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All (10) ((10 results))
- Articles and reports: 82-003-X201500514169Description:
The Cancer Risk Management Model incorporates the risk of developing cancer, disease screening and clinical management with cost and labour data to assess health outcomes and economic impact. A screening module added to the lung cancer module enables a variety of scenarios to be evaluated for different target populations with varying rates of participation, compliance, and frequency of low-dose computed tomography screening.
Release date: 2015-05-20 - Articles and reports: 82-003-X201200311707Geography: CanadaDescription:
This study compares waist circumference measured using World Health Organization and National Institutes of Health protocols to determine if the results differ significantly, and whether equations can be developed to allow comparison between waist circumference taken at the two different measurement sites.
Release date: 2012-09-20 - Articles and reports: 82-003-X201200211648Geography: CanadaDescription: This analysis uses information from the 2007 to 2009 Canadian Health Measures Survey to examine moderate-to-vigorous physical activity, sedentary behaviour and sleep duration in children aged 6 to 11. The objective was to compare and contrast findings from these data collection methods and explore differences in their associations with health markers in children.Release date: 2012-04-18
- 4. Respondent differences and length of data collection in the Behavioral Risk Factor Surveillance System ArchivedArticles and reports: 12-001-X201000211384Description:
The current economic downturn in the US could challenge costly strategies in survey operations. In the Behavioral Risk Factor Surveillance System (BRFSS), ending the monthly data collection at 31 days could be a less costly alternative. However, this could potentially exclude a portion of interviews completed after 31 days (late responders) whose respondent characteristics could be different in many respects from those who completed the survey within 31 days (early responders). We examined whether there are differences between the early and late responders in demographics, health-care coverage, general health status, health risk behaviors, and chronic disease conditions or illnesses. We used 2007 BRFSS data, where a representative sample of the noninstitutionalized adult U.S. population was selected using a random digit dialing method. Late responders were significantly more likely to be male; to report race/ethnicity as Hispanic; to have annual income higher than $50,000; to be younger than 45 years of age; to have less than high school education; to have health-care coverage; to be significantly more likely to report good health; and to be significantly less likely to report hypertension, diabetes, or being obese. The observed differences between early and late responders on survey estimates may hardly influence national and state-level estimates. As the proportion of late responders may increase in the future, its impact on surveillance estimates should be examined before excluding from the analysis. Analysis on late responders only should combine several years of data to produce reliable estimates.
Release date: 2010-12-21 - 5. A comparison of individual and area-based socio-economic data for monitoring social inequalities in health ArchivedArticles and reports: 82-003-X200900411035Geography: CanadaDescription:
Area-based indicators are commonly used to measure and track health outcomes by socio-economic group. This is largely because of the absence of information about individuals in health health administrative databases. This study compares area-based and individual indicators.
Release date: 2009-12-16 - Articles and reports: 11-522-X20020016718Description:
Cancer surveillance research requires accurate estimates of risk factors at the small area level. These risk factors are often obtained from surveys such as the National Health Interview Survey (NHIS) or the Behavioral Risk Factors Surveillance Survey (BRFSS). Unfortunately, no one population-based survey provides ideal prevalence estimates of such risk factors. One strategy is to combine information from multiple surveys, using the complementary strengths of one survey to compensate for the weakness of the other. The NHIS is a nationally representative, face-to-face survey with a high response rate; however, it cannot produce state or substate estimates of risk factor prevalence because sample sizes are too small. The BRFSS is a state-level telephone survey that excludes non-telephone households and has a lower response rate, but does provide reasonable sample sizes in all states and many counties. Several methods are available for constructing small-area estimators that combine information from both the NHIS and the BRFSS, including direct estimators, estimators under hierarchical Bayes models and model-assisted estimators. In this paper, we focus on the latter, constructing generalized regression (GREG) and 'minimum-distance' estimators and using existing and newly developed small-area smoothing techniques to smooth the resulting estimators.
Release date: 2004-09-13 - Articles and reports: 11-522-X20020016719Description:
This study takes a look at the modelling methods used for public health data. Public health has a renewed interest in the impact of the environment on health. Ecological or contextual studies ideally investigate these relationships using public health data augmented with environmental characteristics in multilevel or hierarchical models. In these models, individual respondents in health data are the first level and community data are the second level. Most public health data use complex sample survey designs, which require analyses accounting for the clustering, nonresponse, and poststratification to obtain representative estimates of prevalence of health risk behaviours.
This study uses the Behavioral Risk Factor Surveillance System (BRFSS), a state-specific US health risk factor surveillance system conducted by the Center for Disease Control and Prevention, which assesses health risk factors in over 200,000 adults annually. BRFSS data are now available at the metropolitan statistical area (MSA) level and provide quality health information for studies of environmental effects. MSA-level analyses combining health and environmental data are further complicated by joint requirements of the survey sample design and the multilevel analyses.
We compare three modelling methods in a study of physical activity and selected environmental factors using BRFSS 2000 data. Each of the methods described here is a valid way to analyse complex sample survey data augmented with environmental information, although each accounts for the survey design and multilevel data structure in a different manner and is thus appropriate for slightly different research questions.
Release date: 2004-09-13 - Surveys and statistical programs – Documentation: 11-522-X19990015658Description:
Radon, a naturally occurring gas found at some level in most homes, is an established risk factor for human lung cancer. The U.S. National Research Council (1999) has recently completed a comprehensive evaluation of the health risks of residential exposure to radon, and developed models for projecting radon lung cancer risks in the general population. This analysis suggests that radon may play a role in the etiology of 10-15% of all lung cancer cases in the United States, although these estimates are subject to considerable uncertainty. In this article, we present a partial analysis of uncertainty and variability in estimates of lung cancer risk due to residential exposure to radon in the United States using a general framework for the analysis of uncertainty and variability that we have developed previously. Specifically, we focus on estimates of the age-specific excess relative risk (ERR) and lifetime relative risk (LRR), both of which vary substantially among individuals.
Release date: 2000-03-02 - Surveys and statistical programs – Documentation: 11-522-X19990015688Description:
The geographical and temporal relationship between outdoor air pollution and asthma was examined by linking together data from multiple sources. These included the administrative records of 59 general practices widely dispersed across England and Wales for half a million patients and all their consultations for asthma, supplemented by a socio-economic interview survey. Postcode enabled linkage with: (i) computed local road density; (ii) emission estimates of sulphur dioxide and nitrogen dioxides, (iii) measured/interpolated concentration of black smoke, sulphur dioxide, nitrogen dioxide and other pollutants at practice level. Parallel Poisson time series analysis took into account between-practice variations to examine daily correlations in practices close to air quality monitoring stations. Preliminary analyses show small and generally non-significant geographical associations between consultation rates and pollution markers. The methodological issues relevant to combining such data, and the interpretation of these results will be discussed.
Release date: 2000-03-02 - Articles and reports: 11F0019M1997099Geography: CanadaDescription:
Context : Lung cancer has been the leading cause of cancer deaths in Canadian males for many years, and since 1994, this has been the case for Canadian femalesas well. It is therefore important to evaluate the resources required for its diagnosis and treatment. This article presents an estimate of the direct medical costsassociated with the diagnosis and treatment of lung cancer calculated through the use of a micro-simulation model. For disease incidence, 1992 was chosen as thereference year, whereas costs are evaluated according to the rates that prevailed in 1993.Methods : A model for lung cancer has been incorporated into the Population Health Model (POHEM). The parameters of the model were drawn in part fromStatistics Canada's Canadian Cancer Registry (CCR), which provides information on the incidence and histological classification of lung cancer cases in Canada.The distribution of cancer stage at diagnosis was estimated by using information from two provincial cancer registries. A team of oncologists derived "typical" treatment approaches reflective of current practice, and the associated direct costs were calculated for these approaches. Once this information and the appropriatesurvival curves were incorporated into the POHEM model, overall costs of treatment were estimated by means of a Monte Carlo simulation.Results: It is estimated that overall, the direct medical costs of lung cancer diagnosis and treatment were just over $528 million. The cost per year of life gained as aresult of treatment of the disease was approximately $19,450. For the first time in Canada, it was possible to estimate the five year costs following diagnosis, bystage of the disease at the time of diagnosis. It was possible to estimate the cost per year of additional life gained for three alternative treatments of non small-cell lungcancer (NSCLC). Sensitivity analyses showed that these costs varied between $1,870 and $6,860 per year of additional life gained, which compares favourablywith the costs that the treatment of other diseases may involve.Conclusions: Contrary to widespread perceptions, it appears that the treatment of lung cancer is effective from an economic standpoint. In addition, the use of amicro-simulation model such as POHEM not only makes it possible to incorporate information from various sources in a coherent manner but also offers thepossibility of estimating the effect of alternative medical procedures from the standpoint of financial pressures on the health care system.
Release date: 1997-04-22
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Analysis (8)
Analysis (8) ((8 results))
- Articles and reports: 82-003-X201500514169Description:
The Cancer Risk Management Model incorporates the risk of developing cancer, disease screening and clinical management with cost and labour data to assess health outcomes and economic impact. A screening module added to the lung cancer module enables a variety of scenarios to be evaluated for different target populations with varying rates of participation, compliance, and frequency of low-dose computed tomography screening.
Release date: 2015-05-20 - Articles and reports: 82-003-X201200311707Geography: CanadaDescription:
This study compares waist circumference measured using World Health Organization and National Institutes of Health protocols to determine if the results differ significantly, and whether equations can be developed to allow comparison between waist circumference taken at the two different measurement sites.
Release date: 2012-09-20 - Articles and reports: 82-003-X201200211648Geography: CanadaDescription: This analysis uses information from the 2007 to 2009 Canadian Health Measures Survey to examine moderate-to-vigorous physical activity, sedentary behaviour and sleep duration in children aged 6 to 11. The objective was to compare and contrast findings from these data collection methods and explore differences in their associations with health markers in children.Release date: 2012-04-18
- 4. Respondent differences and length of data collection in the Behavioral Risk Factor Surveillance System ArchivedArticles and reports: 12-001-X201000211384Description:
The current economic downturn in the US could challenge costly strategies in survey operations. In the Behavioral Risk Factor Surveillance System (BRFSS), ending the monthly data collection at 31 days could be a less costly alternative. However, this could potentially exclude a portion of interviews completed after 31 days (late responders) whose respondent characteristics could be different in many respects from those who completed the survey within 31 days (early responders). We examined whether there are differences between the early and late responders in demographics, health-care coverage, general health status, health risk behaviors, and chronic disease conditions or illnesses. We used 2007 BRFSS data, where a representative sample of the noninstitutionalized adult U.S. population was selected using a random digit dialing method. Late responders were significantly more likely to be male; to report race/ethnicity as Hispanic; to have annual income higher than $50,000; to be younger than 45 years of age; to have less than high school education; to have health-care coverage; to be significantly more likely to report good health; and to be significantly less likely to report hypertension, diabetes, or being obese. The observed differences between early and late responders on survey estimates may hardly influence national and state-level estimates. As the proportion of late responders may increase in the future, its impact on surveillance estimates should be examined before excluding from the analysis. Analysis on late responders only should combine several years of data to produce reliable estimates.
Release date: 2010-12-21 - 5. A comparison of individual and area-based socio-economic data for monitoring social inequalities in health ArchivedArticles and reports: 82-003-X200900411035Geography: CanadaDescription:
Area-based indicators are commonly used to measure and track health outcomes by socio-economic group. This is largely because of the absence of information about individuals in health health administrative databases. This study compares area-based and individual indicators.
Release date: 2009-12-16 - Articles and reports: 11-522-X20020016718Description:
Cancer surveillance research requires accurate estimates of risk factors at the small area level. These risk factors are often obtained from surveys such as the National Health Interview Survey (NHIS) or the Behavioral Risk Factors Surveillance Survey (BRFSS). Unfortunately, no one population-based survey provides ideal prevalence estimates of such risk factors. One strategy is to combine information from multiple surveys, using the complementary strengths of one survey to compensate for the weakness of the other. The NHIS is a nationally representative, face-to-face survey with a high response rate; however, it cannot produce state or substate estimates of risk factor prevalence because sample sizes are too small. The BRFSS is a state-level telephone survey that excludes non-telephone households and has a lower response rate, but does provide reasonable sample sizes in all states and many counties. Several methods are available for constructing small-area estimators that combine information from both the NHIS and the BRFSS, including direct estimators, estimators under hierarchical Bayes models and model-assisted estimators. In this paper, we focus on the latter, constructing generalized regression (GREG) and 'minimum-distance' estimators and using existing and newly developed small-area smoothing techniques to smooth the resulting estimators.
Release date: 2004-09-13 - Articles and reports: 11-522-X20020016719Description:
This study takes a look at the modelling methods used for public health data. Public health has a renewed interest in the impact of the environment on health. Ecological or contextual studies ideally investigate these relationships using public health data augmented with environmental characteristics in multilevel or hierarchical models. In these models, individual respondents in health data are the first level and community data are the second level. Most public health data use complex sample survey designs, which require analyses accounting for the clustering, nonresponse, and poststratification to obtain representative estimates of prevalence of health risk behaviours.
This study uses the Behavioral Risk Factor Surveillance System (BRFSS), a state-specific US health risk factor surveillance system conducted by the Center for Disease Control and Prevention, which assesses health risk factors in over 200,000 adults annually. BRFSS data are now available at the metropolitan statistical area (MSA) level and provide quality health information for studies of environmental effects. MSA-level analyses combining health and environmental data are further complicated by joint requirements of the survey sample design and the multilevel analyses.
We compare three modelling methods in a study of physical activity and selected environmental factors using BRFSS 2000 data. Each of the methods described here is a valid way to analyse complex sample survey data augmented with environmental information, although each accounts for the survey design and multilevel data structure in a different manner and is thus appropriate for slightly different research questions.
Release date: 2004-09-13 - Articles and reports: 11F0019M1997099Geography: CanadaDescription:
Context : Lung cancer has been the leading cause of cancer deaths in Canadian males for many years, and since 1994, this has been the case for Canadian femalesas well. It is therefore important to evaluate the resources required for its diagnosis and treatment. This article presents an estimate of the direct medical costsassociated with the diagnosis and treatment of lung cancer calculated through the use of a micro-simulation model. For disease incidence, 1992 was chosen as thereference year, whereas costs are evaluated according to the rates that prevailed in 1993.Methods : A model for lung cancer has been incorporated into the Population Health Model (POHEM). The parameters of the model were drawn in part fromStatistics Canada's Canadian Cancer Registry (CCR), which provides information on the incidence and histological classification of lung cancer cases in Canada.The distribution of cancer stage at diagnosis was estimated by using information from two provincial cancer registries. A team of oncologists derived "typical" treatment approaches reflective of current practice, and the associated direct costs were calculated for these approaches. Once this information and the appropriatesurvival curves were incorporated into the POHEM model, overall costs of treatment were estimated by means of a Monte Carlo simulation.Results: It is estimated that overall, the direct medical costs of lung cancer diagnosis and treatment were just over $528 million. The cost per year of life gained as aresult of treatment of the disease was approximately $19,450. For the first time in Canada, it was possible to estimate the five year costs following diagnosis, bystage of the disease at the time of diagnosis. It was possible to estimate the cost per year of additional life gained for three alternative treatments of non small-cell lungcancer (NSCLC). Sensitivity analyses showed that these costs varied between $1,870 and $6,860 per year of additional life gained, which compares favourablywith the costs that the treatment of other diseases may involve.Conclusions: Contrary to widespread perceptions, it appears that the treatment of lung cancer is effective from an economic standpoint. In addition, the use of amicro-simulation model such as POHEM not only makes it possible to incorporate information from various sources in a coherent manner but also offers thepossibility of estimating the effect of alternative medical procedures from the standpoint of financial pressures on the health care system.
Release date: 1997-04-22
Reference (2)
Reference (2) ((2 results))
- Surveys and statistical programs – Documentation: 11-522-X19990015658Description:
Radon, a naturally occurring gas found at some level in most homes, is an established risk factor for human lung cancer. The U.S. National Research Council (1999) has recently completed a comprehensive evaluation of the health risks of residential exposure to radon, and developed models for projecting radon lung cancer risks in the general population. This analysis suggests that radon may play a role in the etiology of 10-15% of all lung cancer cases in the United States, although these estimates are subject to considerable uncertainty. In this article, we present a partial analysis of uncertainty and variability in estimates of lung cancer risk due to residential exposure to radon in the United States using a general framework for the analysis of uncertainty and variability that we have developed previously. Specifically, we focus on estimates of the age-specific excess relative risk (ERR) and lifetime relative risk (LRR), both of which vary substantially among individuals.
Release date: 2000-03-02 - Surveys and statistical programs – Documentation: 11-522-X19990015688Description:
The geographical and temporal relationship between outdoor air pollution and asthma was examined by linking together data from multiple sources. These included the administrative records of 59 general practices widely dispersed across England and Wales for half a million patients and all their consultations for asthma, supplemented by a socio-economic interview survey. Postcode enabled linkage with: (i) computed local road density; (ii) emission estimates of sulphur dioxide and nitrogen dioxides, (iii) measured/interpolated concentration of black smoke, sulphur dioxide, nitrogen dioxide and other pollutants at practice level. Parallel Poisson time series analysis took into account between-practice variations to examine daily correlations in practices close to air quality monitoring stations. Preliminary analyses show small and generally non-significant geographical associations between consultation rates and pollution markers. The methodological issues relevant to combining such data, and the interpretation of these results will be discussed.
Release date: 2000-03-02