Comparison of methods and programs for calculating health life expectancies.
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1 Comparison of methods and programs for calculating health life expectancies. Fiona Matthews, Vikki O Neill, Carol Jagger, Pia Wohland REVES - 29 th May 2014
2 Outline Software used to calculate health expectancies Worked example - CFAS Data ADL MMSE Summary
3 Longitudinal software imach: A maximum likelihood computer program using Interpolation of Markov Chains SPACE: Stochastic Population Analysis for Complex Events GLSMT: Gibbs Sampler for Multistate Life Tables Software ELECT: Estimation of Life Expectancies using Continuous-Time multi-state models LXPCT 2: Multistate Life Expectancy Calculator
4 Longitudinal methods Discrete multi-state models Continuous multi-state models Increment decrement life tables
5 Longitudinal methods Discrete multi-state models imach, SPACE, GLSMT Continuous multi-state models ELECT Increment decrement life tables LXPCT 2
6 Summary imach: SPACE: euroreves.ined.fr/ imach/ Latest version 0.98k Standalone package Designed for flexibility and simplicity Multiple living states, multiple absorbing states (not attempted!) Needs recovery Data - one line per person cdc.gov/nchs/data_ access/space.htm Wrapper available from authors Runs from within SAS Designed for complex population sampling Can do semi-markov Models (dependent on time in state) Data - Multiple lines, one per time point
7 Summary ELECT: GLSMT: ucl.ac.uk/~ucakadl/ indexelect.html Builds from MSM in R Designed for continuous time multi-state models Data - multiple lines per person, one per state 3 state model (ELECT only, MSM more flexible) Flexible covariates, both stratification and adjustment Request programme from Authors Based in R Designed to undertake Bayesian MSM Data - one line, two waves, one per transition (start, end) Lots of covariate flexibility (stratification)
8 Summary LXPCT 2: Stata ADO file Needs age specific transitions imach or MSM can provide these Flexible number of states (both living and absorbing) Covariates handled by stratification No confidence intervals
9 Dates Continuous age (any measure) Month and year Age (single years) Age (months) One year or five year intervals
10 Dates Continuous age (any measure) ELECT Month and year imach Age (single years) SPACE, LXPCT 2 Age (months) SPACE work ongoing One year or five year intervals GLSMT
11 MRC Cognitive Function and Ageing study
12 CFAS Data summary: Sample size: 13,004 Disability free life expectancy Classifications of Disability: State 1: No Disability State 2: Mild to Severe Disability State 3: Death Cognitive impairment free life expectancy Stroke free life expectancy
13 CFAS For comparing software: Females Sample size: 6,842 Youngest age 64, oldest age 103 Interval in months between two states (min 1, max 171 months) No missing states at baseline No two events in same month Data right-censored at 12/2005
14 Disability free life expectancy ELECT: imach: Female marginal LEs for age range specified Legend Total LE LE in state No Disability LE in state Mild Severe Disability Life Expectancy (Years) Age
15 Disability free life expectancy SPACE: SPACE: Female marginal LEs for age range specified Legend Total LE LE in state No Disability LE in state Mild Severe Disability Life Expectancy (Years) Age
16 Disability free life expectancy SPACE: SPACE: Female marginal LEs for age range specified Legend Total LE LE in state No Disability LE in state Mild Severe Disability Life Expectancy (Years) Age
17 Disability: Comparison
18 Cognitive Impairment ELECT: imach: Female marginal LEs for age range specified Legend Total LE LE in state MMSE LE in state MMSE 0 17 Life Expectancy (Years) Age
19 Cognitive Impairment SPACE: SPACE: Female marginal LEs for age range specified Legend Total LE LE in state MMSE LE in state MMSE 0 17 Life Expectancy (Years) Age
20 Cognitive Impairment SPACE: SPACE: Female marginal LEs for age range specified Legend Total LE LE in state MMSE LE in state MMSE 0 17 Life Expectancy (Years) Age
21 Cognitive Impairment: Comparison
22 Summary Software: imach SPACE ELECT GLSMT LxPct 2 Common disorder No recovery Rare recovery Uneven observations Right censored data More than two waves Flexibility Useability
23 Questions Thanks for listening. Questions?
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