五岁以下儿童死亡率的片断线性多重变化点模型

Sukanta Chakraborty, Soma Biswas
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摘要

在处理死亡率数据时,使用片断线性多重变化点模型而不是更传统的生存技术更为有利。利用这种技术,可以估算出危险模型,并找到切点位置的数量。利用各种协变量(如社会人口学、生物学和近因协整因素),这种片断危险模型适用于 2014 年孟加拉国人口与健康调查的婴儿死亡率数据。利用最大似然估计过程找到变化点以及协变量对危险率的影响。参数的显著性随后通过 Wald 检验统计量得到支持。结果表明,母亲的教育状况、宗教信仰、母亲的年龄(岁)、曾经生育过的孩子数量、目前的母乳喂养情况、孩子的大小、想要更多孩子的愿望、剖宫产、产前检查次数和分娩顺序都是重要的因素。研究还发现,危险率的检测变化点对孩子五岁前的发育极为重要。通过不同的时间切点,我们发现片断线性多重变化点模型对五岁以下儿童死亡率非常重要。公共卫生专家、研究人员和临床医生都能从这种片断危险模型中受益。降低儿童死亡率的最关键因素之一是时间。
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Piecewise Linear Multiple Change Point Modelling for Under-Five Child Mortality
Using a piecewise linear multiple change-point model instead of more traditional survival techniques is more beneficial when dealing with mortality data. Utilizing this technique, the hazard model is estimated and the number of cut-point locations is found. Using various covariates, such as sociodemographic, biological, and proximate co-factors, this piecewise hazard model is fitted to the Infant Mortality Data of Bangladesh Demographic and Health Survey 2014. Finding the change point and the impact of covariates on the hazard rate is done using the maximum likelihood estimation process. The parameter's significance is subsequently supported by the Wald test statistic. It turns out that the mother's educational status, religion, mother's age in years, the number of children they have ever had, currently breastfeeding, the size of the child, desire for more children, cesarean delivery, ANC visits, and birth orders are all significant factors. It is also discovered that the detected change point of the hazard rate is extremely important for the child until they reach the age of five. Through the various time cut points, it is found that a piecewise linear multiple change-point model is very important for under-five child mortality. Public health specialists, researchers, and clinicians can all benefit from this piecewise hazard model. One of the most crucial elements in lowering child mortality is time.
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