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Dissertation
Misclassification and biased estimates of adult hepatitis B immune prevalence in the United States
Doctor of Philosophy (Ph.D.), Drexel University
May 2020
DOI:
https://doi.org/10.17918/00000997
Abstract
Two key measures used to estimate the prevalence of immunity to hepatitis B virus among adults in the United States are self-reported vaccination and antibody to hepatitis B surface antigen. Both of these may be thought of as surrogate measures of immunity to hepatitis B virus given that they do not directly measure immunity itself. Misclassification of immune status when using these measures may lead to incorrect estimates of hepatitis B immunity in the U.S., and the impact of this misclassification may be greater in some demographic groups than others. This dissertation is presented in a three-paper format, starting with broad questions about misclassification and moving to increasingly narrow questions. Aim 1 investigates shared patterns of misclassification across multiple self-reported health conditions. We conceptualize these patterns as being associated with one another through latent classes of response, and use latent class analysis to examine whether observed patterns match our hypothesis. Aim 2 uses national survey data and a Bayesian approach to misclassification correction to re-estimate the prevalence of immunity to hepatitis B virus in the United States. Finally, Aim 3 investigates the prevalence of immunity to hepatitis B virus among Asian Americans and Pacific Islanders living in the Philadelphia area. In both Aim 2 and Aim 3, the impact of bias on estimates of immunity within different demographic subgroups is compared.
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Details
- Title
- Misclassification and biased estimates of adult hepatitis B immune prevalence in the United States
- Creators
- Daniel Timothy Vader
- Contributors
- Alison A. Evans (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xi, 143 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics; Drexel University
- Other Identifier
- 991014695542304721