Biostatistics in Medical Research

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Questions and Answers

What statistical method was used to analyze trends in the data?

Multistate Markov chain models

Multiple Correspondence Analysis

Cochrane-Armitage test

Poisson regression (correct)

What is the primary focus of Theme 2 in multimorbidity research?

Prevalence and determinants of multimorbidity in an urban, multi-ethnic area

Identifying longitudinal clusters of multimorbidity (correct)

Inequalities in developing multimorbidity over time

Distribution of patient long-term condition count by age group

What is the main aim of the talk on statistics in real research?

To understand the role of statistics in real research (correct)

To learn advanced statistical methods

To examine the use of statistics in research

To develop a new statistical tool

What type of model was used to represent the transitions between chronic diseases?

Multistate Markov chain models Signup and view all the answers

What is the limitation of the King's College Criteria in acute liver failure?

It is outdated Signup and view all the answers

What is the name of the journal where the multimorbidity research output was published?

The Lancet Regional Health - Europe Signup and view all the answers

What statistical method was used to develop the prognostic models in the acute liver failure study?

Cox proportional hazards Signup and view all the answers

What was the sample size for the distribution of patient long-term condition count by age group?

816,901 Signup and view all the answers

What was the primary focus of Theme 3 in multimorbidity research?

Inequalities in developing multimorbidity over time Signup and view all the answers

What is the purpose of the online app developed in the acute liver failure study?

To collect data from liver specialists Signup and view all the answers

What type of analysis was used to graphically depict chronic diseases, age, gender, deprivation, and ethnicity?

Multiple Correspondence Analysis Signup and view all the answers

What is the evaluation metric used to measure the model discrimination in the acute liver failure study?

Area under receiver operating characteristic curve (AUROC) Signup and view all the answers

What is the name of the hospital where the King's College Criteria was developed?

King's College Hospital, London Signup and view all the answers

What is the age range for which selected probabilities from the transition matrices were depicted?

40-59 Signup and view all the answers

What is the purpose of the external validation datasets in the acute liver failure study?

To test the performance of the prognostic models Signup and view all the answers

What is the clinical specialty area where the dynamic outcome prediction model was developed?

Hepatology Signup and view all the answers

What is the primary advantage of the new model described?

It is a practical high performance statistical model with over 90% precision. Signup and view all the answers

What is the primary goal of the online app mentioned?

To validate and fine-tune the model. Signup and view all the answers

What percentage of the population in the South London Stroke Register is White?

56% Signup and view all the answers

What is the estimated completeness of case ascertainment in the SLSR?

80% Signup and view all the answers

What is the name of the criteria used to classify ischaemic stroke aetiologies in the SLSR?

TOAST criteria Signup and view all the answers

What is the formula used to calculate the incidence rate in the SLSR?

Incidence = (Number of cases / population) × 100,000 Signup and view all the answers

What is the purpose of direct age-standardisation in the SLSR?

To compare data to the mid-year population of England and Wales Signup and view all the answers

What is the duration of the SLSR study?

Established in 1995, with no specific duration mentioned Signup and view all the answers

What was the primary focus of the study published in the British Journal of General Practice in 2021?

Identifying multimorbidity clusters with the highest primary care use Signup and view all the answers

Which of the following studies applied resolved and remission codes to reduce prevalence of multimorbidity?

The study published in the Journal of Clinical Epidemiology in 2021 Signup and view all the answers

What was the focus of the systematic review published in the British Journal General Practice in 2021?

The impact of multimorbidity on health care costs and utilisation in the UK Signup and view all the answers

What percentage of people in south London live with multiple long-term conditions, according to the Daily Mail?

One in five people Signup and view all the answers

Which of the following journals published a study on identifying longitudinal clusters of multimorbidity in an urban setting?

The Lancet Regional Health - Europe Signup and view all the answers

What is the common theme among the studies mentioned in the content?

Multimorbidity in urban multi-ethnic populations Signup and view all the answers

Study Notes

Introduction to Biostatistics

Aims to understand the role of statistics in real research through senior statisticians' own collaborative research.
Not to learn statistics as some methods are very advanced, but to see how it is used in practice.

Statistics in Acute Liver Failure

Developed a dynamic outcome prediction model for paracetamol-induced acute liver failure.
The King's College Criteria is outdated, and the new model aims to reflect current outcomes and generate a dynamic updated estimation of risk of death.
Patients from intensive care units in the UK and Denmark were used for the development and validation of the model.
The model's performance was tested using area under receiver operating characteristic curve (AUROC) and calibration by root mean square error (RMSE).
An online app was developed to collect data and further validate and fine-tune the model.

What's New

Previous models were static, while the new model is dynamic and updating, so the prognosis changes if a patient's condition changes.
The model has high performance and can make individual and updated survival predictions with over 90% precision.

The South London Stroke Register

Long-term trends in incidence and risk factors for ischaemic stroke subtypes.
The South London Stroke Register is a prospective study established in 1995, conducting population-based case ascertainment of first-ever strokes in a defined population of inner London.
The register used multiple overlapping reporting systems and estimated a completeness of case ascertainment at approximately 80%.
Aetiological classification of ischaemic stroke was done using TOAST criteria into five subtypes.

Statistical Methods

Incidence rates were calculated using direct age-standardization to the mid-year population of England and Wales (2011 census).
Trends were analyzed using Poisson regression, Cochrane-Armitage test, and loess regression.
Calculations were done for each TOAST subtype and further stratified by age.

Multimorbidity Research

Theme 1: Prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15 years.
Theme 2: Identifying longitudinal clusters of multimorbidity in an urban setting.
Theme 3: Inequalities in developing multimorbidity over time using multistate Markov chain models.

Research Output

Selected papers on multimorbidity research were published in The Lancet Regional Health - Europe, British Journal of General Practice, and Journal of Clinical Epidemiology.

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Description

Learn how biostatistics is applied in medical research, particularly in acute liver failure, through real-world examples and case studies.