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对生命阶段进行分类并寻找决定因素的可行性:1996 - 2011年医疗支出面板调查的结果

Feasibility of Classifying Life Stages and Searching for the Determinants: Results from the Medical Expenditure Panel Survey 1996-2011.

作者信息

Chao Yi-Sheng, Wu Hau-Tieng, Wu Chao-Jung

机构信息

Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montréal, QC, Canada.

Department of Mathematics, University of Toronto, Toronto, ON, Canada.

出版信息

Front Public Health. 2017 Oct 27;5:247. doi: 10.3389/fpubh.2017.00247. eCollection 2017.

Abstract

BACKGROUND

Life stages are not clearly defined and significant determinants for the identification of stages are not discussed. This study aims to test a data-driven approach to define stages and to identify the major determinants.

METHODS

This study analyzed the data on the Medical Expenditure Panel Survey interviewees from 1996 to 2011 in the United States. This study first selected features with the Spearman's correlation to remove redundant variables and to increase computational feasibility. The retained 430 variables were log transformed, if applicable. Sixty-four nominal variables were replaced with 164 binominal variables. This led to 525 variables that were available for principal component analysis (PCA). Life stages were proposed to be periods of ages with significantly different values of principal components (PCs).

RESULTS

After retaining subjects followed throughout the panels, 244,089 were eligible for PCA, and the number of civilians was estimated to be 4.6 billion. The age ranged from 0 to 90 years old (mean = 35.88, 95% CI = 35.67-36.09). The values of the first PC were not significant from age of 6 to 13, 30 to 41, 46 to 60, and 76 to 90 years (adjusted  > 0.5), and the major determinants were related to functional status, employment, and poverty.

CONCLUSION

Important stages and their major determinants, including the status of functionality and cognition, income, and marital status, can be identified. Identifying stages of stability or transition will be important for research that relies on a research population with similar characteristics to draw samples for observation or intervention.

CONTRIBUTION

This study sets an example of defining stages of transition and stability across ages with social and health data. Among all available variables, cognitive limitations, income, and poverty are important determinants of these stages.

摘要

背景

生命阶段没有得到明确界定,且未讨论用于识别阶段的重要决定因素。本研究旨在测试一种数据驱动的方法来定义阶段并识别主要决定因素。

方法

本研究分析了1996年至2011年美国医疗支出小组调查受访者的数据。本研究首先使用斯皮尔曼相关性选择特征,以去除冗余变量并提高计算可行性。保留的430个变量在适用时进行对数变换。64个名义变量被替换为164个二项变量。这产生了525个可用于主成分分析(PCA)的变量。生命阶段被提议为具有显著不同主成分(PC)值的年龄时期。

结果

在保留整个小组中跟踪的受试者后,244,089人符合PCA条件,估计平民人数为46亿。年龄范围为0至90岁(平均 = 35.88,95% CI = 35.67 - 36.09)。第一主成分的值在6至13岁、30至41岁、46至60岁和76至90岁时不显著(调整后>0.5),主要决定因素与功能状态、就业和贫困有关。

结论

可以识别重要阶段及其主要决定因素,包括功能和认知状态、收入和婚姻状况。识别稳定或过渡阶段对于依赖具有相似特征的研究人群进行样本抽取以进行观察或干预的研究很重要。

贡献

本研究为利用社会和健康数据定义不同年龄段的过渡和稳定阶段树立了榜样。在所有可用变量中,认知限制、收入和贫困是这些阶段的重要决定因素。

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