Grant: Discovery Grants Program - Individual

This proposal develops efficient methods for the design of clinical studies that monitor recurrent events, for example, skin or other cancer recurrences or epileptic seizures. Sometimes continuous monitoring of individuals experiencing recurrent events is not possible or imperative. There may be situations where, ethically, patients need not be subjected to such monitoring based on the need for care, and at the same time, funds spent in continuous or overly-frequent monitoring could be better allocated; alternatively, events may occur too frequently for their exact times of occurrence to be recorded. Statistical challenges to the design of studies that monitor recurrent events lie in determining optimal times for followup and the number of followup times required, accounting for the numerous distinctions that characterize studies of human subjects, for example, substantial heterogeneity in responses to treatments amongst individuals and missingness of data. The methods employed by the proposed research afford minimal assumptions on the underlying process that generates recurrences, making them highly generalizable.The proposal also considers methods for mapping disease or mortality rates. Maps such as these are important for epidemiological research, to suggest factors which may be linked to mortality, and in health policy, where they provide an overall description of mortality and are used to allocate health funding. The strength of the methods developed is their capacity to take into account the spatial arrangement of the regions and any correlations which exist because of such configurations. They isolate time trends that manifest at the broad regional level as well as the small-area level, thus permitting an overall provincial and localized policy impact.