Jun 4 - Jun 4
2018
5:00 PM - 6:00 PM
Mon - Mon

Help the Biostatistician! What You Need to Know About Estimating Power Calculations and Sample Size

Speaker

Biostatistician 3, Stanford-Surgery Policy Improvement Research & Education Ctr, Stanford-Surgery Policy Improvement Research and Education Center

Bio

Amber W. Trickey, PhD, MS, CPH, is Senior Biostatistician of the S-SPIRE Center. She supports multidisciplinary teams in research design, implementation, and analysis. In over 15 years of health services research, with 10 years focused in surgery and emergency medicine, Dr. Trickey has collaborated with diverse investigators, including attending physicians, residents, nurses, psychologists, and engineers. Dr. Trickey obtained degrees in epidemiology and biostatistics, and certifications in public health and SAS data analysis. She has evaluated data quality in surgical and trauma care, supported multiple clinical trials, and led data validation studies using the ACS-NSQIP surgical registry and administrative claims. Dr. Trickey has contributed to public and private grants on surgical safety, healthcare quality metrics, simulation-based training, team communication, error disclosure, and emergency services.

Publications

  • Financial Burden of Traumatic Injury Amongst the Privately Insured. Annals of surgery Fu, S. J., Arnow, K., Trickey, A., Spain, D. A., Morris, A., Knowlton, L. 2021

    Abstract

    OBJECTIVE: We sought to evaluate the overall financial burden associated with traumatic injury amongst patients with private insurance and assess the effect of high deductible plans on out-of-pocket costs.SUMMARY BACKGROUND DATA: Traumatic injury can be a source of unexpected financial burden for households. However, the effect of increasing participation in higher cost-sharing private health insurance plans remains unknown.METHODS: We conducted a retrospective cohort observational study, using the Clinformatics Data Mart Database, a nationwide single-payer administrative claims database to identify US adults who required emergency department services or hospital admission for single traumatic injury from 2008 to 2018. A two-part model using a logistic regression and a generalized linear model with gamma distribution and log link was used to evaluate 12-month out-of-pocket costs after traumatic injury. Multivariable logistic regression was used to evaluate the likelihood of catastrophic health expenditure after injury.RESULTS: Of 426,945 included patients, 53% were male, 71% were white, and median age was 42 years. Patients faced monthly OOPC of

  • Revascularization for Intermittent Claudication Significantly Increases the 5-year Risk of Major Amputation in the Veterans Health Administration George, E. L., Chen, R., Barreto, N., Langston, A. H., Trickey, A., Arya, S. MOSBY-ELSEVIER. 2021: E309
  • Recruitment and Outcome Reporting for Women and Minorities in Stent Device Development Trials for Endovascular Abdominal Aortic Aneurysm Repair Patel, J., Pallapothu, S., Trickey, A., Langston, A., Goodney, P., Arya, S. MOSBY-ELSEVIER. 2021: E54
  • Racial disparities in the utilization of parathyroidectomy among patients with primary hyperparathyroidism: Evidence from a nationwide analysis of Medicare claims. Surgery Alobuia, W. M., Meng, T., Cisco, R. M., Lin, D. T., Suh, I., Tamura, M. K., Trickey, A. W., Kebebew, E., Seib, C. D. 2021

    Abstract

    BACKGROUND: Among patients with primary hyperparathyroidism, parathyroidectomy offers a chance of cure and mitigation of disease-related complications. The impact of race/ethnicity on referral and utilization of parathyroidectomy has not been fully explored.METHODS: Population-based, retrospective cohort study using 100% Medicare claims from beneficiaries with primary hyperparathyroidism from 2006 to 2016. Associations of race/ethnicity with disease severity, surgeon evaluation, and subsequent parathyroidectomy were analyzed using adjusted multivariable logistic regression models.RESULTS: Among 210,206 beneficiaries with primary hyperparathyroidism, 63,136 (30.0%) underwent parathyroidectomy within 1 year of diagnosis. Black patients were more likely than other races/ethnicities to have stage 3 chronic kidney disease (10.8%) but had lower prevalence of osteoporosis and nephrolithiasis compared to White patients, Black and Hispanic patients were more likely to have been hospitalized for primaryhyperparathyroidism-associated conditions (White 4.8%, Black 8.1%, Hispanic 5.8%; P < .001). Patients who were White and met operative criteria were more likely to undergo parathyroidectomy than Black, Hispanic, or Asian patients (White 30.5%, Black 23.0%, Hispanic 21.4%, Asian 18.7%; P < .001). Black and Hispanicpatients had lower adjusted odds of being evaluated by a surgeon (odds ratios 0.71 [95% confidenceinterval 0.69-0.74], 0.68 [95% confidence interval 0.61-0.74], respectively) and undergoing parathyroidectomy if evaluated by a surgeon (odds ratios 0.72 [95% confidence interval 0.68-0.77], 0.82 [95%confidence interval 0.67-0.99]). Asian race was associated with lower adjusted odds of being evaluated by a surgeon (odds ratio 0.64 [95% confidence interval 0.57-0.71]), but no difference in odds of parathyroidectomy.CONCLUSION: Racial/ethnic disparities exist in the management of primary hyperparathyroidism among older adults. Determining the factors that account for this disparity require urgent attention to achieve parity in the management of primary hyperparathyroidism.

    View details for DOI 10.1016/j.surg.2021.05.037

    View details for PubMedID 34229901

  • Association of parathyroidectomy with 5-year clinically significant kidney stone events in patients with primary hyperparathyroidism. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists Seib, C. D., Ganesan, C., Arnow, K. D., Suh, I., Pao, A. C., Leppert, J. T., Tamura, M. K., Trickey, A. W., Kebebew, E. 2021

    Abstract

    OBJECTIVE: Patients with primary hyperparathyroidism (PHPT) are at increased risk of kidney stones. Guidelines recommend parathyroidectomy in PHPT patients with a history of stone disease. This study aimed to compare the 5-year incidence of clinically significant kidney stone events in patients with PHPT treated with parathyroidectomy vs. non-operative management.METHODS: We performed a longitudinal cohort study of patients with PHPT in a national commercial insurance claims database (2006-2019). Propensity score inverse probability weighting-adjusted multivariable regression models were calculated.RESULTS: We identified 7,623 patients ≥35 years-old with continuous enrollment >1 year before and >5 years after PHPT diagnosis. 2,933 patients (38.5%) were treated with parathyroidectomy. The cohort had a mean age of 66.5 years, 78.1% were female, 72.4% were White. Over 5 years, the unadjusted incidence of ≥1 kidney stone event was higher in patients managed with parathyroidectomy compared to those managed non-operatively overall (5.4% vs. 4.1%) and among those with a history of kidney stones at PHPT diagnosis (17.9% vs. 16.4%). On multivariable analysis, parathyroidectomy was associated with no statistically significant difference in the odds of 5-year kidney stone event among patients with a history of kidney stones (OR 1.03, 95%CI 0.71-1.50) or those without history of kidney stones (OR 1.16, 95%CI 0.84-1.60).CONCLUSION: Based on this claims analysis, there was no difference in the odds of 5-year kidney stone events in PHPT patients treated with parathyroidectomy vs. non-operative management. Time-horizon for benefit should be considered when making treatment decisions for PHPT based on risk of kidney stone events.

    View details for DOI 10.1016/j.eprac.2021.06.004

    View details for PubMedID 34126246

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Stanford, CA 94305
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