient-sharing physician networks and implantable cardioverter defibrillator therapy
This study supports previous reports on how variation in physician network structure relates to utilization of care, and motivates future work using physician network measures to examine variation in evidence-based medicine. (Source: Health Services and Outcomes Research Methodology)
Source: Health Services and Outcomes Research Methodology - June 26, 2016 Category: Statistics Source Type: research

Measuring performance change in Scottish hospitals: a Malmquist and times-series approach
Abstract We applied a Malmquist approach to assess levels and change of efficiency and technology in Scottish hospitals. The biased corrected Malmquist index, the efficiency change index, and the technology change index appear to vacillate improving and regressing over the four time intervals with the overall indices (2003–2007). We did not detect steady movement in these measures in one way or another, but we have advanced the literature by employing a time-series trend analysis to gauge changes without the obfuscation by white noise. By using regression, we found a definite and statistically significa...
Source: Health Services and Outcomes Research Methodology - June 24, 2016 Category: Statistics Source Type: research

Maximizing an ROC-type measure via linear combinations of biomarkers
Abstract The receiver operating characteristic curve is a popular tool to describe and compare the diagnostic accuracy of biomarkers when the binary-scale gold standard is available. There are, however, many examples of diagnostic tests whose gold standards are continuous. Hence, several extensions are proposed to evaluate the diagnostic potential of biomarkers when the gold standard is continuous-scale. In practice, there may exist more than one biomarkers and diagnostic accuracy can be improved by combining multiple biomarkers. In this paper, an explicit form of diagnostic accuracy index and the ...
Source: Health Services and Outcomes Research Methodology - June 19, 2016 Category: Statistics Source Type: research

Accounting for misclassification in electronic health records-derived exposures using generalized linear finite mixture models
Abstract Exposures derived from electronic health records (EHR) may be misclassified, leading to biased estimates of their association with outcomes of interest. An example of this problem arises in the context of cancer screening where test indication, the purpose for which a test was performed, is often unavailable. This poses a challenge to understanding the effectiveness of screening tests because estimates of screening test effectiveness are biased if some diagnostic tests are misclassified as screening. Prediction models have been developed for a variety of exposure variables that can be derived fro...
Source: Health Services and Outcomes Research Methodology - June 2, 2016 Category: Statistics Source Type: research

The willingness to pay for in vitro fertilization-related information and its attributes: a cross-sectional study in Israel
The objective of this study is to measure the willingness-to-pay (WTP) for in vitro fertilization (IVF) treatment-related information and its attributes, and to analyse the factors affecting WTP, because of the apparent problems in providing information and the absence of specific guidelines for Israeli health care providers regarding IVF-related information, caused by limited time and resources, making it difficult for medical providers to interact adequately with IVF patients. There is a need for changes in government and health care policy in order to deal with these market failures. The study employed contingent valuat...
Source: Health Services and Outcomes Research Methodology - May 17, 2016 Category: Statistics Source Type: research

Estimating causal effects: considering three alternatives to difference-in-differences estimation
Abstract Difference-in-differences (DiD) estimators provide unbiased treatment effect estimates when, in the absence of treatment, the average outcomes for the treated and control groups would have followed parallel trends over time. This assumption is implausible in many settings. An alternative assumption is that the potential outcomes are independent of treatment status, conditional on past outcomes. This paper considers three methods that share this assumption: the synthetic control method, a lagged dependent variable (LDV) regression approach, and matching on past outcomes. Our motivating empirical s...
Source: Health Services and Outcomes Research Methodology - May 6, 2016 Category: Statistics Source Type: research

The study of service use among homeless persons with mental illness: a methodological review
The objective of this paper is to critically review the methods used to study service use by homeless persons with mental illness, and discuss gaps in the evidence base and research implications. Searches were conducted of PsycINFO, MEDLINE, and PubMed to identify service use studies published between 2000 and 2014. Data were extracted on the types of services studied, quantification of service use, assessment tools, period of service use assessment, and analytic design. The review identified 27 studies described in 46 publications. The majority of the studies had observational designs that measured service use quantitativ...
Source: Health Services and Outcomes Research Methodology - April 28, 2016 Category: Statistics Source Type: research