The Effect of Ignoring Statistical Interactions in Regression Analyses Conducted in Epidemiologic Studies: An Example with Survival Analysis Using Cox Proportional Hazards Regression Model

Vatcheva, Kristina; M, Lee; McCormick, Joseph B.; Mh, Rahbar

doi:10.4172/2161-1165.1000216

Cited by 21 publications

(1 citation statement)

References 12 publications

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“…Violations of the proportional hazard assumption were examined using Schoenfeld's residuals and effect modifications from covariates were tested using likelihood ratio tests. 29 The shared γ frailty component was added to account for dependence of bilateral cases. 30 Usage rates were calculated per calendar year on a unit level.…”

Section: Discussionmentioning

confidence: 99%

Does changes in unicompartmental knee arthroplasty practice pattern influence reasons for revision?

Mikkelsen,

Rasmussen,

Price

et al. 2023

Bone Jt Open

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AimsThe aim of this study was to describe the pattern of revision indications for unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) and any change to this pattern for UKA patients over the last 20 years, and to investigate potential associations to changes in surgical practice over time.MethodsAll primary knee arthroplasty surgeries performed due to primary osteoarthritis and their revisions reported to the Danish Knee Arthroplasty Register from 1997 to 2017 were included. Complex surgeries were excluded. The data was linked to the National Patient Register and the Civil Registration System for comorbidity, mortality, and emigration status. TKAs were propensity score matched 4:1 to UKAs. Revision risks were compared using competing risk Cox proportional hazard regression with a shared γ frailty component.ResultsAseptic loosening (loosening) was the most common revision indication for both UKA (26.7%) and TKA (29.5%). Pain and disease progression accounted for 54.6% of the remaining UKA revisions. Infections and instability accounted for 56.1% of the remaining TKA revision. The incidence of revision due to loosening or pain decreased over the last decade, being the second and third least common indications in 2017. There was a decrease associated with fixation method for pain (hazard ratio (HR) 0.40; 95% confidence interval (CI) 0.17 to 0.94) and loosening (HR 0.29; 95% CI 0.10 to 0.81) for cementless compared to cemented, and units UKA usage for pain (HR 0.67, 95% CI 0.50 to 0.91), and loosening (HR 0.51; 95% CI 0.37 to 0.70) for high usage.ConclusionThe overall revision patterns for UKA and TKA for the last 20 years are comparable to previous published patterns. We found large changes to UKA revision patterns in the last decade, and with the current surgical practice, revision due to pain or loosening are significantly less likely.Cite this article: Bone Jt Open 2023;4(12):923–931.

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Section: Discussionmentioning

confidence: 99%

Does changes in unicompartmental knee arthroplasty practice pattern influence reasons for revision?

Mikkelsen,

Rasmussen,

Price

et al. 2023

Bone Jt Open

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The impact of changes in job security on mental health across gender and family responsibility: evidence from the UK Household Longitudinal Study

Chum

Kaur

Teo

et al. 2021

Soc Psychiatry Psychiatr Epidemiol

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Potential Sex Differences Relative to Autism Spectrum Disorder and Metals

Dickerson

Rotem

Christian

et al. 2017

Curr Envir Health Rpt

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Sex differences in ASD diagnosis and mutagenic effects of toxic exposures indicate that sex differences may play a major part in the causal relationship of any potential associations seen; however, we were only able to find three studies that reported on sex differences in observed associations with toxic metals exposure and ASD. We also found several studies investigating associations between ASD and metals exposures, including 11 on aluminum, 6 on antimony, 15 on arsenic, 5 on beryllium, 17 on cadmium, 11 on chromium, 25 on lead, 14 on manganese, and 13 on nickel with markers of exposure in hair, urine, blood, teeth, fingernails, and air pollution. Results for each metal were conflicting, but studies on cadmium and lead yielded the highest proportion of studies with positive results (72% and 36%, respectively). Based on our examination of existing literature, the current evidence warrants a considerable need for evaluations of sex differences in future studies assessing the association between metals exposures and ASD. Additionally, failure to account for potential sex differences could result in bias and misinterpretation of exposure-disease relationships.

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The Effect of Ignoring Statistical Interactions in Regression Analyses Conducted in Epidemiologic Studies: An Example with Survival Analysis Using Cox Proportional Hazards Regression Model

Cited by 21 publications

References 12 publications

Does changes in unicompartmental knee arthroplasty practice pattern influence reasons for revision?

Does changes in unicompartmental knee arthroplasty practice pattern influence reasons for revision?

The impact of changes in job security on mental health across gender and family responsibility: evidence from the UK Household Longitudinal Study

Potential Sex Differences Relative to Autism Spectrum Disorder and Metals

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