Disease maps are geographical maps that display local estimates of disease risk. When the disease is rare, crude risk estimates can be highly variable, leading to extreme estimates in areas with low population density. Bayesian hierarchical models are commonly used to stabilize the disease map, making them more easily interpretable. By exploiting assumptions about the correlation structure in space and time, the statistical model stabilizes the map by shrinking unstable, extreme risk estimates to the risks in surrounding areas (local spatial smoothing) or to the risks at contiguous time points (temporal smoothing). Extreme estimates that are based on smaller populations are subject to a greater degree of shrinkage, particularly when the risks in adjacent areas or at contiguous time points do not support the extreme value and are more stable themselves. / A common goal in disease mapping studies is to identify areas of elevated risk. The objective of this thesis is to compare the accuracy of several fully Bayesian hierarchical models in discriminating between high-risk and background-risk areas. These models differ according to the various spatial, temporal and space-time interaction terms that are included in the model, which can greatly affect the smoothing of the risk estimates. This was accomplished with simulations based on the cervical cancer rate of Kentucky and at-risk person-years of the state of Kentucky's 120 counties from 1995 to 2002. High-risk areas were 'planted' in the generated maps that otherwise had background relative risks of one. The various disease mapping models were applied and their accuracy in correctly identifying high- and background-risk areas was compared by means of Receiver Operating Characteristic curve methodology. Using data on Multiple Sclerosis (MS) on the island of Sardinia, Italy we apply the more successful models to identify areas of elevated MS risk.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.103370 |
| Date | January 2007 |
| Creators | Charland, Katia. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Occupational Health.) |
| Rights | © Katia Charland, 2007 |
| Relation | alephsysno: 002652238, proquestno: AAINR38569, Theses scanned by UMI/ProQuest. |
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