Tuesday, April 17, 2012

All I Ever Wanted To Know About Competing Risks, Administrative Data & Data Quality Assurance

Last Friday, the Health User Group met in Toronto, an occasion which always brings me great joy when it occurs. The Executive Committee is a great mix of savvy SAS supporters who have seen – and survived! – almost everything, and bright young SAS stars who are already making a name for themselves in the world of the SAS Canada Community. The group consistently delivers in terms of potent presenters, engaged audiences, timely and topical questions, and great dialogue. In these respects, last Friday’s meeting didn’t disappoint.

I should mention that we didn’t escape unscathed from the sense of dread which seems to permeate Friday the 13th… for there were a few hiccups in an otherwise very smooth meeting. Overlapping meetings meant that the normally cozy environment of our meeting rooms at SAS Canada threatened to be even more so; the entire company was to be having breakfast in the midst of the registration process! This proved to be a non-factor: in fact, I think some of the attendees did benefit from connecting with some familiar faces on the SAS side. Regardless, it was very tempting to all of us as the smells of the delicious company breakfast wafted over our group. I found myself looking down at my bagel and fruit resignedly as my colleagues filled up on hash browns, bacon and more… not to complain, of course: I guess I was just thinking a bit too much with my stomach early in the morning.

One of the happy consequences of having a company breakfast and lunch around the Health User Group was that we were treated to a slightly different set-up in terms of the meeting space. The normally cramped and confined quarters of rows of chairs gave way to a much more ‘civilized’ arrangement. Tables were provided with groups of 4 chairs at each. This situation afforded people the chance to network and get to know their fellow healthcare SAS practitioners even more than normal… and as a Community Manager, there’s nothing I like to see more than connections being made between people. An obvious secondary benefit: a clear, clean writing surface! This made note-taking easy, and given the strength of all 3 of our presenters, this was undoubtedly a good thing.

The meeting led off with a powerhouse of a presentation. Melania Pintilie of the Ontario Cancer Institute at Princess Margaret Hospital came with the highest possible recommendation from Ruth Croxford, the HUG President. I trust Ruth implicitly in all things, and she certainly hit a home run in lining up Melania to present. Her talk was on competing risks in survival analysis, a topic she knew inside and out, having authored a book on the subject and taught a course or two as well. Her relaxed approach to a very complex topic – as a non-statistician, I felt lucky to understand a small bit of the complex mathematics she explained – was clearly popular with the crowd, an observation which was reflected by the extremely high average mark of appreciation on the evaluation forms. I think Melania managed to shed new light on something many in the room had never considered: that death itself could be considered a competing risk in certain survival analysis models. It certainly provoked many questions… and even more nervousness from a few of the attendees I chatted with afterwards! It was clear that the insight they received had caused them to rethink the accuracy of their own models, and many were grateful for the shift in perspective. I’m curious to see if there is any future feedback on how their model accuracy has improved. Melania’s talk was a tough act to follow, but Simon Tavasoli of CIHI managed to do so… in spades.

Simon is a fascinating individual. Well-educated, well-spoken and clearly well-versed in database administration, he is part of a ‘tactical data squad’ which is tasked with performing quick, short turnover data pulls and analysis. Who better to talk about efficiencies in administrative data? Simon has seen and done it all. His talk was comprehensive and even more importantly, comprehensible. Progressing through many elements of SAS programming, Simon clearly demonstrated how proper syntax, thinking through the structured order of a SAS statement and streamlining database processing could clearly improve wait time on job completion. He almost took a step-wise approach to data steps, if that makes sense. Even for a moderately skilled programmer such as myself, the tips and tricks he shared were ones which I could embrace and call forth in the future. Great talk, Simon!

Finally, we were treated to Mahmoud Azimaee of ICES talking about data quality assurance: a perfect progression from the previous efficiency-based talk. Mahmoud has graced the SAS Global Forum stage with a more in-depth version of the technical aspects of this talk… and it was a treat for me to see the theory behind the practice. He is a very gifted speaker; affable, intelligent, and well-polished. Of course, his knowledge in this space is second to none as well! In a perfectly timed talk he was able to lay out the vision of the Manitoba Centre for Health Policy’s data quality approach, the progression to how they determined their needs, process and practice, and offered many resources and contacts along the way. Given the feedback on the evaluation forms many of the attendees were also impressed with Mahmoud’s thoroughness, and many were looking forward to taking a closer look at his presentation.

All in all, the meeting was a great success. The attendees seemed to be extremely happy with the presentations and I was thrilled with the engagement and synergies flowing between the attendees, presenters and myself. I echo one of the comments on the evaluation which said ‘I wish these meetings could happen over weekends: there’s so much to learn!’. Next up for me: Quebec City, home of my favourite poutine in the world as well as some of my favourite users. I’ll have more on that meeting upcoming…. And of course, SAS Global Forum!

Until then….

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