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Congestive heart failure (CHF) is a leading cause of morbidity, mortality and healthcare costs, impacting $>$23 million individuals worldwide. Large electronic health records data provide an opportunity to improve clinical management of diseases, but statistical inference on large amounts of relevant personal data is still challenging. Thus, accurately identifying influential risk factors is pivotal to reducing information dimensionality. Bayesian variable selection in survival regression is a common approach towards solving this problem. Here, we propose placing a beta prior directly on the model coefficient of determination (Bayesian $R^2$), which induces a prior on the global variance of the predictors and provides shrinkage. Through reparameterization using an auxiliary variable, we are able to update a majority of the parameters with Gibbs sampling, simplifying computation and quickening convergence. Performance gains over competing variable selection methods are showcased through an extensive simulation study. Finally, the method is applied in a mediation analysis to identify community context attributes impacting time to first congestive heart failure diagnosis of patients enrolled in University of North Carolina Cardiovascular Device Surveillance Registry. The model has high predictive performance and we find that factors associated with higher socioeconomic inequality increase risk of heart failure.

Observations of groundwater pollutants, such as arsenic or Perfluorooctane sulfonate (PFOS), are riddled with left censoring. These measurements have impact on the health and lifestyle of the populace. Left censoring of these spatially correlated observations are usually addressed by applying Gaussian processes (GPs), which have theoretical advantages. However, this comes with a challenging computational complexity of $\mathcal{O}(n^3)$, which is impractical for large datasets. Additionally, a sizable proportion of the data being left-censored creates further bottlenecks, since the likelihood computation now involves an intractable high-dimensional integral of the multivariate Gaussian density. In this article, we tackle these two problems simultaneously by approximating the GP with a Gaussian Markov random field (GMRF) approach that exploits an explicit link between a GP with Mat\'ern correlation function and a GMRF using stochastic partial differential equations (SPDEs). We introduce a GMRF-based measurement error into the model, which alleviates the likelihood computation for the censored data, drastically improving the speed of the model while maintaining admirable accuracy. Our approach demonstrates robustness and substantial computational scalability, compared to state-of-the-art methods for censored spatial responses across various simulation settings. Finally, the fit of this fully Bayesian model to the concentration of PFOS in groundwater available at 24,959 sites across California, where 46.62\% responses are censored, produces prediction surface and uncertainty quantification in real time, thereby substantiating the applicability and scalability of the proposed method. Code for implementation is made available via GitHub.

Understanding the effects of interventions, such as restrictions on community and large group gatherings, is critical to controlling the spread of COVID-19. Susceptible-Infectious-Recovered (SIR) models are traditionally used to forecast the infection rates but do not provide insights into the causal effects of interventions. We propose a spatiotemporal model that estimates the causal effect of changes in community mobility (intervention) on infection rates. Using an approximation to the SIR model and incorporating spatiotemporal dependence, the proposed model estimates a direct and indirect (spillover) effect of intervention. Under an interference and treatment ignorability assumption, this model is able to estimate causal intervention effects, and additionally allows for spatial interference between locations. Reductions in community mobility were measured by cell phone movement data. The results suggest that the reductions in mobility decrease Coronavirus cases 4 to 7 weeks after the intervention., Comment: 25 pages, 1 figure, 3 tables

Unobserved spatial confounding variables are prevalent in environmental and ecological applications where the system under study is complex and the data are often observational. Instrumental variables (IVs) are a common way to address unobserved confounding; however, the efficacy of using IVs on spatial confounding is largely unknown. This paper explores the effectiveness of IVs in this situation -- with particular attention paid to the spatial scale of the instrument. We show that, in case of spatially-dependent treatments, IVs are most effective when they vary at a finer spatial resolution than the treatment. We investigate IV performance in extensive simulations and apply the model in the example of long term trends in the air pollution and cardiovascular mortality in the United States over 1990-2010. Finally, the IV approach is also extended to the spatial interference setting, in which treatments can affect nearby responses., Comment: 27 pages, 5 figures, 9 tables

The scientific rigor and computational methods of causal inference have had great impacts on many disciplines, but have only recently begun to take hold in spatial applications. Spatial casual inference poses analytic challenges due to complex correlation structures and interference between the treatment at one location and the outcomes at others. In this paper, we review the current literature on spatial causal inference and identify areas of future work. We first discuss methods that exploit spatial structure to account for unmeasured confounding variables. We then discuss causal analysis in the presence of spatial interference including several common assumptions used to reduce the complexity of the interference patterns under consideration. These methods are extended to the spatiotemporal case where we compare and contrast the potential outcomes framework with Granger causality, and to geostatistical analyses involving spatial random fields of treatments and responses. The methods are introduced in the context of observational environmental and epidemiological studies, and are compared using both a simulation study and analysis of the effect of ambient air pollution on COVID-19 mortality rate. Code to implement many of the methods using the popular Bayesian software OpenBUGS is provided.

Wildland fire smoke exposures are an increasing threat to public health, and thus there is a growing need for studying the effects of protective behaviors on reducing health outcomes. Emerging smartphone applications provide unprecedented opportunities to deliver health risk communication messages to a large number of individuals when and where they experience the exposure and subsequently study the effectiveness, but also pose novel methodological challenges. Smoke Sense, a citizen science project, provides an interactive smartphone app platform for participants to engage with information about air quality and ways to protect their health and record their own health symptoms and actions taken to reduce smoke exposure. We propose a new, doubly robust estimator of the structural nested mean model parameter that accounts for spatially- and time-varying effects via a local estimating equation approach with geographical kernel weighting. Moreover, our analytical framework is flexible enough to handle informative missingness by inverse probability weighting of estimating functions. We evaluate the new method using extensive simulation studies and apply it to Smoke Sense data reported by the citizen scientists to increase the knowledge base about the relationship between health preventive measures and improved health outcomes. Our results estimate how the protective behaviors effects vary over space and time and find that protective behaviors have more significant effects on reducing health symptoms in the Southwest than the Northwest region of the USA.

Wildland fire smoke contains hazardous levels of fine particulate matter PM2.5, a pollutant shown to adversely effect health. Estimating fire attributable PM2.5 concentrations is key to quantifying the impact on air quality and subsequent health burden. This is a challenging problem since only total PM2.5 is measured at monitoring stations and both fire-attributable PM2.5 and PM2.5 from all other sources are correlated in space and time. We propose a framework for estimating fire-contributed PM2.5 and PM2.5 from all other sources using a novel causal inference framework and bias-adjusted chemical model representations of PM2.5 under counterfactual scenarios. The chemical model representation of PM2.5 for this analysis is simulated using Community Multi-Scale Air Quality Modeling System (CMAQ), run with and without fire emissions across the contiguous U.S. for the 2008-2012 wildfire seasons. The CMAQ output is calibrated with observations from monitoring sites for the same spatial domain and time period. We use a Bayesian model that accounts for spatial variation to estimate the effect of wildland fires on PM2.5 and state assumptions under which the estimate has a valid causal interpretation. Our results include estimates of absolute, relative and cumulative contributions of wildfire smoke to PM2.5 for the contiguous U.S. Additionally, we compute the health burden associated with the PM2.5 attributable to wildfire smoke.

Fine particulate matter, PM$_{2.5}$, has been documented to have adverse health effects and wildland fires are a major contributor to PM$_{2.5}$ air pollution in the US. Forecasters use numerical models to predict PM$_{2.5}$ concentrations to warn the public of impending health risk. Statistical methods are needed to calibrate the numerical model forecast using monitor data to reduce bias and quantify uncertainty. Typical model calibration techniques do not allow for errors due to misalignment of geographic locations. We propose a spatiotemporal downscaling methodology that uses image registration techniques to identify the spatial misalignment and accounts for and corrects the bias produced by such warping. Our model is fitted in a Bayesian framework to provide uncertainty quantification of the misalignment and other sources of error. We apply this method to different simulated data sets and show enhanced performance of the method in the presence of spatial misalignment. Finally, we apply the method to a large fire in Washington state and show that the proposed method provides more realistic uncertainty quantification than standard methods.

Climate change is expected to alter the distribution of ambient ozone levels and temperatures which, in turn, may impact public health. Much research has focused on the effect of short-term ozone exposures on mortality and morbidity while controlling for temperature as a confounder, but less is known about the joint effects of ozone and temperature. The extent of the health effects of changing ozone levels and temperatures will depend on whether these effects are additive or synergistic. In this paper we propose a spatial, semi-parametric model to estimate the joint ozone-temperature risk surfaces in 95 US urban areas. Our methodology restricts the ozone-temperature risk surfaces to be monotone in ozone and allows for both nonadditive and nonlinear effects of ozone and temperature. We use data from the National Mortality and Morbidity Air Pollution Study (NMMAPS) and show that the proposed model fits the data better than additive linear and nonlinear models. We then examine the synergistic effect of ozone and temperature both nationally and locally and find evidence of a nonlinear ozone effect and an ozone-temperature interaction at higher temperatures and ozone concentrations., Comment: Published in at http://dx.doi.org/10.1214/14-AOAS754 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org)