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Journal Article

Citation

Zubizarreta JR, Cerdá M, Rosenbaum PR. Epidemiology 2013; 24(1): 79-87.

Affiliation

From the aDepartment of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, PA; and bDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/EDE.0b013e318277367e

PMID

23222557

Abstract

In 2010, a magnitude 8.8 earthquake hit Chile, devastating parts of the country. Having just completed its national socioeconomic survey, the Chilean government reinterviewed a subsample of respondents, creating unusual longitudinal data about the same persons before and after a major disaster. The follow-up evaluated posttraumatic stress symptoms (PTSS) using Davidson's Trauma Scale. We use these data with two goals in mind. Most studies of PTSS after disasters rely on recall to characterize the state of affairs before the disaster. We are able to use prospective data on preexposure conditions, free of recall bias, to study the effects of the earthquake. Second, we illustrate recent developments in statistical methodology for the design and analysis of observational studies. In particular, we use new and recent methods for multivariate matching to control 46 covariates that describe demographic variables, housing quality, wealth, health, and health insurance before the earthquake. We use the statistical theory of design sensitivity to select a study design with findings expected to be insensitive to small or moderate biases from failure to control some unmeasured covariate. PTSS were dramatically but unevenly elevated among residents of strongly shaken areas of Chile when compared with similar persons in largely untouched parts of the country. In 96% of exposed-control pairs exhibiting substantial PTSS, it was the exposed person who experienced stronger symptoms (95% confidence interval = 0.91-1.00).


Language: en

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