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Estimate of influenza cases using generalized linear, additive and mixed models.

ABSTRACT: We investigated the relationship between reported cases of influenza in Catalonia (Spain). Covariates analyzed were: population, age, data of report of influenza, and health region during 2010-2014 using data obtained from the SISAP program (Institut Catala de la Salut - Generalitat of Catalonia). Reported cases were related with the study of covariates using a descriptive analysis. Generalized Linear Models, Generalized Additive Models and Generalized Additive Mixed Models were used to estimate the evolution of the transmission of influenza. Additive models can estimate non-linear effects of the covariates by smooth functions; and mixed models can estimate data dependence and variability in factor variables using correlations structures and random effects, respectively. The incidence rate of influenza was calculated as the incidence per 100 000 people. The mean rate was 13.75 (range 0-27.5) in the winter months (December, January, February) and 3.38 (range 0-12.57) in the remaining months. Statistical analysis showed that Generalized Additive Mixed Models were better adapted to the temporal evolution of influenza (serial correlation 0.59) than classical linear models.

SUBMITTER: Oviedo M

PROVIDER: S-EPMC4514424 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Renal transplant patients are mandated to have continuous assessment of their kidney function over time to monitor disease progression determined by changes in blood urea nitrogen (BUN), serum creatinine (Cr), and estimated glomerular filtration rate (eGFR). Multivariate analysis of these outcomes that aims at identifying the differential factors that affect disease progression is of great clinical significance. Thus our study aims at demonstrating the application of different joint modeling approaches with random coefficients on a cohort of renal transplant patients and presenting a comparison of their performance through a pseudo-simulation study. The objective of this comparison is to identify the model with best performance and to determine whether accuracy compensates for complexity in the different multivariate joint models. METHODS AND RESULTS:We propose a novel application of multivariate Generalized Linear Mixed Models (mGLMM) to analyze multiple longitudinal kidney function outcomes collected over 3 years on a cohort of 110 renal transplantation patients. The correlated outcomes BUN, Cr, and eGFR and the effect of various covariates such patient's gender, age and race on these markers was determined holistically using different mGLMMs. The performance of the various mGLMMs that encompass shared random intercept (SHRI), shared random intercept and slope (SHRIS), separate random intercept (SPRI) and separate random intercept and slope (SPRIS) was assessed to identify the one that has the best fit and most accurate estimates. A bootstrap pseudo-simulation study was conducted to gauge the tradeoff between the complexity and accuracy of the models. Accuracy was determined using two measures; the mean of the differences between the estimates of the bootstrapped datasets and the true beta obtained from the application of each model on the renal dataset, and the mean of the square of these differences. The results showed that SPRI provided most accurate estimates and did not exhibit any computational or convergence problem. CONCLUSION:Higher accuracy was demonstrated when the level of complexity increased from shared random coefficient models to the separate random coefficient alternatives with SPRI showing to have the best fit and most accurate estimates.

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Estimate of influenza cases using generalized linear, additive and mixed models.

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