Teaching Analytic Methods in Maternal and Child Health

1. Teaching Analytic Methods in Maternal and Child Health ATMCH C.E. Institute Teaching Maternal and Child Health Competencies: Tools and Techniques for Graduate Programs November 16, 2003 Deborah Rosenberg, PhD Division of Epidemiology and Biostatistics School of Public Health University of Illinois at Chicago

2. Teaching Analytic Methods What analytic methods do MCH professionals need to understand? What skills in using analytic methods do MCH professionals need to have? Do all MCH professionals need to know and be skilled in analytic methods?

3. Questions from the Field “We are constructing an index of MCH need ... we have nearly 22 indicators and I am ranking each by neighborhood ... can I sum the ranks and create a sum of ranks variable or do i need to scale these on a similar metric (e.g. create z scores) and then sum these? ... the distributions of each vary ... some normal some not.  and the indicators cover a wide range of domains ...” MPH in Epidemiology, working for a health department 

4. Questions from the Field “... are you familiar or aware of any method whereby the zipcode data can be transformed or manipulated to approximate 90-95% of the population at higher levels of aggregation?are there any rules or thresholds for acceptable 'overlaps' of populations so to speak when using zipcode data?” PhD in MCH, consultant

5. Questions from the Field “There are several indicators that we apply a three-year moving average to in order to 'stabilize' the rate ... when computing the standard error, is the ‘n’ I use the averaged population over the three-year period or the sum of the population? ... Also, is it okay to compare state data for 98-00 to US data for 2000? When is a small population too small to use one year of data?” MS in Biostatistics, working for a state

6. Questions from the Academy “In the low birth weight example you covered in class, you created only two dummy variables, "teen" and "plus35” (for age). Does this mean the 20-34 age group is the reference group? Why?” MPH student

7. Questions from the Academy “I’m doing a study of subtypes of preterm delivery ... do I need to run separate models for each subtype and a comparison group or can I somehow consider all subtypes jointly?” PhD student

8. Questions from the Academy “I am putting several variables in a model as sets of dummy variables. This means when I look for effect modification I have many beta coefficients to consider. How do I interpret these, especially if some are significant and some aren’t?” PhD student

9. Questions from the Academy “I was looking at severe preeclamptic women ... For some patients there is more than one preventability factor present ... women were given ‘credit’ for each preventable factor they had. Is it possible to do comparative statistics, i.e. something, like a chi square even though some individuals were double counted??” Physician researcher

10. Why Are We Teaching Analytic Methods Anyway? Some typical compartmentalizations: • Graduate Degree Program • Continuing education • Technical Assistance • Research • Surveillance • Assessment

11. Teaching Analytic Methods Graduate course Graduate Seminar Continuing Certificate Education Program Workshop Technical Thesis project Assistance Multiple areas, over time • Special • topics, • compressed • time Individually Customized

12. And What Analytic Methods are We Talking About Anyway? Some typical compartmentalizations: • Statistical methods • Epidemiologic methods • Methods for health services research • Psychometrics • Econometrics • Other • Qualitative Methods

13. Teaching Analytic Methods Reconciling Disciplinary Jargon Synthesizing Disciplinary Approaches a few examples • ANOVA ... regression analysis • statistical bias ... study bias ... validity • difference measures ... ratio measures • computational formulas ... notation

14. Teaching Analytic Methods And then there’s format and level: Basic Advanced Lecture “hands-on” Paper/pencil Computer Face to face Distance Clean data Messy data Group Work Individual work

15. What Is “Hands-On” Anyway? • Specifying a conceptual framework • Specifying hypotheses • Writing computer code • Drawing table shells • Designing graphs • Writing an analysis plan • Identifying appropriate statistical tests

16. Teaching Analytic Methods For “hands-on” data analysis, what data should we use? Historically and currently, analytic methods are often taught using datasets with few observations and few variables • pedagogical rationale • technological constraints

17. Dataset Options Each option has pros and cons:

18. Teaching Analytic Methods Small datasets keep the focus narrow, uncluttered by either data management or substantive issues Work best for first encounters with specific methods, both basic and advanced

19. Teaching Analytic Methods Large datasets can be used with a narrow or broad focus Works for teaching complete data analysis, integrating substantive, methodological, data management, and software issues

20. Teaching Analytic Methods Is This Graduate Education? • Data organization • Data management • Software mechanics

21. Teaching Analytic Methods Data Management / Software Mechanics • accessing and inputting data • linking / merging / concatenating data • subsetting data • moving files between software • organizing data for tabling • organizing data for graphing

22. Teaching Analytic Methods Organizing Data for Analysis • recoding variables • creating new variables • defining reference groups • defining comparison groups • handling missing values • choosing appropriate statistical procedures

23. Teaching Analytic Methods To really internalize the analytic process: Conceptual overview Methodological overview Demonstration of method Bits of analysis

24. Teaching Analytic Methods To really internalize the analytic process, continued: Methodological detail Full analysis Presentation of results Interpretation of results Discussion and reanalysis

25. Teaching Analytic Methods To really use the analysis: What’s the “SO WHAT”? Beyond interpretation, what are the recommendations for action?

26. Teaching Analytic Methods Assignments can be designed in terms of grant, report, or manuscript development methods results discussion

27. Summary Artificial lines drawn between statistical, epidemiologic, and other methods Artificial lines drawn between data management, software mechanics, and conducting analysis Artificial lines drawn between theory and application Artificial lines drawn between conducting analysis and presentation and interpretation of results

28. Summary To the extent feasible, design courses that synthesize across disciplinary and pedagogical boundaries Teach analytic methods in the context of the MCH planning cycle

29. Summary Design MCH-specific exercises and data analyses Textbooks aren’t enough!! (and hardly exist in a format that is sufficient)

30. Summary Acknowledge the time and intensity required for teaching analytic methods Acknowledge how teaching analytic methods might change other aspects of the MCH curriculum

31. Summary But everyone can’t do everything! Let’s just give a consulting contract to a statistician