Category: Statistics

Int J Methods Psychiatr Res. 2022 May 18:e1916. doi: 10.1002/mpr.1916. Online ahead of print.

ABSTRACT

OBJECTIVES: Longitudinal survey data allow for the estimation of developmental trajectories of substance use from adolescence to young adulthood, but these estimates may be subject to attrition bias. Moreover, there is a lack of consensus regarding the most effective statistical methodology to adjust for sample selection and attrition bias when estimating these trajectories. Our objective is to develop specific recommendations regarding adjustment approaches for attrition in longitudinal surveys in practice.

METHODS: Analyzing data from the national U.S. Monitoring the Future panel study following four cohorts of individuals from modal ages 18 to 29/30, we systematically compare alternative approaches to analyzing longitudinal data with a wide range of substance use outcomes, and examine the sensitivity of inferences regarding substance use prevalence and trajectories as a function of college attendance to the approach used.

RESULTS: Our results show that analyzing all available observations in each wave, while simultaneously accounting for the correlations among repeated observations, sample selection, and attrition, is the most effective approach. The adjustment effects are pronounced in wave-specific descriptive estimates but generally modest in covariate-adjusted trajectory modeling.

CONCLUSIONS: The adjustments can refine the precision, and, to some extent, the implications of our findings regarding young adult substance use trajectories.

PMID:35582963 | DOI:10.1002/mpr.1916

Hypertension. 2022 May 18:101161HYPERTENSIONAHA12219134. doi: 10.1161/HYPERTENSIONAHA.122.19134. Online ahead of print.

ABSTRACT

BACKGROUND: Aldosterone production and mineralocorticoid receptor activation are implicated in myocardial fibrosis and cardiovascular events.

METHODS: Cardiac structure and function were assessed in 4547 participants without prevalent heart failure (HF) in the ARIC study (Atherosclerosis Risk in Communities), with echocardiography, aldosterone, and plasma renin activity measurement (2011-2013). Subjects were characterized by plasma renin activity as suppressed (≤0.5 ng/mL per hour) or unsuppressed (>0.5 ng/mL per hour). Cross-sectional relationships with cardiac structure and function, and longitudinal relationships with outcomes (HF hospitalization; HF and all-cause death; HF, death, myocardial infarction, and stroke; and incident atrial fibrillation) were assessed. Models were adjusted for demographic and anthropometric characteristics and additively, for blood pressure and antihypertensives.

RESULTS: Evidence of primary aldosteronism physiology was prevalent (11.6% with positive screen) and associated with echocardiographic parameters. Renin suppression was associated with greater left ventricular mass, left ventricular volumes, and left atrial volume index, and a lower E/A ratio (adjusted P<0.001 for all). Higher aldosterone was associated with greater left ventricular mass and lower global longitudinal strain and lateral E’. The highest tertile of aldosterone was associated with a hazard ratio of 1.37 (95% CI, 1.06-1.77; 5.5-year follow-up) for incident atrial fibrillation relative to the lowest. Renin suppression was associated with HF (hazard ratio, 1.34 [95% CI, 1.05-1.72]; 7.3-year follow-up), although these relationships did not remain statistically significant after additional adjustment for hypertension.

CONCLUSIONS: Renin suppression and aldosterone excess, consistent with primary aldosteronism pathophysiology, were associated with cardiac structural and functional alterations and may represent an early target for mitigation of fibrosis with mineralocorticoid receptor antagonists.

PMID:35582954 | DOI:10.1161/HYPERTENSIONAHA.122.19134

Clin Neuropsychol. 2022 May 18:1-55. doi: 10.1080/13854046.2022.2054360. Online ahead of print.

ABSTRACT

OBJECTIVE: Examination of gender and diversity issues within clinical neuropsychology, using data from the 2020 professional practice and “salary survey.”

METHODS: Clinical neuropsychologists in the U.S. and Canada were invited to participate in an online survey. The final sample consisted of 1677 doctoral-level practitioners.

RESULTS: Approximately, 60% of responding neuropsychologists are women and 53.8% of those women identify as early career psychologists (ECPs). Conversely, a majority of men in the sample are advanced career psychologists (ACPs). Both genders work predominantly in institutions, but more men than women work in private practice. ACP men produce a greater number of peer-reviewed publications and conference presentations. Across all work settings, women earn significantly less than men, and are less satisfied with their incomes. Establishing and maintaining family life is the biggest obstacle to attaining greater income and job satisfaction for both genders. Ethnic/racial minority status was identified in 12.9% of respondents, with 59.2% being ECPs. Job satisfaction and hostility in the workplace vary across ethnic/racial minority groups. Hispanic/Latino(a) and White neuropsychologists report higher incomes, but there were no statistically significant differences between any of the groups.

CONCLUSIONS: Income and select practice differences persist between female and male neuropsychologists. There is a slow rate of increased ethnic/racial diversity over time, which is much more apparent among early career practitioners. Trajectories and demographics suggest that the gender income gap is unlikely to be improved by the next survey iteration in 2025, whereas it is very likely that ethnic/racial diversity will continue to increase gradually.

PMID:35582913 | DOI:10.1080/13854046.2022.2054360

J Evol Biol. 2022 May 18. doi: 10.1111/jeb.14009. Online ahead of print.

ABSTRACT

A paradigm shift away from null hypothesis significance testing seems in progress. Based on simulations, we illustrate some of the underlying motivations. First, p-values vary strongly from study to study, hence dichotomous inference using significance thresholds is usually unjustified. Second, ‘statistically significant’ results have overestimated effect sizes, a bias declining with increasing statistical power. Third, ‘statistically non-significant’ results have underestimated effect sizes, and this bias gets stronger with higher statistical power. Fourth, the tested statistical hypotheses usually lack biological justification and are often uninformative. Despite these problems, a screen of 48 papers from the 2020 volume of the Journal of Evolutionary Biology exemplifies that significance testing is still used almost universally in evolutionary biology. All screened studies tested default null hypotheses of zero effect with the default significance threshold of p = 0.05, none presented a pre-specified alternative hypothesis, pre-study power calculation and the probability of ‘false negatives’ (beta error rate). The results sections of the papers presented 49 significance tests on average (median 23, range 0-390). Of 41 studies that contained verbal descriptions of a ‘statistically non-significant’ result, 26 (63%) falsely claimed the absence of an effect. We conclude that studies in ecology and evolutionary biology are mostly exploratory and descriptive. We should thus shift from claiming to ‘test’ specific hypotheses statistically to describing and discussing many hypotheses (possible true effect sizes) that are most compatible with our data, given our statistical model. We already have the means for doing so, because we routinely present compatibility (‘confidence’) intervals covering these hypotheses.

PMID:35582935 | DOI:10.1111/jeb.14009

J Magn Reson Imaging. 2022 May 18. doi: 10.1002/jmri.28236. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnosis of residual or recurrent tumor in soft-tissue sarcomas (STS) is a differential diagnostic challenge since post-therapeutic changes impede diagnosis.

PURPOSE: To evaluate the diagnostic accuracy of quantitative dynamic contrast enhanced (DCE)-MRI and diffusion-weighted imaging (DWI) to detect local recurrence of STS of the limb.

STUDY TYPE: Prospective.

POPULATION: A totalof 64 consecutive patients with primary STS of the limbs were prospectively included 3-6 months after surgery between January 2016 and July 2021.

FIELD STRENGTH/SEQUENCE: A 1.5 T; axial DWI echo-planar imaging sequences and DCE-MRI using a 3D T1-weighted spoiled gradient-echo sequence.

ASSESSMENT: The quantitative DCE-MRI parameters relative plasma flow (rPF) and relative mean transit time (rMTT) were calculated and ADC mapping was used to quantify diffusion restriction. Regions of interest of tumor growth and postoperative changes were drawn in consensus by two experts for diffusion and perfusion analysis. An additional morphological assessment was done by three independent and blinded radiologists.

STATISTICAL TEST: Unpaired t-test, ROC-analysis, and a logistic regression model were applied. Interobserver reliability was calculated using Fleiss kappa statistics. A P value of 0.05 was considered statistically significant.

RESULTS: A total of 11 patients turned out to have local recurrence. rPF was significantly higher in cases of local recurrence when compared to cases without local recurrence (61.1-4.5) while rMTT was slightly and significantly lower in local recurrence. ROC-analysis showed an area under the curve (AUC) of 0.95 (SEM ± 0.05) for rPF while a three-factor multivariate logistic regression model showed a high diagnostic accuracy of rPF (R² = 0.71). Compared with morphological assessment, rPF had a distinct higher specificity and true positive value in detection of LR.

DATA CONCLUSION: DCE-MRI is a promising additional method to differentiate local recurrence from benign postoperative changes in STS of the limb. Especially specificity in detection of LR is increased compared to morphological assessment.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:35582900 | DOI:10.1002/jmri.28236

Health Educ Res. 2022 May 18:cyac011. doi: 10.1093/her/cyac011. Online ahead of print.

ABSTRACT

Designing corrective messages to debunk misinformation online is an important practice toward ending the coronavirus disease (COVID-19) pandemic as health-related misinformation has proliferated on social media misguiding disease prevention measures. Despite research on the use of statistical evidence and message modality in persuasion, the effects of evidence type (assertions with versus without statistical evidence) and presentation mode (text-only versus image-only versus text-plus-image) have been understudied. This study examined the impact of evidence type and presentation mode on individuals’ responses to corrective messages about COVID-19 on social media. The results showed that the presence of statistical evidence in assertions reduced message elaboration, which in turn reduced the effects of the message in correcting misperceptions, decreased perceived message believability and lowered social media users’ intentions to further engage with and disseminate the corrective message. Compared to the text-only modality and the text-plus-image modality, the image-only modality triggered significantly lower levels of message elaboration, which subsequently heightened message believability and increased user engagement intentions. The theoretical and practical implications are discussed.

PMID:35582892 | DOI:10.1093/her/cyac011

Health Educ Res. 2022 May 18:cyac012. doi: 10.1093/her/cyac012. Online ahead of print.

ABSTRACT

Managing hypertension is not only concerned with lowering blood pressure (BP) by using antihypertensive medications but also aims at minimizing its consequences through adopting self-care. The aim of this study was to assess the effectiveness of mobile application on self-care, BP control, self-efficacy and hypertension-related knowledge among adult patients with hypertension. A randomized design, two groups, pretest-posttest, between subjects with a 1:1 allocation ratio was used. The sample was selected from cardiology clinics has completed the study. Using a block randomization method, 57 of the participants were assigned to the intervention group receiving the educational application intervention, and 59 of them were assigned to the control group receiving usual care. The study’s findings showed that participants in the intervention group reported statistically significant higher self-care and knowledge scores than the participants in the control group after 8 weeks of receiving the study intervention. Additionally, compared with the control group participants, more participants in the intervention group demonstrated BP control. The educational application is effective in improving knowledge, self-care and BP control. The positive results indicate the value of integrating mobile applications in the care of patients with hypertension.

PMID:35582884 | DOI:10.1093/her/cyac012

Expert Rev Pharmacoecon Outcomes Res. 2022 May 18. doi: 10.1080/14737167.2022.2079497. Online ahead of print.

ABSTRACT

INTRODUCTION: Many diseases have a sequential treatment pathway. Compared with patients without previous treatment, patients who fail initial treatment may have lower success rates with a second treatment. This phenomenon can be explained by a correlation between treatment effects.

METHODS: We developed a statistical model of covariance for the underlying unobserved correlation between treatments and established a mathematical expression for the magnitude of the latent correlation term. We conducted a simulation study of clinical trials to investigate the correlation between two treatments and explored clinical examples based on published literature to illustrate the identification and evaluation of these correlations.

RESULTS: Our simulation study confirmed that a treatment correlation reduces the probability of success for the second treatment, compared with no correlation. We found that treatment correlations may be observable in clinical trials, such as for depression and lung cancer, and the magnitude of correlation may be estimated. We illustrated that treatment correlations can be incorporated into an economic model, with possible impacts on cost-effectiveness results. Additional applications of correlation concepts are also discussed.

CONCLUSIONS: We evaluated the correlation between treatment effects and our approach can be applied to clinical trial design and economic modelling of sequential clinical treatment pathways.

PMID:35582876 | DOI:10.1080/14737167.2022.2079497

J Viral Hepat. 2022 May 18. doi: 10.1111/jvh.13702. Online ahead of print.

ABSTRACT

Chronic hepatitis B (CHB) is characterized by progression through different phases of hepatitis B virus (HBV) infection and disease. Although not necessary for HBV replication, there is increasing evidence that HBV splice variants are associated with liver disease progression and pathogenesis. However there have been no studies to date on the frequency or diversity of splice variants for different HBV genotypes across the phases of CHB. Next generation sequencing data from 404 patient samples of HBV genotype A, B, C, or D in Phase I, Phase II or Phase IV of CHB was analysed for HBV splice variants using an in house bioinformatics pipeline. HBV splice variants differed in frequency and type by genotype and phase of natural history. Splice variant Sp1 was the most frequently detected (206/404 51% of patients), followed by Sp13 (151/404 37% of patients). The frequency of variants was generally highest in Phase II (123/165 75% of patients), a phase typically associated with enhanced immune activation, followed by Phase I (69/99 70% of patients). Splice variants were associated with reduced hepatitis B e antigen (HBeAg) levels and statistically reduced likelihood of achieving HBsAg loss (functional cure) in Phase II patients for Sp1 and Sp13 (p=0.0014 and 0.0156, respectively). The frequency of HBV splice variants in patient serum differed markedly by HBV genotype and phase of CHB natural history. The increased levels of HBV splice variants detected in CHB phase II patients compared to the higher replicative Phase I in particular warrants further investigation.

PMID:35582878 | DOI:10.1111/jvh.13702

Psychiatr Hung. 2022;37(2):133-149.

ABSTRACT

Low sexual desire, also called Hypoactive Sexual Desire Disorder or Sexual Interest/ Arousal Disorder, is a type of Female Sexual Dysfunction (FSD). This article reviews diagnostic considerations, a historical overview of how current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria was developed, including a crossover from Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) to DSM-5, diagnostic considerations in pharmaceutical treatments for low female sexual desire as well as the predominant sexual response cycle models that DSM-5 criteria was built on. It provides a historical overview of the two majorly divergent camps of perspective, namely the DSM-5 and the ICSM/ ICD classification systems, their theoretical and research basis. It concludes that female sexual desire is a rather complex phenomenon and a mechanism set in motion by intricate hormonal, emotional, relational and biological processes. Psychiatrists are well-suited in both recognizing, diagnosing and treating female sexual desire problems. Authors of this review encourage flexibility and a patient focused approach in clinical practice, which would both require utilizing a biopsychosocial perspective and the use of a multi-specialty team.

PMID:35582867