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 1 Estimation of the maximum flow-mediated brachial artery response using local regression methods
Authors Andrew-ME; Li-S; Fekedulegn-D; Dorn-J; Joseph-PN; Violanti-J; Burchfiel-CM 
Source Physiol Meas 2007 Oct; 28(10):1213-1224 
Link http://dx.doi.org/10.1088/0967-3334/28/10/007 
NIOSHTIC No. 20032835 
AbstractWe consider methods for estimating the maximum from a sequence of measurements of flow-mediated diameter of the brachial artery. Flow-mediated vasodilation (FMD) is represented using the maximum change from a baseline diameter measurement after the release of a blood pressure cuff that has been inflated to reduce flow in the brachial artery. The influence of the measurement error on the maximum diameter from raw data can lead to overestimation of the average maximum change from the baseline for a sample of individuals. Nonparametric regression models provide a potential means for dealing with this problem. When using this approach, it is necessary to make a judicious choice of regression methods and smoothing parameters to avoid overestimation or underestimation of FMD. This study presents results from simulation studies using kernel-based local linear regression methods that characterize the relationship between the measurement error, smoothing and bias in estimates of FMD. Comparisons between fixed or constant smoothing and automated smoothing parameter selection using the generalized cross validation (GCV) statistic are made, and it is shown that GCV-optimized smoothing may over-smooth or under-smooth depending on the heart rate, measurement error and measurement frequency. We also present an example using measured data from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) pilot study. In this example, smoothing resulted in lower estimates of FMD and there was no clear evidence of an optimal smoothing level. The choice to use smoothing and the appropriate smoothing level to use may depend on the application. 
KeywordsPsychological-factors; Statistical-analysis; Analytical-processes; Time-weighted-average-exposure; Blood-pressure; Cardiac-function; Stress; Cardiovascular-function; Cardiovascular-system-disorders 
ContactME Andrew, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevent, MS 4050, 1095 Willowdale Rd, Morgantown, WV 26505-2888 
CODENPMEAE3 
Publication Date20070901 
Document TypeJournal Article 
Fiscal Year2008 
NTIS Accession No. 
NTIS Price 
Issue of Publication10 
ISSN0967-3334 
NIOSH DivisionHELD 
Source NamePhysiological Measurement 
StateWV; NY 
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