In this thesis, we apply and adapt a new method to assess conditional associations in a large dataset from the Vanderbilt University Medical Center Electronic Health Record (EHR). We estimate pairwise rank correlations among disease status and lab values in the EHR after adjusting for demographical information. Our covariate-adjusted rank correlations involve fitting cumulative probability models (CPMs), extracting probability-scale residuals (PSRs) from these models, and computing the sample correlation between PSRs for different outcomes. This approach is rank-based, robust, and applicable to a variety of data types. Computational challenges arise with large datasets, particularly when we apply these methods to continuous outcome variables such as most lab values; we propose some workaround solutions. We present our results with estimates and confidence intervals for the partial Spearmanâs rank correlations among all pairwise combinations of the most frequent 250 ICD codes and 50 lab results among 472,570 patients with data in the EHR. We
also present results stratified by sex and diabetes status, demonstrating how to assess for differences in correlations between different population strata.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-07112017-225536 |
| Date | 03 August 2017 |
| Creators | Fu, Lingjun |
| Contributors | Bryan Shepherd, Matthew Shotwell |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-07112017-225536/ |
| Rights | restrictone, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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