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अखिल भारतीय आयुर्विज्ञान संस्थान, नई दिल्ली
All India Institute Of Medical Sciences, New Delhi

Research

                                                 Research

 

S. No.

Name of the Project

Description of the Project

01.

Task Force on Inborn Metabolic Disorders: Newborn Screening for Congenital hypothyroidism & Congenital Adrenal Hyperplasia: ICMR Multicentric Study

 

Data Coordinating Centre under:    Dr. R. M. Pandey

 

Source of Funding: ICMR

 

Amount: Rs. 9 lacs

 

Status: On going

This is a pilot study and only 2 diseases of the more common metabolic disorders have been identified including Congenital hypothyroidism (CH) and Congenital adrenal hyperplasia (CAH) which would be screened in a population of 1 lakh newborns at 5 centers in the country.  Delhi (North), Mumbai (West), Chennai (South), Hyderabad (Central), Kolkata (East) with Central Coordinating Unit at ICMR, New Delhi.  This pilot study would provide the data about the magnitude of burden of these diseases in the country as well as establish the feasibility of introducing neonatal screening as a public health program. The primary objective of the study is to evaluate the feasibility of a newborn screening for the different geo-ethnic regions of the Indian Population and attempt to define the incidence of the selected inborn metabolic errors i.e. CH and CAH in our population.

National level data coordination, data scrutiny and data analysis of the project are under the umbrella of Department of Biostatistics.

02.

A multicentric randomized controlled clinical trial of adefovir, adefovir+lamivudine, and combination of adefovir and glycyrrhizin in HBV related decompensated cirrhosis.

 

Data Coordinating Centre under    Dr V Sreenivas

 

Source of Funding: ICMR

 

Amount: Rs. 8.25 lakhs

 

Status: On going

The primary objective of this study is to assess the efficacy of Adefovir, Adefovir + Lamivudine and Adefovir + Glycyrrhizin in patients with HBV related decompensated cirrhosis liver, by way of clinical, biochemical and virological outcome. A total of 300 patients would be randomized in to the three treatment arms from 7 centres in the country, over a period or 3 years.  The treatment would be for 18 months.  The clinical and biochemical assessment are at every month and the virological assessment is at every 3 months.  The Department of Biostatistics is the Co-ordinating centre for this multi-center trial and is responsible for the procurement and distribution of drugs, randomization of patients, collating the monthly data from every centre, checking and scrutiny of the forms etc, data entry, periodic analyses and monitoring the trial etc.

03.

HCV - The Indian Face

 

Data Coordinating Centre under    Dr V Sreenivas

 

Source of Funding: Bristol Myer's Squibb Foundation

 

Amount: 5,43,840.00

Status : On going

This multicentric study aims to determine the hospital based prevalence of liver diseases in India along with the etiology & spectrum of liver disease among the patients attending the major hospitals. It is also aimed to assess the health care resources utilization patterns among patients of liver disease.  The Department of Biostatistics is the nodal agency for the coordination of data collection, compilation, quality control & analysis.

04.

Survey of Abuse in Family Environment in India (India Safe Study)

 

P.I.: Dr. R. M. Pandey

 

Source of Funding: ICRW, USA

 

Amount:30 lacs

 

Status: Completed

The IndiaSAFE study was a population based cross-sectional survey administered in seven sites (New Delhi, Lucknow, Bhopal, Chennai, Trivandrum, Nagpur and Vellore) in India between April 1998 and September 1999.  Funded by the International center for Research on Women (ICRW) through a grant from USAID.  The study examined the prevalence of physical and psychological maltreatment against adult women in the family; community, family, and individual factors associated with family violence in India; and differences in family violence among rural and urban families in India.  Primary interviewees were 9938 mothers (index Women) of dependent children.  Secondarily, sample of 1000 mothers-in-laws were interviewed as well.  Focus group discussions were also conducted.  One fifth of the women reported a lifetime experience of violent physical behaviors of husband.  Women in rural areas reported highest rates of beating: women in urban slum areas, the highest rates of hitting and kicking.  Women from urban non-slum areas reported the lowest rates of all three behaviors, less than half of those reported by women in rural and urban slum areas.  Psychological violence was more prevalent than physical violent behaviors.  Nearly half of the women who reported being hit by their husbands said that this behavior occurred while they were pregnant.  More than half of the women who reported being kicked or beaten by their husbands reported that this behavior occurred while they were pregnant

05.

Development of appropriate prevention and intervention strategies for non-communicable nutritional related disorders among women in post-reproductive period  

 

P.I: Dr. R. M. Pandey

 

Source of Funding: DST

 

Amount: Rs. 22.86 lacs

 

Status: Completed

It is cross sectional multi-site observational study across the country.  The objectives of the study was (i) to prepare the health and nutritional profile for women in post reproductive period, (ii) to identify their health problems and the factors contributing to the problems predominantly nutrition associated, (iii) to develop strategies for primary prevention and management of these health problems and (iv) to train health workers within the community in population based awareness generation.  National level data coordination, data scrutiny and data analysis of the project are under the umbrella of Department of Biostatistics.

06.

Comparison of multivariate statistical methods of classification: Logistic Regression, classification and Regression Tree, and Artificial neural network

 

 

Senior Research Fellowship under Dr. R. M. Pandey 

 

 

Status: Completed

In this study, an attempt is being made to develop a classification rule on Indian population and compare Logistic regression, Classification and Regression tree & Artificial neural network for its ability to predict the dysglycemia in Asian Indians. Dataset of two epidemiological studies combined together focusing on various risk factors for diabetes done on Asian Indians in north India is being be used to develop classification rule for classifying subjects at high risk for developing diabetes using demographic, family history, lifestyle factors, anthropometric and biochemical profile as the independent variables. The objective of the study is to develop classification rule involving readily available clinical information capable of predicting prediabetes/diabetes using Logistic regression, Classification and regression tree and Artificial neural network as the method of classification and comparing there relative performances

07.

Multilevel Analysis for Epidemiological Understanding of Contraceptive Adoption in India.

 

P.I:  Dr. S. N. Dwivedi

 

Source of Funding: AIIMS

 

Amount: Rs. 50000

 

Status: Completed

For the first time, models using multilevel analysis of Indian data and related simulation results were reported, that takes hierarchical structure into account and makes it possible to incorporate variables from all levels at their own levels to get correct analysis and proper interpretation of the data on current contraceptive use. The data of an Indian State "Uttar Pradesh (UP)" covered under National Family Health Survey (NFHS) conducted during 10th October 1992 to 22nd February 1993 was used. For model I, currently married 7851 women who were neither pregnant nor continuing with post‑partum amenorrhea (PPA) were considered. Again, for model II, these women with at least one child (n=6748) were used.  Two‑level logistic regression analysis was carried out for which women's level (level 1) and PSU (Primary Sampling Unit) level (level 2) variables were considered.  These results reveal that survival status of last child tremendously affects the contraceptive adoption in UP. They further support that the public health education (TV message) is more effective among less educated women. Also, PSU‑level presence of all weather roads is equally effective. Consideration of higher-level variables provides not only more accurate results but also important public health clues to help the policy planners.

08.

Multilevel Epidemiological Analysis to Assess the Role of Community Level Effects on Public Health/ Family-Welfare  

P.I. Dr S.N. Dwivedi  

Source of Funding: ICMR

 

Amount: Rs. 4 lacs

 

Status: Completed

In the field of public health, in general, data on any aspect including that on infant mortality has inbuilt hierarchical structure. This becomes almost certain also in a case where there is involvement of cluster sampling in study design under large scale studies. Using traditional regression approach in data analysis, i.e., ignoring hierarchical structure, either at micro (individual) or at macro (community) level will be avoiding desired assumption related to independence of records. Accordingly, this may result into distortion in the result due to probable underestimation of standard error of the regression coefficients. To be more specific, from public health program point of view, an irrelevant covariate may emerge as an important covariate leading to inappropriate public health implications. To overcome this problem, the objective of the present work was to deal with multilevel analysis of the data on infant mortality available under second round of National family Health Survey, 1998-99. This method provides more accurate results leading to meaningful public health implications. In addition, under this method, estimation of variability at different levels and their covariance are also obtained. Basically,  objective of the study was two folds:    the multilevel analysis carried out on above mentioned dataset as well as those on data considering only from rural India. The results indicate that the community (e.g., district, state) level variables still have major role regarding infant mortality in India. In summary, if computational facilities are available, multilevel analysis may be preferred in dealing with data involving hierarchical structure leading to accurate results having meaningful public health implications.

09.

Some Epidemiological Models for Contraceptive Adoption in India and their comparisons.

 

P.I.: Dr. S. N. Dwivedi 

 

Source of Funding: AIIMS

 

Amount: Rs. 50000

 

Status: Completed

This study dealt with random effects models for contraceptive adoption using currently available data of an Indian State "Uttar Pradesh (UP)" covered under National Family Health Survey (NFHS) conducted during 1998-99. The first model utilized a total number of 5028 currently married women who were neither pregnant nor continuing with post‑partum amenorrhea (PPA). Again, the second model utilized these women with at least one child (n=4359). As reported under earlier project, this procedure takes into account prevailing hierarchical structure of data making it possible to incorporate variables from all levels at their own levels to get more accurate analysis leading to more reliable interventions. Two‑level logistic regression analysis was carried out that considered women's level variables at level 1 and PSU (Primary Sampling Unit) level variables at level 2. These models were worked out considering same set of covariates as considered under the models based on data of NFHS conducted during 1992-93 so that these models can be compared with them. In contrary to earlier results (1992-93), these results reveal that survival status of last child does not remain an important factor regarding contraceptive adoption in UP. However, other factors like education of women still remain important.

10.

A study on primary, secondary and tertiary delays in prevention and treatment in relation to breast, oral and oesophagus cancer patients  

 

Senior Research Fellowship under Dr. S. N. Dwivedi 

 

Source of Funding: ICMR

 

Status: Completed

The major site-specific cancers prevailing among females are breast and cervix whereas among males are oral, esophagus and lung. The early detection of cancer and its early treatment may be the most important factors for reducing morbidity and improving survival. However, in developing countries like India, more than 70% of cancer patients get detected in advanced stages that make the task of management of cancer patients complicated. Detection of cancer in advanced stages may be mainly attributed to delays in referral of patients to tertiary level where the appropriate treatments including diagnostic tools might be available. The referral process starts from onsets of symptoms to till appropriate treatments either by a doctor or patients themselves (called as self referral). Therefore, delay may occur at any stages during this referral process. As obvious, among the existing studies mainly reported from western countries, there is wide variation in consideration of delays during the referral process and consequently there is likelihood of contradictory reports regarding the effect of delays on stage of cancer at the time of presentation and also on survival. In general, the delay may occur at any of the three stages: delay on the part of the patient, delay by the general practitioner prior to referral, delay occurred at tertiary level after referral (Carter, Winslet, 1998). Accordingly, the delay in the path of referral may be broadly categorized as: duration between the onset of symptoms and first presentation to doctor (primary delay); the duration between first presentation to doctor and diagnosis of cancer (secondary delay); and the duration between diagnosis of cancer and time of starting treatment (tertiary delay). For the first time from India, this study is planned to estimate the primary, secondary and tertiary delays and its associated medical and non-medical factors in relation to breast, oral and esophagus cancers patients. Obviously, the findings related to this study is expected to provide preliminary clues leading to the suggestive intervention programs to be achieved through Information Education Communication (IEC) and/or screening program.

 

 

 

 

 

 

 

 
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