CHESS-IMS Summer school · CHESS-IMS Summer school . A ‘joint venture’ between the CHESS postgraduate programme and the Institutional-collaboration programme between CHESS and

CHESS-IMS Summer school

A ‘joint venture’ between the CHESS postgraduate programme and the Institutional-collaboration programme between CHESS and IMS*.

10-21 August 2009

*The STINT-Institutional Grants Programme is intended to develop collaboration and exchange between researchers at CHESS and Institute of social medicine (IMS) at the UERJ University in Rio de Janeiro, Brazil, and the project leaders are Professors Johan Fritzell at CHESS and Antonio Ponce de Leon at IMS.

CHESS-IMS Summer School 2009 It is a great pleasure to invite you to the first CHESS-IMS Summer School in August 10-21, 2009. The Summer School is based on the Institutional Collaboration between Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro and Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet and organised as a joint venture between CHESS postgraduate programme (forskarskola sponsored by FAS) and an Institutional Grants Programme (sponsored by STINT). We offer three courses: “Multilevel modelling” (Ponce de Leon), “Scaling theory” (Reichenheim) and “Introduction to the statistical software R” (Leite Junger) and we are especially glad to introduce our three main lecturers: Antonio Ponce de Leon received his PhD in Statistics from London School of Economics and is presently professor at the Department of Epidemiology, IMS and is also affiliated to Karolinska Institutet and to CHESS. Michael Reichenheim received his PhD in Epidemiology from London School of Hygiene and Tropical Medicine and is presently professor and head of the Department of Epidemiology, IMS. Washington Leite Junger, received his PhD in Public Health at IMS and has now a position as professor adjunto, at the Department of Epidemiology, IMS. All courses take place at Sveaplan, Sveavägen 160. In the following pages you can find short information on objectives, schedules and essential readings for the courses. Those who satisfactorily complete a course will receive a Course Certificate. More detailed information about social events will be given when the school begins – coffee at the breaks will be served at CHESS, 5th floor, Sveaplan. If you have questions please do not hesitate to ask Jennie Bacchus Hertzman 08-674 7988, [email protected] . We look forward seeing everyone in August. Johan Fritzell, Susanna Toivanen and Jennie Bacchus Hertzman

mailto:[email protected]

Preliminary Schedule Time Mon Aug 10 Tue Aug 11 Wed Aug 12 Thu Aug 13 Fri Aug 1409:00 – 10:00

Lecture- Scaling Theory

Lecture- Multilevel modelling



10:00 – 10:20

Gathering and Coffe at CHESS

5th floor, SveaplanCoffee break Coffee break Coffee break Coffee break

10:20 – 12:00 Introduction Lecture-

Scaling Theory




12:00 – 13:00

LUNCH LUNCH LUNCH LUNCH LUNCH

13:00 – 14:40






14:40 – 15:00

Coffee break Coffee break Coffee break Coffee break Coffee break

15:00 – 17:00





Lecture & Examination-

Scaling Theory 17:30 – Social event

Time Mon Aug 17 Tue Aug 18 Wed Aug 19 Thu Aug 20 Fri Aug 2109:00 – 10:00


Lecture-Introduction to R




10:00 – 10:20


10:20 – 12:00






12:00 – 13:00

LUNCH LUNCH LUNCH LUNCH LUNCH

13:00 – 14:40






14:40 – 15:00


15:00 – 17:00 Lecture-

Introduction to R



Lecture & Introduction to R

Lecture & Examination-

Multilevel modelling

17.30 – Social event

Multilevel Modelling

Antonio Ponce de Leon 10-21 August 2009

In this course the basics of multilevel modelling will be covered, starting with the motivation for modelling data with hierarchical structures using mixed effects models (fixed and random effects) as opposed to only fixed effect models (ordinary generalised linear modelling). Models for continuous and discrete data are to be approached and illustrated. Further multilevel concepts are to be discussed, including the role of upper level residuals, variance functions, and variance partition. The software MLwiN 2.10 will be used throughout the course. Depending on the interest, R packages are also to be used for modelling hierarchical data. More advanced techniques will be introduced towards the end of the course, e.g. using the bootstrap for bias correction, multinomial logistic modelling with random effects, modelling multiple responses, and modelling panel data / longitudinal responses, especially rates. Textbooks:

1. T. Snijders & R. Bosker (1999). Multilevel Analysis. SAGE Publications More information about this book, including the data sets that are used to illustrate some methods, can be found at the following site: http://stat.gamma.rug.nl/snijders/mlbook1.htm

2. Joop Hox (2002). Multilevel analysis: techniques and applications. Lawrence

Erlbaum Associates. Articles:

1. Harvey Goldstein (2007). Becoming familiar with multilevel modeling. Significance, 4(3), pp. 133-135.

2. Alastair Leyland & Peter Groenewegen (2003). Multilevel modeling and

public health policy. Scan J Public Health 31, pp. 267-274.

3. Harvey Goldstein, William Browne & Jon Rasbash (2002). Multilevel modeling of medical data. Statistics in Medicine, 21, pp. 3291-3315.

4. Diez Roux, A.V. 2002. “A glossary for multilevel analysis”, J Epidemiol

Community Health, 56: 588-94.

http://stat.gamma.rug.nl/snijders/mlbook1.htm

Schedule - Multilevel modellingDate Schedule Topics Reading

Tue 11-aug

13:00-14:40 Introduction to ML: Hierarchical data; OLS vs. ML models; software. Textbooks and articles.

15:00-17:00 Continuous Outcomes: Fixed vs. Random Effects; Empty Model and ICC; Random Intercept Models; Centring variables; Significance Tests for Fixed Effects.

Textbooks

Wed 12-aug 9:00-10:00

Introduction to MLwiN: Entering data; Worksheet; Equation window; Hierarchy Viewer; Basic statistics window. Fitting classical and random intercept models; calculate window; practice with own data.

MLwiN Manual

10:20-12:00 Continuous outcomes: Model predictions; Multilevel residuals; Ransom slope models; Cross level interactions; Significance Tests for Random Effects.

Textbooks

Thu 13-aug

13:00-14:40 Introduction to GLM: Linear Predictor; Link Function; Continuous Outcomes; Binary data – Logistic; Count data – Poisson .

Textbooks

15:00-17:00Tutorial: Fitting Random Slope Models; Assessing Model Fit; Deviance tests; Variance Function. MLwiN Manual

Mon 17-aug

9:00-10:00 Tutorial: Residual diagnostics; More MLwiN windows; Graphic facilities; practice with own data. MLwiN Manual

10:20-12:00 Discrete outcomes: Count data; Poisson model; Normal approximation: Incidence and Offset; Parameter interpretation; overdispersion.

Textbooks

Tue 18-aug 13:00-14:40

Binary outcomes: Logistic Regression; Logit and Odds Ratio; Other link functions; Parameter interpretation; Multilevel logistic regression; multinomial logistic regression..

Textbooks

15:00-17:00 “Contextual analyses: theoretical debates”, Johan Fritzell and Maria L. Kölegård.

Fri 21-aug

9:00-10:00 Tutorial: Fitting count data; Offset, log link and risk; assessing overdispersion; predictions; anti-logit; residuals and plots.

MLwiN Manual

10:20-12:00 Fitting binary data: MQL/PQL; 1st/2nd; graphic facilities; practice with own data. MLwiN Manual

13:00-14:40Binary outcomes: contextual effects; random intercept model; random slope model; Overdispersion; Predictions; Residuals.

Textbooks

15:00-17:00Tutorial: fitting binary data; assessing overdispersion; predictions and residuals; practice with own data. Examination.

MLwiN Manual

Departamento de Epidemiologia

Scaling theory

Measurement scales: Development and cross-cultural adaptation

Michael E. Reichenheim

10-14 August 2009 A common feature of health research is the use of various health measurement scales. This course will introduce the students to two important aspects regarding measurement tools for applied research: first, the development of new instruments, i.e., mapping new latent constructs; and second, the issue of cross-culturally adapting established instruments to other socio-linguistic and cultural settings. In order to evaluate the quality of newly developed instruments or their adaptations we have to consider a number of different steps. The course will go through several operational stages, starting from transforming theory to an empirical framework (including, item identification), to internal and external evaluation and the final decision as to whether the instrument is effectively ready for use in a particular setting. Several analysis procedures are involved in the process and presented along the way. Main literature: Streiner, D. L. & Norman, G. R., 2008. Health measurement scales. A practical guide to their development and use. (4 ed.). Oxford: Oxford University Press.

Additional literature (Scaling theory) Behling, O. & Law, K. S., 2000. Translating questionnaires and other research instruments: problems and

solutions. (Vol. 133). Thousand Oaks, CA: Sage Publications, pp. 1-70.

Brown, T. A., 2006. Confirmatory Factor Analysis for Applied Research. New York: The Guilford Press.

Embretson, S. E. & Reise, S. P., 2000. Item response theory for psychologists. Maheah, New Jersey: Lawrence Erlbaum Associates, Publishers.

Guillemin, F.; Bombardier, C. & Beaton, D., 1993. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. Journal of Clinical Epidemiology, 46:1417-1432.

Herdman, M.; Fox-Rushby, J. & Badia, X., 1997. "Equivalence" and the translation and adaptation of health-related quality of life questionnaires. Quality of Life Research, 6:237-247.

Herdman, M.; Fox-Rushby, J. & Badia, X., 1998. A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach. Quality of Life Research, 7:323-335.

Kline, R. B., 2005. Principles and practice of structural equation modeling. (2 ed.). London: The Guilford Press.

Moraes, C. L. & Reichenheim, M. E., 2002. Cross-cultural measurement equivalence of the Revised Conflict Tactics Scales (CTS2) Portuguese version used to identify violence within couples. Cadernos de Saúde Pública, 18:783-796.

Pett, M. A.; Lackey, N. R. & Sullivan, J. J., 2003. Making sense of factor analysis: the use of factor analysis for instrument development in health care research. Thousand Oaks, Ca: Sage Publication Ltd.

Regan, K. V.; Bartholomew, K.; Oram, D. & Landolt, M. A., 2002. Measuring Physical Violence in Male Same-Sex Relationships: An Item Response Theory Analysis of the Conflict Tactics Scales. Journal of Interpersonal Violence, 17:235-252.

Reichenheim, M. E.; Klein, R. & Moraes, C. L., 2007. Assessing the physical violence component of the Revised Conflict Tactics Scales when used in heterosexual couples: An item response theory analysis. Cadernos de Saúde Pública, 23:53-62.

Reichenheim, M. E. & Moraes, C. L., 2007. Operationalizing the cross-cultural adaptation of epidemiological measurement instruments (text in English: http://www.scielo.br/pdf/rsp/v41n4/en_6294.pdf). Revista de Saúde Pública, 41:665-673.

Reichenheim, M. E.; Paixão Jr., C. M. & Moraes, C. L., 2009. Reassessing construct validity of a Brazilian version of the instrument Caregiver Abuse Screen (CASE) used to identify risk of domestic violence against the elderly. Journal of Epidemiological Community Health:(in press).

Rothman, K. J.; Greenland, S. & Lash, T. L., 2008. Modern Epidemiology. (3 ed.). Philadelphia, PA: Lippincott Williams & Wilkins, pp. 851.

Sijtsma, K. & Molenaar, I. W., 2002. Introduction to nonparametric item response theory. Thousand Oaks: Sage Publications, Inc.

Wilson, M., 2005. Constructing measures. An item response modeling approach. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers.

http://www.scielo.br/pdf/rsp/v41n4/en_6294.pdf)

Date Schedule Topics Suggested supporting literature

10/8

13:00-14:40

• Greetings / Introduction to the course• First things first: • Rothman, Greenland & Lash, 2008

Information validity as one of the pillars of overall validity in (epidemiological) research

• Streiner & Norman, 2008, ch. 2

Important definitions (syntax, nomenclature, notations) ‘Dimensional’ vs . ‘pragmatic’ intruments

15:00-17:00

Deciding: to develop a new instrument or cross-culturally adapt existing ones?

11/89:00-10:00

• Development of new instruments 1: from theory to prototypes • Streiner & Norman, 2008, ch. 3 - 7 Specifying the construct map: ‘transposing’ theory to an empirical framework • Wilson, 2005

Specifying the item design: developing and refining semantics Specifying the outcome space: item categorization

10:20-12:00

Pre-testing and proposing prototypes (for further testing)

12/8

13:00-14:40

• Development of new instruments 2: specifying and evaluating the measurement model - Preliminaries

• Streiner & Norman, 2008, ch. 8 - 10

Reliability Validity

15:00-17:00

• Development of new instruments 3: specifying and evaluating the measurement model - ‘internal validity’ (incl. overview of EFA and CFA)

• Pett, Lackey & Sullivan, 2003

Corroborating dimensionality • Brown, 2006 Evaluating item measurement errors • Kline, 2005, ch. 4 and 7 Scrutinizing method effects / item redundancy (error correlations) • Reichenheim, Paixão Jr. & Moraes, 2009 (example study)

Evaluating internal consistency (factorial and by proxy) Corroborating dimensional (scale) convergent validity Corroborating dimensional (scale) discriminant validity

Date Schedule Topics Suggested supporting literature

13/8

9:00-10:00

• Development of new instruments 4: specifying and evaluating the measurement model - ‘internal validity’ (cont., incl. overview of IRT)

• Embretson & Reise, 2000

Corroborating item ‘discriminability’ • Wilson, 2005 Scrutinizing item positioning vis-à-vis latent trace • Sijtsma & Molenaar, 2002, ch. 4 Scrutinizing information (latent trace) coverage • Streiner & Norman, 2008, ch. 12 Scrutinizing universality (differential item function across subgroups) • Reichenheim, Klein & Moraes, 2007 (example study) Evaluating scalability • Regan et al., 2002 (example study) Evaluating reliability via scale temporal stability Evaluating reliability via scale inter-rater stability

10:20-12:00

• Development of new instruments 5: specifying and evaluating the measurement model - ‘external (content) validity’

• Streiner & Norman, 2008, ch. 10

Scrutinizing theoretical adequacy via construct validity studies Scrutinizing theoretical adequacy via criterion validity studies

14/8

9:00-10:00

• Cross-cultural adaptation process: views • Reichenheim & Moraes, 2007• Cross-cultural adaptation process: operational steps • Herdman, Fox-Rushby & Badia, 1997

Conceptual (theoretical) equivalence • Herdman, Fox-Rushby & Badia, 1998 Item equivalence • Guillemin, Bombardier & Beaton, 1993 Operational equivalence • Behling & Law, 2000 Semantic equivalence • Reichenheim, Klein & Moraes, 2007 (example study) Measurement equivalence • Moraes & Reichenheim, 2002 (example study)

10:20-12:00

Functional equivalence

13:00-14:40

• STARD initiative (a quick appraisal of ...) • Streiner & Norman, 2008, ch. 15

15:00-17:00

• Examination

Introduction to the statistical software ‘R’

Washington Leite Junger 17-20 August 2009

R is a free, open-source, and cooperatively developed environment for statistical programming and computing. The purpose of this course is to get the students started using R. The course will cover the introductory aspects of using R in basic statistical analysis. Main literature: Dalgaard, Peter, 2008. Introductory Statistics with R. (2ed.). Springer, New York.

Schedule - Introduction to the statistical software 'R'

Date Schedule Topics Reading

Mon 17-aug

13:00-14:40

Basics Introductory Statistics with R 2nd ed., chapter 1, sections 1.2 and chapter 2, section 2.1

15:00-17:00

Data managementIntroductory Statistics with R 2nd ed., chapter 2, section 2.4 and chapter 10

Tue 18-aug

9:00-10:00 Descriptive StatisticsIntroductory Statistics with R 2nd ed., chapter 4, sections 4.1 and 4.3

10:20-12:00

Tables and Correlation Introductory Statistics with R 2nd ed., chapter 4, section 4.5 and chapter 6, section 6.4

Wed 17-aug

9:00-10:00 Graphics IIntroductory Statistics with R 2nd ed., chapter 4, sections 4.2, 4.4, and 4.6

10:20-12:00

Graphics II

13:00-14:40

Regression Models IIntroductory Statistics with R 2nd ed., chapters 6, 11, and 12

15:00-17:00

Regression Models II

Thu 18-aug

9:00-10:00 Logistic Regression IIntroductory Statistics with R 2nd ed., chapter 13

10:20-12:00

Logistic Regression II

13:00-14:40

Survival Analysis IIntroductory Statistics with R 2nd ed., chapter 14

15:00-17:00

Survival Analysis II and Beyond

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CHESS-IMS Summer school · CHESS-IMS Summer school . A ‘joint venture’ between the CHESS postgraduate programme and the Institutional-collaboration programme between CHESS and