Power evaluation of focused cluster tests |
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Authors: | Robin C Puett Andrew B Lawson Allan B Clark James R Hebert Martin Kulldorff |
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Institution: | (1) Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;(2) Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;(3) School of Medicine, Health Policy and Practice, University of East Anglia, UK;(4) South Carolina Statewide Cancer Prevention & Control Program, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA |
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Abstract: | Many statistical tests have been developed to assess the significance of clusters of disease located around known sources
of environmental contaminants, also known as focused disease clusters. The majority of focused-cluster tests were designed
to detect a particular spatial pattern of clustering, one in which the disease cluster centers around the pollution source
and declines in a radial fashion with distance. However, other spatial patterns of environmentally related disease clusters
are likely given that the spatial dispersion patterns of environmental contaminants, and thus human exposure, depend on a
number of factors (i.e., meteorology and topography). For this study, data were simulated with five different spatial patterns
of disease clusters, reflecting potential pollutant dispersion scenarios: (1) a radial effect decreasing with increasing distance,
(2) a radial effect with a defined peak and decreasing with distance, (3) a simple angular effect, (4) an angular effect decreasing
with increasing distance and (5) an angular effect with a defined peak and decreasing with distance. The power to detect each
type of spatially distributed disease cluster was evaluated using Stone’s Maximum Likelihood Ratio Test, Tango’s Focused Test,
Bithell’s Linear Risk Score Test, and variations of the Lawson–Waller Score Test. Study findings underscore the importance
of considering environmental contaminant dispersion patterns, particularly directional effects, with respect to focused-cluster
test selection in cluster investigations. The effect of extra variation in risk also is considered, although its effect is
not substantial in terms of the power of tests. |
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