Health Services and Outcomes Research Methodology最新文献

{"title":"The role of spatially varying loadings in dynamic spatial factor models for modeling the opioid syndemic.","authors":"Eva Murphy, David Kline, Staci A Hepler","doi":"10.1007/s10742-025-00356-7","DOIUrl":"10.1007/s10742-025-00356-7","url":null,"abstract":"<p><p>Understanding the interactions and spatio-temporal variations of public health outcomes is crucial for gaining insight into interrelated epidemics across different locations and time periods. Dynamic spatial factor models provide a flexible framework for capturing shared variability among multiple outcomes through a latent factor and its corresponding loadings. A common assumption in these models is that factor loadings are spatially constant, implying uniform relationships between outcomes across the study region. However, this assumption may overlook important regional differences in how outcomes relate to the underlying latent factor. In this study, we derive the covariance structure of the outcome vector to highlight how spatially varying versus constant loadings influence the overall correlation structure. We find that when loadings vary across space, the spatial covariance of the outcomes is shaped by both the spatial covariance of the loadings and the latent factors. In contrast, when loadings are spatially constant, the spatial covariance of the outcomes is determined primarily by the latent factors, leading to uniform variation across the spatial domain. To assess these differences in practice, we apply a Bayesian hierarchical spatial dynamic factor model to analyze the opioid syndemic in North Carolina. Our results suggest that incorporating spatially varying loadings provides a more detailed, county-specific understanding of the epidemic. This added flexibility enables a localized interpretation of opioid-related interactions and offers insights that could inform targeted public health interventions.</p>","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"25 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining multiple sources of relationships in a network to advance understanding of physicians' beliefs regarding peer-effects.","authors":"Yifan Zhao, Carly A Bobak, Megan A Murphy, Olivia Sacks, Lili Liu, Natasha Ray, Amber E Barnato, A James O'Malley","doi":"10.1007/s10742-025-00343-y","DOIUrl":"https://doi.org/10.1007/s10742-025-00343-y","url":null,"abstract":"<p><p>Patient-sharing physician networks are increasingly recognized as valuable tools for examining physician relationships in healthcare research. However, very few studies have examined the reliability of such networks and summary measures derived from them in relation to directly measured physician relationships. In this paper, we evaluate the level of congruence between a survey-based network derived from survey responses to specific name-generator questions and a patient-sharing network derived from claims data. We also examine the association of summary measures derived from either network with physicians' beliefs about peer influence in medical practice. Statistical models with hierarchical and multiple-membership structures were used to estimate the strength of the associations. We found that a survey measure indicating whether a physician was nominated by others was statistically significantly associated with their survey reported beliefs about peer influence. We also observed notable associations between the physicians' structural importance in the network reflected in their eigenvector and betweenness centrality in the patient-sharing network and their beliefs about peer influence. This study of multi-source network relational information advances our understanding of physician survey responses and yields more precise predictions of physician beliefs toward peer-influence than either data source alone. Overall, we found that patient-sharing networks are an important alternative to directly measured survey-based name-generator questions in health services research and other applications. While patient-sharing networks recover some of the information in directly measured peer physician nominations, they also contain distinct information that is helpful for interpreting healthcare insights.</p>","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12385539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical challenges in mediation analysis: a guide for applied researchers.","authors":"Megan S Schuler, Donna L Coffman, Elizabeth A Stuart, Trang Q Nguyen, Brian Vegetabile, Daniel F McCaffrey","doi":"10.1007/s10742-024-00327-4","DOIUrl":"10.1007/s10742-024-00327-4","url":null,"abstract":"<p><p>Mediation analysis is a statistical approach that can provide insights regarding the intermediary processes by which an intervention or exposure affects a given outcome. Mediation analyses rose to prominence, particularly in social science research, with the publication of Baron and Kenny's seminal paper and is now commonly applied in many research disciplines, including health services research. Despite the growth in popularity, applied researchers may still encounter challenges in terms of conducting mediation analyses in practice. In this paper, we provide an overview of conceptual and methodological challenges that researchers face when conducting mediation analyses. Specifically, we discuss the following key challenges: (1) Conceptually differentiating mediators from other \"third variables,\" (2) Extending beyond the single mediator context, (3) Identifying appropriate datasets in which measurement and temporal ordering support the hypothesized mediation model, (4) Selecting mediation effects that reflect the scientific question of interest, (5) Assessing the validity of underlying assumptions of no omitted confounders, (6) Addressing measurement error regarding the mediator, and (7) Clearly reporting results from mediation analyses. We discuss each challenge and highlight ways in which the applied researcher can approach these challenges.</p>","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"25 1","pages":"57-84"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Belt has lower efficiency in providing diabetes preventive care than surrounding counties.","authors":"Hyojung Kang, Min-Woong Sohn, Soyoun Kim, Siyao Zhang, Rajesh Balkrishnan, Roger Anderson, Anthony McCall, Timothy McMurry, Jennifer Mason Lobo","doi":"10.1007/s10742-023-00310-5","DOIUrl":"10.1007/s10742-023-00310-5","url":null,"abstract":"<p><p>Annual preventive care is essential for diabetes patients to reduce the risk of complications including hypoglycemic events and blindness. Our aim was to examine the relative efficiency of Diabetes Belt (DB) and non-Diabetes Belt (NDB) counties in providing recommended preventive care for Medicare beneficiaries with diabetes using available health professional resources and to understand county-level socioeconomic factors associated with inefficient provision of preventive care. A data envelopment analysis (DEA) model was developed to assess relative efficiency of counties in providing diabetes preventive care. Logistic regression was performed to identify socioeconomic characteristics associated with inefficiencies. We used Medicare claims data to extract individual-level information of diabetes preventive service use and obtained county-level estimates of health resources information from the Area Health Resources File. More than 80% of counties had more than 10% inefficiencies on average. Compared to counties in the NDB, the odds of being inefficient were 2.44 times more likely in the DB (OR 2.44, CI 1.67-3.58). Counties with lower median income, with a smaller proportion of non-Hispanic Black population, and in a rural area had higher odds of being inefficient in providing preventive care. Our DEA results showed that counties in the DB and NDB were mostly inefficient. The availability of care providers may be less of a problem than how efficiently the resources are used in providing preventive care. Identifying sources of inefficiency within each community with low resource utilization and developing targeted strategies is needed to improve uptake of preventive care cost-effectively.</p>","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"191 1","pages":"200-210"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73273693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATRAcTR (Authentic Transparent Relevant Accurate Track-Record): a screening tool to assess the potential for real-world data sources to support creation of credible real-world evidence for regulatory decision-making","authors":"Marc L. Berger, William H. Crown, Jim Z. Li, Kelly H. Zou","doi":"10.1007/s10742-023-00319-w","DOIUrl":"https://doi.org/10.1007/s10742-023-00319-w","url":null,"abstract":"","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"22 1","pages":"1-18"},"PeriodicalIF":1.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139211718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of survey delivery methods in a national study of Veteran’s healthcare preferences","authors":"N. Disher, Jennifer Scott, Anna Tyzik, S. Golden, Georgia Baker, Denise M. Hynes, C. Slatore","doi":"10.1007/s10742-023-00320-3","DOIUrl":"https://doi.org/10.1007/s10742-023-00320-3","url":null,"abstract":"","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"257 1","pages":"1-21"},"PeriodicalIF":1.5,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139219232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propensity score weighting with survey weighted data when outcomes are binary: a simulation study","authors":"Chen Yang, M. Cuerden, Wei Zhang, Melissa Aldridge, Lihua Li","doi":"10.1007/s10742-023-00317-y","DOIUrl":"https://doi.org/10.1007/s10742-023-00317-y","url":null,"abstract":"","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"19 1","pages":"1-21"},"PeriodicalIF":1.5,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139262444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bootstrap approach to disparity testing with source uncertainty in the data","authors":"Gary C. McDonald, Joseph F. Willard","doi":"10.1007/s10742-023-00318-x","DOIUrl":"https://doi.org/10.1007/s10742-023-00318-x","url":null,"abstract":"","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"43 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive and inferential analysis of features for Dysphonia and Dysarthria Parkinson’s disease symptoms","authors":"Saiyed Umer, Ranjeet Kumar Rout","doi":"10.1007/s10742-023-00316-z","DOIUrl":"https://doi.org/10.1007/s10742-023-00316-z","url":null,"abstract":"","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"35 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135270791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inspecting the quality of care: a comparison of CUSUM methods for inter hospital performance","authors":"Daniel Gomon, Julie Sijmons, Hein Putter, Jan Willem Dekker, Rob Tollenaar, Michel Wouters, Pieter Tanis, Marta Fiocco, Mirko Signorelli","doi":"10.1007/s10742-023-00315-0","DOIUrl":"https://doi.org/10.1007/s10742-023-00315-0","url":null,"abstract":"Abstract During the past 14 years, a clinical audit has been used in the Netherlands to provide hospitals with data on their performance in colorectal cancer care. Continuous feedback on the quality of care provided at each hospital is essential to improve patient outcomes. It is unclear which methods should be used to generate most informative output for the identification of potential quality issues. Our aim is to compare the commonly employed funnel plot with existing cumulative sum (CUSUM) methodology for the evaluation of postoperative survival and hospital stay outcomes of patients who underwent colorectal surgery in the Netherlands. Data from the Dutch ColoRectal Audit on 25367 patients in the Netherlands who underwent surgical resection for colorectal cancer in 71 hospitals between 2019 and 2021 is used to compare four methods for the detection of deviations in the quality of care. Two methods based on binary outcomes (funnel plot, binary CUSUM) and two CUSUM charts based on survival outcomes (BK-CUSUM and CGR-CUSUM) are considered. A novel approach for determining hospital specific control limits for CUSUM charts is proposed. The ability to detect deviations as well as the time until detection are compared for the four methods. Charts were constructed for the inspection of both postoperative survival and hospital stay. Methods using survival outcomes always yielded faster detection times compared to approaches employing binary outcomes. Detections between methods mostly coincided for postoperative survival. For hospital stay detections varied strongly, with methods based on survival outcomes signalling over half the hospitals. Further pros and cons as well as pitfalls of all methods under consideration are discussed. Methodology for the continuous inspection of the quality of care should be tailored to the specific outcome. Properly understanding how the mechanism of a control chart functions is crucial for the correct interpretation of results. This is particularly true for CUSUM charts, which require the choice of a parameter that greatly influences the results. When applying CUSUM charts, consideration of these issues is strongly recommended.","PeriodicalId":45600,"journal":{"name":"Health Services and Outcomes Research Methodology","volume":"18 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}