Statistical approaches tailored to analyzing longitudinal data that have multiple outcomes with different distributions are scarce. This paucity is due to the non-availability of multivariate distributions that jointly model outcomes with different distributions other than the multivariate normal. A plethora of research has been done on the specific combination of binary-Gaussian bivariate outcomes but a more general approach that allows other mixtures of distributions for multiple longitudinal outcomes has not been thoroughly demonstrated and examined. Here we study a multivariate generalized linear mixed models approach that jointly models multiple longitudinal outcomes with different combinations of distributions and incorporates the correlations between the various outcomes through separate yet correlated random intercepts. Every outcome is linked to the set of covariates through a proper link function that allows the incorporation and joint modelling of different distributions. A novel application was demonstrated on a cohort study of Type 1 diabetic patients to jointly model a mix of longitudinal cardiovascular outcomes and to explore for the first time the effect of glycemic control treatment, plasma prekallikrein biomarker, gender and age on cardiovascular risk factors collectively.
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http://dx.doi.org/10.1080/02664763.2015.1103708 | DOI Listing |
Purpose: Heart failure (HF) is a disease that leads to approximately 300,000 fatalities annually in Europe and 250,000 deaths each year in the United States. Type 2 Diabetes Mellitus (T2DM) is a significant risk factor for HF, and testing for N-terminal (NT)-pro hormone BNP (NT-proBNP) can aid in early detection of HF in T2DM patients. We therefore developed and validated the HFriskT2DM-HScore, an algorithm to predict the risk of HF in T2DM patients, so guiding NT-proBNP investigation in a primary care setting.
View Article and Find Full Text PDFBreast Cancer Res Treat
January 2025
Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Purpose: To evaluate the prognostic significance of changes in pre- and post-neoadjuvant chemotherapy (NACT) Ki67 in patients with primary invasive triple-negative breast cancer (TNBC).
Methods: Population-based registry data were retrieved for patients diagnosed with TNBC between 2007 and 2021 (n = 9262). Multivariable Cox regression analysis was performed for disease-specific survival (DSS) and overall survival (OS) adjusted for age and residual disease in the breast and nodes (RDBN).
BMC Cancer
January 2025
Department of Community & Family Medicine, All India Institute of Medical Sciences, 151001, Bathinda, Punjab, India.
Introduction: Existing evidence suggests a lower uptake of cervical cancer screening among Indian women. Coverage is lower in rural than urban women, but such disparities are less explored. So, the present study was conducted to explore the self-reported coverage of cervical cancer screening in urban and rural areas stratified by socio-demographic characteristics, determine the spatial patterns and identify any regional variations, ascertain the factors contributing to urban-rural disparities and those influencing the likelihood of screening among women aged 30-49 years factors residing in urban, rural, and overall Indian settings.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Neurosurgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
Karnofsky Performance Status (KPS) is a widely used scale to assess performance status. KPS ≥ 50% implies that patients can live at home. Therefore, maintaining KPS ≥ 50% is important to improve the quality of life of patients with glioblastoma, whose median survival is less than 2 years.
View Article and Find Full Text PDFSurg Obes Relat Dis
December 2024
Northwestern Quality Improvement, Research and Education in Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Background: Utilization of metabolic and bariatric surgery has increased significantly over the last 2decades, yet barriers to access remain.
Objectives: This study aimed to 1) define rates of metabolic and bariatric surgery utilization for qualifying adults in Illinois and 2) describe patient characteristics associated with undergoing surgery at Illinois hospitals with low metabolic and bariatric surgery volume.
Setting: Metabolic and bariatric surgery at all nonfederal Illinois hospitals was included.
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