Int J Health Geogr - Analyzing spatial aggregation error in statistical models of late-stage cancer risk: a Monte Carlo simulation approach.

Tópicos

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Resumo

RPOSE: This paper examines the effect of spatial aggregation error on statistical estimates of the association between spatial access to health care and late-stage cancer.METHODS: Monte Carlo simulation was used to disaggregate cancer cases for two Illinois counties from zip code to census block in proportion to the age-race composition of the block population. After the disaggregation, a hierarchical logistic model was estimated examining the relationship between late-stage breast cancer and risk factors including travel distance to mammography, at both the zip code and census block levels. Model coefficients were compared between the two levels to assess the impact of spatial aggregation error.RESULTS: We found that spatial aggregation error influences the coefficients of regression-type models at the zip code level, and this impact is highly dependent on the study area. In one study area (Kane County), block-level coefficients were very similar to those estimated on the basis of zip code data; whereas in the other study area (Peoria County), the two sets of coefficients differed substantially raising the possibility of drawing inaccurate inferences about the association between distance to mammography and late-stage cancer risk.CONCLUSIONS: Spatial aggregation error can significantly affect the coefficient values and inferences drawn from statistical models of the association between cancer outcomes and spatial and non-spatial variables. Relying on data at the zip code level may lead to inaccurate findings on health risk factors.

Resumo Limpo

rpose paper examin effect spatial aggreg error statist estim associ spatial access health care latestag cancermethod mont carlo simul use disaggreg cancer case two illinoi counti zip code census block proport agerac composit block popul disaggreg hierarch logist model estim examin relationship latestag breast cancer risk factor includ travel distanc mammographi zip code census block level model coeffici compar two level assess impact spatial aggreg errorresult found spatial aggreg error influenc coeffici regressiontyp model zip code level impact high depend studi area one studi area kane counti blocklevel coeffici similar estim basi zip code data wherea studi area peoria counti two set coeffici differ substanti rais possibl draw inaccur infer associ distanc mammographi latestag cancer riskconclus spatial aggreg error can signific affect coeffici valu infer drawn statist model associ cancer outcom spatial nonspati variabl reli data zip code level may lead inaccur find health risk factor

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