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Continuous Rural-Urban Coding for Cancer Disparity Studies: Is It Appropriate for Statistical Analysis?

机译:连续城乡编码进行癌症差异研究:是否适合进行统计分析?

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Background : The dichotomization or categorization of rural-urban codes, as nominal variables, is a prevailing paradigm in cancer disparity studies. The paradigm represents continuous rural-urban transition as discrete groups, which results in a loss of ordering information and landscape continuum, and thus may contribute to mixed findings in the literature. Few studies have examined the validity of using rural-urban codes as continuous variables in the same analysis. Methods : We geocoded cancer cases in north central Florida between 2005 and 2010 collected by Florida Cancer Data System. Using a linear hierarchical model, we regressed the occurrence of late stage cancer (including breast, colorectal, hematological, lung, and prostate cancer) on the rural-urban codes as continuous variables. To validate, the results were compared to those from using a truly continuous rurality data of the same study region. Results : In term of associations with late-stage cancer risk, the regression analysis showed that the use of rural-urban codes as continuous variables produces consistent outcomes with those from the truly continuous rurality for all types of cancer. Particularly, the rural-urban codes at the census tract level yield the closest estimation and are recommended to use when the continuous rurality data is not available. Conclusions : Methodologically, it is valid to treat rural-urban codes directly as continuous variables in cancer studies, in addition to converting them into categories. This proposed continuous-variable method offers researchers more flexibility in their choice of analytic methods and preserves the information in the ordering. It can better inform how cancer risk varies, degree by degree, over a finer spectrum of rural-urban landscape.
机译:背景:作为名义变量的城乡代码的二分法或分类法是癌症差异研究中的主要范例。该范式代表了离散的群体从农村到城市的连续过渡,这导致了订购信息和景观连续性的丢失,因此可能有助于文献中的混合发现。在相同的分析中,很少有研究检验使用城乡代码作为连续变量的有效性。方法:我们对佛罗里达州中部地区2005年至2010年之间由佛罗里达癌症数据系统收集的癌症病例进行了地理编码。使用线性分层模型,我们以城乡代码为连续变量对晚期癌症(包括乳腺癌,结肠直肠癌,血液学,肺癌和前列腺癌)的发生进行了回归分析。为了进行验证,将结果与使用相同研究区域的真实连续农村数据得出的结果进行了比较。结果:就与晚期癌症风险的关联性而言,回归分析表明,使用城乡代码作为连续变量,与所有癌症类型的真正连续农村地区产生的结果一致。特别是,在人口普查领域的城乡代码产生了最接近的估计值,当无法获得连续的农村数据时,建议使用该代码。结论:从方法上讲,除了将其转换为类别之外,将城乡代码直接作为连续变量用于癌症研究是有效的。提出的连续变量方法为研究人员在选择分析方法时提供了更大的灵活性,并按顺序保留了信息。它可以更好地说明在更精细的城乡景观范围内,癌症风险如何逐级变化。

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