Browsing by Subject "Joinpoint regression"

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    A Bayesian joinpoint regression model with an unknown number of break-points
    (Institute of Mathematical Statistics, 2011-09) Martínez-Beneito, M.A.; García-Donato, G.; Salmerón, D.; Ciencias Sociosanitarias
    Joinpoint regression is used to determine the number of segments needed to adequately explain the relationship between two variables. This methodology can be widely applied to real problems, but we focus on epidemiological data, the main goal being to uncover changes in the mortality time trend of a specific disease under study. Traditionally, Joinpoint regression problems have paid little or no attention to the quantification of uncertainty in the estimation of the number of change-points. In this context, we found a satisfactory way to handle the problem in the Bayesian methodology. Nevertheless, this novel approach involves significant difficulties (both theoretical and practical) since it implicitly entails a model selection (or testing) problem. In this study we face these challenges through (i) a novel reparameterization of the model, (ii) a conscientious definition of the prior distributions used and (iii) an encompassing approach which allows the use of MCMC simulation-based techniques to derive the results. The resulting methodology is flexible enough to make it possible to consider mortality counts (for epidemiological applications) as Poisson variables. The methodology is applied to the study of annual breast cancer mortality during the period 1980–2007 in Castellón, a province in Spain.
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    Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
    (Elsevier, 2020-12) Cirera, L; Márquez-Calderón, S; Saez, M; Salmerón, D; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Ciencias Sociosanitarias
    Objectives: The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain. Study design: A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results: HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions: Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.
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    Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
    (Elsevier, 2020-12) Cirera, Lluís; Márquez Calderón, S.; Ballesta Ruiz, Mónica; Chirlaque López, María Dolores; Sáez, Marc; Salmerón Martínez, Diego; Mortality working group of the Spanish Epidemiological Association; Ciencias Sociosanitarias; Facultades de la UMU::Facultad de Enfermería
    Objectives The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975–2016 in Spain. Study design A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975–2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods. Results HIV/AIDS shaped the increasing trend period of infectious diseases in 1989–1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995–1999 and 1999–2016. Lung cancer fell gradually from 1994 in men (−0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980–2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes. Conclusions Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.