Statistical Modelling 13 (3) (2013), 253–274

Adaptive change-point mixed models applied to data on outpatient tetracycline use in Europe

Girma Minalu
Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT),
Hasselt University,
Belgium


Marc Aerts
Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT),
Hasselt University,
Belgium
eMail: marc.aerts@uhasselt.be

Samuel Coenen
Vaccine & Infectious Disease Institute (VAXINFECTIO),
Centre for General Practice,
University of Antwerp,
Belgium


Ann Verspoten
Laboratory of Medical Microbiology,
Vaccine & Infectious Diseases Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Arno Muller
Laboratory of Medical Microbiology,
Vaccine & Infectious Diseases Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Niels Adriaenssens
Laboratory of Medical Microbiology,
Vaccine & Infectious Diseases Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Philippe Beutels
Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID),
Centre for the Evaluation of Vaccination,
Vaccine and Infectious Disease Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Geert Molenberghs
Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT),
Catholic University of Leuven,
Belgium


Herman Goosens
Laboratory of Medical Microbiology,
Vaccine & Infectious Diseases Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Niel Hens
Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID),
Centre for the Evaluation of Vaccination,
Vaccine and Infectious Disease Institute (VAXINFECTIO),
University of Antwerp,
Belgium


Abstract:

In this paper, we propose a change-point mixed model to assess the change in the trend of outpatient antibiotic use in a Bayesian framework, where the change-points are unknown parameters of the model. Model selection using DIC indicates that the data supports the model with a country-specific change-point. The location of the change-points may be related to points in time where public health strategies aiming at increasing the awareness of the public to a more rational use of antibiotics or targeting to reduce overconsumption of antibiotics were initiated.

Keywords:

amplitude; antibiotic use; change-point model; non-linear model; phase shift; seasonal variation
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