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Marginal Modeling and Multiple Imputation Methods for Correlated Binary Data Generated from Clinical Periodontal Examinations.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Marginal Modeling and Multiple Imputation Methods for Correlated Binary Data Generated from Clinical Periodontal Examinations./
Author:	Shing, Tracie L.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2022,
Description:	162 p.
Notes:	Source: Dissertations Abstracts International, Volume: 83-11, Section: B.
Contained By:	Dissertations Abstracts International83-11B.
Subject:	Biostatistics. -
ISBN:	9798438797630

Marginal Modeling and Multiple Imputation Methods for Correlated Binary Data Generated from Clinical Periodontal Examinations.
Shing, Tracie L.

Marginal Modeling and Multiple Imputation Methods for Correlated Binary Data Generated from Clinical Periodontal Examinations. - Ann Arbor : ProQuest Dissertations & Theses, 2022 - 162 p.

Source: Dissertations Abstracts International, Volume: 83-11, Section: B.

Thesis (Dr.P.H.)--The University of North Carolina at Chapel Hill, 2022.

This item must not be sold to any third party vendors.

Large epidemiological studies of periodontitis often use partial mouth oral examinations, where a fraction of teeth or tooth sites are examined for periodontal disease, in lieu of full mouth examinations to reduce physical burdens and costs. Partial mouth examinations consistently underestimate prevalence when case definitions classify individuals as having periodontitis using only information from observed sites. Meanwhile, the Preisser et al. (2017) prevalence formula based on simple site-level disease assumptions produces less biased prevalence estimates for partial mouth examinations; however, the estimator is generally biased as it does not incorporate complex intraoral disease patterns or case definitions.To better characterize intraoral patterns of disease, we employ marginal regression analyses in an epidemiological investigation of tooth site-level periodontal disease in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Since few methods and software are available for marginal analysis of binary outcomes when complex within-cluster correlation structures are of interest, we first develop a SAS macro, GEECORR, to implement the Prentice (1988) extension to the Liang and Zeger (1986) generalized estimating equations (GEE) method. This allows for flexible modeling of both the marginal mean and within-cluster correlation as a function of their respective covariate risk factors. Then, we use the Prentice (1988) GEE method to examine several mean and correlation models and detail both site-level probabilities and correlation patterns of periodontal disease in the HCHS/SOL population.Finally, we describe a novel methodology for multiply imputing missing correlated binary observations from incomplete clusters using the Prentice (1988) GEE approach to estimate an imputation model and the conditional linear family of statistical distributions Qaqish (2003) to generate "complete" clusters. We apply our imputation-based method to partial mouth examination protocols generated with simple random samples of tooth sites from the 2013-2014 National Health and Nutrition Examination Survey full mouth periodontal examination. Prevalence estimates from multiply imputed clusters are compared to gold standard full mouth estimates. We demonstrate that periodontitis prevalence estimands based on complex disease definitions for the full mouth can be validly estimated from partial mouth samples using multiple imputation to generate complete clusters.

ISBN: 9798438797630Subjects--Topical Terms:

1002712
Biostatistics.
Subjects--Index Terms:

Correlated binary data

Marginal Modeling and Multiple Imputation Methods for Correlated Binary Data Generated from Clinical Periodontal Examinations.
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500 $a Source: Dissertations Abstracts International, Volume: 83-11, Section: B.
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520 $a Large epidemiological studies of periodontitis often use partial mouth oral examinations, where a fraction of teeth or tooth sites are examined for periodontal disease, in lieu of full mouth examinations to reduce physical burdens and costs. Partial mouth examinations consistently underestimate prevalence when case definitions classify individuals as having periodontitis using only information from observed sites. Meanwhile, the Preisser et al. (2017) prevalence formula based on simple site-level disease assumptions produces less biased prevalence estimates for partial mouth examinations; however, the estimator is generally biased as it does not incorporate complex intraoral disease patterns or case definitions.To better characterize intraoral patterns of disease, we employ marginal regression analyses in an epidemiological investigation of tooth site-level periodontal disease in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Since few methods and software are available for marginal analysis of binary outcomes when complex within-cluster correlation structures are of interest, we first develop a SAS macro, GEECORR, to implement the Prentice (1988) extension to the Liang and Zeger (1986) generalized estimating equations (GEE) method. This allows for flexible modeling of both the marginal mean and within-cluster correlation as a function of their respective covariate risk factors. Then, we use the Prentice (1988) GEE method to examine several mean and correlation models and detail both site-level probabilities and correlation patterns of periodontal disease in the HCHS/SOL population.Finally, we describe a novel methodology for multiply imputing missing correlated binary observations from incomplete clusters using the Prentice (1988) GEE approach to estimate an imputation model and the conditional linear family of statistical distributions Qaqish (2003) to generate "complete" clusters. We apply our imputation-based method to partial mouth examination protocols generated with simple random samples of tooth sites from the 2013-2014 National Health and Nutrition Examination Survey full mouth periodontal examination. Prevalence estimates from multiply imputed clusters are compared to gold standard full mouth estimates. We demonstrate that periodontitis prevalence estimands based on complex disease definitions for the full mouth can be validly estimated from partial mouth samples using multiple imputation to generate complete clusters.
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