Michele Morara

A Bayesian Hierarchical Approach for Relating PM2.5 Exposure to Cardiovascular Mortality in North Carolina

Considerable attention has been given to the relationship between levels of fine particulate matter (particulate matter ≤ 2.5 μm in aerodynamic diameter; PM2.5) in the atmosphere and health effects in human populations. Since the U.S. Environmental Protection Agency began widespread monitoring of PM2.5 levels in 1999, the epidemiologic community has performed numerous observational studies modeling mortality and morbidity responses to PM2.5 levels using Poisson generalized additive models (GAMs). Although these models are useful for relating ambient PM2.5 levels to mortality, they cannot directly measure the strength of the effect of exposure to PM2.5 on mortality. In order to assess this effect, we propose a three-stage Bayesian hierarchical model as an alternative to the classical Poisson GAM. Fitting our model to data collected in seven North Carolina counties from 1999 through 2001, we found that an increase in PM2.5 exposure is linked to increased risk of cardiovascular mortality in the same day and next 2 days. Specifically, a 10-μg/m3 increase in average PM2.5 exposure is associated with a 2.5% increase in the relative risk of current-day cardiovascular mortality, a 4.0% increase in the relative risk of cardiovascular mortality the next day, and an 11.4% increase in the relative risk of cardiovascular mortality 2 days later. Because of the small sample size of our study, only the third effect was found to have > 95% posterior probability of being > 0. In addition, we compared the results obtained from our model to those obtained by applying frequentist (or classical, repeated sampling-based) and Bayesian versions of the classical Poisson GAM to our study population.

Relating Ambient Particulate Matter Concentration Levels to Mortality Using an Exposure Simulator

Since the U.S. Environmental Protection Agency began widespread monitoring of PM2.5 (particulate matter <2.5 μ in diameter) concentration levels in the late 1990s, the epidemiological community has performed several observational studies directly relating PM2.5 concentration to various health endpoints including mortality and morbidity. However, recent research suggests that human exposure to the constituents of PM2.5 may differ significantly from ambient (or outdoor) PM2.5 concentration measured by monitors because people spend a great deal of time in environments, such as various indoor environments, where they are partially shielded from ambient sources of PM and are exposed to nonambient sources of PM. Recent research has provided some ways to include exposure information, but little has been done to determine the impact of including such information in a statistical model. To address this concern, we develop a three-stage Bayesian hierarchical model based on the Poisson regression model that is traditionally used to characterize the relationship between PM2.5 concentration and health endpoints. Our approach includes a spatial model relating monitor readings to average county PM2.5 concentration and an exposure simulator that links average ambient PM2.5 concentration to average personal exposure using activity pattern data. We apply our model to a study population in North Carolina and explore the impact of various exposure modeling assumptions on the conclusions that can be drawn about the link between PM2.5 exposure and cardiovascular mortality.

Improving cost‐effectiveness of epidemiological studies via designed missingness strategies

Modern epidemiological studies face opportunities and challenges posed by an ever-expanding capacity to measure a wide range of environmental exposures, along with sophisticated biomarkers of exposure and response at the individual level. The challenge of deciding what to measure is further complicated for longitudinal studies, where logistical and cost constraints preclude the collection of all possible measurements on all participants at every follow-up time. This is true for the National Childrens Study (NCS), a large-scale longitudinal study that will enroll women both prior to conception and during pregnancy and collect information on their environment, their pregnancies, and their childrens development through early adulthood-with a goal of assessing key exposure/outcome relationships among a cohort of approximately 100 000 children. The success of the NCS will significantly depend on the accurate, yet cost-effective, characterization of environmental exposures thought to be related to the health outcomes of interest. The purpose of this paper is to explore the use of cost saving, yet valid and adequately powered statistical approaches for gathering exposure information within epidemiological cohort studies. The proposed approach involves the collection of detailed exposure assessment information on a specially selected subset of the study population, and collection of less-costly, and presumably less-detailed and less-burdensome, surrogate measures across the entire cohort. We show that large-scale efficiency in costs and burden may be achieved without making substantive sacrifices on the ability to draw reliable inferences concerning the relationship between exposure and health outcome. Several detailed scenarios are provided that document how the targeted sub-sampling design strategy can benefit large cohort studies like the NCS, as well as other more focused environmental epidemiologic studies.

Gauss–Seidel Estimation of Generalized Linear Mixed Models With Application to Poisson Modeling of Spatially Varying Disease Rates

Generalized linear mixed models (GLMMs) are often fit by computational procedures such as penalized quasi-likelihood (PQL). Special cases of GLMMs are generalized linear models (GLMs), which are often fit using algorithms like iterative weighted least squares (IWLS). High computational costs and memory space constraints make it difficult to apply these iterative procedures to datasets having a very large number of records. We propose a computationally efficient strategy based on the Gauss–Seidel algorithm that iteratively fits submodels of the GLMM to collapsed versions of the data. The strategy is applied to investigate the relationship between ischemic heart disease, socioeconomic status, and age/gender category in New South Wales, Australia, based on outcome data consisting of approximately 33 million records. For Poisson and binomial regression models, the Gauss–Seidel approach is found to substantially outperform existing methods in terms of maximum analyzable sample size. Remarkably, for both models, the average time per iteration and the total time until convergence of the Gauss–Seidel procedure are less than 0.3% of the corresponding times for the IWLS algorithm. Platform-independent pseudo-code for fitting GLMS, as well as the source code used to generate and analyze the datasets in the simulation studies, are available online as supplemental materials.

Semantic network analysis for evidence evaluation: The threat anticipation initiative

Semantic network analysis offers a computational method for discovery, pattern matching, and reasoning with large amounts of unstructured, semi-structured and structured information. The Threat Anticipation Platform replaces more cumbersome and computationally complex forms of semantic inference with metrics on graph representations of labeled, directed semantic networked data to identify the degree of evidence within multiple data sources for specified hypotheses about potential events.