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A Demonstration of Multilevel, Small Area Modeling: Estimating HPV Vaccine Coverage in Texas Counties
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AEP Vol. 20, No. 9 September 2010: 691–724
ABSTRACTS (ACE)
categories ranging from documented clinical diagnosis of Autism to suspicion of ASD with no diagnostic or educational documentation. Changes in the distribution of cases across categories both by time and presence of Intellectual Disability were modeled using Bayesian multinomial regression. RESULTS: We observed an increase in the proportion of children with a clinical diagnosis of Autistic Disorder from 2002 onwards and a decrease in the proportion suspected of ASD with no clinical or school documentation. Among children without an ID, there was a similarly timed increase in the proportion receiving school services for ASD without a clinical diagnosis. CONCLUSION: Using a Bayesian approach provided a number of analytic and interpretive advantages including direct estimation of uncertainty concerning the true classification probabilities through the posterior distributions and the ability to evaluate changes in the the classification probabilities without the interpretive difficulty associated with sampling-based inference in the more common frequentist approach.
P76 A DEMONSTRATION OF MULTILEVEL, SMALL AREA MODELING: ESTIMATING HPV VACCINE COVERAGE IN TEXAS COUNTIES JM Eberth, MDM Hossain, SW Vernon, JA Tiro, University of Texas School of Public Health, Houston TX
PURPOSE: Local health data can be used in policy development, resource allocation, program planning, hypothesis generation, and health disparities research. Methods to produce local estimates using data collected for larger regions are known as small area estimation (SAE). Here, we demonstrate the use of model-based SAE to estimate HPV vaccine coverage. METHODS: Graphically and quantitatively, we show the steps involved in the development and evaluation of a multilevel, small area (SA) model for estimating HPV vaccine coverage among girls aged 11–17. The outcome (1 dose GardasilÒ or HPV4) and level 1 predictors were obtained from the 2008 Texas Behavioral Risk Factor Surveillance System. Level 2 predictors and county population counts were obtained from auxiliary datasets. RESULTS: The predicted probabilities from our SA model were linked with demographic-specific population counts from the U.S. Census to derive county level estimates of HPV vaccine coverage. Preliminary analyses show geographic variability in HPV vaccine coverage at the county level, with estimates ranging from w10–40%. Only 1 county (i.e. Loving County) had too few residents to estimate HPV vaccine coverage among girls aged 11–17. The 2008 National Immunization Survey estimates 32% of girls aged 13-17 in TX have obtained at least 1 dose of HPV4.
CONCLUSION: Although geographic variability in HPV vaccination has been previously reported, our study is the first to predict coverage rates at the county level using model-based SAE. NUTRITION P77 ASSOCIATION BETWEEN POLYMORPHIC VARIATION IN GC AND CIRCULATING LEVELS OF VITAMIN D METABOLITES EA Hibler1,2, EC LeRoy2, ME Martinez1,2, PA Thompson1,2, ET Jacobs1,2, 1Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 2Arizona Cancer Center, University of Arizona, Tucson, AZ
PURPOSE: Gc-globulin (GC) is the protein responsible for transport of vitamin D metabolites in serum and shows variation associated with skin pigmentation. Two GC polymorphisms have been consistently associated with variation in circulating levels of 25(OH)D, however, whether additional genetic variation in GC affects circulating levels of 1,25 (OH)2D or 25(OH)D has not been established. METHODS: We used a single nucleotide polymorphism (SNP) tagging approach to evaluate the association between SNPs in GC and serum levels of 1,25(OH)2D and 25(OH)D. A total of 25 tagSNPs in GC were analyzed in a sample of 415 participants. Principal components analysis and regression models were used to evaluate overall gene and individual SNP level associations. Additional modeling approaches are being used to further test pathway approaches for this type of genetic analysis. RESULTS: Principal components analyses revealed a strong gene-level association between GC and serum 25 (OH)D concentrations (P ! 0.0001), but not 1,25(OH) 2D (P Z 0.37). Seven SNPs remained significant in the regression models after a multiple comparisons adjustment was applied. CONCLUSION: These results confirm an association between genetic variation in GC and 25(OH)D serum concentrations, and also identify novel SNPs that may contribute to this association. P78 ANTIOXIDANTS AND PULMONARY FUNCTION AMONG POLICE OFFICERS LE Charles1, CM Burchfiel1, A Mnatsakanova1, D Fekedulegn1, C Tinney-Zara1, PN Joseph1, ME Andrew1, JM Violanti2, HJ Schunemann3, HM Ochs-Balcom2, 1National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 2University at Buffalo, Buffalo, NY, 3McMaster University, Hamilton, Ontario, Canada
PURPOSE: Certain occupational exposures may place police officers at increased risk for poor pulmonary function.
AEP Vol. 20, No. 9 September 2010: 691–724
ABSTRACTS (ACE)
categories ranging from documented clinical diagnosis of Autism to suspicion of ASD with no diagnostic or educational documentation. Changes in the distribution of cases across categories both by time and presence of Intellectual Disability were modeled using Bayesian multinomial regression. RESULTS: We observed an increase in the proportion of children with a clinical diagnosis of Autistic Disorder from 2002 onwards and a decrease in the proportion suspected of ASD with no clinical or school documentation. Among children without an ID, there was a similarly timed increase in the proportion receiving school services for ASD without a clinical diagnosis. CONCLUSION: Using a Bayesian approach provided a number of analytic and interpretive advantages including direct estimation of uncertainty concerning the true classification probabilities through the posterior distributions and the ability to evaluate changes in the the classification probabilities without the interpretive difficulty associated with sampling-based inference in the more common frequentist approach.
P76 A DEMONSTRATION OF MULTILEVEL, SMALL AREA MODELING: ESTIMATING HPV VACCINE COVERAGE IN TEXAS COUNTIES JM Eberth, MDM Hossain, SW Vernon, JA Tiro, University of Texas School of Public Health, Houston TX
PURPOSE: Local health data can be used in policy development, resource allocation, program planning, hypothesis generation, and health disparities research. Methods to produce local estimates using data collected for larger regions are known as small area estimation (SAE). Here, we demonstrate the use of model-based SAE to estimate HPV vaccine coverage. METHODS: Graphically and quantitatively, we show the steps involved in the development and evaluation of a multilevel, small area (SA) model for estimating HPV vaccine coverage among girls aged 11–17. The outcome (1 dose GardasilÒ or HPV4) and level 1 predictors were obtained from the 2008 Texas Behavioral Risk Factor Surveillance System. Level 2 predictors and county population counts were obtained from auxiliary datasets. RESULTS: The predicted probabilities from our SA model were linked with demographic-specific population counts from the U.S. Census to derive county level estimates of HPV vaccine coverage. Preliminary analyses show geographic variability in HPV vaccine coverage at the county level, with estimates ranging from w10–40%. Only 1 county (i.e. Loving County) had too few residents to estimate HPV vaccine coverage among girls aged 11–17. The 2008 National Immunization Survey estimates 32% of girls aged 13-17 in TX have obtained at least 1 dose of HPV4.
CONCLUSION: Although geographic variability in HPV vaccination has been previously reported, our study is the first to predict coverage rates at the county level using model-based SAE. NUTRITION P77 ASSOCIATION BETWEEN POLYMORPHIC VARIATION IN GC AND CIRCULATING LEVELS OF VITAMIN D METABOLITES EA Hibler1,2, EC LeRoy2, ME Martinez1,2, PA Thompson1,2, ET Jacobs1,2, 1Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 2Arizona Cancer Center, University of Arizona, Tucson, AZ
PURPOSE: Gc-globulin (GC) is the protein responsible for transport of vitamin D metabolites in serum and shows variation associated with skin pigmentation. Two GC polymorphisms have been consistently associated with variation in circulating levels of 25(OH)D, however, whether additional genetic variation in GC affects circulating levels of 1,25 (OH)2D or 25(OH)D has not been established. METHODS: We used a single nucleotide polymorphism (SNP) tagging approach to evaluate the association between SNPs in GC and serum levels of 1,25(OH)2D and 25(OH)D. A total of 25 tagSNPs in GC were analyzed in a sample of 415 participants. Principal components analysis and regression models were used to evaluate overall gene and individual SNP level associations. Additional modeling approaches are being used to further test pathway approaches for this type of genetic analysis. RESULTS: Principal components analyses revealed a strong gene-level association between GC and serum 25 (OH)D concentrations (P ! 0.0001), but not 1,25(OH) 2D (P Z 0.37). Seven SNPs remained significant in the regression models after a multiple comparisons adjustment was applied. CONCLUSION: These results confirm an association between genetic variation in GC and 25(OH)D serum concentrations, and also identify novel SNPs that may contribute to this association. P78 ANTIOXIDANTS AND PULMONARY FUNCTION AMONG POLICE OFFICERS LE Charles1, CM Burchfiel1, A Mnatsakanova1, D Fekedulegn1, C Tinney-Zara1, PN Joseph1, ME Andrew1, JM Violanti2, HJ Schunemann3, HM Ochs-Balcom2, 1National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 2University at Buffalo, Buffalo, NY, 3McMaster University, Hamilton, Ontario, Canada
PURPOSE: Certain occupational exposures may place police officers at increased risk for poor pulmonary function.