Untitled

Abstract

BackgroundSpatial variation in patterns of disease outcomes is often explored with techniques such as cluster detection analysis. In other types of investigations, geographically varying individual or community level characteristics are often used as independent predictors in statistical models which also attempt to explain variation in disease outcomes. However, there is a lack of research which combines geographically referenced exploratory analysis with multilevel models. We used a spatial scan statistic approach, in combination with predicted block group-level disease patterns from multilevel models, to examine geographic variation in prostate cancer grade and stage at diagnosis.ResultsWe examined data from 20928 Maryland men with incident prostate cancer reported to the Maryland Cancer Registry during 1992–1997. Initial cluster detection analyses, prior to adjustment, indicated that there were four statistically significant clusters of high and low rates of each outcome (later stage at diagnosis and higher histologic grade of tumor) for prostate cancer cases in Maryland during 1992–1997. After adjustment for individual case attributes, including age, race, year of diagnosis, patterns of clusters changed for both outcomes. Additional adjustment for Census block group and county-level socioeconomic measures changed the cluster patterns further.ConclusionsThese findings provide evidence that, in locations where adjustment changed patterns of clusters, the adjustment factors may be contributing causes of the original clusters. In addition, clusters identified after adjusting for individual and area-level predictors indicate area of unexplained variation, and merit further small-area investigations.

Spatial Disparity of HIV/AIDS Service Providers: The Case of Miami-Dade County

“…Several attribute layers are combined to give a composite depiction of the feature. Program managers at the Centers for Disease Control and Prevention (CDC) have increasingly recognized the potential of GIS to organize and analyze information about HIV prevention services (Hanchette, Gibbs, Fogarty, & Bruhn, 2005). GIS has been adopted in the health care field to show the results of complex analyses (Richards, Croner, Rushton, Brown, & Fowler, 1999) and to assist in evidence based practices by community health organizations (Boulos, 2004).…”

Measuring Economic Growth from Outer Space

“…A number of researchers have shown that night lights reflect human economic activity (e.g., Croft (1978), Elvidge et al (1997b), Sutton and Costanza (2002), Ebener et al (2005), Doll et al (2006) and Sutton et al (2007)) 3 , but have not used lights in a statistical framework to measure real economic growth. Satellite data on land cover has been used to examine the spatial expansion of settlements in the USA (e.g., Burchfield et al, 2006).…”

Cannabis cultivation in Quebec: Between space–time hotspots and coldspots

“…Kulldorff's scan statistics have been quite widely used in epidemiology to detect cancers (DeChello & Sheehan, 2007;Dietz et al, 2011;Klassen, Kulldorff, & Curriero, 2005) and other infectious diseases (Cooper, Smith, Regan, Large, & Groenewegen, 2008). Nevertheless, few studies have used Kulldorff's scan statistics to analyze violent and property crimes (Ceccato & Haining, 2004), and even fewer for drug crimes.…”