MBBS January 23: Introduction to Biostatistics

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Questions and Answers

What distinguishes the new statistical model from previous models in terms of prognosis?

It focuses solely on historical data.

It is only applicable to a specific ethnic group.

It updates prognosis based on changes in a patient's condition. (correct)

It is static and does not change.

What was the estimated completeness of case ascertainment for the South London Stroke Register?

50%

90%

80% (correct)

70%

Which of the following is NOT one of the classifications used for ischaemic stroke by the TOAST criteria?

Large artery atherosclerosis (LAA)

Small vessel occlusion (SVO)

Cardio-embolism (CE)

Vascular malformation (VM) (correct)

What population demographic is primarily represented in the source population of the South London Stroke Register?

Diverse with majority White and Black ethnicities Signup and view all the answers

How long has the South London Stroke Register been established as a prospective study?

Since 1995 Signup and view all the answers

Which method is used for the calculation of stroke incidence in the data from 2000 to 2015?

Direct age-standardisation to the mid-year population. Signup and view all the answers

What feature makes the new online app significant in the context of the statistical model?

It facilitates worldwide data collection to enhance model validation. Signup and view all the answers

In which population is the South London Stroke Register operating?

Inner city areas with low economic status Signup and view all the answers

What was the primary aim of developing a new prognostic tool for acute liver failure?

To reflect current outcomes and update risk estimations Signup and view all the answers

Which statistical method was used for developing prognostic models in the study?

Cox proportional hazards Signup and view all the answers

What does AUROC stand for in the context of model discrimination?

Area Under Receiver Operating Characteristic Signup and view all the answers

For which of the following aspects was the new online app designed?

To collect data and validate the model globally Signup and view all the answers

What is a significant limitation of the King's College Criteria mentioned in the content?

It is based on outdated outcomes. Signup and view all the answers

What aspect of multimorbidity is explored in the talks?

Statistics relevant to effects on liver health Signup and view all the answers

Which cities provided data for the development of the prognostic models?

Birmingham, London, and Edinburgh Signup and view all the answers

How is model calibration assessed in the new prognostic tool?

By root mean square error (RMSE) Signup and view all the answers

What was the primary objective of the studies indicated in the citations regarding multimorbidity?

To investigate the prevalence and clustering of multimorbidity in various populations. Signup and view all the answers

Which publication focused specifically on the impact of multimorbidity on healthcare costs and utilization?

Impact of multimorbidity on health care costs and utilisation. Signup and view all the answers

What method was suggested to reduce the prevalence of multimorbidity in the urban population?

Applying resolved and remission codes. Signup and view all the answers

In which geographical location was the reported prevalence of people living with multiple long-term conditions specified?

South London Signup and view all the answers

Which study focused on identifying longitudinal clusters of multimorbidity?

Identifying longitudinal clusters of multimorbidity in an urban setting. Signup and view all the answers

What kind of study design was employed in 'Identifying longitudinal clusters of multimorbidity'?

Cross-sectional study. Signup and view all the answers

What statistical theme focuses on the prevalence and determinants of multimorbidity over a 15-year period?

Theme 1 Signup and view all the answers

Which analytical method is used to identify longitudinal clusters of multimorbidity in an urban setting?

Cluster analyses Signup and view all the answers

In the context of multimorbidity, what does the term 'multistate Markov chain models' refer to?

Tracking disease progression over time Signup and view all the answers

What type of analysis is performed to depict chronic diseases alongside factors such as age and ethnicity?

Multiple Correspondence Analysis Signup and view all the answers

What is the main objective of analyzing the ten most common dyads and triads in the multimorbid sample?

To compare prevalence over different time cohorts Signup and view all the answers

Which of the following statements is most accurate regarding the urban, multi-ethnic borough study on multimorbidity?

It involves data from over 1 million patients. Signup and view all the answers

Which model is represented to illustrate the probabilities of acquiring three conditions in a first order context?

Transition matrix Signup and view all the answers

Which author is not included in the cited research output regarding multimorbidity inequalities?

Doe, J. Signup and view all the answers

Study Notes

Aims of the Session

Purpose is to understand the application of statistics in medical research through real-world examples.
Focus on collaborative research conducted by senior statisticians rather than teaching advanced statistical methods.

Clinical Speciality Areas

Areas highlighted include Hepatology, Neurology, and Multimorbidity.

Statistics in Acute Liver Failure

A new dynamic outcome prediction model was developed for paracetamol-induced acute liver failure.
The outdated King's College Criteria was replaced with a simpler, more current prognostic tool.
Study involved patients from intensive care units across the UK and Denmark.
Use of Cox proportional hazards for developing prognostic models.
Models were validated using external datasets, employing AUROC and RMSE for evaluation.
An innovative online application was created for global data collection to continuously refine predictions.
The model demonstrated over 90% predictive precision and could adapt to changes in patient conditions.

The South London Stroke Register (SLSR)

Established in 1995, SLSR is a prospective study focusing on first-ever strokes in an urban population.
Covers a population of 357,308 with diverse ethnic demographics: 56% White, 25% Black (various backgrounds), 4% mixed, and 15% other ethnicities.
Case ascertainment was approx. 80% effective through multiple reporting systems.
Aetiological classification of ischaemic strokes based on TOAST criteria, which includes large artery atherosclerosis, cardio-embolism, small vessel occlusion, and others.
Statistical analysis involved age-standardisation, Poisson regression, and other methods to assess long-term trends from 2000 to 2015.

Statistical Themes in Multimorbidity Research

Theme 1: Examined prevalence and determinants of multimorbidity over 15 years, considering the impact of resolution/remission codes.
Theme 2: Longitudinal cluster analyses were used to identify patterns in multimorbidity.
Theme 3: Focused on inequalities and trajectories of multimorbidity through multistate Markov chain models.

Long-term Condition Prevalence

Analysis conducted on a total of 816,901 patients to ascertain prevalence and patterns of long-term conditions.
Data visualisation techniques employed, including Multiple Correspondence Analysis, illustrating relationships among chronic diseases, age, gender, deprivation, and ethnicity.

Research Output on Multimorbidity

Multiple publications resulted from the research, addressing inequalities, health care usage, and the impact of multimorbidity.
Media coverage highlighted that one in five individuals in South London lives with multiple long-term conditions.

Questions and Discussion

Open floor for inquiries regarding the applications and implications of statistical methods in clinical research.

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Description

This quiz explores the role of statistics in real-world medical research, emphasizing collaborative efforts by senior statisticians. It aims to provide insights into practical applications rather than focusing on advanced statistical methods. Discover how statistics influences clinical studies and research processes.