• Title/Summary/Keyword: Longitudinal counts data

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Note on Working Correlation in the GEE of Longitudinal Counts Data

  • Jeong, Kwang-Mo
    • Communications for Statistical Applications and Methods
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    • v.18 no.6
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    • pp.751-759
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    • 2011
  • The method of generalized estimating equations(GEE) is widely used in the analysis of a correlated dataset that consists of repeatedly observed responses within subjects. The GEE uses a quasi-likelihood equations to find the parameter estimates without assuming a specific distribution for the correlated responses. In this paper we study the importance of specifying the working correlation structure appropriately in fitting GEE for correlated counts data. We investigate the empirical coverages of confidence intervals for the regression coefficients according to four kinds of working correlations where one structure should be specified by the users. The confidence intervals are computed based on the asymptotic normality and the sandwich variance estimator.

Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients (중환자실 경장영양 환자의 영양지원, 위 잔여량 및 영양상태)

  • Lee, Minju;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.621-629
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    • 2014
  • Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

Lung Function Trajectory Types in Never-Smoking Adults With Asthma: Clinical Features and Inflammatory Patterns

  • Kim, Joo-Hee;Chang, Hun Soo;Shin, Seung Woo;Baek, Dong Gyu;Son, Ji-Hye;Park, Choon-Sik;Park, Jong-Sook
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.614-627
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    • 2018
  • Purpose: Asthma is a heterogeneous disease that responds to medications to varying degrees. Cluster analyses have identified several phenotypes and variables related to fixed airway obstruction; however, few longitudinal studies of lung function have been performed on adult asthmatics. We investigated clinical, demographic, and inflammatory factors related to persistent airflow limitation based on lung function trajectories over 1 year. Methods: Serial post-bronchodilator forced expiratory volume (FEV) 1% values were obtained from 1,679 asthmatics who were followed up every 3 months for 1 year. First, a hierarchical cluster analysis was performed using Ward's method to generate a dendrogram for the optimum number of clusters using the complete post-FEV1 sets from 448 subjects. Then, a trajectory cluster analysis of serial post-FEV1 sets was performed using the k-means clustering for the longitudinal data trajectory method. Next, trajectory clustering for the serial post-FEV1 sets of a total of 1,679 asthmatics was performed after imputation of missing post-FEV1 values using regression methods. Results: Trajectories 1 and 2 were associated with normal lung function during the study period, and trajectory 3 was associated with a reversal to normal of the moderately decreased baseline FEV1 within 3 months. Trajectories 4 and 5 were associated with severe asthma with a marked reduction in baseline FEV1. However, the FEV1 associated with trajectory 4 was increased at 3 months, whereas the FEV1 associated with trajectory 5 was persistently disturbed over 1 year. Compared with trajectory 4, trajectory 5 was associated with older asthmatics with less atopy, a lower immunoglobulin E (IgE) level, sputum neutrophilia and higher dosages of oral steroids. In contrast, trajectory 4 was associated with higher sputum and blood eosinophil counts and more frequent exacerbations. Conclusions: Trajectory clustering analysis of FEV1 identified 5 distinct types, representing well-preserved to severely decreased FEV1. Persistent airflow obstruction may be related to non-atopy, a low IgE level, and older age accompanied by neutrophilic inflammation and low baseline FEV1 levels.