IAN COOKE

Homework 08 due Monday 2014-11-10

Class 12 (Part 1: 1.a-h, 2.a-e; Part 2: 1.a-g)
Part 1: 1.a-h
In a case-control study on the associations of risk factors for the presence of aortic stenosis,
investigators examined the association between aortic stenosis and smoking.
The file stenosis.dta is a Stata data file containing data on aortic stenosis, smoking, and gender.
The variable disease is a binary variable coded 1 if the participant has aortic stenosis and 0
otherwise. The variable smoke is a binary variable for smoking, and the variable sex is a binary
variable coded 1 for men, and 0 for women. The data file also contains the product of these two
variables labeled sex_smoke.
1. Use Stata and this data file to do the following:
a) Obtain the 2 x 2 table for the association between aortic stenosis (disease) and smoking
(smoke) in men and women separately. Treat disease as the outcome variable and smoke
as the exposure variable and use woolf option to report the Woolf approximation for the 95%
confidence interval.
0 = woman
1 = man

b) Obtain test for homogeneity of the gender-specific odds ratios, the Mantel-Haenszel
combined odds ratio, and the results of the test of the hypothesis that there is no association
between smoking and aortic stenosis after adjusting for gender. (Hint: use by(sex))

c) What are the odds of aortic stenosis in smokers? Show which frequencies you used.

Odds of aortic stenosis in smokers = 51/43 = 1.186

d) What are the odds of aortic stenosis in non-smokers? Show which frequencies you used.
Odds of aortic stenosis in non-smokers = 54/67 = 0.806
e) What are the odds of aortic stenosis in smokers relative to the odds in nonsmokers for each
gender?
OR women: 1.194
OR men: 1.233
f) Do either of the odds ratios in e) differ significantly from 1.0? Explain your answer.
No, neither of these odds ratios differs significantly from 1.0 because neither p value is
<0.05
g) State the null and alternative hypothesis for the test of homogeneity? What does p-value for
this test tell you?
H0 = OR(female) = OR(male)
H1 = OR(female) is significantly different than OR(male)
P = 0.956
Since p is not less than 0.05, we accept our null hypothese; there is no significant
difference between rates of aortic stenosis among male and female smokers.
h)

What is the Mantel-Haenszel estimate of the combined odds ratio and its corresponding
95% confidence interval? Does this odds ratio differ significantly from 1.0? Justify your
answer.

The M-H estimate of the combined OR is 1.215, and its corresponding 95% CI is 0.6882.146. Since p = 0.504, this difference is not significant, and we can not say that this
odds ratio differs significantly from 1.0.
Part 1: 2.a-e
2. Use Stata and stenosis.dta to do the following:
a) Obtain the logistic regression of disease on smoke and sex. Obtain the output presenting
the regression coefficient, and the output presenting the odds ratio.

b) What is the odds ratio for smoke and what does it mean?
The odds ratio for smoke is 1.215. This indicates that someone with aortic stenosis is
1.215 times as likely to have smoked as someone without aortic stenosis.
c) How does the odds ratio for smoke and its 95% confidence interval compare with the
Mantel-Haenszel combined estimates of the odds ratio and 95% confidence interval?
The odds ratio for the M-H combined estimate is 1.215 with a confidence interval of 0.6882.146.
The odds ratio for the logistic regression is 1.215 with a confidence interval of 0.6882.146
They are basically identical.
d) Is sex significantly related to disease, with adjustment for smoking? Justify your answer.
Yes, sex is significantly related to disease with adjustment for smoking. The OR for sex
while holding smoking constant was 2.054 with a 95% CI of 1.168-3.613 and a p value
of 0.012. Based on the significant p value, the odds ratio was significantly different
than 1.0, and thus sex was related to disease.
e) Add sex_smoke to the model containing sex and smoke. Does this model indicate that
there is a significant interaction between gender and smoking in relation to aortic stenosis?
How does the p-value for this variable compare to that of the M-H test of homogeneity?
Justify your answer.

Based on this model, there is no significant interaction between gender and smoking in
relation to aortic stenosis. The OR for sex_smoke is 1.032 and the p-value is 0.956
(not significant).
The M-H p value was also identical to the p value found here (0.956). See table above.

Part 2: 1.a-e
The Chicago Heart Association Detection Project in Industry is a cross-sectional and
prospective investigation of 39,572 young adult and middle-aged men and women screened
from November, 1967 to January, 1973 in 84 cooperating companies and organizations in
Chicago. Screenees have been followed annually for assessment of vital status, i.e., to
determine whether or not each person is alive or dead. Variables measured at baseline have
been examined for their relationship with cause specific mortality as well as mortality from all
causes.
The file chaf2.dta is a Stata data file containing baseline data for women ages 40-59 on age,
body mass index, systolic blood pressure, total cholesterol, presence of diabetes (yes or no),
heart rate, serum uric acid, number of cigarettes smoked per day, as well as follow-up data on
whether or not the woman died of coronary heart disease between the baseline exam and
12/31/95 (CHD_DTH).
1. Use Stata and this data file to do the following:
a) Obtain the logistic regression of chd_dth on age (age), body mass index (bmi), total
cholesterol (chol), systolic blood pressure (sbp), diabetes (diabetes), heart rate (hrate),
serum uric acid (uric), and number of cigarettes smoked per day (ncig) with mortality from
coronary heart disease over an average of 25 years of follow-up. Obtain the output
presenting the regression coefficient, and the output presenting the odds ratio by clicking on
Reporting and asking Stata to report the odds ratio.

b) Which baseline variables are significantly related to CHD death? Use =0.05.
all of the baseline variables tested were significantly related to CHD death at =0.05.
c) Which variables are not significantly related to CHD death? Use =0.05.
See above. All of the baseline variables tested were significantly related to CHD death at
=0.05.
d) Which variable has the smallest p-value for the association with CHD death?
Age, bmi, diabetes and ncig all had p-values less than 0.001.
e) What is the odds ratio for the association of diabetes with CHD death? Interpret the odds
ratio.
The OR is 2.522. People with the outcome (CHD death) were 2.522 times more likely to
have had diabetes than people without CHD death.
f) What is the odds ratio corresponding to cigarette smoking higher by 10 cigarettes/day and its
95% confidence interval for the odds ratio? Show the calculation and check your results
using the lincom command.

ln(OR) = .0406
OR (10 units) = e.0406x10= 1.5008
95% CI for OR (10 units) = [exp(10 (b1 1.96 se(b1)), exp(10 (b1 +1.96 se(b1))]
= [exp(10 (.0406 (1.96 .00525)), exp(10 (.0406 +(1.96 .00525))]
= [exp(10 .03031), exp(10 .05089)]
= [exp(.3031), exp(.5089)]
= [1.35 ; 1.6634]

g) Can you think of reasons why logistic regression may not be an appropriate means of
analyzing the associations with CHD death?
Logistic regression is not always an appropriate means of analyzing the associations
because some of the values are stored in binary variables which doesnt make sense to
look at logistically.