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Biomedical subjects

J M Robins

Publications and source records attributed to J M Robins.

63 records · Page 4Linked to original sources

Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestations.

The extraspinal manifestations of Forestier's disease are described in 21 consecutive cases; diffuse idiopathic skeletal hyperostosis (DISH) is suggested as a more appropriate description of this ossifying diathesis. Characteristic roentgen abnormalities of the spine were present in all individuals and associated with significant axial clinical complaints. In extraspinal locations, hyperostosis at ligament attachments usually occurs in the pelvis, calcaneus, tarsal bones, ulnar olecranon and patella, and is occasionally associated with clinical signs and symptoms requiring surgery. The radiographic appearance in the peripheral skeleton is frequently distinctive and allows the radiologist to suggest the correct diagnosis, even in the absence of axial radiographs.

Aged↗

Non-response models for the analysis of non-monotone non-ignorable missing data.

I introduce a new class of non-ignorable non-monotone missing data models. These models are useful for investigating the sensitivity of one's estimates to untestable assumptions about the missing data process. I use the new models to analyse data from a case-control study of the effect of radiation on breast cancer.

Breast Neoplasms↗

Non-response models for the analysis of non-monotone ignorable missing data.

We discuss a new class of ignorable non-monotone missing data models-the randomized monotone missingness (RMM) models. We argue that the RMM models represent the most general plausible physical mechanism for generating non-monotone ignorable data. We show that there exists ignorable missing data processes that are not RMM. We argue that it may therefore be inappropriate to analyse non-monotone missing data under the assumption that the missingness mechanism is ignorable, if a statistical test has rejected the hypothesis that the missing data process is RMM representable. We use RMM models to analyse data from a case-control study of the effects of radiation on breast cancer.

Algorithms↗

Toward a curse of dimensionality appropriate (CODA) asymptotic theory for semi-parametric models.

We argue, that due to the curse of dimensionality, there are major difficulties with any pure or smoothed likelihood-based method of inference in designed studies with randomly missing data when missingness depends on a high-dimensional vector of variables. We study in detail a semi-parametric superpopulation version of continuously stratified random sampling. We show that all estimators of the population mean that are uniformly consistent or that achieve an algebraic rate of convergence, no matter how slow, require the use of the selection (randomization) probabilities. We argue that, in contrast to likelihood methods which ignore these probabilities, inverse selection probability weighted estimators continue to perform well achieving uniform n 1/2-rates of convergence. We propose a curse of dimensionality appropriate (CODA) asymptotic theory for inference in non- and semi-parametric models in an attempt to formalize our arguments. We discuss whether our results constitute a fatal blow to the likelihood principle and study the attitude toward these that a committed subjective Bayesian would adopt. Finally, we apply our CODA theory to analyse the effect of the 'curse of dimensionality' in several interesting semi-parametric models, including a model for a two-armed randomized trial with randomization probabilities depending on a vector of continuous pretreatment covariates X. We provide substantive settings under which a subjective Bayesian would ignore the randomization probabilities in analysing the trial data. We then show that any statistician who ignores the randomization probabilities is unable to construct nominal 95 per cent confidence intervals for the true treatment effect that have both: (i) an expected length which goes to zero with increasing sample size; and (ii) a guaranteed expected actual coverage rate of at least 95 per cent over the ensemble of trials analysed by the statistician during his or her lifetime. However, we derive a new interval estimator, depending on the Randomization probabilities, that satisfies (i) and (ii).

Algorithms↗

Endocrine and reproductive dysfunction in men associated with occupational inorganic lead intoxication.

In an attempt to define a postulated effect of lead on male endocrine function, seven men with symptomatic occupational lead intoxication (maximum whole blood lead levels 66-139 micrograms/dl) underwent in-patient endocrine evaluation at the time of diagnosis. Defects in thyroid function, probably of central origin, were present in three patients. Six patients had subnormal glucocorticoid production measured by 24-hr urinary 17-hydroxycorticosteroids and plasma cortisol responses to vasopressin- and/or insulin-induced hypoglycemia. Although serum testosterone concentration was normal in six patients, five had defects in spermatogenesis, including two with oligospermia and two with azoospermia. Repeat examinations after chelation therapy showed only partial improvement. It is concluded that heavy occupational exposure to lead, sufficient to cause clinical poisoning, may be associated with diffuse disturbances of endocrine and reproductive functions in men which are not rapidly reversible with standard treatment. Since men without overt poisoning have not been studied, these results cannot yet be included as sequelae of low-dose exposures.

Adrenal Cortex Function Tests↗