Search PubMed⌕ Search

Biomedical subjects

E B Hook

Publications and source records attributed to E B Hook.

At least 37 records · Page 2Linked to original sources

Validity of methods for model selection, weighting for model uncertainty, and small sample adjustment in capture-recapture estimation.

In log-linear capture-recapture approaches to population size, the method of model selection may have a major effect upon the estimate. In addition, the estimate may also be very sensitive if certain cells are null or very sparse, even with the use of multiple sources. The authors evaluated 1) various approaches to the issue of model uncertainty and 2) a small sample correction for three or more sources recently proposed by Hook and Regal. The authors compared the estimates derived using 1) three different information criteria that included Akaike's Information Criterion (AIC) and two alternative formulations of the Bayesian Information Criterion (BIC), one proposed by Draper ("two pi") and one by Schwarz ("not two pi"); 2) two related methods of weighting estimates associated with models; 3) the independent model; and 4) the saturated model, with the known totals in 20 different populations studied by five separate groups of investigators. For each method, we also compared the estimate derived with or without the proposed small sample correction. At least in these data sets, the use of AIC appeared on balance to be preferable. The BIC formulation suggested by Draper appeared slightly preferable to that suggested by Schwarz. Adjustment for model uncertainty appears to improve results slightly. The proposed small sample correction appeared to diminish relative log bias but only when sparse cells were present. Otherwise, its use tended to increase relative log bias. Use of the saturated model (with or without the small sample correction) appears to be optimal if the associated interval is not uselessly large, and if one can plausibly exclude an all-source interaction. All other approaches led to an estimate that was too low by about one standard deviation.

Bayes Theorem↗

Use of computer simulation to evaluate a putative cluster of genetic or teratologic outcomes: adjustment for "multiple hypotheses" and application to a reported excess of Down's syndrome.

The identification of an apparent excess of a genetic outcome in a particular area and/or a particular time often provokes considerable public alarm about the presence of an environmental mutagen. It is often difficult to determine in any particular case whether the observation, whatever its nominal statistical significance, is due to chance concatenation of events or to an environmental factor. Statistical evaluation is made more difficult by the profuse number of possible hypotheses that could have triggered concern about an excess. This renders it difficult to calculate the actual probability of the observation (or one more extreme). By attempting to identify similar types of outcomes that could have provoked an apparent excess and then undertaking computer simulations assuming random deviations from a constant rate, one may attempt to adjust for the problem of multiple hypotheses. We apply this approach to a reported excess of Down's syndrome in Norway in 1985-1986 in younger mothers, and conclude that there is a high probability that it arose by chance.

Adolescent↗

Morality play.

Explore the source record for details and available documents.

California↗

Rates of Down syndrome at livebirth by one-year maternal age intervals in studies with apparent close to complete ascertainment in populations of European origin: a proposed revised rate schedule for use in genetic and prenatal screening.

Precision and accuracy in determining rates of Down syndrome at livebirth are indispensible to algorithms which determine eligibility for prenatal cytogenetic diagnostic services. We derived Down syndrome rates by single year of maternal age which we propose as a revised rate schedule for background risk. Data on European-origin populations were obtained from 5 sources judged most likely to have complete ascertainment of cases. A "constant plus exponent" regression model and variants extending the analysis to higher powers of maternal age were applied to several ranges of maternal age. Confidence intervals about the rates were calculated. This analysis results in rates significantly higher than those in widespread use though the confidence intervals show a need for caution in assuming precision. Sources of variation in rates are also considered.

Adolescent↗

The association between maternal serum alpha-fetoprotein and preterm birth, small for gestational age infants, preeclampsia, and placental complications.

OBJECTIVE: To determine whether high levels of serum alpha-fetoprotein (AFP) predict increased risk of adverse pregnancy outcomes, including preterm birth (before 37 weeks), preterm birth occurring at or before 28 weeks, small for gestational age (SGA) infant, preeclampsia, and placental abnormalities, and to determine whether low levels of serum AFP predict increased or decreased risk of these outcomes. METHODS: Using the mother's first name, last name, and zip code, we linked the records of 51,008 women who participated in the California Alpha-Fetoprotein Screening Program between June 15, 1986, and October 31, 1987, with California birth certificates for singleton infants born in 1987. The accuracy of the data linkage was confirmed by manually examining complete names, mother's ethnicity, and mother's age for a sample of 500 of the mother-infant linkages. Blood samples were obtained at 15-19 weeks. RESULTS: A strong gradient of increasing risk of preterm birth with increasing levels of serum AFP was observed (test for trend, P < .01). Among women with high levels of serum AFP (at least 2.5 multiples of the median [MoM]), 24.3% had preterm births, compared with 3.8% of women with low levels of serum AFP (0.81 MoM or less), odds ratio 8.7, 95% confidence interval 7.1-10.7). This gradient persisted when preterm infants of 28 weeks or less were examined separately. Similar gradients were observed for the risk of preeclampsia and placental abnormalities. There was a weaker U-shaped relation between serum AFP level and the risk of an SGA infant. CONCLUSION: Low levels of second-trimester maternal serum AFP are associated with a very low risk of preterm birth, preeclampsia, and placental complications. High levels of serum AFP are strongly associated with preterm birth, preeclampsia, and placental abnormalities. There is a modest association between AFP levels (both low and high) and SGA birth.

Adolescent↗

Cytogenetic and epidemiological findings in Down syndrome, England and Wales 1989 to 1993. National Down Syndrome Cytogenetic Register and the Association of Clinical Cytogeneticists.

Data from the National Down Syndrome Cytogenetic Register is used to describe the cytogenetics and epidemiology of registered cases. The register comprises notifications from cytogenetics laboratories in England and Wales. This report is of 5737 cases registered between 1989 and 1993: 2169 prenatal and 3436 postnatal diagnoses, and 132 spontaneous abortions. Eighty eight registrations were from multiple pregnancies. Ninety five percent had regular trisomy 21. In 4% there was a translocation, mostly Robertsonian t(14;21) or t(21;21). One percent were mosaics with one normal cell line. Mean maternal age was raised in free trisomy 21, but not in translocations. Where families had been investigated, about a third of translocations were inherited, six to seven times more often from the mother than the father. Associations between free trisomy 21 and structural chromosomal defects in the births were no more common than expected from newborn series. The overall sex ratio was raised (male to female: 1.23 to 1), and there was an excess of associated male sex chromosomal aneuploidy. However, in mosaics with one normal cell line the male to female ratio was 0.8 to 1, and in twins discordant for trisomy 21 there was also a female excess.

Adult↗

Internal validity analysis: a method for adjusting capture-recapture estimates of prevalence.

The authors propose a method for adjusting results of log-linear multi-source capture-recapture estimates of total population. The method compares the totals in some subpopulations of known size with estimates derived from various capture-recapture approaches to these subpopulations. The authors term such an approach an "internal validity analysis". Trends in the ratios of the estimates to the known true values of these subpopulations provide a plausible indicator of the bias of some types of estimates of the total population especially when underlying assumptions of the methods used have not been met in analysis of the total population. The authors apply this method to published data on an open population of injection drug users that had been previously analyzed with a standard capture-recapture analysis as if it were a closed population. Internal validity analysis suggests that the size of this population is about 15% greater than that previously estimated.

Data Interpretation, Statistical↗

Use of capture-recapture analyses in fetal alcohol syndrome surveillance in Alaska.

Capture-recapture methods were used to estimate the prevalence of fetal alcohol syndrome among Alaska Natives born during the period 1982-1989. Potential cases were identified through an Indian Health Service (IHS) patient case file, a pediatric practice case file, and Medicaid claims from private physicians. A total of 74 Alaska Native children aged 3-10 years were identified with a notation of fetal alcohol syndrome by a physician in a medical record. Because not all of these cases had supporting documentation regarding the syndrome, they were classified as possible cases. Of these possible cases, 50 met all five criteria for chart verification of the syndrome: physician notation of fetal alcohol syndrome, growth deficiency, facial features of the syndrome, central nervous system impairment, and a maternal history of alcohol abuse. These data provided observed prevalence rates of chart-verified fetal alcohol syndrome of 3.1 per 1,000 live births for children born 1982-1985 (age 7-10 years), and 2.0 per 1,000 live births for children born 1986-1989 (age 3-6 years). Capture-recapture analyses were conducted using cases identified by IHS and private physicians. These analyses estimated a prevalence of the syndrome of 3.8 per 1,000 live births for children born 1982-1985, and 3.1 per 1,000 live births for children born 1986-1989. Based on the capture-recapture predicted number of cases, the IHS case file ascertained a greater percentage of cases among the older cohort (75%) than among the younger cohort (56%). These data illustrate the use of capture-recapture analyses in identifying the extent to which observed trends in rates may reflect differences in cases ascertainment over time (or by birth cohort). The application of capture-recapture in fetal alcohol syndrome surveillance, however, requires careful attention to the underlying assumptions of capture-recapture methods.

Alaska↗

Fetal karyotyping for chromosome abnormalities after an unexplained elevated maternal serum alpha-fetoprotein screening.

OBJECTIVE: To study the chromosome abnormality rate among women with elevated levels of maternal serum alpha-fetoprotein (MSAFP) and the types of chromosome abnormalities in this population, and to compare this rate with reports in the literature and the rate observed in the general population. METHODS: We studied 8097 women who chose to undergo amniocentesis and fetal karyotyping after having an elevated MSAFP test of 2.5 multiples of the median (MOM) or higher. All abnormal karyotypes were reviewed and grouped according to whether the elevated MSAFP value could be explained by a ventral wall or neural tube defect. RESULTS: The overall chromosome abnormality rate was 13.83 per 1000 amniocenteses. The rate in the "unexplained" group was 10.92 per 1000 amniocenteses. Just over half (53%) of the abnormal karyotypes were autosomal anomalies, and 47% were sex chromosome abnormalities. The autosomal aneuploidies observed most frequently were triploidy and trisomy 13. The sex chromosome abnormalities observed most frequently were the XXY and XYY karyotypes. CONCLUSION: Women who have unexplained elevated MSAFP values of 2.5 MOM or greater have a twofold increase in the rate of chromosome abnormalities in their fetuses compared with the general population (P < or = .001). This rate is consistent with other studies that used a 2.5 MOM cutoff. Studies that used a 2.0 MOM cutoff have reported chromosome abnormality rates that do not vary from general population estimates.

Adult↗