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Eckermann HA, Lugones M, Abdala D, Roge H, de Weerth C. Maternal early life and prenatal stress in relation to birth outcomes in Argentinian mothers. Dev Psychobiol 2024; 66:e22502. [PMID: 38807271 DOI: 10.1002/dev.22502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Environmental influences before and during pregnancy significantly impact offspring development. This study investigates open research questions regarding the associations between maternal early life stress (ELS), prenatal psychosocial stress, prenatal hair cortisol (HC), and birth outcomes in Argentinian women. Data on ELS, prenatal life events, HC (two samples representing first and second half of pregnancy), and birth outcomes were collected from middle-class Argentinian women (N = 69) upon delivery. Linear mixed models indicated that HC increased from the first half to the second half of pregnancy with considerable variability in the starting values and slopes between individuals. Mothers who experienced more ELS, were taller, or more educated, tended to show lower increases in HC. Older age was positively related to HC increases. Our data did not suggest an interaction between ELS and prenatal life events in relation to HC. We found that the change in HC was most likely negatively associated with birth weight. Our data are most compatible with either a weak or the absence of an association between ELS or prenatal life events and absolute values of HC. Mothers with stronger increases in hair cortisol tended to have newborns with slightly lower birth weight. Hence, ELS and birthweight may either have been related to changes in cortisol exposure during pregnancy or to factors that influence accumulation or retention of cortisol in hair.
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Affiliation(s)
- Henrik Andreas Eckermann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Micaela Lugones
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Daniel Abdala
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Horacio Roge
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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Wigard I, Meyerbröker K, Ehring T, Topper M, Arntz A, Emmelkamp P. Skills training followed by either EMDR or narrative therapy for posttraumatic stress disorder in adult survivors of childhood abuse: a randomized controlled trial. Eur J Psychotraumatol 2024; 15:2332104. [PMID: 38629403 PMCID: PMC11025408 DOI: 10.1080/20008066.2024.2332104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
Background: Individuals suffering from PTSD following childhood abuse represent a large subgroup of patients attending mental health services. The aim of phase-based treatment is to tailor treatment to the specific needs to childhood abuse survivors with PTSD with a Skills Training in Affective and Interpersonal Regulation (STAIR) phase, in which emotion dysregulation and interpersonal problems are targeted, and a trauma-focused phase.Objective: The purpose of this study was to compare STAIR + Eye Movement Desensitization and Reprocessing (EMDR) vs. STAIR + Narrative Therapy (NT) as treatments for PTSD following childhood-onset trauma in a routine clinical setting.Method: Sixty-eight adults were randomly assigned to STAIR/EMDR (8 STAIR-sessions followed by 12 EMDR-sessions) or STAIR/NT (8 STAIR-sessions followed by 12 NT-sessions). Assessments took place at pre-treatment, after each treatment phase and at 3 and 12 months post-intervention follow-up. Primary outcomes were interviewer-rated and self-reported symptom levels of PTSD. Secondary outcomes included symptom levels of depression and disturbances in emotion regulation and interpersonal skills.Results: Multilevel analyses in the intent-to-treat sample indicated that patients in both treatments improved substantially on PTSD symptom severity (CAPS: d = 0.81 to 1.29; PDS: d = 1.68 to 2.15), as well as on symptom levels of depression, anxiety, emotion regulation, dissociation and interpersonal skills. Effects increased or were maintained until 12-month follow-up. At mid-treatment, after STAIR, patients in both treatments improved moderately on PTSD symptom severity (PDS: d = 1.68 to 2.15), as well as on symptom levels of depression (BDI: d = .32 to .31). Symptoms of anxiety, emotion dysregulation, interpersonal problems and dissociation were not decreased after STAIR. There were no significant differences between the two conditions on any outcome.Conclusion: PTSD in adult survivors of childhood interpersonal trauma can effectively be treated by phase-based interventions using either EMDR or NT in the trauma-processing phase.Trial registration: ClinicalTrials.gov identifier: NCT01443182..
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Affiliation(s)
- I. Wigard
- Parnassiagroep, Amsterdam, the Netherlands
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - K. Meyerbröker
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
- Altrecht Academic Anxiety Centre, Utrecht, the Netherlands
| | - T. Ehring
- Department of Psychology, LMU Munich, Munich, Germany
| | - M. Topper
- GGZ-Noord-Holland-Noord, Alkmaar, the Netherlands
| | - A. Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - P. Emmelkamp
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Matsui M, Ishii K, Suzuki K, Togashi K. Chronotype and emotional/behavioral problems mediate the association between leisure screen time and academic achievement in children. Chronobiol Int 2024; 41:513-520. [PMID: 38380819 DOI: 10.1080/07420528.2024.2320231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
Leisure screen time is associated with poor academic achievement; however, the mechanism underlying this relationship is unclear. Chronotypes and emotional/behavioral problems may be linked to this association. This study aimed to examine the associations between leisure screen time, chronotype, emotional/behavioral problems, and academic achievement using mediation analysis. A total of 113 children aged 9-12 years participated in this study. All participants were assessed for leisure screen time, chronotype, emotional/behavioral problems, and academic achievement. Leisure screen time was evaluated using a self-reported questionnaire. Chronotypes were measured using The Japanese Children's Chronotype Questionnaire, and the morningness/eveningness (M/E) score was calculated. Emotional/behavioral problems were assessed using The Japanese Strengths and Difficulties Questionnaire, and the total difficulties score (TDS) was calculated. Academic achievement was assessed by the homeroom teacher for each of the seven school subjects. Partial correlation analysis adjusted for grade, sex, and sleep duration indicated that leisure screen time was associated with M/E scores and academic achievement (p < 0.05). There was a positive association between M/E score and TDS (p < 0.05) and a negative association between TDS and academic achievement (p < 0.05). A mediation analysis adjusted for grade, sex, and sleep duration was performed. There was a significant total effect of leisure screen time on academic achievement (p < 0.05). Additionally, the M/E score and TDS significantly mediated the association between leisure screen time and academic achievement (p < 0.05). Our findings suggest that the serial path between chronotype and emotional/behavioral problems weakly but significantly mediates the association of leisure screen time with academic achievement.
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Affiliation(s)
- Masahiro Matsui
- Institute of Health and Sports Science & Medicine, Juntendo University, Chiba, Japan
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Koya Suzuki
- Institute of Health and Sports Science & Medicine, Juntendo University, Chiba, Japan
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Waterschoot J, Vansteenkiste M, Yzerbyt V, Morbée S, Klein O, Luminet O, Schmitz M, Van Oost P, Van Raemdonck E, Brisbois M, Van den Bergh O. Risk perception as a motivational resource during the COVID-19 pandemic: the role of vaccination status and emerging variants. BMC Public Health 2024; 24:731. [PMID: 38448885 PMCID: PMC10918917 DOI: 10.1186/s12889-024-18020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND People's perceived risk of being infected and having severe illness was conceived as a motivational source of adherence to behavioral measures during the COVID-19 crisis. METHODS We used online self-reported data, spanning 20 months of the COVID-19 crisis in Belgium (n = 221,791; 34.4% vaccinated; July 2020 - March 2022) to study the association between risk perception and motivation. RESULTS Both perceived infection probability and severity fluctuated across time as a function of the characteristics of emerging variants, with unvaccinated persons perceiving decreasingly less risk compared to vaccinated ones. Perceived severity (and not perceived probability) was the most critical predictor of autonomous motivation for adherence to health-protective measures, a pattern observed at both the between-day and between-person level among both vaccinated and unvaccinated individuals. An integrated process model further indicated that on days with higher hospitalization load, participants reported being more adherent because risk severity and autonomous motivation for adherence were more elevated on these days. CONCLUSIONS These findings suggest that risk severity served as a critical and dynamic resource for adherence to behavioral measures because it fostered greater autonomous regulation.
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Affiliation(s)
- Joachim Waterschoot
- Faculty of Psychology, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium.
| | - Maarten Vansteenkiste
- Faculty of Psychology, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium
| | - Vincent Yzerbyt
- Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Sofie Morbée
- Faculty of Psychology, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium
| | - Olivier Klein
- Center for Social and Cultural Psychology (CeSCuP), Faculty of Psychological Sciences and Education, Université libre de Bruxelles, Bruxelles, Belgium
| | - Olivier Luminet
- Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Mathias Schmitz
- Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Pascaline Van Oost
- Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Eveline Van Raemdonck
- Faculty of Psychology, Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, B-9000, Ghent, Belgium
| | - Marie Brisbois
- Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
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Hultink D, Souwer ETD, Bastiaannet E, Dekker JWT, Steup WH, Hamaker ME, Sonneveld DJA, Consten ECJ, Neijenhuis PA, Portielje JEA, van den Bos F. The prognostic value of a geriatric risk score for older patients undergoing emergency surgery of colorectal cancer: A retrospective cohort study. J Geriatr Oncol 2024; 15:101711. [PMID: 38310662 DOI: 10.1016/j.jgo.2024.101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/24/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Emergency surgery of colorectal cancer is associated with high mortality rates in older patients. We investigated whether information on four geriatric domains has prognostic value for 30-day mortality and postoperative morbidity including severe complications. MATERIALS AND METHODS All consecutive patients aged 70 years or older who underwent emergency colorectal cancer surgery in six Dutch hospitals (2014-2017) were studied. Presence of geriatric risk factors was scored prior to surgery as either 0 (risk absent) or 1 (risk present) in each of four geriatric domains and summed up to calculate a sumscore with a value between 0 and 4. In addition, we separately investigated the use of a mobility aid. Primary outcome was 30-day mortality. Secondary outcomes were any postoperative complications and severe complications. Multivariable logistic regression model was used to evaluate the sumscore and outcomes. RESULTS Two hundred seven patients were included. Median age was 79.4 years. One hundred seventy-five patients (76%) presented with obstruction, 22 (11%) with a perforation, and 17 (8%) with severe anemia. Mortality rates were 2.9%, 13.6%, and 29.6% for patients with a sumscore of 0, 1-2, and 3-4 respectively, with odds ratio (OR) 4.8 [95% confidence interval (CI) 1.03-22.95] and OR 10.6 [95% CI 1.99-56.34] for a sumscore of 1-2 and 3-4 respectively. Use of a mobility aid was associated with increased mortality OR 8.0 [95% CI 2.74-23.43] and severe complications OR 2.31 [95% CI 1.17-4.55]. DISCUSSION This geriatric sumscore and the use of a mobility aid have strong association with 30-day mortality after emergency surgery of colorectal cancer. This could provide better insight into surgical risk and help select high-risk patients for alternative strategies.
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Affiliation(s)
- Daniëlle Hultink
- Department of Internal Medicine, Haga Hospital, The Hague, the Netherlands.
| | - Esteban T D Souwer
- Department of Internal Medicine, Haga Hospital, The Hague, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Esther Bastiaannet
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - W H Steup
- Department of Surgery, Haga Hospital, The Hague, the Netherlands
| | - Marije E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis, Utrecht, the Netherlands
| | | | - Esther C J Consten
- Department of Surgery, Meander Medisch Centrum, Amersfoort, the Netherlands
| | | | - Johanna E A Portielje
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frederiek van den Bos
- Department of Geriatric Medicine, University Medical Center Leiden, Utrecht, the Netherlands
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Morris TP, White IR, Cro S, Bartlett JW, Carpenter JR, Pham TM. Comment on Oberman & Vink: Should we fix or simulate the complete data in simulation studies evaluating missing data methods? Biom J 2024; 66:e2300085. [PMID: 37823668 DOI: 10.1002/bimj.202300085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
For simulation studies that evaluate methods of handling missing data, we argue that generating partially observed data by fixing the complete data and repeatedly simulating the missingness indicators is a superficially attractive idea but only rarely appropriate to use.
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Affiliation(s)
- Tim P Morris
- MRC Clinical Trials Unit at UCL, University College London, London, UK
| | - Ian R White
- MRC Clinical Trials Unit at UCL, University College London, London, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Jonathan W Bartlett
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - James R Carpenter
- MRC Clinical Trials Unit at UCL, University College London, London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Tra My Pham
- MRC Clinical Trials Unit at UCL, University College London, London, UK
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7
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Vidal N, Brunet-Gouet E, Frileux S, Aouizerate B, Aubin V, Belzeaux R, Courtet P, D'Amato T, Dubertret C, Etain B, Haffen E, Januel D, Leboyer M, Lefrere A, Llorca PM, Marlinge E, Olié E, Polosan M, Schwan R, Walter M, Passerieux C, Roux P. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment and self-reported side effects in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort. Eur Neuropsychopharmacol 2023; 77:67-79. [PMID: 37741163 DOI: 10.1016/j.euroneuro.2023.08.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/25/2023]
Abstract
Bipolar disorders (BD) are characterized by cognitive impairment during the euthymic phase, to which treatments can contribute. The anticholinergic properties of medications, i.e., the ability of a treatment to inhibit cholinergic receptors, are associated with cognitive impairment in elderly patients and people with schizophrenia but this association has not been well characterized in individuals with remitted BD. Moreover, the validity of only one anticholinergic burden scale designed to assess the anticholinergic load of medications has been tested in BD. In a literature review, we identified 31 existing scales. We first measured the associations between 27 out of the 31 scales and objective cognitive impairment in bivariable regressions. We then adjusted the bivariable models with covariates: the scales significantly associated with cognitive impairment in bivariable and multiple logistic regressions were defined as having good concurrent validity to assess cognitive impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a neuropsychological battery, two scales had good concurrent validity to assess cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents, the number of antipsychotics, or the number of treatments had not. Finally, similar analyses with subjective anticholinergic side-effects as outcome variables reported 14 scales with good concurrent validity to assess self-reported peripheral anticholinergic side-effects and 13 to assess self-reported central anticholinergic side-effects. Thus, we identified valid scales to monitor the anticholinergic burden in BD, which may be useful in estimating iatrogenic cognitive impairment in studies investigating cognition in BD.
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Affiliation(s)
- N Vidal
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France.
| | - E Brunet-Gouet
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - S Frileux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - V Aubin
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - R Belzeaux
- Fondation FondaMental, Créteil, France; Pôle universitaire de psychiatrie, CHU de Montpellier, Montpellier, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P Courtet
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; University Lyon 1, Villeurbanne; INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France, Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - B Etain
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Haffen
- Fondation FondaMental, Créteil, France; Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - D Januel
- Fondation FondaMental, Créteil, France; Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory,; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - A Lefrere
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; Centre Hospitalier et Universitaire, Département de Psychiatrie, Université d'Auvergne, EA 7280, Clermont-Ferrand, France
| | - E Marlinge
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Olié
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - M Polosan
- Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - R Schwan
- Fondation FondaMental, Créteil, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - M Walter
- Fondation FondaMental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - P Roux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
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Komamine M, Fujimura Y, Omiya M, Sato T. Dealing with missing data in laboratory test results used as a baseline covariate: results of multi-hospital cohort studies utilizing a database system contributing to MID-NET ® in Japan. BMC Med Inform Decis Mak 2023; 23:242. [PMID: 37904196 PMCID: PMC10617177 DOI: 10.1186/s12911-023-02345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 10/19/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND To evaluate missing data methods applied to laboratory test results used for confounding adjustment, utilizing data from 10 MID-NET®-collaborative hospitals. METHODS Using two scenarios, five methods dealing with missing laboratory test results were applied, including three missing data methods (single regression imputation (SRI), multiple imputation (MI), and inverse probability weighted (IPW) method). We compared the point estimates of adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) between the five methods. Hospital variability in missing data was considered using the hospital-specific approach and overall approach. Confounding adjustment methods were propensity score (PS) weighting, PS matching, and regression adjustment. RESULTS In Scenario 1, the risk of diabetes due to second-generation antipsychotics was compared with that due to first-generation antipsychotics. The aHR adjusted by PS weighting using SRI, MI, and IPW by the hospital-specific-approach was 0.61 [95%CI, 0.39-0.96], 0.63 [95%CI, 0.42-0.93], and 0.76 [95%CI, 0.46-1.25], respectively. In Scenario 2, the risk of liver injuries due to rosuvastatin was compared with that due to atorvastatin. Although PS matching largely contributed to differences in aHRs between methods, PS weighting provided no substantial difference in point estimates of aHRs between SRI and MI, similar to Scenario 1. The results of SRI and MI in both scenarios showed no considerable changes, even upon changing the approaches considering hospital variations. CONCLUSIONS SRI and MI provide similar point estimates of aHR. Two approaches considering hospital variations did not markedly affect the results. Adjustment by PS matching should be used carefully.
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Affiliation(s)
- Maki Komamine
- Department of Biostatistics, Kyoto University School of Public Health, Yoshida-konoecho, Sakyo-ku, Kyoto, 606-8501, Japan.
- Office of Medical Informatics and Epidemiology, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan.
| | - Yoshiaki Fujimura
- Head Office, Tokushukai Information System Incorporated, Osaka, Japan
| | - Masatomo Omiya
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tosiya Sato
- Department of Biostatistics, Kyoto University School of Public Health, Yoshida-konoecho, Sakyo-ku, Kyoto, 606-8501, Japan
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9
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Jaspard M, Mulangu S, Juchet S, Serra B, Dicko I, Lang HJ, Baka BM, Komanda GM, Katsavara JM, Kabuni P, Mambu FM, Isnard M, Vanhecke C, Letord A, Dieye I, Patterson-Lomba O, Mbaya OT, Isekusu F, Mangala D, Biampata JL, Kitenge R, Kinda M, Anglaret X, Muyembe JJ, Kojan R, Ezzedine K, Malvy D. Development of the PREDS score to predict in-hospital mortality of patients with Ebola virus disease under advanced supportive care: Results from the EVISTA cohort in the Democratic Republic of the Congo. EClinicalMedicine 2022; 54:101699. [PMID: 36263398 PMCID: PMC9574409 DOI: 10.1016/j.eclinm.2022.101699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND As mortality remains high for patients with Ebola virus disease (EVD) despite new treatment options, the ability to level up the provided supportive care and to predict the risk of death is of major importance. This analysis of the EVISTA cohort aims to describe advanced supportive care provided to EVD patients in the Democratic Republic of the Congo (DRC) and to develop a simple risk score for predicting in-hospital death, called PREDS. METHODS In this prospective cohort (NCT04815175), patients were recruited during the 10th EVD outbreak in the DRC across three Ebola Treatment Centers (ETCs). Demographic, clinical, biological, virological and treatment data were collected. We evaluated factors known to affect the risk of in-hospital death and applied univariate and multivariate Cox proportional-hazards analyses to derive the risk score in a training dataset. We validated the score in an internal-validation dataset, applying C-statistics as a measure of discrimination. FINDINGS Between August 1st 2018 and December 31th 2019, 711 patients were enrolled in the study. Regarding supportive care, patients received vasopressive drug (n = 111), blood transfusion (n = 101), oxygen therapy (n = 250) and cardio-pulmonary ultrasound (n = 15). Overall, 323 (45%) patients died before day 28. Six independent prognostic factors were identified (ALT, creatinine, modified NEWS2 score, viral load, age and symptom duration). The final score range from 0 to 13 points, with a good concordance (C = 86.24%) and calibration with the Hosmer-Lemeshow test (p = 0.12). INTERPRETATION The implementation of advanced supportive care is possible for EVD patients in emergency settings. PREDS is a simple, accurate tool that could help in orienting early advanced care for at-risk patients after external validation. FUNDING This study was funded by ALIMA.
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Affiliation(s)
- Marie Jaspard
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Sabue Mulangu
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Sylvain Juchet
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Beatrice Serra
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Ibrahim Dicko
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Hans-Joeg Lang
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | | | | | | | - Patricia Kabuni
- Kinshasa University Hospital, Democratic Republic of the Congo
| | - Fabrice Mbika Mambu
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | | | | | - Alexia Letord
- Surgical Intensive Care Unit, Henri Mondor University Hospital, Créteil, France
| | | | | | - Olivier Tshiani Mbaya
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Fiston Isekusu
- Kinshasa University Hospital, Democratic Republic of the Congo
| | | | - Jean Luc Biampata
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Richard Kitenge
- Ministry of Health, National Emergency and Humanitarian Action Program, Democratic Republic of the Congo
| | - Moumouni Kinda
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Xavier Anglaret
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Jean Jacques Muyembe
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Richard Kojan
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Khaled Ezzedine
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Créteil, France and Université Paris Est (UPEC), EpiDermE research unit, Paris, France
| | - Denis Malvy
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
- Department of Infectious Diseases and Tropical Medicine, Tropical Medicine and Clinical International Health Unit, Hôpital Pellegrin Bordeaux University Hospital, Bordeaux, France
- Corresponding author at: Department of Infectious Diseases and Tropical Medicine, Tropical Medicine and Clinical International Health Unit, Hôpital Pellegrin Bordeaux University Hospital, Bordeaux, France.
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10
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Yamate S, Hamai S, Kawahara S, Hara D, Motomura G, Ikemura S, Fujii M, Sato T, Harada S, Harada T, Kokubu Y, Nakashima Y. Multiple Imputation to Salvage Partial Respondents: Analysis of the Forgotten Joint Score-12 After Total Hip Arthroplasty. J Bone Joint Surg Am 2022; 104:2195-2203. [PMID: 36302043 DOI: 10.2106/jbjs.21.01547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Missing responses are common when Asian patients complete the Forgotten Joint Score-12 (FJS-12), which is widely used to evaluate total hip arthroplasty (THA). We aimed to provide orthopaedic researchers with a solution for handling missing values in such patient-reported outcome measures (PROMs). METHODS Patients who had undergone primary THA between 1998 and 2016 (n = 1,021) were investigated in 2020. The FJS-12 and 9 other PROMs, including questions related to Asian lifestyle activities, were administered. Risk factors for missing FJS-12 items were investigated. Partial respondents were matched with complete respondents; then, in each pair, the items not completed by the partial respondent were deleted from the responses of the complete respondent. Predictive mean matching (PMM) was performed in an attempt to recover the deleted items, using 65 sets of imputation models. After the missing values had been imputed, we explored patient characteristics that affected the FJS-12, using data from all complete and partial respondents. RESULTS A total of 652 patients responded to the survey (393 complete and 193 partial respondents). Partial respondents were older, more often female, and less active. Older respondents were more likely to skip items involving the bed, while those who reported a better ability to sit in the seiza style (traditional Japanese floor sitting) were more likely to skip items about chair sitting. The imputed FJS-12 value exhibited excellent reliability (intraclass correlation coefficient for agreement with the true scores, 0.985). FJS-12 values of complete respondents were significantly higher than those of respondents with 4 to 11 missing items (51.6 versus 32.8, p < 0.001). Older age was associated with higher FJS-12 values, which was revealed only via analysis of the multiply imputed data sets (p < 0.001). CONCLUSIONS Analysis of only complete FJS-12 responses after THA resulted in a nonresponse bias, preferentially excluding older, female, and less active individuals and those with a traditional floor living style. Multiple imputation could provide a solution to scoring and analyzing PROMs with missing responses by permitting the inclusion of partial respondents. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Satoshi Yamate
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medical-Engineering Collaboration for Healthy Longevity, Kyushu University, Fukuoka, Japan
| | - Shinya Kawahara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Hara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Fujii
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Taishi Sato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoru Harada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsunari Harada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiko Kokubu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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11
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Liu R, Liu H, Li L, Wang Z, Li Y. Predicting in-hospital mortality for MIMIC-III patients: A nomogram combined with SOFA score. Medicine (Baltimore) 2022; 101:e31251. [PMID: 36281193 PMCID: PMC9592355 DOI: 10.1097/md.0000000000031251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Predicting the mortality of patients provides a reference for doctors to judge their physical condition. This study aimed to construct a nomogram to improve the prediction accuracy of patients' mortality. Patients with severe diseases were screened from the Medical Information Mart for Intensive Care (MIMIC) III database; 70% of patients were randomly selected as the training set for the model establishment, while 30% were used as the test set. The least absolute shrinkage and selection operator (LASSO) regression method was used to filter variables and select predictors. A multivariable logistic regression fit was used to determine the association between in-hospital mortality and risk factors and to construct a nomogram. A total of 9276 patients were included. The area under the curve (AUC) for the clinical nomogram based on risk factors selected by LASSO and multivariable logistic regressions were 0.849 (95% confidence interval [CI]: 0.835-0.863) and 0.821 (95% CI: 0.795-0.846) in the training and test sets, respectively. Therefore, this nomogram might help predict the in-hospital mortality of patients admitted to the intensive care unit (ICU).
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Affiliation(s)
- Ran Liu
- Department of Anesthesiology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Haiwang Liu
- Department of Pathology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Ling Li
- Department of Anesthesiology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Zhixue Wang
- Department of Anesthesiology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Yan Li
- Department of Anesthesiology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
- *Correspondence: Yan Li, Department of Anesthesiology, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, China (e-mail: )
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12
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Theophanous S, Lønne PI, Choudhury A, Berbee M, Dekker A, Dennis K, Dewdney A, Gambacorta MA, Gilbert A, Guren MG, Holloway L, Jadon R, Kochhar R, Mohamed AA, Muirhead R, Parés O, Raszewski L, Roy R, Scarsbrook A, Sebag-Montefiore D, Spezi E, Spindler KLG, van Triest B, Vassiliou V, Malinen E, Wee L, Appelt AL. Development and validation of prognostic models for anal cancer outcomes using distributed learning: protocol for the international multi-centre atomCAT2 study. Diagn Progn Res 2022; 6:14. [PMID: 35922837 PMCID: PMC9351222 DOI: 10.1186/s41512-022-00128-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anal cancer is a rare cancer with rising incidence. Despite the relatively good outcomes conferred by state-of-the-art chemoradiotherapy, further improving disease control and reducing toxicity has proven challenging. Developing and validating prognostic models using routinely collected data may provide new insights for treatment development and selection. However, due to the rarity of the cancer, it can be difficult to obtain sufficient data, especially from single centres, to develop and validate robust models. Moreover, multi-centre model development is hampered by ethical barriers and data protection regulations that often limit accessibility to patient data. Distributed (or federated) learning allows models to be developed using data from multiple centres without any individual-level patient data leaving the originating centre, therefore preserving patient data privacy. This work builds on the proof-of-concept three-centre atomCAT1 study and describes the protocol for the multi-centre atomCAT2 study, which aims to develop and validate robust prognostic models for three clinically important outcomes in anal cancer following chemoradiotherapy. METHODS This is a retrospective multi-centre cohort study, investigating overall survival, locoregional control and freedom from distant metastasis after primary chemoradiotherapy for anal squamous cell carcinoma. Patient data will be extracted and organised at each participating radiotherapy centre (n = 18). Candidate prognostic factors have been identified through literature review and expert opinion. Summary statistics will be calculated and exchanged between centres prior to modelling. The primary analysis will involve developing and validating Cox proportional hazards models across centres for each outcome through distributed learning. Outcomes at specific timepoints of interest and factor effect estimates will be reported, allowing for outcome prediction for future patients. DISCUSSION The atomCAT2 study will analyse one of the largest available cross-institutional cohorts of patients with anal cancer treated with chemoradiotherapy. The analysis aims to provide information on current international clinical practice outcomes and may aid the personalisation and design of future anal cancer clinical trials through contributing to a better understanding of patient risk stratification.
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Affiliation(s)
- Stelios Theophanous
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
| | - Per-Ivar Lønne
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Ananya Choudhury
- MAASTRO (Dept of Radiotherapy), GROW School of Oncology and Developmental Biology, Maastricht University and Maastricht University Medical Centre+, P. Debyelaan 25, 6229, Maastricht, Netherlands
| | - Maaike Berbee
- MAASTRO (Dept of Radiotherapy), GROW School of Oncology and Developmental Biology, Maastricht University and Maastricht University Medical Centre+, P. Debyelaan 25, 6229, Maastricht, Netherlands
| | - Andre Dekker
- MAASTRO (Dept of Radiotherapy), GROW School of Oncology and Developmental Biology, Maastricht University and Maastricht University Medical Centre+, P. Debyelaan 25, 6229, Maastricht, Netherlands
| | | | | | | | - Alexandra Gilbert
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Marianne Grønlie Guren
- Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lois Holloway
- Ingham Research Institute and Liverpool Hospital, Liverpool, New South Wales, Australia
| | | | | | | | | | | | | | - Rajarshi Roy
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Andrew Scarsbrook
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | | | | | - Baukelien van Triest
- The Netherlands Cancer Institute-Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
| | | | - Eirik Malinen
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Leonard Wee
- MAASTRO (Dept of Radiotherapy), GROW School of Oncology and Developmental Biology, Maastricht University and Maastricht University Medical Centre+, P. Debyelaan 25, 6229, Maastricht, Netherlands
| | - Ane L Appelt
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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13
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Binnenmars SH, Hoogslag GE, Yeung SMH, Brouwers FP, Bakker SJL, van Gilst WH, Gansevoort RT, Navis G, Voors AA, de Borst MH. Fibroblast Growth Factor 23 and Risk of New Onset Heart Failure With Preserved or Reduced Ejection Fraction: The PREVEND Study. J Am Heart Assoc 2022; 11:e024952. [PMID: 35876420 PMCID: PMC9375507 DOI: 10.1161/jaha.121.024952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The role of fibroblast growth factor 23 (FGF23) in the development of new‐onset heart failure (HF) with reduced (HFrEF) or preserved ejection fraction (HFpEF) in the general population is unknown. Therefore, we set out to investigate associations of C‐terminal FGF23 with development of new‐onset HF and, more specifically, with HFrEF or HFpEF in a large, prospective, population‐based cohort. Methods and Results We studied 6830 participants (aged 53.8±12.1 years; 49.7% men; estimated glomerular filtration rate, 93.1±15.7 mL/min per 1.73 m2) in the community‐based PREVEND (Prevention of Renal and Vascular End‐Stage Disease) study who were free of HF at baseline. Cross‐sectional multivariable linear regression analysis showed that ferritin (standardized β, −0.24; P<0.001) and estimated glomerular filtration rate (standardized β, −0.13; P<0.001) were the strongest independent correlates of FGF23. Multivariable Cox proportional hazard regression was used to study the association between baseline FGF23 and incident HF, HFrEF (ejection fraction ≤40%) or HFpEF (ejection fraction ≥50%). After median follow‐up of 7.4 [IQR 6.9–7.9] years, 227 individuals (3.3%) developed new‐onset HF, of whom 132 had HFrEF and 88 had HFpEF. A higher FGF23 level was associated with an increased risk of incident HF (fully adjusted hazard ratio, 1.29 [95% CI, 1.06–1.57]) and with an increased risk of incident HFrEF (fully adjusted hazard ratio, 1.31 [95% CI, 1.01–1.69]). The association between FGF23 and incident HFpEF lost statistical significance after multivariable adjustment (hazard ratio, 1.22 [95% CI, 0.87–1.71]). Conclusions Higher FGF23 is independently associated with new‐onset HFrEF in analyses fully adjusted for cardiovascular risk factors and other potential confounders. The association between FGF23 and incident HFpEF lost statistical significance upon multivariable adjustment.
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Affiliation(s)
- S Heleen Binnenmars
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Georgette E Hoogslag
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Stanley M H Yeung
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Frank P Brouwers
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Wiek H van Gilst
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Ron T Gansevoort
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Adriaan A Voors
- Department of Cardiology University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology University of Groningen, University Medical Center Groningen Groningen The Netherlands
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14
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Bonneville EF, Resche-Rigon M, Schetelig J, Putter H, de Wreede LC. Multiple imputation for cause-specific Cox models: Assessing methods for estimation and prediction. Stat Methods Med Res 2022; 31:1860-1880. [PMID: 35658734 PMCID: PMC9523822 DOI: 10.1177/09622802221102623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In studies analyzing competing time-to-event outcomes, interest often lies in both estimating the effects of baseline covariates on the cause-specific hazards and predicting cumulative incidence functions. When missing values occur in these baseline covariates, they may be discarded as part of a complete-case analysis or multiply imputed. In the latter case, the imputations may be performed either compatibly with a substantive model pre-specified as a cause-specific Cox model [substantive model compatible fully conditional specification (SMC-FCS)], or approximately so [multivariate imputation by chained equations (MICE)]. In a large simulation study, we assessed the performance of these three different methods in terms of estimating cause-specific regression coefficients and predicting cumulative incidence functions. Concerning regression coefficients, results provide further support for use of SMC-FCS over MICE, particularly when covariate effects are large and the baseline hazards of the competing events are substantially different. Complete-case analysis also shows adequate performance in settings where missingness is not outcome dependent. With regard to cumulative incidence prediction, SMC-FCS and MICE are performed more similarly, as also evidenced in the illustrative analysis of competing outcomes following a hematopoietic stem cell transplantation. The findings are discussed alongside recommendations for practising statisticians.
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Affiliation(s)
- Edouard F Bonneville
- Department of Biomedical Data Sciences, 4501Leiden University Medical Center, Leiden, The Netherlands
| | - Matthieu Resche-Rigon
- Service de Biostatistique et Information Médicale, 55663Hôpital Saint-Louis, Paris, France.,538360Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité, Paris, France.,ECSTRRA Team, 27102INSERM, Paris, France
| | - Johannes Schetelig
- 39063Dresden University Hospital, Dresden, Germany.,DKMS Clinical Trials Unit, Dresden, Germany
| | - Hein Putter
- Department of Biomedical Data Sciences, 4501Leiden University Medical Center, Leiden, The Netherlands
| | - Liesbeth C de Wreede
- Department of Biomedical Data Sciences, 4501Leiden University Medical Center, Leiden, The Netherlands.,DKMS Clinical Trials Unit, Dresden, Germany
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15
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Remigio RV, Turpin R, Raimann JG, Kotanko P, Maddux FW, Sapkota AR, Liang XZ, Puett R, He X, Sapkota A. Assessing proximate intermediates between ambient temperature, hospital admissions, and mortality in hemodialysis patients. ENVIRONMENTAL RESEARCH 2022; 204:112127. [PMID: 34582801 PMCID: PMC8901270 DOI: 10.1016/j.envres.2021.112127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Typical thermoregulatory responses to elevated temperatures among healthy individuals include reduced blood pressure and perspiration. Individuals with end-stage kidney disease (ESKD) are susceptible to systemic fluctuations caused by ambient temperature changes that may increase morbidity and mortality. We investigated whether pre-dialysis systolic blood pressure (preSBP) and interdialytic weight gain (IDWG) can independently mediate the association between ambient temperature, all-cause hospital admissions (ACHA), and all-cause mortality (ACM). METHODS The study population consisted of ESKD patients receiving hemodialysis treatments at Fresenius Medical Care facilities in Philadelphia County, PA, from 2011 to 2019 (n = 1981). Within a time-to-event framework, we estimated the association between daily maximum dry-bulb temperature (TMAX) and, as separate models, ACHA and ACM during warmer calendar months. Clinically measured preSBP and IDWG responses to temperature increases were estimated using linear mixed effect models. We employed the difference (c-c') method to decompose total effect models for ACHA and ACM using preSBP and IDWG as time-dependent mediators. Covariate adjustments for exposure-mediator and total and direct effect models include age, race, ethnicity, blood pressure medication use, treatment location, preSBP, and IDWG. We considered lags up to two days for exposure and 1-day lag for mediator variables (Lag 2-Lag 1) to assure temporality between exposure-outcome models. Sensitivity analyses for 2-day (Lag 2-only) and 1-day (Lag 1-only) lag structures were also conducted. RESULTS Based on Lag 2- Lag 1 temporal ordering, 1 °C increase in daily TMAX was associated with increased hazard of ACHA by 1.4% (adjusted hazard ratio (HR), 1.014; 95% confidence interval, 1.007-1.021) and ACM 7.5% (adjusted HR, 1.075, 1.050-1.100). Short-term lag exposures to 1 °C increase in temperature predicted mean reductions in IDWG and preSBP by 0.013-0.015% and 0.168-0.229 mmHg, respectively. Mediation analysis for ACHA identified significant indirect effects for all three studied pathways (preSBP, IDWG, and preSBP + IDWG) and significant indirect effects for IDWG and conjoined preSBP + IDWG pathways for ACM. Of note, only 1.03% of the association between temperature and ACM was mediated through preSBP. The mechanistic path for IDWG, independent of preSBP, demonstrated inconsistent mediation and, consequently, potential suppression effects in ACHA (-15.5%) and ACM (-6.3%) based on combined pathway models. Proportion mediated estimates from preSBP + IDWG pathways achieved 2.2% and 0.3% in combined pathway analysis for ACHA and ACM outcomes, respectively. Lag 2 discrete-time ACM mediation models exhibited consistent mediation for all three pathways suggesting that 2-day lag in IDWG and preSBP responses can explain 2.11% and 4.41% of total effect association between temperature and mortality, respectively. CONCLUSION We corroborated the previously reported association between ambient temperature, ACHA and ACM. Our results foster the understanding of potential physiological linkages that may explain or suppress temperature-driven hospital admissions and mortality risks. Of note, concomitant changes in preSBP and IDWG may have little intermediary effect when analyzed in combined pathway models. These findings advance our assessment of candidate interventions to reduce the impact of outdoor temperature change on ESKD patients.
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Affiliation(s)
- Richard V Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA.
| | - Rodman Turpin
- Department of Epidemiology and Biostatistics, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | | | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA; Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | | | - Amy Rebecca Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Sciences, University of Maryland-College Park, College Park, MD, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland-College Park, School of Public Health, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland-College Park, School of Public Health, College Park, MD, USA
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16
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Signorovitch J, Moshyk A, Zhao J, Le TK, Burns L, Gooden K, Hamilton M. Overall survival in the real-world and clinical trials: a case study validating external controls in advanced melanoma. Future Oncol 2022; 18:1321-1331. [PMID: 35048743 DOI: 10.2217/fon-2021-1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: We assessed the suitability of real-world data (RWD) as an external control for analysis of overall survival (OS) compared with clinical trial data (CTD) in advanced melanoma. Methods: OS among adults receiving ipilimumab for advanced melanoma was compared between trials (CTD group) and the Flatiron Health database (RWD group) using Cox models. Adjusted analyses accounted for differences in baseline factors; missing data were addressed through multiple imputation. Results: After adjusting for baseline factors and accounting for missingness, OS was similar in the CTD (n = 241) versus RWD groups (n = 816) (hazard ratio: 0.98; 95% CI: 0.75-1.26). Conclusion: Flatiron Health data is suitable to construct external control groups for OS in advanced melanoma trials after adjusting for baseline factors and missing data.
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Affiliation(s)
- James Signorovitch
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA 02199, USA
| | - Andriy Moshyk
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08540, USA
| | - Jing Zhao
- Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA 02199, USA
| | - Trong Kim Le
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08540, USA
| | - Leah Burns
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08540, USA
| | - Kyna Gooden
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08540, USA
| | - Melissa Hamilton
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ 08540, USA
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Costi S, Morris LS, Collins A, Fernandez NF, Patel M, Xie H, Kim-Schulze S, Stern ER, Collins KA, Cathomas F, Parides MK, Whitton AE, Pizzagalli DA, Russo SJ, Murrough JW. Peripheral immune cell reactivity and neural response to reward in patients with depression and anhedonia. Transl Psychiatry 2021; 11:565. [PMID: 34741019 PMCID: PMC8571388 DOI: 10.1038/s41398-021-01668-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/10/2021] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Increased levels of peripheral cytokines have been previously associated with depression in preclinical and clinical research. Although the precise nature of peripheral immune dysfunction in depression remains unclear, evidence from animal studies points towards a dysregulated response of peripheral leukocytes as a risk factor for stress susceptibility. This study examined dynamic release of inflammatory blood factors from peripheral blood mononuclear cells (PBMC) in depressed patients and associations with neural and behavioral measures of reward processing. Thirty unmedicated patients meeting criteria for unipolar depressive disorder and 21 healthy control volunteers were enrolled. PBMCs were isolated from whole blood and stimulated ex vivo with lipopolysaccharide (LPS). Olink multiplex assay was used to analyze a large panel of inflammatory proteins. Participants completed functional magnetic resonance imaging with an incentive flanker task to probe neural responses to reward anticipation, as well as clinical measures of anhedonia and pleasure including the Temporal Experience of Pleasure Scale (TEPS) and the Snaith-Hamilton Pleasure Scale (SHAPS). LPS stimulation revealed larger increases in immune factors in depressed compared to healthy subjects using an aggregate immune score (t49 = 2.83, p = 0.007). Higher peripheral immune score was associated with reduced neural responses to reward anticipation within the ventral striatum (VS) (r = -0.39, p = 0.01), and with reduced anticipation of pleasure as measured with the TEPS anticipatory sub-score (r = -0.318, p = 0.023). Our study provides new evidence suggesting that dynamic hyper-reactivity of peripheral leukocytes in depressed patients is associated with blunted activation of the brain reward system and lower subjective anticipation of pleasure.
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Affiliation(s)
- Sara Costi
- grid.59734.3c0000 0001 0670 2351Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Laurel S. Morris
- grid.59734.3c0000 0001 0670 2351Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Abigail Collins
- grid.59734.3c0000 0001 0670 2351Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Nicolas F. Fernandez
- grid.59734.3c0000 0001 0670 2351Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Manishkumar Patel
- grid.59734.3c0000 0001 0670 2351Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Hui Xie
- grid.59734.3c0000 0001 0670 2351Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Seunghee Kim-Schulze
- grid.59734.3c0000 0001 0670 2351Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.59734.3c0000 0001 0670 2351Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Emily R. Stern
- grid.137628.90000 0004 1936 8753Department of Psychiatry, New York University School of Medicine, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Katherine A. Collins
- grid.59734.3c0000 0001 0670 2351Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan Kline Institute for Psychiatric Research, Orangeburg, NY USA
| | - Flurin Cathomas
- grid.59734.3c0000 0001 0670 2351Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Michael K. Parides
- grid.240283.f0000 0001 2152 0791Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY USA
| | - Alexis E. Whitton
- grid.38142.3c000000041936754XDepartment of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA USA ,grid.1013.30000 0004 1936 834XSchool of Medical Sciences, The University of Sydney, Sydney, NSW Australia
| | - Diego A. Pizzagalli
- grid.38142.3c000000041936754XDepartment of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA USA
| | - Scott J. Russo
- grid.59734.3c0000 0001 0670 2351Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.59734.3c0000 0001 0670 2351Center for Affective Neuroscience, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - James W. Murrough
- grid.59734.3c0000 0001 0670 2351Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.59734.3c0000 0001 0670 2351Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY USA
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van Ginkel JR, Kroonenberg PM. Multiple imputation to balance unbalanced designs for two-way analysis of variance. METHODOLOGY-EUROPEAN JOURNAL OF RESEARCH METHODS FOR THE BEHAVIORAL AND SOCIAL SCIENCES 2021. [DOI: 10.5964/meth.6085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A balanced ANOVA design provides an unambiguous interpretation of the F-tests, and has more power than an unbalanced design. In earlier literature, multiple imputation was proposed to create balance in unbalanced designs, as an alternative to Type-III sum of squares. In the current simulation study we studied four pooled statistics for multiple imputation, namely D₀, D₁, D₂, and D₃ in unbalanced data, and compared them with Type-III sum of squares. Statistics D₁ and D₂ generally performed best regarding Type-I error rates, and had power rates closest to that of Type-III sum of squares. Additionally, for the interaction, D₁ produced power rates higher than Type-III sum of squares. For multiply imputed datasets D₁ and D₂ may be the best methods for pooling the results in multiply imputed datasets, and for unbalanced data, D₁ might be a good alternative to Type-III sum of squares regarding the interaction.
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19
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Alsaber AR, Pan J, Al-Hurban A. Handling Complex Missing Data Using Random Forest Approach for an Air Quality Monitoring Dataset: A Case Study of Kuwait Environmental Data (2012 to 2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031333. [PMID: 33540610 PMCID: PMC7908071 DOI: 10.3390/ijerph18031333] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
In environmental research, missing data are often a challenge for statistical modeling. This paper addressed some advanced techniques to deal with missing values in a data set measuring air quality using a multiple imputation (MI) approach. MCAR, MAR, and NMAR missing data techniques are applied to the data set. Five missing data levels are considered: 5%, 10%, 20%, 30%, and 40%. The imputation method used in this paper is an iterative imputation method, missForest, which is related to the random forest approach. Air quality data sets were gathered from five monitoring stations in Kuwait, aggregated to a daily basis. Logarithm transformation was carried out for all pollutant data, in order to normalize their distributions and to minimize skewness. We found high levels of missing values for NO2 (18.4%), CO (18.5%), PM10 (57.4%), SO2 (19.0%), and O3 (18.2%) data. Climatological data (i.e., air temperature, relative humidity, wind direction, and wind speed) were used as control variables for better estimation. The results show that the MAR technique had the lowest RMSE and MAE. We conclude that MI using the missForest approach has a high level of accuracy in estimating missing values. MissForest had the lowest imputation error (RMSE and MAE) among the other imputation methods and, thus, can be considered to be appropriate for analyzing air quality data.
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Affiliation(s)
- Ahmad R. Alsaber
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, UK;
- Correspondence:
| | - Jiazhu Pan
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, UK;
| | - Adeeba Al-Hurban
- Department of Earth and Environmental Sciences, Faculty of Science, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait;
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20
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Griffin KW, Scheier LM, Komarc M, Botvin GJ. Adolescent Transitions in Self-Management Strategies and Young Adult Alcohol Use. Eval Health Prof 2021; 44:25-41. [DOI: 10.1177/0163278720983432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals use a variety of strategies to manage their thoughts, emotions, and behaviors across the lifespan. In this study, we used latent class analysis to derive distinct subtypes of self-management skills in early adolescence and latent transition analysis to examine whether movement between different classes was associated with later young adult alcohol use. Assessments of behavioral self-control, affective self-regulation, and cognitive self-reinforcement were obtained in the seventh and 10th grades from students participating in two independent drug prevention trials (control group participants only, N = 3,939). Assessment of alcohol use was obtained when participants were young adults (23–26). A model distinguishing four subtypes of self-management skills fit best for both the seventh and 10th grades. While findings indicated modest stability in class structure over time, maintaining class membership characterized by high cognitive self-reinforcement and high affective self-regulation was consistently protective in terms of young adult alcohol use relative to movement from this to other classes. Transitions in class membership involving an expansion of self-management strategies were protective and associated with lower levels of young adult alcohol use and transitions involving a contraction of self-management strategies associated with higher young adult alcohol use. This study illustrates the important use of person-centered techniques to exemplify how typologies of self-management during adolescence can play a protective role in young adult alcohol use.
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Affiliation(s)
- Kenneth W. Griffin
- Department of Global and Community Health, College of Health & Human Services, George Mason University, Fairfax, VA, USA
| | - Lawrence M. Scheier
- LARS Research Institute, Inc., Scottsdale, AZ, USA
- Prevention Strategies, Greensboro, NC
| | - Martin Komarc
- Faculty of Physical Education and Sport, Department of Kinanthropology and Humanities, Charles University in Prague, Czech Republic
| | - Gilbert J. Botvin
- National Health Promotion Associates, Westchester, NY, USA
- Department of Population Health Sciences, Weill Medical College Cornell University, New York, NY, USA
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21
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Bauvin P, Delacôte C, Lassailly G, Ntandja Wandji LC, Gnemmi V, Dautrecque F, Louvet A, Caiazzo R, Raverdy V, Leteurtre E, Pattou F, Deuffic-Burban S, Mathurin P. A tool to predict progression of non-alcoholic fatty liver disease in severely obese patients. Liver Int 2021; 41:91-100. [PMID: 32881244 DOI: 10.1111/liv.14650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Severely obese patients are a growing population at risk of non-alcoholic fatty liver disease (NAFLD). Considering the increasing burden, a predictive tool of NAFLD progression would be of interest. Our objective was to provide a tool allowing general practitioners to identify and refer the patients most at risk, and specialists to estimate disease progression and adapt the therapeutic strategy. METHODS This predictive tool is based on a Markov model simulating steatosis, fibrosis and non-alcoholic steatohepatitis (NASH) evolution. This model was developped from data of 1801 severely obese, bariatric surgery candidates, with histological assessment, integrating duration of exposure to risk factors. It is then able to predict current disease severity in the absence of assessment, and future cirrhosis risk based on current stage. RESULTS The model quantifies the impact of sex, body-mass index at 20, diabetes, age of overweight onset, on progression. For example, for 40-year-old severely obese patients seen by the general practitioners: (a) non-diabetic woman overweight at 20, and (b) diabetic man overweight at 10, without disease assessment, the model predicts their current risk to have NASH or F3-F4: for (a) 5.7% and 0.6%, for (b) 16.1% and 10.0% respectively. If those patients have been diagnosed F2 by the specialist, the model predicts the 5-year cirrhosis risk: 1.8% in the absence of NASH and 6.0% in its presence for (a), 10.3% and 26.7% respectively, for (b). CONCLUSIONS This model provides a decision-making tool to predict the risk of liver disease that could help manage severely obese patients.
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Affiliation(s)
- Pierre Bauvin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Claire Delacôte
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Guillaume Lassailly
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, CHRU Lille, Lille, France
| | | | - Viviane Gnemmi
- Department of Pathology, Centre de Biologie Pathologie, Univ. Lille, CHU Lille, Inserm UMR-S 1172, Lille, France
| | - Flavien Dautrecque
- Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, CHRU Lille, Lille, France
| | - Alexandre Louvet
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, CHRU Lille, Lille, France
| | - Robert Caiazzo
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, Lille, France
| | | | - Emmanuelle Leteurtre
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPARC - Jean-Pierre Aubert Research Center, Lille, France
| | | | - Sylvie Deuffic-Burban
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Université de Paris, IAME, INSERM, Paris, France
| | - Philippe Mathurin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, CHRU Lille, Lille, France
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22
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van Ginkel JR, Kroonenberg PM. Much ado about nothing: Multiple imputation to balance unbalanced designs for two-way analysis of variance. METHODOLOGY-EUROPEAN JOURNAL OF RESEARCH METHODS FOR THE BEHAVIORAL AND SOCIAL SCIENCES 2020. [DOI: 10.5964/meth.4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In earlier literature, multiple imputation was proposed to create balance in unbalanced designs, as an alternative to Type III sum of squares in two-way ANOVA. In the current simulation study we studied four pooled statistics for multiple imputation, namely D₀, D₁, D₂, and D₃ in unbalanced data, and compared these statistics with Type III sum of squares. Statistics D₀ and D₂ generally performed best regarding Type-I error rates, and had power rates closest to that of Type III sum of squares. However, none of the statistics produced power rates higher than Type III sum of squares. The results lead to the conclusion that for multiply imputed datasets D₀ and D₂ may be the best methods for pooling the results of multiparameter estimates in multiply imputed datasets, and that for unbalanced data, Type III sum of square is to be preferred over using multiple imputation in obtaining ANOVA results.
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23
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Brown JC, Rosenthal MH, Ma C, Zhang S, Nimeiri HS, McCleary NJ, Abrams TA, Yurgelun MB, Cleary JM, Rubinson DA, Schrag D, Bullock AJ, Allen J, Zuckerman D, Chan E, Chan JA, Wolpin B, Constantine M, Weckstein DJ, Faggen MA, Thomas CA, Kournioti C, Yuan C, Zheng H, Hollis BW, Fuchs CS, Ng K, Meyerhardt JA. Effect of High-Dose vs Standard-Dose Vitamin D 3 Supplementation on Body Composition among Patients with Advanced or Metastatic Colorectal Cancer: A Randomized Trial. Cancers (Basel) 2020; 12:cancers12113451. [PMID: 33233566 PMCID: PMC7699725 DOI: 10.3390/cancers12113451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Skeletal muscle and adipose tissue express the vitamin D receptor and may be a mechanism through which vitamin D supplementation slows cancer progression and reduces cancer death. It is unknown if high-dose vitamin D3 impacts skeletal muscle and adipose tissue, as compared with standard-dose vitamin D3, in patients with advanced or metastatic colorectal cancer. In this exploratory analysis of a phase II randomized trial, high-dose vitamin D3 did not lead to changes of body weight, body mass index, muscle area, muscle attenuation, visceral adipose tissue area, or subcutaneous adipose tissue area, as compared with standard-dose vitamin D3. High-dose vitamin D3 did not change body composition in patients receiving chemotherapy for advanced or metastatic colorectal cancer. Abstract Skeletal muscle and adipose tissue express the vitamin D receptor and may be a mechanism through which vitamin D supplementation slows cancer progression and reduces cancer death. In this exploratory analysis of a double-blind, multicenter, randomized phase II clinical trial, 105 patients with advanced or metastatic colorectal cancer who were receiving chemotherapy were randomized to either high-dose vitamin D3 (4000 IU) or standard-dose (400 IU) vitamin D3. Body composition was measured with abdominal computed tomography at enrollment (baseline) and after cycle 8 of chemotherapy (16 weeks). As compared with standard-dose vitamin D3, high-dose vitamin D3 did not significantly change body weight [−0.7 kg; (95% CI: −3.5, 2.0)], body mass index [−0.2 kg/m2; (95% CI: −1.2, 0.7)], muscle area [−1.7 cm2; (95% CI: −9.6, 6.3)], muscle attenuation [−0.4 HU; (95% CI: −4.2, 3.2)], visceral adipose tissue area [−7.5 cm2; (95% CI: −24.5, 9.6)], or subcutaneous adipose tissue area [−8.3 cm2; (95% CI: −35.5, 18.9)] over the first 8 cycles of chemotherapy. Among patients with advanced or metastatic colorectal cancer, the addition of high-dose vitamin D3, vs standard-dose vitamin D3, to standard chemotherapy did not result in any changes in body composition.
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Affiliation(s)
- Justin C. Brown
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70012, USA
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70012, USA
- Correspondence: ; Tel.: +1-225-763-2715
| | - Michael H. Rosenthal
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Chao Ma
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Sui Zhang
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Halla S. Nimeiri
- Division of Hematology Oncology, Department of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Nadine J. McCleary
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Thomas A. Abrams
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Matthew B. Yurgelun
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - James M. Cleary
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Douglas A. Rubinson
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Deborah Schrag
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | | | - Jill Allen
- Massachusetts General Hospital, Boston, MA 02114, USA; (J.A.); (H.Z.)
| | - Dan Zuckerman
- St Luke’s Mountain States Tumor Institute, Boise, ID 83712, USA;
| | - Emily Chan
- Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Jennifer A. Chan
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Brian Wolpin
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | | | | | | | | | | | - Chen Yuan
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Hui Zheng
- Massachusetts General Hospital, Boston, MA 02114, USA; (J.A.); (H.Z.)
| | - Bruce W. Hollis
- Department of Pediatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA;
| | | | - Kimmie Ng
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
| | - Jeffrey A. Meyerhardt
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA; (M.H.R.); (C.M.); (S.Z.); (N.J.M.); (T.A.A.); (M.B.Y.); (J.M.C.); (D.A.R.); (D.S.); (J.A.C.); (B.W.); (C.Y.); (K.N.); (J.A.M.)
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24
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Kar S, Garin V, Kholová J, Vadez V, Durbha SS, Tanaka R, Iwata H, Urban MO, Adinarayana J. SpaTemHTP: A Data Analysis Pipeline for Efficient Processing and Utilization of Temporal High-Throughput Phenotyping Data. FRONTIERS IN PLANT SCIENCE 2020; 11:552509. [PMID: 33329623 PMCID: PMC7714717 DOI: 10.3389/fpls.2020.552509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
The rapid development of phenotyping technologies over the last years gave the opportunity to study plant development over time. The treatment of the massive amount of data collected by high-throughput phenotyping (HTP) platforms is however an important challenge for the plant science community. An important issue is to accurately estimate, over time, the genotypic component of plant phenotype. In outdoor and field-based HTP platforms, phenotype measurements can be substantially affected by data-generation inaccuracies or failures, leading to erroneous or missing data. To solve that problem, we developed an analytical pipeline composed of three modules: detection of outliers, imputation of missing values, and mixed-model genotype adjusted means computation with spatial adjustment. The pipeline was tested on three different traits (3D leaf area, projected leaf area, and plant height), in two crops (chickpea, sorghum), measured during two seasons. Using real-data analyses and simulations, we showed that the sequential application of the three pipeline steps was particularly useful to estimate smooth genotype growth curves from raw data containing a large amount of noise, a situation that is potentially frequent in data generated on outdoor HTP platforms. The procedure we propose can handle up to 50% of missing values. It is also robust to data contamination rates between 20 and 30% of the data. The pipeline was further extended to model the genotype time series data. A change-point analysis allowed the determination of growth phases and the optimal timing where genotypic differences were the largest. The estimated genotypic values were used to cluster the genotypes during the optimal growth phase. Through a two-way analysis of variance (ANOVA), clusters were found to be consistently defined throughout the growth duration. Therefore, we could show, on a wide range of scenarios, that the pipeline facilitated efficient extraction of useful information from outdoor HTP platform data. High-quality plant growth time series data is also provided to support breeding decisions. The R code of the pipeline is available at https://github.com/ICRISAT-GEMS/SpaTemHTP.
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Affiliation(s)
- Soumyashree Kar
- Centre of Studies in Resources Engineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Vincent Garin
- Crop Physiology, International Crop Research Institute for Semi-Arid Tropics (ICRISAT), Hyderabad, India
| | - Jana Kholová
- Crop Physiology, International Crop Research Institute for Semi-Arid Tropics (ICRISAT), Hyderabad, India
| | - Vincent Vadez
- Crop Physiology, International Crop Research Institute for Semi-Arid Tropics (ICRISAT), Hyderabad, India
- Institut de Recherche pour le Développement (IRD) – Université de Montpellier – UMR DIADE, Montpellier, France
| | - Surya S. Durbha
- Centre of Studies in Resources Engineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Ryokei Tanaka
- Laboratory of Biometrics and Bioinformatics, University of Tokyo, Tokyo, Japan
| | - Hiroyoshi Iwata
- Laboratory of Biometrics and Bioinformatics, University of Tokyo, Tokyo, Japan
| | - Milan O. Urban
- Bean Physiology - Agrobiodiversity, Alliance of Bioversity International and CIAT, Cali, Colombia
| | - J. Adinarayana
- Centre of Studies in Resources Engineering, Indian Institute of Technology Bombay, Mumbai, India
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25
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Lee S, Chang AM, Buxton OM, Jackson CL. Various Types of Perceived Job Discrimination and Sleep Health Among Working Women: Findings From the Sister Study. Am J Epidemiol 2020; 189:1143-1153. [PMID: 32406503 DOI: 10.1093/aje/kwaa075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 04/29/2020] [Indexed: 12/27/2022] Open
Abstract
Job discrimination, a social stressor, may lead to sleep health disparities among workers; yet, limited research has examined this relationship and specific sources of job discrimination. We used a US sample of working women (n = 26,085), participants in the Sister Study (2008-2016), to examine the associations of perceived job discrimination due to sex, race, age, health conditions, and/or sexual orientation with sleep health. Cross-sectionally, linear or logistic regression models revealed that each source of job discrimination was independently associated with different sleep problems after controlling for other sources of job discrimination. Longitudinally, among participants without short sleep (<7 hours/night) at time 1 (2012-2014), age-specific job discrimination was associated with 21% increased odds of new-onset short sleep (odds ratio = 1.21, 95% confidence interval: 1.03, 1.43) at time 2 (2014-2016). Among those without insomnia symptoms at time 1, race-specific job discrimination was associated with 37% increased odds of new-onset insomnia symptoms (odds ratio = 1.37, 95% confidence interval: 1.07, 1.75) at time 2. Sex- and health-specific job discrimination also predicted new-onset sleepiness. There were dose-response relationships such that a greater number of sources of job discrimination (≥3) was associated with greater odds of prevalent and incident sleep problems. Perceived job discrimination may contribute to working women's poor sleep health over time, raising concerns about sleep health disparities emanating from the workplace.
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26
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Green A, Vasquez Osorio E, Aznar MC, McWilliam A, van Herk M. Image Based Data Mining Using Per-voxel Cox Regression. Front Oncol 2020; 10:1178. [PMID: 32793486 PMCID: PMC7386130 DOI: 10.3389/fonc.2020.01178] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/10/2020] [Indexed: 11/13/2022] Open
Abstract
Image Based Data Mining (IBDM) is a novel analysis technique allowing the interrogation of large amounts of routine radiotherapy data. Using this technique, unexpected correlations have been identified between dose close to the prostate and biochemical relapse, and between dose to the base of the heart and survival in lung cancer. However, most analyses to date have considered only dose when identifying a region of interest, with confounding variables accounted for post-hoc, most often using a multivariate Cox regression. In this work, we introduce a novel method to account for confounding variables directly in the analysis, by performing a Cox regression in every voxel of the dose distribution, and apply it in the analysis of a large cohort of lung cancer patients. Our method produces three-dimensional maps of hazard for clinical variables, accounting for dose at each spatial location in the patient. Results confirm that a region of interest exists in the base of the heart where those patients with poor performance status (PS), PS > 1, have a stronger adverse reaction to incidental dose, but that the effect changes when considering other clinical variables, with patient age becoming dominant. Analyses such as this will help shape future clinical trials in which hypotheses generated by the analysis will be tested.
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Affiliation(s)
- Andrew Green
- The University of Manchester, Radiotherapy Related Research, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Eliana Vasquez Osorio
- The University of Manchester, Radiotherapy Related Research, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Marianne C. Aznar
- The University of Manchester, Radiotherapy Related Research, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alan McWilliam
- The University of Manchester, Radiotherapy Related Research, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Marcel van Herk
- The University of Manchester, Radiotherapy Related Research, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
- NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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27
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Santos IKSD, Conde WL. [Predictive Mean Matching as an alternative imputation method to hot deck in Vigitel]. CAD SAUDE PUBLICA 2020; 36:e00167219. [PMID: 32609171 DOI: 10.1590/0102-311x00167219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 05/17/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the estimated means for weight, height, and body mass index (BMI) according to two imputation methods, using data from Vigitel (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interview). This was a cross-sectional study that used secondary data from the Vigitel survey from 2006 to 2017. The two imputation methods used in the study were hot deck and Predictive Mean Matching (PMM). The weight and height variables imputed by hot deck were provided by Vigitel. Two models were conducted with PMM: (i) explanatory variables - city, sex, age in years, race/color, and schooling; (ii) explanatory variables - city, sex, and age in years. Weight and height were the outcome variables in the two models. PMM combines linear regression and random selection of the value for imputation. Linear prediction is used as a measure of distance between the missing value and the possible donors, thereby creating the virtual space with the candidate cases for yielding the value for imputation. One of the candidates from the pool is randomly selected, and its value is assigned to the missing unit. BMI was calculated by dividing weight in kilograms by height squared. The result shows the means and standard deviations for weight, height, and BMI according to imputation method and year. The estimates used the survey module from Stata, which considers the sampling effects. The mean values for weight, height, and BMI estimated by hot deck and PMM were similar. The results with the Vigitel data suggest the applicability of PMM to the set of health surveys.
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Affiliation(s)
- Iolanda Karla Santana Dos Santos
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.,Fundação Universidade Federal do ABC, Santo André, Brasil
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28
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Hermes GDA, Eckermann HA, de Vos WM, de Weerth C. Does entry to center-based childcare affect gut microbial colonization in young infants? Sci Rep 2020; 10:10235. [PMID: 32581284 PMCID: PMC7314774 DOI: 10.1038/s41598-020-66404-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 05/13/2020] [Indexed: 12/12/2022] Open
Abstract
Entry to center-based childcare (CC) at three months of life can be an important challenge for infants as it includes major stressors such as long maternal separations and frequently changing caregivers. Stress and the new environment may in turn alter the composition of the gut microbiota with possible implications for future health outcomes. As part of an ongoing longitudinal study, we investigated whether CC, as compared to being cared for by the parents at home, alters the composition of the gut microbiota, while accounting for known covariates of the infant gut microbiota. Stool samples of infants who entered CC (n = 49) and control infants (n = 49) were obtained before and four weeks after CC entrance. Using Redundancy analysis, Random Forests and Bayesian linear models we found that infant gut microbiota was not affected in a uniform way by entry to CC. In line with the literature, breastfeeding, birth mode, age, and the presence of siblings were shown to significantly impact the microbial composition.
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Affiliation(s)
- Gerben D A Hermes
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Henrik A Eckermann
- Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willem M de Vos
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.
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29
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Kawashima H, Gao C, Takahashi K, Tomaniak M, Ono M, Hara H, Wang R, Chichareon P, Suryapranata H, Walsh S, Cotton J, Koning R, Rensing B, Wykrzykowska J, de Winter RJ, Garg S, Anderson R, Hamm C, Steg PG, Onuma Y, Serruys PW. Comparative Assessment of Predictive Performance of PRECISE-DAPT, CRUSADE, and ACUITY Scores in Risk Stratifying 30-Day Bleeding Events. Thromb Haemost 2020; 120:1087-1095. [PMID: 32572864 PMCID: PMC8289707 DOI: 10.1055/s-0040-1712449] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background
The utility of the PRECISE-DAPT score in predicting short-term major bleeding, either alone, or in comparison with the CRUSADE and ACUITY scores, has not been investigated. This analysis compared the predictive performances of the three bleeding scores in stratifying the risk of 30-day major bleeding postpercutaneous coronary intervention in patients with dual-antiplatelet therapy.
Methods
In this post hoc subanalysis of the GLOBAL LEADERS trial, the primary safety objective (bleeding according to the Bleeding Academic Research Consortium [BARC] criteria [type 3 or 5]) was assessed at 30 days according to the three scores in the overall population, and in patients with acute (ACS) and chronic coronary syndrome (CCS).
Results
In a total of 15,968 patients, we calculated all three scores in 14,709 (92.1%). Irrespective of clinical presentation, the PRECISE-DAPT (
c
-statistics: 0.648, 0.653, and 0.641, respectively), CRUSADE (
c
-statistics: 0.641, 0.639, and 0.644, respectively), and ACUITY (
c
-statistics: 0.633, 0.638, and 0.623, respectively) scores were no significant between-score differences in discriminatory performance for BARC 3 or 5 bleeding up to 30 days, and similarly the PRECISE-DAPT score had a comparable discriminative capacity according to the integrated discrimination improvement when compared with the other scores. In ACS, the CRUSADE score had a poor calibration ability (Hosmer–Lemeshow goodness-of-fit [GOF] chi-square = 15.561,
p
= 0.049), whereas in CCS, the PRECISE-DAPT score had poor calibration (GOF chi-square = 15.758,
p
= 0.046).
Conclusion
The PRECISE-DAPT score might be clinically useful in the overall population and ACS patients for the prediction of short-term major bleeding considering its discriminative and calibration abilities.
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Affiliation(s)
- Hideyuki Kawashima
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands.,Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Chao Gao
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
| | - Kuniaki Takahashi
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Mariusz Tomaniak
- First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Masafumi Ono
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands.,Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Hironori Hara
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Rutao Wang
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
| | - Ply Chichareon
- Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Simon Walsh
- Department of Cardiology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - James Cotton
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | - Benno Rensing
- Sint-Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Joanna Wykrzykowska
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Robbert J de Winter
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands
| | - Scot Garg
- East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom
| | | | - Christian Hamm
- Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany
| | - Philippe Gabriel Steg
- Assistance Publique-Hôpitaux de Paris, INSERM U-1148, FACT (French Alliance for Cardiovascular Trials), Hôpital Bichat, Université de Paris, Paris, France.,Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland.,NHLI, Imperial College London, London, United Kingdom
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30
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Daily SM, Mann MJ, Lilly CL, Bias TK, Smith ML, Kristjansson AL. School Climate as a Universal Intervention to Prevent Substance Use Initiation in Early Adolescence: A Longitudinal Study. HEALTH EDUCATION & BEHAVIOR 2020; 47:402-411. [PMID: 32281413 DOI: 10.1177/1090198120914250] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Initiation of substance use often starts during adolescence, with tobacco and alcohol use frequently preceding the use of marijuana and other illicit drugs. Studies suggest that a positive school climate may prevent substance use while promoting healthy student behaviors. The purpose of this study was to determine the longitudinal associations between school climate and substance use initiation in a group of middle school students. Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2,097 sixth-, seventh-, and eighth-grade students across 16 regional schools located in three counties in West Virginia. Results suggest that a positive school climate may prevent substance use initiation (β = -0.07 to -0.25, p < .01). However, perceptions of school climate decreased on their own over time (β = -0.28 to -0.66, p < .01). Furthermore, substance use initiation also increased as students grew older (β = 0.96 to 0.99, p < .01) and reduced the effects of school climate longitudinally (β = -0.07 to -0.24, p < .01). Early substance use initiation may be a warning sign of other underlying student issues and requires additional school support to foster student success. Findings suggest that a positive school climate may delay substance use initiation and promote school success. School climate may, therefore, be useful as an intervention to support school-based health promotion.
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31
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Schjørring OL, Jensen AK, Nielsen CG, Ciubotariu A, Perner A, Wetterslev J, Lange T, Rasmussen BS. Arterial oxygen tensions in mechanically ventilated ICU patients and mortality: a retrospective, multicentre, observational cohort study. Br J Anaesth 2020; 124:420-429. [DOI: 10.1016/j.bja.2019.12.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/05/2019] [Accepted: 12/23/2019] [Indexed: 11/28/2022] Open
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32
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van Ginkel JR. Standardized Regression Coefficients and Newly Proposed Estimators for [Formula: see text] in Multiply Imputed Data. PSYCHOMETRIKA 2020; 85:185-205. [PMID: 32162232 PMCID: PMC7186259 DOI: 10.1007/s11336-020-09696-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 01/30/2020] [Indexed: 06/10/2023]
Abstract
Whenever statistical analyses are applied to multiply imputed datasets, specific formulas are needed to combine the results into one overall analysis, also called combination rules. In the context of regression analysis, combination rules for the unstandardized regression coefficients, the t-tests of the regression coefficients, and the F-tests for testing [Formula: see text] for significance have long been established. However, there is still no general agreement on how to combine the point estimators of [Formula: see text] in multiple regression applied to multiply imputed datasets. Additionally, no combination rules for standardized regression coefficients and their confidence intervals seem to have been developed at all. In the current article, two sets of combination rules for the standardized regression coefficients and their confidence intervals are proposed, and their statistical properties are discussed. Additionally, two improved point estimators of [Formula: see text] in multiply imputed data are proposed, which in their computation use the pooled standardized regression coefficients. Simulations show that the proposed pooled standardized coefficients produce only small bias and that their 95% confidence intervals produce coverage close to the theoretical 95%. Furthermore, the simulations show that the newly proposed pooled estimates for [Formula: see text] are less biased than two earlier proposed pooled estimates.
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Affiliation(s)
- Joost R van Ginkel
- Faculty of Social and Behavioural Sciences, Department of Methodology and Statistics, Leiden University, PO Box 9500, 2300 RB, Leiden, The Netherlands.
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33
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Daily SM, Mann MJ, Lilly CL, Dyer AM, Smith ML, Kristjansson AL. School Climate as an Intervention to Reduce Academic Failure and Educate the Whole Child: A Longitudinal Study. THE JOURNAL OF SCHOOL HEALTH 2020; 90:182-193. [PMID: 31903632 PMCID: PMC7427837 DOI: 10.1111/josh.12863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/10/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Preventing student academic failure is crucial to student health and life success. Previous studies suggest a positive school climate may reduce students' risk for academic failure and contribute to academic success. The purpose of this study was to determine the longitudinal associations between school climate and academic grades in a group of middle school students who transition into high school. METHODS Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2604 in 6th, 7th, and 8th-grade students across 16 regional schools located in 3 counties in West Virginia. RESULTS Students with higher perceptions of a positive school climate exhibited sustained or improved academic achievement over time (β = 0.22 to 0.30, p < .01). Higher positive perceptions of school climate appear to sustain students who earn As/Bs (β = 0.20 to 0.27, p < .01) and strengthen students who earn Cs/Ds/Fs (β = -0.16 to -0.46, p < .05). CONCLUSIONS Positive student perceptions of school climate may sustain high academic performance while strengthening students who earn Cs/Ds/Fs. School climate may be useful as an intervention to support school-based health promotion to reduce the achievement gap in the United States.
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Affiliation(s)
- Shay M Daily
- Research Associate, , West Virginia University School of Public Health, 1 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26505
| | - Michael J Mann
- Associate Professor, , Boise State University, 1910 University Drive, Boise, ID 83725
| | - Christa L Lilly
- Associate Professor, , West Virginia University School of Public Health, 1 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26506
| | - Angela M Dyer
- Research Associate, , West Virginia University School of Public Health, 1 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26506
| | - Megan L Smith
- Assistant Professor, , Boise State University, 1910 University Drive, Boise, ID 83725
| | - Alfgeir L Kristjansson
- Associate Professor, , West Virginia University School of Public Health, 1 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26506
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34
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Ward RC, Axon RN, Gebregziabher M. Approaches for missing covariate data in logistic regression with MNAR sensitivity analyses. Biom J 2020; 62:1025-1037. [PMID: 31957905 DOI: 10.1002/bimj.201900117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/11/2019] [Accepted: 10/31/2019] [Indexed: 11/11/2022]
Abstract
Data with missing covariate values but fully observed binary outcomes are an important subset of the missing data challenge. Common approaches are complete case analysis (CCA) and multiple imputation (MI). While CCA relies on missing completely at random (MCAR), MI usually relies on a missing at random (MAR) assumption to produce unbiased results. For MI involving logistic regression models, it is also important to consider several missing not at random (MNAR) conditions under which CCA is asymptotically unbiased and, as we show, MI is also valid in some cases. We use a data application and simulation study to compare the performance of several machine learning and parametric MI methods under a fully conditional specification framework (MI-FCS). Our simulation includes five scenarios involving MCAR, MAR, and MNAR under predictable and nonpredictable conditions, where "predictable" indicates missingness is not associated with the outcome. We build on previous results in the literature to show MI and CCA can both produce unbiased results under more conditions than some analysts may realize. When both approaches were valid, we found that MI-FCS was at least as good as CCA in terms of estimated bias and coverage, and was superior when missingness involved a categorical covariate. We also demonstrate how MNAR sensitivity analysis can build confidence that unbiased results were obtained, including under MNAR-predictable, when CCA and MI are both valid. Since the missingness mechanism cannot be identified from observed data, investigators should compare results from MI and CCA when both are plausibly valid, followed by MNAR sensitivity analysis.
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Affiliation(s)
- Ralph C Ward
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Robert Neal Axon
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
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35
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Spronk I, Van Loey NEE, Sewalt C, Nieboer D, Renneberg B, Moi AL, Oster C, Orwelius L, van Baar ME, Polinder S. Recovery of health-related quality of life after burn injuries: An individual participant data meta-analysis. PLoS One 2020; 15:e0226653. [PMID: 31923272 PMCID: PMC6953837 DOI: 10.1371/journal.pone.0226653] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/29/2019] [Indexed: 01/23/2023] Open
Abstract
Background A prominent outcome measure within burn care is health related quality of life (HRQL). Until now, no model for long-term recovery of HRQL exists for adult burn patients which requires large samples with repeated measurements. Re-use and the combination of existing data is a way to achieve larger data samples that enable the estimation of long-term recovery models. The aim of this secondary data analysis was to assess the recovery of HRQL after a burn injury over time. Methods and findings Data from ten European studies on generic HRQL assessed in adult burn patients (either with the EQ-5D or SF-36) from five different countries were merged into one dataset. SF-36 outcomes were transformed into EQ-5D outcomes. A 24-month recovery of HRQL (EQ-5D utility) was modeled using a linear mixed-effects model and adjusted for important patient and burn characteristics. Subgroups of patients with mild and intermediate burns (≤20% total body surface area (TBSA) burned) and with major burns (>20% TBSA burned) were compared. The combined database included 1687 patients with a mean age of 43 (SD 15) years and a median %TBSA burned of 9% (IQR 4–18). There was large improvement in HRQL up to six months after burns, and HRQL remained relatively stable afterwards (studied up to 24 months post burn). However, the estimated EQ-5D utility scores remained below the norm scores of the general population. In this large sample, females, patients with a long hospital stay and patients with major burns had a delayed and worse recovery. The proportion of patients that reported problems for the EQ-5D dimensions ranged from 100% (pain/discomfort at baseline in patients with major burns) to 10% (self-care ≥3 months after injury in patients with mild and intermediate burns). After 24 months, both subgroups of burn patients did not reach the level of the general population in the dimensions pain/discomfort and anxiety/depression, and patients with major burns in the dimension usual activities. A main limitation of the study includes that the variables in the model were limited to age, gender, %TBSA, LOS and time since burn as these were the only variables available in all datasets. Conclusions The 24-month recovery model can be used in clinical practice to inform patients on expected HRQL outcomes and provide clinicians insights into the expected recovery of HRQL. In this way, a delayed recovery can be recognized in an early stage and timely interventions can be started in order to improve patient outcomes. However, external validation of the developed model is needed before implementation into clinical practice. Furthermore, our study showed the benefit of secondary data usage within the field of burns.
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Affiliation(s)
- Inge Spronk
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam, Netherlands
- * E-mail:
| | - Nancy E. E. Van Loey
- Association of Dutch Burn Centres, Department Behavioural Research, Beverwijk, the Netherlands
- Utrecht University, Department Clinical Psychology, Utrecht, the Netherlands
| | - Charlie Sewalt
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Daan Nieboer
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Babette Renneberg
- Freie Universität Berlin, Department of Clinical Psychology and Psychotherapy, Berlin, Germany
| | - Asgjerd Litleré Moi
- Western Norway University of Applied Sciences, Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Bergen, Norway
- National Burn Centre, Haukeland University Hospital, Department of Plastic, Hand and Reconstructive Surgery, Bergen, Norway
| | - Caisa Oster
- Uppsala University, Department of Neuroscience, Psychiatry, Sweden
| | - Lotti Orwelius
- Linköping University, Department of Anaesthesiology and Intensive Care, and Department of Clinical and Experimental Medicine, Linköping, Sweden
| | - Margriet E. van Baar
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | - Suzanne Polinder
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
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Zelic R, Garmo H, Zugna D, Stattin P, Richiardi L, Akre O, Pettersson A. Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study. Eur Urol 2019; 77:180-188. [PMID: 31606332 DOI: 10.1016/j.eururo.2019.09.027] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/20/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Numerous pretreatment risk classification tools are available for prostate cancer. Which tool is best in predicting prostate cancer death is unclear. OBJECTIVE To systematically compare the prognostic performance of the most commonly used pretreatment risk stratification tools for prostate cancer. DESIGN, SETTING, AND PARTICIPANTS A nationwide cohort study was conducted, including 154 811 men in Prostate Cancer data Base Sweden (PCBaSe) 4.0 diagnosed with nonmetastatic prostate cancer during 1998-2016 and followed through 2016. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We compared the D'Amico, National Institute for Health and Care Excellence (NICE), European Association of Urology (EAU), Genito-Urinary Radiation Oncologists of Canada (GUROC), American Urological Association (AUA), National Comprehensive Cancer Network (NCCN), and Cambridge Prognostic Groups (CPG) risk group systems; the Cancer of the Prostate Risk Assessment (CAPRA) score; and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in predicting prostate cancer death by estimating the concordance index (C-index) and the observed versus predicted cumulative incidences at different follow-up times. RESULTS AND LIMITATIONS A total of 139 515 men were included in the main analysis, of whom 15 961 died from prostate cancer during follow-up. The C-index at 10 yr of follow-up ranged from 0.73 (95% confidence interval [CI]: 0.72-0.73) to 0.81 (95% CI: 0.80-0.81) across the compared tools. The MSKCC nomogram (C-index: 0.81, 95% CI: 0.80-0.81), CAPRA score (C-index: 0.80, 95% CI: 0.79-0.81), and CPG system (C-index: 0.78, 95% CI: 0.78-0.79) performed the best. The order of performance between the tools remained in analyses stratified by primary treatment and year of diagnosis. The predicted cumulative incidences were close to the observed ones, with some underestimation at 5 yr. It is a limitation that the study was conducted solely in a Swedish setting (ie, case mix). CONCLUSIONS The MSKCC nomogram, CAPRA score, and CPG risk grouping system performed better in discriminating prostate cancer death than the D'Amico and D'Amico-derived systems (NICE, GUROC, EAU, AUA, and NCCN). Use of these tools may improve clinical decision making. PATIENT SUMMARY There are numerous pretreatment risk classification tools that can aid treatment decision for prostate cancer. We systematically compared the prognostic performance of the most commonly used tools in a large cohort of Swedish men with prostate cancer. The Memorial Sloan Kettering Cancer Center nomogram, Cancer of the Prostate Risk Assessment score, and Cambridge Prognostic Groups performed best in predicting prostate cancer death. The use of these tools may improve treatment decisions.
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Affiliation(s)
- Renata Zelic
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Hans Garmo
- Division of Cancer Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK; Akademiska Sjukhuset, Regional Cancer Centre, Uppsala, Sweden
| | - Daniela Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, and CPO-Piemonte, Turin, Italy
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, and CPO-Piemonte, Turin, Italy
| | - Olof Akre
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Urology, Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Pettersson
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Ward RC, Egede L, Ramakrishnan V, Frey L, Axon RN, Dismuke CLE, Hunt KJ, Gebregziabher M. An improved comorbidity summary score for measuring disease burden and predicting mortality with applications to two national cohorts. COMMUN STAT-THEOR M 2019. [DOI: 10.1080/03610926.2018.1498896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ralph C. Ward
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Leonard Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Lewis Frey
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Robert Neal Axon
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | | | - Kelly J. Hunt
- College of Medicine, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Mulugeta Gebregziabher
- College of Medicine, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Spronk I, Polinder S, van Loey NE, van der Vlies CH, Pijpe A, Haagsma JA, van Baar ME. Health related quality of life 5–7 years after minor and severe burn injuries: a multicentre cross-sectional study. Burns 2019; 45:1291-1299. [DOI: 10.1016/j.burns.2019.03.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/26/2019] [Indexed: 10/26/2022]
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Cowley LE, Farewell DM, Maguire S, Kemp AM. Methodological standards for the development and evaluation of clinical prediction rules: a review of the literature. Diagn Progn Res 2019; 3:16. [PMID: 31463368 PMCID: PMC6704664 DOI: 10.1186/s41512-019-0060-y] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 05/12/2019] [Indexed: 12/20/2022] Open
Abstract
Clinical prediction rules (CPRs) that predict the absolute risk of a clinical condition or future outcome for individual patients are abundant in the medical literature; however, systematic reviews have demonstrated shortcomings in the methodological quality and reporting of prediction studies. To maximise the potential and clinical usefulness of CPRs, they must be rigorously developed and validated, and their impact on clinical practice and patient outcomes must be evaluated. This review aims to present a comprehensive overview of the stages involved in the development, validation and evaluation of CPRs, and to describe in detail the methodological standards required at each stage, illustrated with examples where appropriate. Important features of the study design, statistical analysis, modelling strategy, data collection, performance assessment, CPR presentation and reporting are discussed, in addition to other, often overlooked aspects such as the acceptability, cost-effectiveness and longer-term implementation of CPRs, and their comparison with clinical judgement. Although the development and evaluation of a robust, clinically useful CPR is anything but straightforward, adherence to the plethora of methodological standards, recommendations and frameworks at each stage will assist in the development of a rigorous CPR that has the potential to contribute usefully to clinical practice and decision-making and have a positive impact on patient care.
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Affiliation(s)
- Laura E. Cowley
- Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff University, Wales, CF14 4YS UK
| | - Daniel M. Farewell
- Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff University, Wales, CF14 4YS UK
| | - Sabine Maguire
- Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff University, Wales, CF14 4YS UK
| | - Alison M. Kemp
- Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff University, Wales, CF14 4YS UK
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Bradley A, Van Der Meer R, McKay CJ. A systematic review of methodological quality of model development studies predicting prognostic outcome for resectable pancreatic cancer. BMJ Open 2019; 9:e027192. [PMID: 31439598 PMCID: PMC6707674 DOI: 10.1136/bmjopen-2018-027192] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To assess the methodological quality of prognostic model development studies pertaining to post resection prognosis of pancreatic ductal adenocarcinoma (PDAC). DESIGN/SETTING A narrative systematic review of international peer reviewed journals DATA SOURCE: Searches were conducted of: MEDLINE, Embase, PubMed, Cochrane database and Google Scholar for predictive modelling studies applied to the outcome of prognosis for patients with PDAC post resection. Predictive modelling studies in this context included prediction model development studies with and without external validation and external validation studies with model updating. Data was extracted following the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) checklist. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes were all components of the CHARMS checklist. Secondary outcomes included frequency of variables included across predictive models. RESULTS 263 studies underwent full text review. 15 studies met the inclusion criteria. 3 studies underwent external validation. Multivariable Cox proportional hazard regression was the most commonly employed modelling method (n=13). 10 studies were based on single centre databases. Five used prospective databases, seven used retrospective databases and three used cancer data registry. The mean number of candidate predictors was 19.47 (range 7 to 50). The most commonly included variables were tumour grade (n=9), age (n=8), tumour stage (n=7) and tumour size (n=5). Mean sample size was 1367 (range 50 to 6400). 5 studies reached statistical power. None of the studies reported blinding of outcome measurement for predictor values. The most common form of presentation was nomograms (n=5) and prognostic scores (n=5) followed by prognostic calculators (n=3) and prognostic index (n=2). CONCLUSIONS Areas for improvement in future predictive model development have been highlighted relating to: general aspects of model development and reporting, applicability of models and sources of bias. TRIAL REGISTRATION NUMBER CRD42018105942.
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Affiliation(s)
- Alison Bradley
- Management Science, University of Strathclyde Business School, Glasgow, UK
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Colin J McKay
- West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK
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Spronk I, Polinder S, Haagsma JA, Nieuwenhuis M, Pijpe A, van der Vlies CH, Middelkoop E, van Baar ME. Patient-reported scar quality of adults after burn injuries: A five-year multicenter follow-up study. Wound Repair Regen 2019; 27:406-414. [PMID: 30793408 PMCID: PMC6850449 DOI: 10.1111/wrr.12709] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/12/2019] [Indexed: 12/28/2022]
Abstract
Scar formation is an important adverse consequence of burns. How patients appraise their scar quality is often studied shortly after sustaining the injury, but information in the long‐term is scarce. Our aim was, therefore, to evaluate long‐term patient‐reported quality of burn scars. Adults with a burn center admission of ≥1 day between August 2011 and September 2012 were invited to complete a questionnaire on long‐term consequences of burns. We enriched this sample with patients with severe burns (>20% total body surface area [TBSA] burned or TBSA full thickness >5%) treated between January 2010 and March 2013. Self‐reported scar quality was assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Patients completed this scale for their—in their opinion—most severe scar ≥5 years after burns. This study included 251 patients with a mean %TBSA burned of 10%. The vast majority (91.4%) reported at least minor differences with normal skin (POSAS item score ≥2) on one or more scar characteristics and 78.9% of the patients’ overall opinion was that their scar deviated from normal skin. Patients with severe burns had higher POSAS scores, representing worse scar quality, than patients with mild/intermediate burns, except for color, which was high in both groups. A longer hospital stay predicted reduced scar quality (both mean POSAS and mean overall opinion of the scar) in multivariate analyses. In addition, female gender was also associated with a poorer overall opinion of the scar. In conclusion, this study provides new insights in long‐term scar quality. Scars differed from normal skin in a large part of the burn population more than 5 years after burns, especially in those with severe burns. Female gender is associated with a poorer patients’ overall opinion of their scar, which may be an indication of gender differences in perception of scar quality after burns.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marianne Nieuwenhuis
- Association of Dutch Burn Centres, Martini Hospital, Groningen, The Netherlands.,Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anouk Pijpe
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands
| | - Cornelis H van der Vlies
- Burn Centre, Maasstad Hospital, Rotterdam, The Netherlands.,Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther Middelkoop
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands
| | - Margriet E van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Chen N, Li M, Liu H. Comparison of maximum likelihood approach, Diggle–Kenward selection model, pattern mixture model with MAR and MNAR dropout data. COMMUN STAT-SIMUL C 2018. [DOI: 10.1080/03610918.2018.1506028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nan Chen
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Meijuan Li
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, Beijing, China
- Beijing Research Center for Education Supervision and Quality Assessment, Beijing Academy of Educational Sciences, Beijing, China
| | - Hongyun Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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43
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Silver SR, Tsai RJ, Morris CR, Boiano JM, Ju J, Scocozza MS, Calvert GM. Codability of industry and occupation information from cancer registry records: Differences by patient demographics, casefinding source, payor, and cancer type. Am J Ind Med 2018; 61:524-532. [PMID: 29574892 DOI: 10.1002/ajim.22840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Industry and occupation (I&O) information collected by cancer registries is useful for assessing associations among jobs and malignancies. However, systematic differences in I&O availability can bias findings. METHODS Codability by patient demographics, payor, identifying (casefinding) source, and cancer site was assessed using I&O text from first primaries diagnosed 2011-2012 and reported to California Cancer Registry. I&O were coded to a U.S. Census code or classified as blank/inadequate/unknown, retired, or not working for pay. RESULTS Industry was codable for 37% of cases; 50% had "unknown" and 9% "retired" instead of usual industry. Cases initially reported by hospitals, covered by preferred providers, or with known occupational etiology had highest codable industry; cases from private pathology laboratories, with Medicaid, or diagnosed in outpatient settings had least. Occupation results were similar. CONCLUSIONS Recording usual I&O for retirees and improving linkages for reporting entities without patient access would improve I&O codability and research validity.
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Affiliation(s)
- Sharon R. Silver
- National Institute for Occupational Safety and Health; Division of Surveillance; Hazard Evaluations, and Field Studies; Cincinnati Ohio
| | - Rebecca J. Tsai
- National Institute for Occupational Safety and Health; Division of Surveillance; Hazard Evaluations, and Field Studies; Cincinnati Ohio
| | - Cyllene R. Morris
- California Cancer Reporting and Epidemiologic Surveillance Program; Institute for Population Health Improvement; University of California Davis Health; Sacramento California
| | - James M. Boiano
- National Institute for Occupational Safety and Health; Division of Surveillance; Hazard Evaluations, and Field Studies; Cincinnati Ohio
| | - Jun Ju
- National Institute for Occupational Safety and Health; Division of Surveillance; Hazard Evaluations, and Field Studies; Cincinnati Ohio
| | - Marilyn S. Scocozza
- California Cancer Reporting and Epidemiologic Surveillance Program; Institute for Population Health Improvement; University of California Davis Health; Sacramento California
| | - Geoffrey M. Calvert
- National Institute for Occupational Safety and Health; Division of Surveillance; Hazard Evaluations, and Field Studies; Cincinnati Ohio
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Gebregziabher M, Eckert MA, Matthews LJ, Teklehaimanot AA, Dubno JR. Joint modeling of multivariate hearing thresholds measured longitudinally at multiple frequencies. COMMUN STAT-THEOR M 2018; 47:5418-5434. [PMID: 30983686 DOI: 10.1080/03610926.2017.1395045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Pure-tone thresholds are used to estimate hearing acuity and, when measured longitudinally, can characterize age-related changes in hearing. Measured at multiple-frequencies, multiple-irregular time points, for right and left ears, these longitudinal studies of age-related hearing loss produce data of inherent complexity due to: 1) multivariate outcomes at different frequencies; 2) longitudinal measurements taken at subject-specific time intervals; and 3) inter-ear correlations due to clustering and nesting. To address limitations in existing methods, we propose a multivariate generalized linear mixed model(mGLMM) and assess its performance. We demonstrate its application using a unique dataset from a cohort study of age-related hearing loss.
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Affiliation(s)
- Mulugeta Gebregziabher
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, USA
| | - Mark A Eckert
- Department of Otolaryngology, Medical University of South Carolina, Charleston, USA
| | - Lois J Matthews
- Department of Otolaryngology, Medical University of South Carolina, Charleston, USA
| | - Abeba A Teklehaimanot
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, USA
| | - Judy R Dubno
- Department of Otolaryngology, Medical University of South Carolina, Charleston, USA
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45
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Arnold Egloff SA, Du L, Loomans HA, Starchenko A, Su PF, Ketova T, Knoll PB, Wang J, Haddad AQ, Fadare O, Cates JM, Lotan Y, Shyr Y, Clark PE, Zijlstra A. Shed urinary ALCAM is an independent prognostic biomarker of three-year overall survival after cystectomy in patients with bladder cancer. Oncotarget 2018; 8:722-741. [PMID: 27894096 PMCID: PMC5352192 DOI: 10.18632/oncotarget.13546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/19/2016] [Indexed: 01/08/2023] Open
Abstract
Proteins involved in tumor cell migration can potentially serve as markers of invasive disease. Activated Leukocyte Cell Adhesion Molecule (ALCAM) promotes adhesion, while shedding of its extracellular domain is associated with migration. We hypothesized that shed ALCAM in biofluids could be predictive of progressive disease. ALCAM expression in tumor (n = 198) and shedding in biofluids (n = 120) were measured in two separate VUMC bladder cancer cystectomy cohorts by immunofluorescence and enzyme-linked immunosorbent assay, respectively. The primary outcome measure was accuracy of predicting 3-year overall survival (OS) with shed ALCAM compared to standard clinical indicators alone, assessed by multivariable Cox regression and concordance-indices. Validation was performed by internal bootstrap, a cohort from a second institution (n = 64), and treatment of missing data with multiple-imputation. While ALCAM mRNA expression was unchanged, histological detection of ALCAM decreased with increasing stage (P = 0.004). Importantly, urine ALCAM was elevated 17.0-fold (P < 0.0001) above non-cancer controls, correlated positively with tumor stage (P = 0.018), was an independent predictor of OS after adjusting for age, tumor stage, lymph-node status, and hematuria (HR, 1.46; 95% CI, 1.03–2.06; P = 0.002), and improved prediction of OS by 3.3% (concordance-index, 78.5% vs. 75.2%). Urine ALCAM remained an independent predictor of OS after accounting for treatment with Bacillus Calmette-Guerin, carcinoma in situ, lymph-node dissection, lymphovascular invasion, urine creatinine, and adjuvant chemotherapy (HR, 1.10; 95% CI, 1.02–1.19; P = 0.011). In conclusion, shed ALCAM may be a novel prognostic biomarker in bladder cancer, although prospective validation studies are warranted. These findings demonstrate that markers reporting on cell motility can act as prognostic indicators.
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Affiliation(s)
- Shanna A Arnold Egloff
- Department of Veterans Affairs, Nashville, TN, USA.,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Liping Du
- Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Holli A Loomans
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alina Starchenko
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Taiwan
| | - Tatiana Ketova
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Jifeng Wang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urology, The Fifth People's Hospital of Shanghai, Shanghai, China
| | - Ahmed Q Haddad
- Department of Urology, The University of Louisville, Louisville, KY, USA.,Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Oluwole Fadare
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,University of California San Diego, La Jolla, CA, USA
| | - Justin M Cates
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yair Lotan
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yu Shyr
- Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Ingram-Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter E Clark
- Vanderbilt Ingram-Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andries Zijlstra
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Ingram-Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
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Adamson PD, Fordyce CB, McAllister DA, Udelson JE, Douglas PS, Newby DE. Identification of patients with stable chest pain deriving minimal value from coronary computed tomography angiography: An external validation of the PROMISE minimal-risk tool. Int J Cardiol 2018; 252:31-34. [PMID: 29249436 PMCID: PMC5761719 DOI: 10.1016/j.ijcard.2017.09.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/01/2017] [Accepted: 09/12/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The PROspective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) minimal-risk tool was recently developed to identify patients with suspected stable angina at very low risk of coronary artery disease (CAD) and clinical events. We assessed the external validity of this tool within the context of the Scottish Computed Tomography of the HEART (SCOT-HEART) multicenter randomised controlled trial of patients with suspected stable angina due to coronary disease. METHODS The minimal-risk tool was applied to 1764 patients with complete imaging and follow-up data. External validity was compared with the guideline-endorsed CAD Consortium (CADC) risk score and determined through tests of model discrimination and calibration. RESULTS A total of 531 (30.1%, mean age 52.4years, female 62.0%) patients were classified as minimal-risk. Compared to the remainder of the validation cohort, this group had lower estimated pre-test probability of coronary disease according to the CADC model (30.0% vs 47.0%, p<0.001). The PROMISE minimal-risk tool improved discrimination compared with the CADC model (c-statistic 0.785 vs 0.730, p<0.001) and was improved further following re-estimation of covariate coefficients (c-statistic 0.805, p<0.001). Model calibration was initially poor (χ2 197.6, Hosmer-Lemeshow [HL] p<0.001), with significant overestimation of probability of minimal risk, but improved significantly following revision of the PROMISE minimal-risk intercept and covariate coefficients (χ2 5.6, HL p=0.692). CONCLUSION AND RELEVANCE Despite overestimating the probability of minimal-risk, the PROMISE minimal-risk tool outperforms the CADC model with regards to prognostic discrimination in patients with suspected stable angina, and may assist clinicians in decisions regarding non-invasive testing. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01149590.
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Affiliation(s)
- Philip D Adamson
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
| | - Christopher B Fordyce
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States; Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - David A McAllister
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - James E Udelson
- The CardioVascular Center, Division of Cardiology, Tufts Medical Center, Boston, MA, United States
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States
| | - David E Newby
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
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Haile SR, Guerra B, Soriano JB, Puhan MA. Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores. BMC Med Res Methodol 2017; 17:172. [PMID: 29268701 PMCID: PMC5740913 DOI: 10.1186/s12874-017-0433-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/20/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. METHODS Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC) which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD) arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. RESULTS We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. CONCLUSIONS We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties of clinical scores. Our large-scale external validation indicates that the scores with the best discriminative properties to predict 3 year mortality in patients with COPD are ADO and eBODE.
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Affiliation(s)
- Sarah R. Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Beniamino Guerra
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Joan B. Soriano
- Servicio de Neumología, Instituto de Investigación del Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Epidemiology & Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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van Ginkel JR, Kroonenberg PM. Evaluation of multiple-imputation procedures for three-mode component models. J STAT COMPUT SIM 2017. [DOI: 10.1080/00949655.2017.1355368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Singh K, Betensky RA, Wright A, Curhan GC, Bates DW, Waikar SS. A Concept-Wide Association Study of Clinical Notes to Discover New Predictors of Kidney Failure. Clin J Am Soc Nephrol 2016; 11:2150-2158. [PMID: 27927892 PMCID: PMC5142057 DOI: 10.2215/cjn.02420316] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 09/01/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Identifying predictors of kidney disease progression is critical toward the development of strategies to prevent kidney failure. Clinical notes provide a unique opportunity for big data approaches to identify novel risk factors for disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We used natural language processing tools to extract concepts from the preceding year's clinical notes among patients newly referred to a tertiary care center's outpatient nephrology clinics and retrospectively evaluated these concepts as predictors for the subsequent development of ESRD using proportional subdistribution hazards (competing risk) regression. The primary outcome was time to ESRD, accounting for a competing risk of death. We identified predictors from univariate and multivariate (adjusting for Tangri linear predictor) models using a 5% threshold for false discovery rate (q value <0.05). We included all patients seen by an adult outpatient nephrologist between January 1, 2004 and June 18, 2014 and excluded patients seen only by transplant nephrology, with preexisting ESRD, with fewer than five clinical notes, with no follow-up, or with no baseline creatinine values. RESULTS Among the 4013 patients selected in the final study cohort, we identified 960 concepts in the unadjusted analysis and 885 concepts in the adjusted analysis. Novel predictors identified included high-dose ascorbic acid (adjusted hazard ratio, 5.48; 95% confidence interval, 2.80 to 10.70; q<0.001) and fast food (adjusted hazard ratio, 4.34; 95% confidence interval, 2.55 to 7.40; q<0.001). CONCLUSIONS Novel predictors of human disease may be identified using an unbiased approach to analyze text from the electronic health record.
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Affiliation(s)
- Karandeep Singh
- Division of Learning and Knowledge Systems, Department of Learning Health Sciences and
- Division of Nephrology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Departments of
| | | | - Adam Wright
- Division of General Internal Medicine, Department of Medicine and
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gary C. Curhan
- Epidemiology, and
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts; and
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - David W. Bates
- Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of General Internal Medicine, Department of Medicine and
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sushrut S. Waikar
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts; and
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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Ayav C, Beuscart JB, Briançon S, Duhamel A, Frimat L, Kessler M. Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study. BMC Nephrol 2016; 17:174. [PMID: 27846810 PMCID: PMC5111196 DOI: 10.1186/s12882-016-0379-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/26/2016] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Although chronic kidney disease (CKD) affects a growing number of people, epidemiologic data on incident CKD in the general population are scarce. Screening strategies to increase early CKD detection have been developed. METHODS From a community-based sample of 4,409 individuals residing in a well-defined geographical area, we determined the number of patients having a first serum creatinine value ≥1.7 mg/dL and present for at least 3 months that allowed us to calculate an annual incidence rate of CKD (stages 3 to 5). CKD (stages 3 to 5) was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. We also described the primary care, outcomes and risk factors associated with outcomes using competing risks analyses for these CKD patients. RESULTS A total of 631 incident CKD patients (stages 3 to 5) were followed-up until the occurrence of death and dialysis initiation for more than 3 years. The annual incidence rate of CKD (stages 3 to 5) was estimated at 977.7 per million inhabitants. Analyses were performed on 514 patients with available medical data. During the study, 155 patients (30.2 %) were referred to a nephrologist, 193 (37.5 %) died and 58 (11.3 %) reached end-stage renal disease and initiated dialysis. A total of 139 patients (27.6 %) had a fast decline of their renal function, 92 (18.3 %) a moderate decline and the 272 remaining patients had a physiological decline (21.1 %) or a small improvement of their renal function (33.0 %). Predictors of death found in both Cox and Fine-Gray multivariable regression models included age at diagnosis, anemia, active neoplasia and chronic heart failure, but not a low glomerular filtration rate (GFR). Age at diagnosis, anemia and a low GFR were independently associated with dialysis initiation in Cox model, but anemia was not found to be a risk factor for dialysis initiation in Fine-Gray model. CONCLUSIONS This large cohort study provided useful epidemiological data on incident CKD (stages 3 to 5) and stressed the need to improve the hands-on implementation of clinical practice guidelines for the evaluation and the management of CKD in primary care.
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Affiliation(s)
- Carole Ayav
- INSERM, CIC-EC 1433, Nancy, France
- Pôle S2R, Epidemiology and clinical evaluation, University Hospital, Vandoeuvre-les-Nancy, France
| | - Jean-Baptiste Beuscart
- Geriatric Department, University Hospital, Lille, France
- Department of Biostatistics, UDSL, Lille, EA2694 France
| | - Serge Briançon
- INSERM, CIC-EC 1433, Nancy, France
- Pôle S2R, Epidemiology and clinical evaluation, University Hospital, Vandoeuvre-les-Nancy, France
- Lorraine University, Paris Descartes University, Apemac, Nancy, EA4360 France
| | - Alain Duhamel
- Department of Biostatistics, UDSL, Lille, EA2694 France
| | - Luc Frimat
- Lorraine University, Paris Descartes University, Apemac, Nancy, EA4360 France
- Department of Nephrology, University Hospital, Vandœuvre-les-Nancy, France
| | - Michèle Kessler
- Department of Nephrology, University Hospital, Vandœuvre-les-Nancy, France
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