spatial clustering of scleroderma in three michigan counties “the toledo twins” sharon...
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![Page 1: Spatial Clustering of Scleroderma in Three Michigan Counties “The Toledo Twins” Sharon HensleyAlford Sarah Ann Cleveland](https://reader036.vdocument.in/reader036/viewer/2022062409/56649ecd5503460f94bda404/html5/thumbnails/1.jpg)
Spatial Clustering of Scleroderma in Three Michigan
Counties“The Toledo Twins”
Sharon HensleyAlford
Sarah Ann Cleveland
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Background
The disease that “turns people to stone”– Chronic, connective tissue disease– Unknown cause– Collagen accumulation in some organs
Classifications– Localized– Systemic
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Who has scleroderma
• Approximately 150,000 people in the United States
• 4 times more women than men
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Symptoms May Include
• Raynaud’s Phenomenon
• Swelling of hands and feet
• Pain and stiffness of joints
• Thickening of the skin
• Kidney, heart, and lung involvement
• Oral, facial, and dental problems
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Diagnosis
• Difficult
• Involvement of several specialists
• May take months to years
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Rates in Study Area
Prevalence
• 242 cases per 1million adults
Incidence
• 19 new cases per 1 million adults per year
Reference: Prevalence, incidence and survival rates of systemic sclerosis in the Detroit metropolitan area. Mayes et al.
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Age Distribution of Cases
Age Distribution of Scleroderma
0
2
4
6
8
10
1 6 11 16 21 26 31 36 41 46 51 56 61 66 71 76 81 86
Age
Num
ber
of C
ases
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Sex Distribution
• 134 Females• 37 Males
• 3.62 times more females than males
78%
22%
020406080100120140160
Males Females
Num
ber o
f Cas
es
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Etiologies
• UNKNOWN
• Possibilities include:– silica dust– vinyl chloride monomer– pet ownership– some solvents– appetite suppressants
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Significance
To Explore...
• Environmental associations
• Spatial pattern Disease process
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Materials
Disease Data– Incidence data for
1989-1991 (N=171)
– Three counties:• Macomb
• Oakland
• Wayne
Population Data– 1990 Census data
– Block and Tract divisions
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Methods
• Gathering population data– Finding census data– Extract pertinent information
• Geocoding cases– ArcView Batch Match– Digitizing unmatched cases
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Working with Unmatched Cases
• Verifying address: US Post: www.usps.gov
• Using web map programs– Mapquest: www.mapquest.com
• gives county lines
– Vicinity: www.mablast.com
• Digitizing
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Matching Rate
171 Original
5 Unmatchable Addresses
n=166
Batch-Matched Addresses
n=148
Non-matched
n=18
Digitized
n=13
Unable to Digitize
n=5161 Matched/166 Total
96% Matching Rate
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Statistical Analysis
Null Hypothesis: No spatial clustering
Alter. Hypothesis: Spatial clustering
Test statistic: Ipop, Moran’s I
Statistical Program: STAT!
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Macomb/Tracts
Assumption R
Variance : 0.0000000
z-score : -0.3175953
Significance : 0.7507920 (2-tailed)
Approximation
Variance : 0.0000000
z-score : -0.3121641
Significance : 0.7549158 (2-tailed)
Simulation
Significance : 0.8800000 (2-tailed)
STAT Output 4/13/1999
Results from Ipop test
Number of runs : 99
Ipop calculations
Areas (m) : 194
cases (n) : 30
Population (x) : 724110
Ipop : -0.0000099
Ipop' : -0.2377846
E[I] : -0.0000014
% within : 99.9752702
% among : 0.0247298
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Macomb/BlockSTAT Output 4/14/1999
Results from Ipop test
Number of runs : 99
Ipop calculations
Areas (m) : 661
cases (n) : 30
Population (x) : 724112
Ipop : -0.0000208
Ipop' : -0.5008514
E[I] : -0.0000014
% within : 99.9957345
% among : 0.0042655
Assumption R
Variance : 0.0000000
z-score : -0.3930764
Significance : 0.6942630 (2-tailed)
Approximation
Variance : 0.0000000
z-score : -0.3855452
Significance : 0.6998335 (2-tailed)
Simulation
Significance : 0.6400000 (2-tailed)
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Oakland/TractsSTAT Output 4/13/1999
Results from Ipop test
Number of runs : 99
Ipop calculations
Population (x) : 1101540
Ipop : 0.0000033
Ipop' : 0.0817093
E[I] : -0.0000009
% within : 99.8772695
% among : 0.1227305
Assumption R
Variance : 0.0000000
z-score : 0.2045747
Significance : 0.8379044 (2-tailed)
Approximation
Variance : 0.0000000
z-score : 0.2022084
Significance : 0.8397538 (2-tailed)
Simulation
Significance : 0.5600000 (2-tailed)
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Oakland/Blocks
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Wayne/TractsSTAT Output 4/13/1999
Results from Ipop test
Number of runs : 99
Ipop calculations
Areas (m) : 632
cases (n) : 86
Population (x) : 2159815
Ipop : -0.0000062
Ipop' : -0.1565116
E[I] : -0.0000005
% within : 100.4700628
% among : -0.4700628
Assumption R
Variance : 0.0000000
z-score : -0.3578355
Significance : 0.7204664 (2-tailed)
Approximation
Variance : 0.0000000
z-score : -0.3542334
Significance : 0.7231640 (2-tailed)
Simulation
Significance : 0.9200000 (2-tailed)
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Wayne/Blocks
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Discussion
Limitations of Analysis– Position uncertainty– Residential history– Reliability of census data
Future Analysis– Stratification by age, sex, race– 3 county combination analysis– Space/Time Analysis
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Thank You
First Honors: Andy Long
Mark Wilson
Dr. Mayes
Geoff Jacquez