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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Risk analysis 3 (1983), S. 0 
    ISSN: 1539-6924
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: The rapid aging of the U.S. population, increases in the absolute prevalence of chronic diseases, and the associated rise in the proportion of the GNP expended on medical care all indicate the need for methods to accurately forecast future health care expenditures for specific chronic diseases. Additionally, if these methods are biomedically realistic, they can be used to evaluate the economic implications of specific prevention strategies designed to reduce chronic disease incidence, prevalence, and mortality. Projection strategies that are not biomedically realistic, such as models that assume that risks for demographic subgroups do not change over time (e.g., “static component” models), though possibly accurate over the short run, are not suitable for assessing the long term effects of specific proposed health policy interventions which are designed to alter risks.In this paper we present a strategy for forecasting health care costs which is based on a model that represents the natural history of a chronic disease in terms of a preclinical state, a clinical state, case fatality rates, cures, and the implications of exogenous medical factors. Using this model we project that the treatment costs associated with respiratory cancer in the white male population of the U.S. may undergo a two-thirds increase in real dollars over the period 1977 to 2000. About one-half of this increase is due to a demographic shift to an older population structure, with the remainder due to higher respiratory cancer incidence rates in younger cohorts. Alteration of certain parameters of the model to simulate various interventions suggests that about three-quarters of the cost of this disease could be eliminated, though realization of any significant part of this savings would require a lengthy phase-in period.
    Type of Medium: Electronic Resource
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  • 2
  • 3
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    Baltimore : Periodicals Archive Online (PAO)
    Human Biology. 55:2 (1983:May) 417 
    ISSN: 0018-7143
    Topics: Biology
    Notes: SURNAMES AS MARKERS OF INBREEDING AND MIGRATION
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Risk analysis 2 (1982), S. 0 
    ISSN: 1539-6924
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: Nonlinear hazard models are used to examine temporal trends in the age-specific mortality risks of chronic obstructive lung diseases for the U.S. population. These hazard functions are fit to age-specific mortality rates for 1968 and 1977 for four race/sex groups. Changes in the parameters of these models are used to assess two types of differences in the age pattern of the rates between 1968 and 1977. The first measure of trend in the age-specific mortality rates is the temporal change in the proportionality constant in the function used to model their age variation. By allowing only this proportionality parameter to vary between 1968 and 1977, it is possible to determine an age-constant percentage increase or decrease. The second measure reflects the absolute displacement in terms of years of life of the fitted mortality curves for the two time points. This second index can be interpreted as the acceleration or deceleration of mortality risks over the life span, i.e., the number of years that is needed for mortality rates to achieve the same level as in the comparison group. The analysis showed that the age changes in chronic obstructive lung disease mortality rates differed by race/sex group and for both measures of change over the period. Adjustment of the fitted curves for the effects of individual variability in risk was significant for three of four groups.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Annals of the Institute of Statistical Mathematics 49 (1997), S. 371-393 
    ISSN: 1572-9052
    Keywords: Probability mixtures ; convex sets ; polytopes ; convex duality ; Grades of Membership
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Notes: Abstract Categorical data of high (but finite) dimensionality generate sparsely populated J-way contingency tables because of finite sample sizes. A model representing such data by a "smooth" low dimensional parametric structure using a "natural" metric would be useful. We discuss a model using a metric determined by convex sets to represent moments of a discrete distribution to order J. The model is shown, from theorems on convex polytopes, to depend only on the linear space spanned by the convex set—it is otherwise measure invariant. We provide an empirical example to illustrate the maximum likelihood estimation of parameters of a particular statistical application (Grade of Membership analysis) of such a model.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Annals of the Institute of Statistical Mathematics 44 (1992), S. 85-95 
    ISSN: 1572-9052
    Keywords: Consistency ; fuzzy partition ; grade of membership
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics
    Notes: Abstract Increasingly, fuzzy partitions are being used in multivariate classification problems as an alternative to the crisp classification procedures commonly used. One such fuzzy partition, the grade of membership model, partitions individuals into fuzzy sets using multivariate categorical data. Although the statistical methods used to estimate fuzzy membership for this model are based on maximum likelihood methods, large sample properties of the estimation procedure are problematic for two reasons. First, the number of incidental parameters increases with the size of the sample. Second, estimated parameters fall on the boundary of the parameter space with non-zero probability. This paper examines the consistency of the likelihood approach when estimating the components of a particular probability model that gives rise to a fuzzy partition. The results of the consistency proof are used to determine the large sample distribution of the estimates. Common methods of classifying individuals based on multivariate observations attempt to place each individual into crisply defined sets. The fuzzy partition allows for individual to individual heterogeneity, beyond simply errors in measurement, by defining a set of pure type characteristics and determining each individual's distance from these pure types. Both the profiles of the pure types and the heterogeneity of the individuals must be estimated from data. These estimates empirically define the fuzzy partition. In the current paper, this data is assumed to be categorical data. Because of the large number of parameters to be estimated and the limitations of categorical data, one may be concerned about whether or not the fuzzy partition can be estimated consistently. This paper shows that if heterogeneity is measured with respect to a fixed number of moments of the grade of membership scores of each individual, the estimated fuzzy partition is consistent.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Journal of mathematical biology 24 (1986), S. 119-140 
    ISSN: 1432-1416
    Keywords: Chronic disease ; Cohort study ; Diffusion ; Framingham heart study ; Human mortality ; Maximum likelihood ; Mortality selection ; Survival with covariates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Mathematics
    Notes: Abstract Analyses of human mortality data classified according to cause of death frequently are based on competing risk theory. In particular, the times to death for different causes often are assumed to be independent. In this paper, a competing risk model with a weaker assumption of conditional independence of the times to death, given an assumed stochastic covariate process, is developed and applied to cause specific mortality data from the Framingham Heart Study. The results generated under this conditional independence model are compared with analogous results under the standard marginal independence model. Under the assumption that this conditional independence model is valid, the comparison suggests that the standard model overestimates by 4% the effect on life expectancy at age 30 due to the hypothetical elimination of cancer and by 7% the effect for cardiovascular/cerebrovascular disease. By age 80 the overestimates were 11% for cancer and 16% for heart disease. These results suggest the importance of avoiding the marginal independence assumption when appropriate data are available — especially when focusing on mortality at advanced ages.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Journal of mathematical biology 34 (1995), S. 1-16 
    ISSN: 1432-1416
    Keywords: Gaussian processes ; Semi-invariants ; Aging and mortality ; Physiological dynamics, mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Mathematics
    Notes: Abstract A model of human health history and aging, based on a multivariate stochastic process with both continuous diffusion and discrete jump components, is presented. Discrete changes generate non-Gaussian diffusion with time varying continuous state distributions. An approach to calculating transition rates in dynamically heterogeneous populations, which generalizes the conditional averaging of hazard rates done in “fixed frailty” population models, is presented to describe health processes with multiple jumps. Conditional semi-invariants are used to approximate the conditional p.d.f. of the unobserved health history components. This is useful in analyzing the age dependence of mortality and health changes at advanced age (e.g., 95 +) where homeostatic controls weaken, and physiological dynamics and survival manifest nonlinear behavior.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Climatic change 11 (1987), S. 179-210 
    ISSN: 1573-1480
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geosciences , Physics
    Notes: Abstract Much interest has been recently focused on forecasting population health changes such as population aging and life expectancy increases at advanced ages, qualitative changes in health and survival, changes in federal reimbursement systems, and the need to forecast for long-range capital investment in specialized health facilities. Recent efforts at forecasting health and morbidity changes in the population are reviewed in this paper and the recent lack of methodological innovation in health forecasting strategies is examined. Two forecasting models—stochastic compartmental systems and mixed multivariate continuous state—discrete state processes—are described. We show how these models can be applied to health forecasting using existing data, how they can be used in a complementary fashion to improve health projections made from any one type of data, and how the mixed multivariate stochastic process model can be used to evaluate assumptions made in the compartment modeling approach.
    Type of Medium: Electronic Resource
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  • 10
    Publication Date: 2009-11-30
    Print ISSN: 0027-8424
    Electronic ISSN: 1091-6490
    Topics: Biology , Medicine , Natural Sciences in General
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