Functional data modelling approach for analysing and predicting trends in incidence rates-an application to falls injury
- Ullah, Shahid, Finch, Caroline
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
The epidemiology of hospitalised wrist fractures in older people, New South Wales, Australia
- Boufous, Soufiane, Finch, Caroline, Lord, Stephen, Close, Jacqueline, Gothelf, Todd, Walsh, William
- Authors: Boufous, Soufiane , Finch, Caroline , Lord, Stephen , Close, Jacqueline , Gothelf, Todd , Walsh, William
- Date: 2006
- Type: Text , Journal article
- Relation: Bone Vol. 39, no. 5 (2006), p. 1144-1148
- Full Text: false
- Reviewed:
- Description: The epidemiology and trends in wrist fracture admissions to public and private acute hospitals in New South Wales (NSW), Australia, between July 1993 and June 2003 were examined using routinely collected hospital separations statistics. During the study period, the number of hospital separations for wrist fractures increased by 71% in men, an average yearly increase of 6.5%, and by 43% in women, an average yearly increase of 3.9%. A modest, but significant, increase in age-specific and age-standardised hospitalisation rates for wrist fractures was also observed. Whilst the majority of wrist fractures were due to falls, the proportion of falls-related wrist fractures decreased significantly over time. This decrease was more pronounced in males and was accompanied by a rise in the proportion of wrist fractures resulting from high energy mechanisms such as transport, violence and machinery-related incidents. The difference in hospitalised wrist fracture rates between men and women could not be explained solely on the basis of the role played by osteoporosis, indicating the need for more research to improve our understanding of the underlying factors of this type of fracture in older people.
- Description: 2003004961
Linked versus unlinked hospital discharge data on hip fractures for estimating incidence and comorbidity profiles
- Vu, Trang, Day, Lesley, Finch, Caroline
- Authors: Vu, Trang , Day, Lesley , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 12, no. 113 (2012), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Studies comparing internally linked (person–identifying) and unlinked (episodes of care) hospital discharge data (HDD) on hip fractures have mainly focused on incidence overestimation by unlinked HDD, but little is known about the impact of overestimation on patient profiles such as comorbidity estimates. In view of the continuing use of unlinked HDD in hip fracture research and the desire to apply research results to hip fracture prevention, we concurrently assessed the accuracy of both incidence and comorbidity estimates derived from unlinked HDD compared to those estimated from internally linked HDD. Methods: We analysed unlinked and internally linked HDD between 01 July 2005 and 30 June 2008, inclusive, from Victoria, Australia to estimate the incidence of hospital admission for fall-related hip fracture in community-dwelling older people aged 65+ years and determine the prevalence of comorbidity in patients. Community-dwelling status was defined as living in private residence, supported residential facilities or special accommodation but not in nursing homes. We defined internally linked HDD as the reference standard and calculated measures of accuracy of fall-related hip fracture incidence by unlinked HDD using standard definitions. The extent to which comorbidity prevalence estimates by unlinked HDD differed from those by the reference standard was assessed in absolute terms. Results: The sensitivity and specificity of a standard approach for estimating fall-related hip fracture incidence using unlinked HDD (i.e. omitting records of in-hospital deaths, inter-hospital transfers and readmissions within 30 days of discharge) were 94.4% and 97.5%, respectively. The standard approach and its variants underestimated the prevalence of some comorbidities and altered their ranking. The use of more stringent selection criteria led to major improvements in all measures of accuracy as well as overall and specific comorbidity estimates. Conclusions: This study strongly supports the use of linked rather than unlinked HDD in injury research. In health systems where linked HDD are unavailable, current approaches for identifying incident hip fractures may be enhanced by incorporating additional evidence-based criteria.
- Authors: Vu, Trang , Day, Lesley , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 12, no. 113 (2012), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Studies comparing internally linked (person–identifying) and unlinked (episodes of care) hospital discharge data (HDD) on hip fractures have mainly focused on incidence overestimation by unlinked HDD, but little is known about the impact of overestimation on patient profiles such as comorbidity estimates. In view of the continuing use of unlinked HDD in hip fracture research and the desire to apply research results to hip fracture prevention, we concurrently assessed the accuracy of both incidence and comorbidity estimates derived from unlinked HDD compared to those estimated from internally linked HDD. Methods: We analysed unlinked and internally linked HDD between 01 July 2005 and 30 June 2008, inclusive, from Victoria, Australia to estimate the incidence of hospital admission for fall-related hip fracture in community-dwelling older people aged 65+ years and determine the prevalence of comorbidity in patients. Community-dwelling status was defined as living in private residence, supported residential facilities or special accommodation but not in nursing homes. We defined internally linked HDD as the reference standard and calculated measures of accuracy of fall-related hip fracture incidence by unlinked HDD using standard definitions. The extent to which comorbidity prevalence estimates by unlinked HDD differed from those by the reference standard was assessed in absolute terms. Results: The sensitivity and specificity of a standard approach for estimating fall-related hip fracture incidence using unlinked HDD (i.e. omitting records of in-hospital deaths, inter-hospital transfers and readmissions within 30 days of discharge) were 94.4% and 97.5%, respectively. The standard approach and its variants underestimated the prevalence of some comorbidities and altered their ranking. The use of more stringent selection criteria led to major improvements in all measures of accuracy as well as overall and specific comorbidity estimates. Conclusions: This study strongly supports the use of linked rather than unlinked HDD in injury research. In health systems where linked HDD are unavailable, current approaches for identifying incident hip fractures may be enhanced by incorporating additional evidence-based criteria.
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