Application of mixed-effects models to study the country-specific outpatient antibiotic use in Europe: a tutorial on longitudinal data analysis
Application of mixed-effects models to study the country-specific outpatient antibiotic use in Europe: a tutorial on longitudinal data analysis
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DOI：
10.1093/jac/dkr460
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发表时间：
2011-12-01
影响因子：
5.2
通讯作者：
Hens, Niel
中科院分区：
文献类型：
--
作者：
Minalu, Girma;Aerts, Marc;Hens, Niel
抗生素耐药性是一个重大的公共卫生问题，人们越来越认识到抗生素的使用是导致这种耐药性的主要选择压力。欧洲抗菌素消费监测（ESAC）项目分别从33个和27个欧洲国家收集了1997-2009年期间门诊抗生素使用的年度和季度数据，并以每天每1000名居民的确定日剂量表示。由于对这些国家采取了重复的措施，因此在分析数据时必须考虑到相关性。本文阐述了混合效应模型在欧洲国家特异性门诊抗生素使用研究中的应用。混合模型在生物医学、物理和社会科学的各种学科中都很有用。在门诊抗生素使用的应用中，线性混合模型扩展为非线性混合模型，允许在全球趋势之上分析季节性变化，对全球平均使用量和幅度以及使用量和幅度随时间的趋势具有国家特定影响。
Resistance to antibiotics is a major public health problem and antibiotic use is being increasingly recognized as the main selective pressure driving this resistance. Yearly and quarterly data on outpatient antibiotic use were collected by the European Surveillance of Antimicrobial Consumption (ESAC) project for the period 1997-2009 from 33 and 27 European countries, respectively, and expressed in defined daily doses per 1000 inhabitants per day. Since repeated measures were taken for the countries, correlation has to be taken into account when analysing the data. This paper illustrates the application of mixed-effects models to the study of country-specific outpatient antibiotic use in Europe. Mixed models are useful in a wide variety of disciplines in the biomedical, physical and social sciences. In this application for outpatient antibiotic use, the linear mixed model is extended to a non-linear mixed model, allowing analysis of seasonal variation on top of a global trend, with country-specific effects for global mean use and amplitude, and trends over time in use and in amplitude.