• Communications for Statistical Applications and Methods
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• v.15 no.3
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• pp.403-409
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• 2008

In this paper we show that the peak of the type I error rate of the Oochran-Armitage trend test could be greater than the nominal level when $2\;{\times}\;C$ contingency tables obtained from two multinomial distributions are extremely unbalanced. This result justifies the use of the exact Cochran-Armitage trend test in extremely unbalanced $2\;{\times}\;C$ contingency tables.

• The Korean Journal of Applied Statistics
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• v.23 no.5
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• pp.845-855
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• 2010

Extensively used case-control designs in medical studies can also be powerful and efficient for family association studies as long as an analysis method is developed for the evaluation of association between candidate genes and disease. Traditional Cochran-Armitage trend test is devised for independent subjects data, and to apply this trend test to the biologically related siblings one has to take into account the covariance among related family members in order to maintain the correct type I error rate. We propose a more powerful trend test by introducing weights that reflect the number of affected siblings in families for the evaluation of the association of genetic markers related to the disease. An application of our method to a sample family data, in addition to a small-scale simulation, is presented to compare the weighted and unweighted trend tests.

• The Korean Journal of Applied Statistics
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• v.24 no.6
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• pp.1045-1054
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• 2011

During clinical trials a researcher is frequently able to observe a disease symptom in a subject as well as a severity score for those who experienced a symptom after a fixed length of treatment. The traditional method to evaluate a decreasing trend in proportion, when there is an intrinsic order in the treatment groups (for example control and two or more treatment groups) is a Cochran-Armitage test, while the method to evaluate a decreasing trend in continuous non-normal data is a Jonckheere-Tersptra test. The Cochran-Armitage test emphasizes the dichotomous data of symptom occurrence and the Jonckheere-Tersptra test emphasizes the continuous non-normal data of severity symptom scores. In this paper we propose new test statistics that consider the combined evidence from a symptom occurrence and disease severity score. We illustrate these methods with example data of schizophrenic inpatients that demonstrated antipsychotic-drug induced constipation. A small-scale simulation is conducted to compare the new trend tests with other trend tests.

• Communications for Statistical Applications and Methods
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• v.24 no.6
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• pp.663-671
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• 2017

Some genetic association tests include an unidentifiable nuisance parameter under the null hypothesis of no association. When the mode of inheritance (MOI) is not specified in a case-control design, the Cochran-Armitage (CA) trend test contains an unidentifiable nuisance parameter. The transmission disequilibrium test (TDT) in a family-based association study that includes the unaffected also contains an unidentifiable nuisance parameter. The hypothesis tests that include an unidentifiable nuisance parameter are typically performed by taking a supremum of the CA tests or TDT over reasonable values of the parameter. The p-values of the supremum test statistics cannot be obtained by a normal or chi-square distribution. A common method is to use a Davies's upper bound of the p-value instead of an exact asymptotic p-value. In this paper, we provide a unified sine-cosine process expression of the CA trend test that does not specify the MOI and the TDT that includes the unaffected. We also present a closed form expression of the exact asymptotic formulas to calculate the p-values of the supremum tests when the score function can be written as a linear form in an unidentifiable parameter. We illustrate how to use the derived formulas using a pharmacogenetics case-control dataset and an attention deficit hyperactivity disorder family-based example.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5859-5861
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• 2015

Background: Kidney cancer has shown an increasing trend in recent decades. This study aimed to determine change in the incidence rate between 2003 and 2009 in Iran. Materials and Methods: In this study, national cancer registry data were used. Crude incidence rates were calculated per 100,000 and age-standardized incidence rates (ASRs) were computed using the direct standardization method and the world standard population. Significant trend of incidence rates was examined by the Cochran-Armitage test for linear trend. Results: A total of 6,944 cases of kidney cancer were reported. The incidence cases increased from 595 patients in 2003 to 1,387 patients in 2009. Sex ratio (male to female) was 1.67. ASR also increased from 1.18 in 2003 to 2.52 in 2009 per 100,000, but the increasing trend was not significant. Conclusions: A slow increasing trend of incidence rate was observed in the study population. This may be due to an increase of risk factors. It is suggested to perform a study on risk factors for the cancer.

• Journal of Korean Academy of Nursing
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• v.50 no.3
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• pp.401-410
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• 2020

Purpose: This study was performed to identify the prevalence of menstrual disorders in Korean women based on body mass index (BMI) and lifestyle factors, by utilizing the Korean National Health Insurance Database. Methods: A retrospective observational study design was used for the secondary data analysis. Data of women aged 15 to 49 years who were diagnosed with menstrual disorders were extracted from The National Health Insurance Service-National Health Screening Cohort in Korea from 2009 to 2016. The age-standardized prevalence rate of menstrual disorders was calculated using SAS version 9.4, and a Chi-square test and Cochran-Armitage test were performed. Results: In total, 2,219,445 cases were extracted from the database. The prevalence of menstrual disorders significantly increased from 8.6% to 11.6% (Z=135.16, p for trend <.001) over the past eight years. In particular, it was higher in underweight women than in women with normal weight across all years (Z=-4.18~-14.72, p<.001). Moreover, statistically significant differences in the prevalence of menstrual disorders were found to be associated with drinking and smoking in all years and with physical activity levels in part (p<.05~.001). Conclusion: These findings present compelling evidence on the prevalence of menstrual disorders based on a national database. Since the prevalence of menstrual disorders has steadily increased and differs based on BMI and lifestyle factors, educational and clinical interventions are necessary to promote risk awareness and appropriate behavioral changes among Korean women.

• Journal of the Korean Society of School Health
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• v.19 no.1
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• pp.1-15
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• 2006

Purpose : This study was to identify the incidence, trend, and situation of the unexpected sudden death of elementary, middle, and high school students in school for 17 years from 1988 to 2004 in seoul. Methods : We used the data of The Seoul Safety Mutual aid Association in seoul. Subjects were 53 unexpected sudden death in school from elementary, middle, and high school students, and we explored the gender, month, a day of the week, year, contents of situation, and medical certificate of death. Statistic analysis were chi-square test, Cochran-Armitage trend test, and the tool was SAS 9.1.Results : There were 53 unexpected sudden death students(male 42 and female 11). The incidence of male students was higher than that of female during 16 years except in 1995. The incidence occurred in middle school students were 31 (58.5%) of 53 and were also most frequent in middle school students in both of male and female students. In 1990, the incidence was 8(15.1%) students, 6(11.3%) in 1992 , and 5(9,4%) in 2000 respectively. The frequency of unsuspected sudden death in March was 11(20.8%) of 53 students, 11 (20.8%) in September, 7(13.2%) in October. In Thursday, it was 12(22.6%) of 53 students. Only 14(26.4%) students of 53 died during general life, but 39(73.6%) were related to excercise. The diagnosis of 14 students died during general life were cardiac arrest 7(50.5%), brain disorder 3(21.4%) which were based on medical certificate. But the diagnosis of 39 students died during or after excercise were brain disorder including cerebral hemorrhage 9(23.1%), heart disease 9(23.1%), cardiac arrest 8(20.5%), and unknown 6(15.4%), respectively. Conclusion : The incidence of unexpected sudden death were more frequent in male students, in middle school, and in excercise-related situation and the trend was similar for 17 years. Therefore, to prevent the unexpected sudden death, it needs to further study substantially the risk factors of unexpected sudden death including past history, life-style, nutrition and development, family history, and learning environment.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.295-305
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• 2024

Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.