spatial statistics for cancer surveillance martin kulldorff harvard medical school and harvard...
TRANSCRIPT
![Page 1: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/1.jpg)
Spatial Statistics for Cancer Surveillance
Martin Kulldorff
Harvard Medical School and
Harvard Pilgrim Health Care
![Page 2: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/2.jpg)
Two Applications of Spatial Data and GIS in Cancer Research
Studies of Specific Hypotheses: Evaluate the relationship between cancer and geographical variables of interest such as radon, pesticide use or income levels, adjusting for geographical variation.
Surveillance: Evaluate the geographical variation of cancer, adjusting for known or suspected variables such as age, gender or income.
![Page 3: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/3.jpg)
Reasons for Geographical Cancer Surveillance
• Disease Etiology• Known Etiology but
Unknown Presence• Health Services
• Public Education• Outbreak Detection• New Diseases
![Page 4: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/4.jpg)
Cancer Prevention and Control
• Are people in some geographical area at higher risk of brain cancer? This could be due to environmental, socio-economical, behavioral or genetic risk factors.
![Page 5: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/5.jpg)
Cancer Prevention and Control
• Are there geographical differences in the access to and/or use of early detection programs, such as mammography screening?
![Page 6: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/6.jpg)
Cancer Prevention and Control
• Are there geographical differences in the access to and/or use of state-of-the-art breast cancer treatment?
![Page 7: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/7.jpg)
Different Types of Cancer Data
• Count Data: Incidence, Mortality, Prevalence
• Categorical Data: Stage, Histology, Treatment
• Continuous Data: Survival
![Page 8: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/8.jpg)
For Incidence and Mortality
Poisson Data
Numerator: Number of CasesDenominator: Person-years at risk
![Page 9: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/9.jpg)
For Prevalence
Bernoulli Data (0/1 Data)
Numerator: People with Thyroid CancerDenominator: Those without Thyroid Cancer
Note: When prevalence is low, a Poisson model is a very good approximation for Bernoulli data.
![Page 10: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/10.jpg)
For Stage, Histology and Treatment
Bernoulli Data (0/1 Data)Numerator: Cases of a specific type, e.g. late stage.Denominator: All cases.
Ordinal Data
For example: Stage 1, 2, 3, 4
![Page 11: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/11.jpg)
For Survival
Survival Data
Length of Survival
(Censored Data is Common)
![Page 12: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/12.jpg)
Data Aggregation (spatial resolution)
• Exact Location
• Census Block Group
• Zip Code
• Census Tract
• County
• State
![Page 13: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/13.jpg)
Data Aggregation
• Same level of aggregation usually needed due to data availability.
• Less aggregation is typically better as more information is retained.
• Many statistical methods can be used irrespectively of aggregation level.
![Page 14: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/14.jpg)
Geographical Cancer Surveillance1. Mapping Rates and Proportions2. Smoothed Maps3. Tests for Spatial Randomness4. Spatial Scan Statistic5. Global Clustering Tests6. Brain Cancer Mortality7. Survival Data
Course Outline
![Page 15: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/15.jpg)
Space-Time Cancer Surveillance8. Space-Time Scan Statistic for the Early
Detection of Disease Outbreaks
Statistical Software9. SaTScan Demonstration
Course Outline
![Page 16: Spatial Statistics for Cancer Surveillance Martin Kulldorff Harvard Medical School and Harvard Pilgrim Health Care](https://reader036.vdocuments.mx/reader036/viewer/2022072010/56649daa5503460f94a982b0/html5/thumbnails/16.jpg)
WELCOME AT ANY TIME
Comments and Questions
Software and Slide Presentation
AVAILABLE FROM THE WEB