PubMed · 15608759
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Steinar Westin. 2004-12-16. [Medicalization without limits].. https://pubmed.ncbi.nlm.nih.gov/15608759/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
In many ways, adjustment for publication bias in meta-analysis parallels adjustment for ascertainment bias in genetic studies. We investigate a previously published simulation-based method for dealing with complex ascertainment bias and show that it can be modified for use in meta-analysis when publication bias is suspected. The method involves simulating sets of pseudo-data under the assumed model using guesses for the unknown parameters. The pseudo-data are subjected to the same selection criteria as are believed to have operated on the original data. A conditional likelihood is then used to estimate the adjusted values of the unknown parameters. This method is used to re-analyse a published meta-analysis of the effect of the MTHFR gene on homocysteine levels. Simulation studies show that the pseudo-data method is unbiased; they give an indication of the number of pseudo-data values required and suggest that a two-stage adjustment produces less variable estimates. This method can be thought of as an example of the selection model approach to publication bias correction. As the selection mechanism must be assumed, it is important to investigate the sensitivity of any conclusions to this assumption.
Despite cardiovascular disease (CVD) being the leading killer of both sexes in the US, there are indications that men and women have different experiences in the health system with prevention and treatment practices. Beyond largely descriptive findings, little research exists that addresses how men and women may differ in their response to certain key influences on CVD health services utilization. This paper examines gender differentials in the effect of insurance coverage on CVD preventive health services in the US. An economics framework is used to model individual demand for preventive services as a function of insurance status, while controlling for a comprehensive set of explanatory variables. The services analyzed include cholesterol and blood pressure screening, pharmaceutical use for hypertension and lipid disorders, and CVD-related physician visits. Both general and high-risk samples are evaluated. The results show that while a lack of insurance is associated with lower rates of utilization in both men and women, there are no observed gender differences in insurance-effects for recommended intervals of risk factor screening in the general population. However, for individuals with previously diagnosed heart disease or stroke, a lack of coverage is more strongly associated with lower rates of screening, pharmaceutical management, and physician contact in women than men. Potential reasons for these findings are discussed and policy implications are noted.
Explore the source record for details and available documents.