Browsing by Subject "COVID‐19 pandemic"

Now showing 1 - 3 of 3
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    Evaluating Meta‐Learners to Analyze Treatment Heterogeneity in Survival Data: Application to Electronic Health Records of Pediatric Asthma Care in COVID‐19 Pandemic
    (Wiley, 2025) Bo, Na; Jeong, Jong-Hyeon; Forno, Erick; Ding, Ying; Pediatrics, School of Medicine
    An important aspect of precision medicine focuses on characterizing diverse responses to treatment due to unique patient characteristics, also known as heterogeneous treatment effects (HTE) or individualized treatment effects (ITE), and identifying beneficial subgroups with enhanced treatment effects. Estimating HTE with right-censored data in observational studies remains challenging. In this paper, we propose a pseudo-ITE-based framework for analyzing HTE in survival data, which includes a group of meta-learners for estimating HTE, a variable importance metric for identifying predictive variables to HTE, and a data-adaptive procedure to select subgroups with enhanced treatment effects. We evaluate the finite sample performance of the framework under various observational study settings. Furthermore, we applied the proposed methods to analyze the treatment heterogeneity of a written asthma action plan (WAAP) on time-to-ED (Emergency Department) return due to asthma exacerbation using a large asthma electronic health records dataset with visit records expanded from pre- to post-COVID-19 pandemic. We identified vulnerable subgroups of patients with poorer asthma outcomes but enhanced benefits from WAAP and characterized patient profiles. Our research provides valuable insights for healthcare providers on the strategic distribution of WAAP, particularly during disruptive public health crises, ultimately improving the management and control of pediatric asthma.
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    Social influence matters: We follow pandemic guidelines most when our close circle does
    (Wiley, 2021) Tunçgenç, Bahar; El Zein, Marwa; Sulik, Justin; Newson, Martha; Zhao, Yi; Dezecache, Guillaume; Deroy, Ophelia; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Why do we adopt new rules, such as social distancing? Although human sciences research stresses the key role of social influence in behaviour change, most COVID‐19 campaigns emphasize the disease’s medical threat. In a global data set (n = 6,675), we investigated how social influences predict people’s adherence to distancing rules during the pandemic. Bayesian regression analyses controlling for stringency of local measures showed that people distanced most when they thought their close social circle did. Such social influence mattered more than people thinking distancing was the right thing to do. People’s adherence also aligned with their fellow citizens, but only if they felt deeply bonded with their country. Self‐vulnerability to the disease predicted distancing more for people with larger social circles. Collective efficacy and collectivism also significantly predicted distancing. To achieve behavioural change during crises, policymakers must emphasize shared values and harness the social influence of close friends and family.
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    Why obesity and psychological stress matter in recovery of post-acute sequelae of SARS-CoV-2
    (Wiley, 2022) Carter, Stephen J.; Baranauskas, Marissa N.; Medicine, School of Medicine
    Numerous elements of the COVID‐19 pandemic have proven challenging to overcome. We now recognize a perplexing characteristic of SARS‐CoV‐2 features mixed, unresolving symptoms that can last 4 weeks or longer after initial diagnosis, termed post‐acute sequelae of SARS‐CoV‐2 (PASC). Full recovery can thus become a protracted ordeal as conservative estimates indicate 20% of SARS‐CoV‐2 cases will develop PASC, with women at increased risk. Emerging evidence suggests latent virus reactivation including cytomegalovirus, Epstein‐Barr virus, and/or varicella zoster virus may perpetuate the burden of PASC. This is problematic because immune dysfunction is linked to obesity and psychological stress, both of which disproportionately affect socioeconomically disadvantaged people and racial/ethnic minorities. Applying a patient‐centered approach in which the principal factors guiding decision‐making are based on the needs and abilities of the individual is essential. Still, the independent and combined influence of obesity and psychological stress on immune function necessitates due consideration in the context of PASC recovery.