Variability in Causal Effects and Noncompliance in a Multisite Trial: A Bivariate Hierarchical Generalized Random Coefficients Model for a Binary Outcome.

Within each of 170 physicians, patients were randomized to access e-assist, an online program that aimed to increase colorectal cancer screening (CRCS), or control. Compliance was partial: of the experimental patients accessed e-assist while no controls were provided the access. Of interest are the average causal effect of assignment to treatment and the complier average causal effect as well as the variation of these causal effects across physicians.

Racial disparities in cancer genetic counseling encounters: study protocol for investigating patient-genetic counselor communication in the naturalistic clinical setting using a convergent mixed methods design.

Background: Despite decades of effort to reduce racial cancer disparities, Black people continue to die at higher rates from cancer than any other U.S. racial group.

An exploration of cultural competency training and genetic counselors' racial biases.

Research shows genetic counselors generally have pro-White implicit biases-both prejudice and stereotyping. Cultural competency training aims to foster equitable beliefs, behaviors, and attitudes in cross-cultural genetic counseling sessions, including those that are racially discordant (genetic counselors and patients are from different racial backgrounds). Therefore, cultural competency training has the potential to mitigate bias and reduce disparities.

Opportunities and Challenges When Using the Electronic Health Record for Practice-Integrated Patient-Facing Interventions: The e-Assist Colon Health Randomized Trial.

Background: Even after a physician recommendation, many people remain unscreened for colorectal cancer (CRC). The proliferation of electronic health records (EHRs) and tethered online portals may afford new opportunities to embed patient-facing interventions within clinic workflows and engage patients following a physician recommendation for care. We evaluated the effectiveness of a patient-facing intervention designed to complement physician office-based recommendations for CRC screening.

Predictors of smell recovery in a nationwide prospective cohort of patients with COVID-19.

Objective: To determine which factors (demographic, symptoms, comorbidities, and treatments) are associated with recovery of smell in patients with COVID-19 associated olfactory loss.

Study Design: Prospective, longitudinal questionnaires.

Setting: National survey.

Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance.

The six-minute walk (6MW) test is a validated assessment method in Multiple Sclerosis (MS) research. While the total distance covered during six minutes ( ) is often used as the standard measurement of gait capacity (i.e.

Quality of life and safety impact of COVID-19 associated smell and taste disturbances.

Objective: The association between COVID-19 and chemosensory loss has garnered substantial attention, however to date little is known about the real-life consequences of impairment in this unique patient population. The aim of this study is to evaluate the quality of life (QOL) and personal safety deficits experienced by patients with COVID-19 infection.

Study Design: Prospective, longitudinal questionnaires.

Impact of adolescent obesity on middle-age health of women given data MAR.

We analyze adolescent BMI and middle-age systolic blood pressure (SBP) repeatedly measured on women enrolled in the Fels Longitudinal Study (FLS) between 1929 and 2010 to address three questions: Do adolescent-specific growth rates in body mass index (BMI) and menarche affect middle-age SBP? Do they moderate the aging effect on middle-age SBP? Have the effects changed over historical time? To address the questions, we propose analyzing a growth curve model (GCM) that controls for age, birth-year cohort, and historical time. However, several complications in the data make the GCM analysis nonstandard. First, the person-specific adolescent BMI and middle-age SBP trajectories are unobservable.

Challenges and opportunities using online portals to recruit diverse patients to behavioral trials.

We describe the use of an online patient portal to recruit and enroll primary care patients in a randomized trial testing the effectiveness of a colorectal cancer (CRC) screening decision support program. We use multiple logistic regression to identify patient characteristics associated with trial recruitment, enrollment, and engagement. We found that compared to Whites, Blacks had lower odds of viewing the portal message (OR = 0.

Randomised trial to evaluate the effectiveness and impact of offering postvisit decision support and assistance in obtaining physician-recommended colorectal cancer screening: the e-assist: Colon Health study-a protocol study.

Introduction: How to provide practice-integrated decision support to patients remains a challenge. We are testing the effectiveness of a practice-integrated programme targeting patients with a physician recommendation for colorectal cancer (CRC) screening.

Methods And Analysis: In partnership with healthcare teams, we developed 'e-assist: Colon Health', a patient-targeted, postvisit CRC screening decision support programme.

Patient-Reported Needs Following a Referral for Colorectal Cancer Screening.

Introduction: Patient-physician communication about colorectal cancer screening can affect screening use, but discussions often lack information that patients need for informed decision making and seldom address personal preferences or barriers. To address this gap, a series of patient focus groups was conducted to guide the development of an online, interactive decision support program. This article presents findings on patient information needs and barriers to colorectal cancer screening after receiving a screening recommendation from a physician, and their perspectives on using electronic patient portals as platforms for health-related decision support.

Statistical Power in Two-Level Hierarchical Linear Models with Arbitrary Number of Factor Levels.

As the US health care system undergoes unprecedented changes, the need for adequately powered studies to understand the multiple levels of main and interaction factors that influence patient and other care outcomes in hierarchical settings has taken center stage. We consider two-level models where lower-level units are nested within each of higher-level clusters (e.g.

Quantifying Variation in Gait Features from Wearable Inertial Sensors Using Mixed Effects Models.

The emerging technology of wearable inertial sensors has shown its advantages in collecting continuous longitudinal gait data outside laboratories. This freedom also presents challenges in collecting high-fidelity gait data. In the free-living environment, without constant supervision from researchers, sensor-based gait features are susceptible to variation from confounding factors such as gait speed and mounting uncertainty, which are challenging to control or estimate.

Longitudinal latent variable models given incompletely observed biomarkers and covariates.

In this paper, we analyze a two-level latent variable model for longitudinal data from the National Growth and Health Study where surrogate outcomes or biomarkers and covariates are subject to missingness at any of the levels. A conventional method for efficient handling of missing data is to re-express the desired model as a joint distribution of variables, including the biomarkers, that are subject to missingness conditional on all of the covariates that are completely observed, and estimate the joint model by maximum likelihood, which is then transformed to the desired model. The joint model, however, identifies more parameters than desired, in general.

Peak Bone Mass and Patterns of Change in Total Bone Mineral Density and Bone Mineral Contents From Childhood Into Young Adulthood.

The literature has not reached a consensus on the age when peak bone mass is achieved. This study examines growth patterns of total bone mineral content (TBMC) and total bone mineral density (TBMD), peak bone mass, effect of concurrent anthropometry measures, and physical activity on growth patterns in a sample of 312 white males and 343 females aged 8-30 yr. We analyzed data from participants enrolled in Fels Longitudinal Study.

Efficient analysis of Q-level nested hierarchical general linear models given ignorable missing data.

This article extends single-level missing data methods to efficient estimation of a Q-level nested hierarchical general linear model given ignorable missing data with a general missing pattern at any of the Q levels. The key idea is to reexpress a desired hierarchical model as the joint distribution of all variables including the outcome that are subject to missingness, conditional on all of the covariates that are completely observed and to estimate the joint model under normal theory. The unconstrained joint model, however, identifies extraneous parameters that are not of interest in subsequent analysis of the hierarchical model and that rapidly multiply as the number of levels, the number of variables subject to missingness, and the number of random coefficients grow.

Confidence Bounds and Power for the Reliability of Observational Measures on the Quality of a Social Setting.

Social scientists are frequently interested in assessing the qualities of social settings such as classrooms, schools, neighborhoods, or day care centers. The most common procedure requires observers to rate social interactions within these settings on multiple items and then to combine the item responses to obtain a summary measure of setting quality. A key aspect of the quality of such a summary measure is its reliability.

Systemic central venous oxygen saturation is associated with clot strength during traumatic hemorrhagic shock: A preclinical observational model.

Background: Clot strength by Thrombelastography (TEG) is associated with mortality during trauma and has been linked to severity of tissue hypoperfusion. However, the optimal method for monitoring this important relationship remains undefined. We hypothesize that oxygen transport measurements will be associated with clot strength during traumatic shock, and test this hypothesis using a swine model of controlled traumatic shock.

Just-identified versus overidentified two-level hierarchical linear models with missing data.

The development of model-based methods for incomplete data has been a seminal contribution to statistical practice. Under the assumption of ignorable missingness, one estimates the joint distribution of the complete data for thetainTheta from the incomplete or observed data y(obs). Many interesting models involve one-to-one transformations of theta.