Tag: statistics

Psychol Methods. 2023 May 11. doi: 10.1037/met0000582. Online ahead of print.

ABSTRACT

Cognitive models provide a substantively meaningful quantitative description of latent cognitive processes. The quantitative formulation of these models supports cumulative theory building and enables strong empirical tests. However, the nonlinearity of these models and pervasive correlations among model parameters pose special challenges when applying cognitive models to data. Firstly, estimating cognitive models typically requires large hierarchical data sets that need to be accommodated by an appropriate statistical structure within the model. Secondly, statistical inference needs to appropriately account for model uncertainty to avoid overconfidence and biased parameter estimates. In the present work, we show how these challenges can be addressed through a combination of Bayesian hierarchical modeling and Bayesian model averaging. To illustrate these techniques, we apply the popular diffusion decision model to data from a collaborative selective influence study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166854 | DOI:10.1037/met0000582

Ann Am Thorac Soc. 2023 Feb 27. doi: 10.1513/AnnalsATS.202209-814OC. Online ahead of print.

ABSTRACT

RATIONALE: Little is known about the safety of infusing vasopressors through a midline catheter.

OBJECTIVES: To evaluate safety outcomes following vasopressor administration though a midline.

METHODS: We conducted a cohort study of adults admitted to 39 hospitals in Michigan (December 2017 – March 2022) who received vasopressors while either a midline or peripherally inserted central catheter (PICC) was in place. Patients receiving vasopressors through a midline were compared to those receiving vasopressors through a PICC and, separately, to those with midlines in place but who received vasopressors through a different catheter. We used descriptive statistics to characterize and compare cohort characteristics. Multivariable mixed effects logistic regression models were fit to determine the association between vasopressor administration through a midline with outcomes, primarily catheter-related complications (bloodstream infection, superficial thrombophlebitis, exit site infection, or catheter occlusion).

RESULTS: Our cohort included 287 patients with midlines through which vasopressors were administered, 1660 with PICCs through which vasopressors were administered, and 884 patients with midlines who received vasopressors through a separate catheter. Age (median [interquartile range]: 68.7 [58.6-75.7], 66.6 [57.1-75.0], and 67.6 [58.7-75.8] years) and gender (percent female: 50.5%, 47.3%, and 43.8%) were similar in all groups. The frequency of catheter-related complications was lower in patients with midlines used for vasopressors than PICCs used for vasopressors (5.2% vs. 13.4%, p<0.001), but similar to midlines with vasopressor administration through a different device (5.2% vs. 6.3%, p=0.49). Following adjustment, administration of vasopressors through a midline was not associated with catheter-related complications compared to PICCs with vasopressors (adjusted odds ratios [aOR] 0.65 [95% confidence interval, 0.31-1.33], p=0.23), nor midlines with vasopressors elsewhere (aOR 0.85 [0.46-1.58], p=0.59). Midlines used for vasopressors were associated with greater risk of systemic thromboembolism (vs PICCs with vasopressors: (aOR 2.69 [1.31,5.49] , p=0.008; vs midlines with vasopressors elsewhere: aOR 2.42 [1.29,4.54], p=0.008) yet not thromboses restricted to the ipsilateral upper extremity (vs PICCs with vasopressors: aOR 2.35 [0.83,6.63], p=0.10; model did not converge for vs midlines with vasopressors elsewhere).

CONCLUSIONS: We found no significant association of vasopressor administration though a midline with catheter-related complications. However, we identified an increased odds of systemic (but not ipsilateral upper extremity) venous thromboembolism warranting further evaluation.

PMID:37166852 | DOI:10.1513/AnnalsATS.202209-814OC

Psychol Assess. 2023 May 11. doi: 10.1037/pas0001218. Online ahead of print.

ABSTRACT

The Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017, 2021) is offered as a dimensional alternative to traditional categorical diagnostic nosologies such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). HiTOP researchers have recently published an open-source assessment system for clinical implementation, the HiTOP Digital Assessment and Tracker (Jonas et al., 2021). Here, we argue that the Minnesota Multiphasic Personality Inventory-3 (MMPI-3; Ben-Porath & Tellegen 2020a), given its structural similarities to HiTOP, can augment these efforts to shift the diagnostic paradigm, with the additional strength of being comprehensively validated, standardized, and normed. Sellbom et al. (2021) examined the factor structure of the MMPI-3 Specific Problems Scales (plus RC6 and RC8), finding a pattern of latent factors much like those proposed by HiTOP in both a general mental health sample and a prisoner sample. The present study is a partial replication of Sellbom et al. (2021) with a primary medical care outpatient sample (n = 164) and a college student sample (n = 529). A sequential factoring approach yielded emergent structures that are comparable to the HiTOP model. These findings with different and important samples support the generalizability of the MMPI-3 in assessing HiTOP constructs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166849 | DOI:10.1037/pas0001218

J Consult Clin Psychol. 2023 May 11. doi: 10.1037/ccp0000820. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of different approaches to personalization in psychological therapy.

METHOD: This was a systematic review and meta-analysis of randomized controlled trials that compared the mental health outcomes of personalized treatment with standardized treatment and other control groups. Eligible studies were identified through three databases (Scopus, APA PsycInfo, and Web of Science). We conducted a narrative synthesis and random effects meta-analysis of available outcomes date, including subgroup analyses to investigate sources of effect size heterogeneity. The review protocol was preregistered in the Open Science Framework.

RESULTS: Seventeen studies (N = 7,617) met inclusion criteria for the review, nine of which (N = 5,134) provided sufficient data for inclusion in meta-analysis. Eight studies were classed as having high risk of bias, eight had moderate risk, and one had low risk. There was no significant evidence of publication bias. A statistically significant effect size was found in favor of personalized treatment relative to standardized treatment (d = 0.22, 95% CI [0.05, 0.39], p = .011). When studies with a high risk of bias were removed, this effect size was smaller but remained statistically significant (d = 0.14, 95% CI [0.08, 0.20], p < .001).

CONCLUSION: Current evidence indicates that personalization is an effective strategy to improve outcomes from psychological therapy, and the seemingly small effect size advantage of personalization could have an important impact at a clinical population level. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166831 | DOI:10.1037/ccp0000820

Emotion. 2023 May 11. doi: 10.1037/emo0001218. Online ahead of print.

ABSTRACT

The ability to measure emotional states in daily life using mobile devices has led to a surge of exciting new research on the temporal evolution of emotions. However, much of the potential of these data still remains untapped. In this paper, we reanalyze emotion measurements from seven openly available experience sampling methodology studies with a total of 835 individuals to systematically investigate the modality (unimodal, bimodal, and more than two modes) and skewness of within-person emotion measurements. We show that both multimodality and skewness are highly prevalent. In addition, we quantify the heterogeneity across items, individuals, and measurement designs. Our analysis reveals that multimodality is more likely in studies using an analog slider scale than in studies using a Likert scale; negatively valenced items are consistently more skewed than positive valenced items; and longer time series show a higher degree of modality in positive and a higher skew in negative items. We end by discussing the implications of our results for theorizing, measurement, and time series modeling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166827 | DOI:10.1037/emo0001218

JAMA Oncol. 2023 May 11. doi: 10.1001/jamaoncol.2023.0646. Online ahead of print.

ABSTRACT

IMPORTANCE: Combination of chemotherapy with (dual) ERBB2 blockade is considered standard in hormone receptor (HR)-positive/ERBB2-positive early breast cancer (EBC). Despite some promising data on endocrine therapy (ET) combination with dual ERBB2 blockade in HR-positive/ERBB2-positive BC, to our knowledge, no prospective comparison of neoadjuvant chemotherapy vs ET plus ERBB2 blockade in particular with focus on molecular markers has yet been performed.

OBJECTIVE: To determine whether neoadjuvant de-escalated chemotherapy is superior to endocrine therapy, both in combination with pertuzumab and trastuzumab, in a highly heterogeneous HR-positive/ERBB2-positive EBC.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter, neoadjuvant randomized clinical trial allocated 207 patients with centrally confirmed estrogen receptor-positive and/or progesterone receptor-positive (>1%) HR-positive/ERBB2-positive EBC to 12 weeks of standard ET (n = 100) vs paclitaxel (n = 107) plus trastuzumab and pertuzumab. A total of 186 patients were required to detect a statistically significant difference in pathological complete response (pCR) (assumptions: 19% absolute difference in pCR; power, ≥80%; 1-sided Fisher exact test, 2.5% significance level).

INTERVENTIONS: Standard ET (aromatase inhibitor or tamoxifen) or paclitaxel, 80 mg/m2, weekly plus trastuzumab and pertuzumab every 21 days.

MAIN OUTCOMES AND MEASURES: The primary end point was pCR (ypT0/is, ypN0). Secondary end points included safety, translational research, and health-related quality of life. Omission of further chemotherapy was allowed in patients with pCR. PAM50 analysis was performed on baseline tumor biopsies.

RESULTS: Of the 207 patients included (median [range] age, 53 [25-83] years), 121 (58%) had cT2 to cT4 tumors, and 58 (28%) had clinically node-positive EBC. The pCR rate in the ET plus trastuzumab and pertuzumab arm was 23.7% (95% CI, 15.7%-33.4%) vs 56.4% (95% CI, 46.2%-66.3%) in the paclitaxel plus trastuzumab and pertuzumab arm (odds ratio, 0.24; 95% CI, 0.12-0.46; P < .001). Both immunohistochemical ERBB2 score of 3 or higher and ERBB2-enriched subtype were independent predictors for pCR in both arms. Paclitaxel was superior to ET only in the first through third quartiles but not in the highest ERBB2 quartile by messenger RNA. In contrast with the paclitaxel plus trastuzumab and pertuzumab arm, no decrease in health-related quality of life after 12 weeks was observed in the ET plus trastuzumab and pertuzumab arm.

CONCLUSIONS AND RELEVANCE: The WSG-TP-II randomized clinical trial is, to our knowledge, the first prospective trial comparing 2 neoadjuvant de-escalation treatments in HR-positive/ERBB2-positive EBC and demonstrated an excellent pCR rate after 12 weeks of paclitaxel plus trastuzumab and pertuzumab that was clearly superior to the pCR rate after ET plus trastuzumab and pertuzumab.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03272477.

PMID:37166817 | DOI:10.1001/jamaoncol.2023.0646

CPT Pharmacometrics Syst Pharmacol. 2023 May 11. doi: 10.1002/psp4.12976. Online ahead of print.

ABSTRACT

The dose/exposure-efficacy analyses are often conducted separately for oncology end points like best overall response, progression-free survival (PFS) and overall survival (OS). Multistate models offer to bridge these dose-end point relationships by describing transitions and transition times from enrollment to response, progression, and death, and evaluating transition-specific dose effects. This study aims to apply the multistate pharmacometric modeling and simulation framework in a dose optimization setting of bintrafusp alfa, a fusion protein targeting TGF-β and PD-L1. A multistate model with six states (stable disease [SD], response, progression, unknown, dropout, and death) was developed to describe the totality of endpoints data (time to response, PFS, and OS) of 80 patients with non-small cell lung cancer receiving 500 or 1200 mg of bintrafusp alfa. Besides dose, evaluated predictor of transitions include time, demographics, premedication, disease factors, individual clearance derived from a pharmacokinetic model, and tumor dynamic metrics observed or derived from tumor size model. We found that probabilities of progression and death upon progression decreased over time since enrollment. Patients with metastasis at baseline had a higher probability to progress than patients without metastasis had. Despite dose failed to be statistically significant for any individual transition, the combined effect quantified through a model with dose-specific transition estimates was still informative. Simulations predicted a 69.2% probability of at least 1 month longer, and, 55.6% probability of at least 2-months longer median OS from the 1200 mg compared to the 500 mg dose, supporting the selection of 1200 mg for future studies.

PMID:37165943 | DOI:10.1002/psp4.12976

Cancer Med. 2023 May 11. doi: 10.1002/cam4.6035. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer diagnosis and treatment increase the potential psychological impact on breast cancer survivors (BCS). The objective of this study was to assess the effects of an interdisciplinary intervention during follow-up in BCS and identify variables related to improvements in HRQoL.

MATERIALS AND METHODS: In a non-randomised quasi-experimental design performed on an outpatient basis in a hospital gynaecology and oncology unit, 60 BCS were assigned to an interdisciplinary experimental group (EG) or a usual care group (CG). The EG underwent 12 sessions of an interdisciplinary program which included Mindfulness and physiotherapy, for 120 min per day, once a week for 6 weeks. At baseline, at 6 weeks and at 3 months after the intervention, participants of EG and CG completed an assessment of HRQoL (EuroQol and EORTC-QLQ-C30) and symptomatology of anxiety and depression. Additionally, EG completed an assessment of satisfaction with the treatment. For data analysis, we used descriptive statistics, Wilcoxon test, Kruskal-Wallis test, Chi-square and Fisher tests and generalised linear models.

RESULTS: After 6 weeks, statistically significant differences were apparent in global and cancer-related health symptoms such as fatigue and pain in the EORTC QLQ-C30 and in anxiety and depression, among the EG (n = 30) compared with the CG (n = 30). Patients receiving the intervention reported a high degree of satisfaction with the treatment. Three months after the intervention, patients in the EG continued to show statistically significant improvements compared with the CG. In addition, allocation to the EG was identified as a variable related to improvement of HRQoL (EORTC QLQ-C30) in the multivariable model.

CONCLUSIONS: The results of our study suggest that a 6-week interdisciplinary intervention may improve HRQoL and symptomatology of anxiety and depression in BCS patients at 3 months. The study presents data that the intervention for BCS appears promising and warrants further study in a randomised controlled trial.

PMID:37165927 | DOI:10.1002/cam4.6035

J Magn Reson Imaging. 2023 May 11. doi: 10.1002/jmri.28742. Online ahead of print.

ABSTRACT

BACKGROUND: Local staging of prostate cancer (PCa) is important for treatment planning. Radiologist interpretation using qualitative criteria is variable with high specificity but low sensitivity. Quantitative methods may be useful in the diagnosis of extracapsular extension (ECE).

PURPOSE: To assess the performance of quantitative MRI markers for detecting ECE.

STUDY TYPE: Systematic review and meta-analysis.

SUBJECTS: 4800 patients from 28 studies with histopathologically confirmed PCa on radical prostatectomy were pooled for meta-analysis. Patients from 46 studies were included for systematic review.

FIELD STRENGTH/SEQUENCE: Diffusion-weighted, T2-weighted, and dynamic contrast-enhanced MRI at 1.5 T or 3 T.

ASSESSMENT: PubMed, Embase, Web of Science, Scopus, and Cochrane databases were searched to identify studies on diagnostic test accuracy or association of any quantitative MRI markers with ECE. Results extracted by two independent reviewers for tumor contact length (TCL) and mean apparent diffusion coefficient (ADC-mean) were pooled for meta-analysis, but not for other quantitative markers including radiomics due to low number of studies available.

STATISTICAL TESTS: Hierarchical summary receiver operating characteristic (HSROC) curves were computed for both TCL and ADC-mean, but summary operating points were computed for TCL only. Heterogeneity was investigated by meta-regression. Results were significant if P ≤ 0.05.

RESULTS: At the 10 mm threshold for TCL, summary sensitivity and specificity were 0.76 [95% confidence interval (CI) 0.71-0.81] and 0.68 [95% CI 0.63-0.73], respectively. At the 15 mm threshold, summary sensitivity and specificity were 0.70 [95% CI 0.53-0.83] and 0.74 [95% CI 0.60-0.84] respectively. The area under the HSROC curves for TCL and ADC-mean were 0.79 and 0.78, respectively. Significant sources of heterogeneity for TCL included timing of MRI relative to biopsy.

DATA CONCLUSION: Both 10 mm and 15 mm thresholds for TCL may be reasonable for clinical use. From comparison of the HSROC curves, ADC-mean may be superior to TCL at higher sensitivities.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.

PMID:37165923 | DOI:10.1002/jmri.28742

Nurs Open. 2023 May 11. doi: 10.1002/nop2.1774. Online ahead of print.

ABSTRACT

AIM: The aim of the study was to analyse the correlations among organizational justice, knowledge-hiding behaviour and nurses’ innovation ability.

DESIGN: A descriptive and cross-sectional design and the data were collected using questionnaires.

METHODS: Demographic information, professional data, innovation capacity scales, knowledge-hiding scales and organizational justice scales were used in this study. Using descriptive statistics, t-tests, one-way analysis of variance and Pearson’s or Spearman’s correlation analyses, we compared the differences and examined the correlations between participants’ demographic and innovation capacity scales, and knowledge-hiding scales and organizational fairness scales.

RESULTS: We received 1486 valid responses, with an effective response rate of 96.68%. We found team role, nursing age, number of training, literature-reading habits, organizational justice, information justice, fair distribution and deaf knowledge-hiding as the influencing factors of nurses’ innovation. Nurses’ sense of organizational fairness negatively correlated with knowledge concealment and positively correlated with innovation ability. Moreover, knowledge hiding negatively correlated with nurses’ innovation ability. Furthermore, knowledge-hiding plays a partial intermediary role between organizational fairness and nurses’ innovation ability.

PMID:37165909 | DOI:10.1002/nop2.1774