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Colin P, Delattre M, Minini P, Micallef S. An Escalation for Bivariate Binary Endpoints Controlling the Risk of Overtoxicity (EBE-CRO): Managing Efficacy and Toxicity in Early Oncology Clinical Trials. J Biopharm Stat 2017; 27:1054-1072. [DOI: 10.1080/10543406.2017.1295248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P. Colin
- AgroParisTech, UMR 518 MIA, Paris, France
- Statistical Science & Modeling, Sanofi R&D, Chilly-Mazarin, France
| | - M. Delattre
- AgroParisTech, UMR 518 MIA, Paris, France
- INRA, UMR 518 MIA, Paris, France
| | - P. Minini
- Biostatistiques, Sanofi R&D, Chilly-Mazarin, France
| | - S. Micallef
- Clinical Pharmacometrics, Roche Pharma Research and Early Development, Basel, Switzerland
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Farnier M, Gaudet D, Valcheva V, Minini P, Miller K, Cariou B. Efficacy of alirocumab in heterozygous familial hypercholesterolemia or high cv risk populations: pooled analyses of eight phase 3 trials. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Minini P, Chavance M. [Analysis of repeated binary data: sensitivity to missing data]. Rev Epidemiol Sante Publique 2005; 52:455-64. [PMID: 15654315 DOI: 10.1016/s0398-7620(04)99081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In longitudinal studies, it is extremely rare that all the planned measurements are actually performed. Missing data are often consecutive to drop-outs, but may also be intermittent. In both cases, the analysis of incomplete data necessarily requires assumptions that are generally unverifiable, and the need for sensitivity analyses has been advocated over the past few years. In this article, the attention will be given to longitudinal binary data. METHODS A method is proposed, which is based on a log-linear model. A sensitivity parameter is introduced that represents the relationship between the response mechanism and the missing data mechanism. It is recommended not to estimate this parameter, but to consider a range of plausible values, and to estimate the parameters of interest conditionally on these plausible values. This allows to assess the sensitivity of the conclusion of a study to various assumptions regarding the missing data mechanism. RESULTS This method was applied to a randomized clinical trial comparing the efficacy of two treatment regimens in patients with persistent asthma. The sensitivity analysis showed that the conclusion of this study was robust to missing data.
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Affiliation(s)
- P Minini
- Laboratoire Glaxo-Smith-Kline, Unité Méthodologie et Biostatistique, 100, route de Versailles, 78163 Marly-le-Roi
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Liese JG, Stojanov S, Berut F, Minini P, Harzer E, Jow S, Schödel F, Boslego J, Hoffenbach A, Kronwitter A, Belohradsky BH. Large scale safety study of a liquid hexavalent vaccine (D-T-acP-IPV-PRP--T-HBs) administered at 2, 4, 6 and 12-14 months of age. Vaccine 2001; 20:448-54. [PMID: 11672908 DOI: 10.1016/s0264-410x(01)00344-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A study was conducted to assess the safety of a new, liquid hexavalent vaccine (Hexavac, Aventis Pasteur MSD, Lyon, France) in a large population of 1783 children in Germany vaccinated at 2, 4, 6 and 12-14 months of age. Immediate reactions, local and systemic reactions, and serious adverse events (SAEs) were monitored. The frequencies of redness > or = 2 cm and swelling > or = 2 cm were 6.7 and 7.1% after all doses of the primary series combined and 13.4 and 12.0% following the booster dose, respectively. Transient swelling of the entire thigh was reported in seven infants after all doses of the primary series (0.1%) and in four children after the booster dose (0.2%). The most frequent systemic adverse events within 3 days after vaccination were irritability (19.3% after primary series and 13.2% after booster) and fever > or = 38.0 degrees C (15.4% after primary series and 28.5% after booster). Fever above 40.0 degrees C was reported in 0.1% of the infants post-primary series and in 0.9% of the children after the booster immunization. Only 3 of 144 SAE were considered to be vaccine related and were seen to resolve spontaneously and without sequelae. The liquid hexavalent vaccine was generally well tolerated when given to children as a primary immunization series at 2, 4 and 6 months and as a booster dose at 12-14 months.
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Affiliation(s)
- J G Liese
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, D-80337 München, Germany
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Minini P, Gaspoz JM, Pichot V, Costes F, Roche F, Lacour JR, Antoniadis A, Barthélémy JC. A practical method to statistically classify devices according to their relative accuracy. Clin Physiol 2001; 21:214-22. [PMID: 11318829 DOI: 10.1046/j.1365-2281.2001.00320.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mathematical methods to statistically compare the relative accuracy of physiological monitoring devices to reference measurements are scarce. We developed such a method to compare any number of devices to each other as well as to reference values. This new statistical comparative procedure uses a combination of different known mathematical processes. The method allows the separation of the error of the devices into two components, the first, being systematic, can be easily amended, while the second, inherent to the technical limitations of the measuring device as well as to the physical properties of the explored phenomenon, cannot be corrected and will thus be used as the comparative criterion for statistics. That method, which is easy to implement should ease comparisons of the accuracy of any number of devices as well as comparison of other sets of physiological values, by giving an easy access to statistical results.
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Affiliation(s)
- P Minini
- Laboratoire de Physiologie, Université Jean Monnet, Saint-Etienne, France
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Pichot V, Roche F, Gaspoz JM, Enjolras F, Antoniadis A, Minini P, Costes F, Busso T, Lacour JR, Barthélémy JC. Relation between heart rate variability and training load in middle-distance runners. Med Sci Sports Exerc 2000; 32:1729-36. [PMID: 11039645 DOI: 10.1097/00005768-200010000-00011] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Monitoring physical performance is of major importance in competitive sports. Indices commonly used, like resting heart rate, VO2max, and hormones, cannot be easily used because of difficulties in routine use, of variations too small to be reliable, or of technical challenges in acquiring the data. METHODS We chose to assess autonomic nervous system activity using heart rate variability in seven middle-distance runners, aged 24.6 +/- 4.8 yr, during their usual training cycle composed of 3 wk of heavy training periods, followed by a relative resting week. The electrocardiogram was recorded overnight twice a week and temporal and frequency indices of heart rate variability, using Fourier and Wavelet transforms, were calculated. Daily training loads and fatigue sensations were estimated with a questionnaire. Similar recordings were performed in a sedentary control group. RESULTS The results demonstrated a significant and progressive decrease in parasympathetic indices of up to -41% (P < 0.05) during the 3 wk of heavy training, followed by a significant increase during the relative resting week of up to +46% (P < 0.05). The indices of sympathetic activity followed the opposite trend, first up to +31% and then -24% (P < 0.05), respectively. The percentage increasing mean nocturnal heart rate variation remained below 12% (P < 0.05). There was no significant variation in the control group. CONCLUSION This study confirmed that heavy training shifted the cardiac autonomic balance toward a predominance of the sympathetic over the parasympathetic drive. When recorded during the night, heart rate variability appeared to be a better tool than resting heart rate to evaluate cumulated physical fatigue, as it magnified the induced changes in autonomic nervous system activity. These results could be of interest for optimizing individual training profiles.
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Affiliation(s)
- V Pichot
- Laboratoire de Physiologie, Université de Saint-Etienne, France
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Roche F, Gaspoz JM, Court-Fortune I, Minini P, Pichot V, Duverney D, Costes F, Lacour JR, Barthélémy JC. Screening of obstructive sleep apnea syndrome by heart rate variability analysis. Circulation 1999; 100:1411-5. [PMID: 10500042 DOI: 10.1161/01.cir.100.13.1411] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Enhanced nocturnal heart rate variability (HRV) has been evoked in sleep-related breathing disorders. However, its capacity to detect obstructive sleep apnea syndrome (OSAS) has not been systematically determined. Thus, we evaluated the discriminant power of HRV parameters in a first group of patients (G1) and validated their discriminant capacity in a second group (G2). METHODS AND RESULTS In G1, 39 of 91 patients (42.8%) were identified as diseased by polysomnography, as were 24 of 52 patients (46%) in G2. Time-domain HRV variables (SD of NN intervals [SDNN], mean of the standard deviations of all NN intervals for all consecutive 5-minute segments of the recording [SDNN index], square root of the mean of the sum of the squares of differences between adjacent normal RR intervals [r-MSSD], and SD of the averages of NN intervals in all 5-minute segments of the recording [SDANN]) were calculated for daytime and nighttime periods, as well as the differences between daytime and nighttime values (Delta[D/N]). Correlations between HRV variables and OSAS status were analyzed in G1 by use of receiver-operating characteristic (ROC) curves and logistic regression analysis. By ROC curve analysis, 7 variables were significantly associated with OSAS. After adjustment for other variables through multiple logistic regression analysis, Delta[D/N]SDNN index and Delta[D/N] r-MSSD remained significant independent predictors of OSAS, with ORs of 8.22 (95% CI, 3.16 to 21.4) and 2.86 (95% CI, 1.21 to 6.75), respectively. The classification and regression tree methodology demonstrated a sensitivity reaching 89.7% (95% CI, 73.7 to 97.7) with Delta[D/N] SDNN index and a specificity of 98.1% (95% CI, 86.4 to 100) with Delta[D/N] SDNN using appropriate thresholds. These thresholds, applied to G2, yielded a sensitivity of 83% using Delta[D/N] SDNN index and a specificity of 96.5% using Delta[D/N] SDNN. CONCLUSIONS Time-domain HRV analysis may represent an accurate and inexpensive screening tool in clinically suspected OSAS patients and may help focus resources on those at the highest risk.
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Affiliation(s)
- F Roche
- Service d'Exploration Fonctionnelle CardioRespiratoire, CHU Nord, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Saint-Etienne, France.
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Barthélémy JC, Roche F, Gaspoz JM, Geyssant A, Minini P, Antoniadis A, Page E, Wolf JE, Wilner C, Isaaz K, Cavallaro C, Lacour JR. Maximal blood lactate level acts as a major discriminant variable in exercise testing for coronary artery disease detection in men. Circulation 1996; 93:246-52. [PMID: 8548895 DOI: 10.1161/01.cir.93.2.246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The interpretation of exercise stress testing for coronary artery disease detection is affected by the many differences in chosen variables and mathematical methods. We conducted a prospective trial to evaluate a global muscle fatigue parameter--the blood lactate level achieved at maximal exercise--as a method of distinguishing between diseased and nondiseased coronary status. METHODS AND RESULTS We evaluated 236 consecutive male patients without previous myocardial infarction who had been referred for the diagnosis of coronary artery disease. None of the patients had cardiomyopathy, severe cardiac heart failure, or valvular heart disease. Blood lactate concentration at maximal exercise was measured as well as other classic variables. Correlations between variables and coronary status as assessed by coronary arteriography were described using receiver operating characteristic (ROC) curves and logistic regression analysis. The first four most powerful variables (lactate level, maximal power output, exercise duration, and percentage of maximal predicted heart rate), which are directly representative of the global functional capacity, showed values of 0.777, 0.775, 0.760, and 0.740, respectively, by ROC curve analysis. Mean +/- SD blood lactate level at peak exercise reached 7.68 +/- 2.70 mmol/L in the 153 diseased and 10.56 +/- 2.75 mmol/L in the 83 nondiseased patients (P < .0001). After adjustment for other variables, blood lactate level remained a significant predictor of coronary artery disease by logistic regression analysis (adjusted odds ratio, 1.2; confidence interval, 1.04 to 1.4). CONCLUSIONS Global muscle fatigue as assessed by lactate levels in the blood at maximal exercise appears to be a powerful distinguisher of diseased and nondiseased coronary status.
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Affiliation(s)
- J C Barthélémy
- Laboratoire de Physiologie-GIP Exercise, Université de Saint-Etienne, France
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Barthélémy JC, Lacour JR, Roche F, Gosse P, Cristol C, Féasson L, Minini P, Geyssant A. Elevated nocturnal blood pressure assessed by ambulatory automatic monitoring during a stay at high altitude. Eur J Appl Physiol Occup Physiol 1995; 70:258-62. [PMID: 7607202 DOI: 10.1007/bf00238573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to explore, in healthy children, the arterial blood pressure response to a 3-week stay at high altitude (4200 m). An auscultatory automatic ambulatory pressuremeter was used to avoid undue environmental influence on the measurement. The blood pressure was monitored three times in a group of ten boys, aged 10.5 (CI 0.9 years): at sea level (control values), at an altitude of 2100 m after at least 24 h of acclimatization and after at least 24 h at 4200 m altitude. Each period of monitoring extended over 24 h with 10-min intervals between successive measurements. Arterial blood pressure was evaluated separately for the night and day periods. Nocturnal recordings revealed an increase with altitude in systolic as well as in the diastolic blood pressure. Because of the technique used to gather data, this is thought to have represented an independent effect of altitude without interference from the medical environment or diurnal activity.
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Affiliation(s)
- J C Barthélémy
- Laboratoire de Physiologie, GIP-Exercise, Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France
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