Digital Module 16: Longitudinal Data Analysis

In this digital ITEMS module, Dr. Jeffrey Harring and Ms. Tessa Johnson introduce the linear mixed effects (LME) model as a flexible general framework for simultaneously modeling continuous repeated measures data with a scientifically defensible function that adequately summarizes both individual change as well as the average response. The module begins with a nontechnical overview of longitudinal data analyses drawing distinctions with cross-sectional analyses in terms of research questions to be addressed. Nuances of longitudinal designs, timing of measurements, and the real possibility of missing data are then discussed. The three interconnected components of the LME model—(1) a model for individual and mean response profiles, (2) a model to characterize the covariation among the time-specific residuals, and (3) a set of models that summarize the extent that individual coefficients vary—are discussed in the context of the set of activities comprising an analysis. Finally, they demonstrate how to estimate the linear mixed effects model within an open-source environment (R). The digital module contains sample R code, diagnostic quiz questions, hands-on activities in R, curated resources, and a glossary.     

A Bioethos for Bodies: Respecting a Priceless Resource

The value that willed body donors provide to medical education is priceless. Their precious gift helps to teach anatomy, spatial relationships between morphological structures, anatomical variation, and professionalism to medical students in a way that plastic models, podcasts, and lectures cannot. They are also an important resource for medical research and a wide variety of postgraduate training opportunities. While many body donation programs throughout the world are nonprofit organizations, there are body donation companies in the United States that sell donors for-profit. These “body brokers” have accumulated large profits from this business. It is incongruous that others would profit from such a priceless, freely donated gift. To prevent this incongruity, it is proposed that the international anatomical community develop a normative culture (a bioethos) for body donation programs. This would involve the conscious and systematic development of ethical principles for the day-to-day policies and practices of institutions that collect and use human bodies. With the development of this bioethos, a cultural shift in how donors are treated would occur and, over time, this would become the normal practice. These principles would become fundamental and foundational for the procurement and use of priceless human tissues.