Collaborative Projects

Statistical Modeling for Nursing Human Health Resources

Investigators: Paul Cabilio (Math & Stats, Acadia), Ying Zhang (Math & Stats, Acadia), Linda O’Brien-Pallas (NHSRU, U of T) and Xiaoqiang Li (NHSRU, U of T)
Students involved: Jingyu Bu (M.Sc. Candidate)
Organization sponsor: Nursing Health Services Research Unit, University of Toronto
Support grant: MITACS Student Internship Grant

Time Series Intervention Analysis with Drug Policy Study

Investigators: Donna Lowe (U of T), Ingrid Sketris and Heather Lummis (Dalhousie) and Ying Zhang (Acadia)
D. O. Lowe, H. Lummis, Y. Zhang and I. S. Sketris (2008). Effect of Education and Policy Interventions on Institutional Utilization of Wet Nebulization Respiratory Drugs and Portable Inhalers. Can J Clin Pharmacol, Vol 15 (2Summer 2008:e334-e343; September 5, 2008.

Metric Development for Medicine Compliance and Other Health Behavior

Abstract: Although different methods are currently used to measure medication compliance, the ability to translate this measure into a meaningful metric, which is interpretable for both methodologists and clinicians, has not yet been realized.  The current medical compliance indices do not provide us with a precise classification of what good or bad medical compliance behavior is.  Distribution based methods may provide useful insight into the best mechanism with which to analyze the data, in order to make it more interpretable and provide better insight into disease patterns and treatment effects.  By quantifying and characterizing the uncertainty of compliance measures, we will be able propose measures that should ideally incorporate variations of any patient’s compliance behavior during a treatment period and model the relationship with mortality, hospital readmissions and emergency room visits.  We will also aim at compliance dependency on drugs and types of diseases.  Medication compliance is closely related to other health behavior compliance.  The results from this project will be used to further develop metrics for monitoring and measuring compliance with other health behavior such as exercise and nutrition intervention, especially for seniors.

Investigators: Ying Zhang (Math & Stats, Acadia), Paul Cabilio (Math & Stats, Acadia), Hugh Chipman (Math & Stats, Acadia), Femida Gwadry-Sridhar (Western), Shanthi Johnson (Nutrition & Dietetics, Acadia)
Students involved: Maja Grubisic (M.Sc. candidate), Heather Ingo (Honors candidate) and Huang Yingru (Honors candidate)
Organization sponsor: London Health Sciences Centre, University of Western Ontario
Support grants: MITACS Student Internship Grant and Acadia Group Research Development Program Grant

Publications related:
Grubisic, Y. Zhang, P. Cabilio and F. Gwadry-Sridhar (2009). A Mixture Distribution Approach to Assessing Medication Refill Compliance.  Statistics in Biopharmaceutical Research. Accepted subject to revision.

Grubisic, M., Gwadry-Sridhar, F., Nichol, MB., Yu, A., Zhang, Y., and Cabilio, P. (2006). Conceptualization and Validation of A New Metric - Sum of Squares Adherence Index (SSAI) - for Medication Compliance.  The 10th European Symposium on Patient Compliance and Persistence.

Femida H. Gwadry-Sridhar, J. Malcolm O. Arnold, Ying Zhang, at al (2005). A Pilot Study to Determine the Impact of a Multi-Disciplinary Educational Intervention in Patients Hospitalized with Heart Failure, American Heart Journal, November 2005. PDF

Intra-Family Housing Alternatives for Seniors

Abstract: Classic views of senior housing choice have correctly noted that household family size shrinks with age and resources devoted to elderly housing consumption can then be redirected to other areas. The debate is about the best way to undertake this change. The alternatives are numerous: Sell and buy smaller vs. sell and rent smaller are special cases of the rent-or-buy decision. Accumulated home equity may be used for retirement leisure, unexpected expenses associated with health matters or different kinds of elder care. The equity need not be withdrawn or exhausted if various reverse amortization mortgage plans are employed. Moving in with younger family members is often discussed but nearly as often dismissed as unsuitable for a host of reasons, nonetheless it must be included in the mix of options. 

This study looks at an intergenerational solution to the housing problem facing the elderly. It describes how a unique combination of family systems, property rights, investment goals and tax benefits can produce optimal solutions for some families. A theoretical model is presented wherein an older family member optimizes health, housing and bequest options while at the same time in the same transaction a younger family member seeks an optimal investment.

Investigators: Roger Brown (San Diego State University) and Ying Zhang (Math & Stats, Acadia)

Roger Brown and Ying Zhang (2006), Senior Housing: An Inter-Generational Solution, Journal of Housing for the Elderly, Volume 20 (Preprint paper and preprint graphs).