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Evaluating Trends in Successful Resuscitation after Cardiac Arrest under Trending Misclassification Error: Estimating Bounds under Partially Verified Data, with Arthur Sweetman

Abstract: Estimating trends over time, including those surrounding policy changes, typically does not address the plausible confounding issue of trends in data quality, leading to a non-classical measurement error problem. This may be a concern with either survey or administrative data, where reporting attitudes may change over time or measurement quality may improve with time. Our application is to administrative health data, which is often used in epidemiological studies to evaluate trends in binary health characteristics and treatments. We address the detection of a trend in a binary outcome – successful resuscitation following cardiac arrest – allowing for trending misclassification error. Employing a mixture model, we compute bounds on the outcome following Horowitz and Manski (1995) under contaminated and corrupt data assumptions. Identification relies on validation information from a non-random subsample of the data allowing us to place upper bounds on measurement error. We also consider how identification is improved with monotonicity assumptions (Manski and Pepper 2000), bounded variation assumptions (Manski & Pepper, 2013, 2017), and subgroup specific verification rates (Dominitz and Sherman 2004, 2006; Kreider and Pepper 2007, 2008). We show evidence of a trend in the successful resuscitation rate for the population of reported cardiac arrests in Ontario under assumptions that are weaker than those in the existing literature.

Other Thesis Chapters

What Happens after Cardiac Arrest? Patterns of Care with Patient Enrollment, with Arthur Sweetman

Temporal Trends in Survival for Patients with In-hospital Cardiac Arrest in Ontario: 2003-2010, with Ahmad von Schlegell, Mathew Mercuri, Madhu K. Natarajan, and Arthur Sweetman

Living for the Weekend with Cardiac Arrest: Survival and Discharge Location by Day of the Week of Arrest Occurrence

Peer-Reviewed Publications

Work in Progress

The Exit Rate of Immigrants in Ontario from Disability Support: A Flexible Parametric Duration Model, with Saeed Kamyana