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ANN ARBOR, MI, United States

This paper describes the combination of three-way contingency tables and geostatistics to visualize the non-linear impact of two putative covariates on individual-level health outcomes and test the significance of this impact, accounting for the pattern of spatial correlation and correcting for multiple testing. The methodology is used to explore the influence of distance to mammography clinics and census-tract poverty level on the rate of late-stage breast cancer diagnosis in three Michigan counties. Incidence rates are significantly lower than the area-wide mean (18.04%) mainly in affluent neighbourhoods [0-5% poverty], while higher incidences are mainly controlled by distance to clinics. The new simulation-based multiple testing correction is very flexible and less conservative than the traditional false discovery rate approach that results in a majority of tests becoming non-significant. Classes with significantly higher frequency of late-stage diagnosis often translate into geographic clusters that are not detected by the spatial scan statistic. © 2009 Elsevier Ltd. All rights reserved.


A common issue in spatial interpolation is the combination of data measured over different spatial supports. For example, information available for mapping disease risk typically includes point data (e.g. patients' and controls' residence) and aggregated data (e.g. socio-demographic and economic attributes recorded at the census track level). Similarly, soil measurements at discrete locations in the field are often supplemented with choropleth maps (e.g. soil or geological maps) that model the spatial distribution of soil attributes as the juxtaposition of polygons (areas) with constant values. This paper presents a general formulation of kriging that allows the combination of both point and areal data through the use of area-to-area, area-to-point, and point-to-point covariances in the kriging system. The procedure is illustrated using two data sets: (1) geological map and heavy metal concentrations recorded in the topsoil of the Swiss Jura, and (2) incidence rates of late-stage breast cancer diagnosis per census tract and location of patient residences for three counties in Michigan. In the second case, the kriging system includes an error variance term derived according to the binomial distribution to account for varying degree of reliability of incidence rates depending on the total number of cases recorded in those tracts. Except under the binomial kriging framework, area-and-point (AAP) kriging ensures the coherence of the prediction so that the average of interpolated values within each mapping unit is equal to the original areal datum. The relationships between binomial kriging, Poisson kriging, and indicator kriging are discussed under different scenarios for the population size and spatial support. Sensitivity analysis demonstrates the smaller smoothing and greater prediction accuracy of the new procedure over ordinary and traditional residual kriging based on the assumption that the local mean is constant within each mapping unit. © 2010 International Association for Mathematical Geosciences.


The analysis of health data and putative covariates, such as environmental, socioeconomic, demographic, behavioral, or occupational factors, is a promising application for geostatistics. Transferring methods originally developed for the analysis of earth properties to health science, however, presents several methodological and technical challenges. These arise because health data are typically aggregated over irregular spatial supports (e.g., counties) and consist of a numerator and a denominator (i.e., rates). This article provides an overview of geostatistical methods tailored specifically to the characteristics of areal health data, with an application to lung cancer mortality rates in 688 U.S. counties of the southeast (1970-1994). Factorial Poisson kriging can filter short-scale variation and noise, which can be large in sparsely populated counties, to reveal similar regional patterns for male and female cancer mortality that correlate well with proximity to shipyards. Rate uncertainty was transferred through local cluster analysis using stochastic simulation, allowing the computation of the likelihood of clusters of low or high cancer mortality. Accounting for population size and rate uncertainty led to the detection of new clusters of high mortality around Oak Ridge National Laboratory for both sexes, in counties with high concentrations of pig farms and paper mill industries for males (occupational exposure) and in the vicinity of Atlanta for females. © 2010 The Ohio State University.


Information available for mapping continuous soil attributes often includes point field data and choropleth maps such as soil or geology maps that model the spatial distribution of soil attributes as the juxtaposition of polygons (areas) with constant values. This paper presents two approaches to incorporate both point and areal data in the spatial interpolation of continuous soil attributes. In the first instance, area-to-point kriging is used to map the variability within soil units while ensuring the coherence of the prediction so that the average of disaggregated estimates is equal to the original areal datum. The resulting estimates are then used as local means in residual kriging. The second approach proceeds in one step and capitalizes on (i) a general formulation of kriging that allows the combination of both point and areal data through the use of area-to-area, area-to-point and point-to-point covariances in the kriging system, (ii) the availability of Geographical Information Systems (GIS) to discretize polygons of irregular shape and size and (iii) knowledge of the point-support variogram model that can be inferred directly from point measurements, thereby eliminating the need for deconvolution procedures. The two approaches are illustrated using the geological map and heavy metal concentrations recorded in the topsoil of the Swiss Jura. Sensitivity analysis indicates that the new procedures improve prediction over ordinary kriging and traditional residual kriging based on the assumption that the local mean is constant within each mapping unit. © 2011 The Author. Journal compilation © 2011 British Society of Soil Science.


Goovaerts P.,Biomedware
International Journal of Applied Earth Observation and Geoinformation | Year: 2013

Analyzing temporal trends in health outcomes can provide a more comprehensive picture of the burden of a disease like cancer and generate new insights about the impact of various interventions. In the United States such an analysis is increasingly conducted using joinpoint regression outside a spatial framework, which overlooks the existence of significant variation among U.S. counties and states with regard to the incidence of cancer. This paper presents several innovative ways to account for space in joinpoint regression: (1) prior filtering of noise in the data by binomial kriging and use of the kriging variance as measure of reliability in weighted least-square regression, (2) detection of significant boundaries between adjacent counties based on tests of parallelism of time trends and confidence intervals of annual percent change of rates, and (3) creation of spatially compact groups of counties with similar temporal trends through the application of hierarchical cluster analysis to the results of boundary analysis. The approach is illustrated using time series of proportions of prostate cancer late-stage cases diagnosed yearly in every county of Florida since 1980s. The annual percent change (APC) in late-stage diagnosis and the onset years for significant declines vary greatly across Florida. Most counties with non-significant average APC are located in the north-western part of Florida, known as the Panhandle, which is more rural than other parts of Florida. The number of significant boundaries peaked in the early 1990s when prostate-specific antigen (PSA) test became widely available, a temporal trend that suggests the existence of geographical disparities in the implementation and/or impact of the new screening procedure, in particular as it began available. © 2012 Elsevier B.V.

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