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Spatial Clustering of Scleroderma in Three Michigan Counties

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Title: Spatial Clustering of Scleroderma in Three Michigan Counties


1
Spatial Clustering of Scleroderma in Three
Michigan Counties
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  • The Toledo Twins
  • Sharon HensleyAlford
  • Sarah Ann Cleveland

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2
?Background?
  • The disease that turns people to stone
  • Chronic, connective tissue disease
  • Unknown cause
  • Collagen accumulation in some organs
  • Classifications
  • Localized
  • Systemic

3
?Who has scleroderma?
  • Approximately 150,000 people in the United States
  • 4 times more women than men

4
?Symptoms May Include?
  • Raynauds 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

5
?Diagnosis?
  • Difficult
  • Involvement of several specialists
  • May take months to years

6
?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.

7
?Age Distribution of Cases?
8
?Sex Distribution?
  • 134 Females
  • 37 Males
  • 3.62 times more females than males

9
?Etiologies?
  • UNKNOWN
  • Possibilities include
  • silica dust
  • vinyl chloride monomer
  • pet ownership
  • some solvents
  • appetite suppressants

10
?Significance?
  • To Explore...
  • Environmental associations
  • Spatial pattern ? Disease process

11
?Materials?
  • Disease Data
  • Incidence data for 1989-1991 (N171)
  • Three counties
  • Macomb
  • Oakland
  • Wayne
  • Population Data
  • 1990 Census data
  • Block and Tract divisions

12
?Methods?
  • Gathering population data
  • Finding census data
  • Extract pertinent information
  • Geocoding cases
  • ArcView Batch Match
  • Digitizing unmatched cases

13
? 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

14
?Matching Rate?
171 Original
5 Unmatchable Addresses n166
161 Matched/166 Total 96 Matching Rate
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18
?Statistical Analysis?
  • Null Hypothesis No spatial clustering
  • Alter. Hypothesis Spatial clustering
  • Test statistic Ipop, Morans I
  • Statistical Program STAT!

19
?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
  • EI -0.0000014
  • within 99.9752702
  • among 0.0247298

20
?Macomb/Block?
  • STAT 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
  • EI -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)

21
?Oakland/Tracts?
  • STAT Output 4/13/1999
  • Results from Ipop test
  • Number of runs 99
  • Ipop calculations
  • Population (x) 1101540
  • Ipop 0.0000033
  • Ipop' 0.0817093
  • EI -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)

22
?Oakland/Blocks?
23
?Wayne/Tracts?
  • STAT 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
  • EI -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)

24
?Wayne/Blocks?
25
?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

26
?Thank You?
  • First Honors Andy Long
  • Mark Wilson
  • Dr. Mayes
  • Geoff Jacquez
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