1
|
Francq BG, Lin D, Hoyer W. Confidence and Prediction in Linear Mixed Models: Do Not Concatenate the Random Effects. Application in an Assay Qualification Study. Stat Biopharm Res 2020. [DOI: 10.1080/19466315.2020.1776762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Dan Lin
- Pre-Clinical & Research – Biostatistics and Statistical Programming, GSK, Rixensart, Belgium
| | - Walter Hoyer
- TRD – CMC Statistical Sciences, GSK, Marburg, Germany
| |
Collapse
|
2
|
Francq BG, Lin D, Hoyer W. Confidence, prediction, and tolerance in linear mixed models. Stat Med 2019; 38:5603-5622. [PMID: 31659784 PMCID: PMC6916346 DOI: 10.1002/sim.8386] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 08/05/2019] [Accepted: 09/13/2019] [Indexed: 11/15/2022]
Abstract
The literature about Prediction Interval (PI) and Tolerance Interval (TI) in linear mixed models is usually developed for specific designs, which is a main limitation to their use. This paper proposes to reformulate the two‐sided PI to be generalizable under a wide variety of designs (one random factor, nested and crossed designs for multiple random factors, and balanced or unbalanced designs). This new methodology is based on the Hessian matrix, namely, the inverse of (observed) Fisher Information matrix, and is built with a cell mean model. The degrees of freedom for the total variance are calculated with the generalized Satterthwaite method and compared to the Kenward‐Roger's degrees of freedom for fixed effects. Construction of two‐sided TIs are also detailed with one random factor, and two nested and two crossed random variables. An extensive simulation study is carried out to compare the widths and coverage probabilities of Confidence Intervals (CI), PIs, and TIs to their nominal levels. It shows excellent coverage whatever the design and the sample size are. Finally, these CIs, PIs, and TIs are applied to two real data sets: one from orthopedic surgery study (intralesional resection risk) and the other from assay validation study during vaccine development.
Collapse
Affiliation(s)
| | - Dan Lin
- Pre-Clinical & Research - Biostatistics and Statistical Programming, GSK, Rixensart, Belgium
| | - Walter Hoyer
- TRD - CMC Statistical Sciences, GSK, Marburg, Germany
| |
Collapse
|
3
|
Costigan SA, Lubans DR, Lonsdale C, Sanders T, Del Pozo Cruz B. Associations between physical activity intensity and well-being in adolescents. Prev Med 2019; 125:55-61. [PMID: 31125627 DOI: 10.1016/j.ypmed.2019.05.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 11/16/2022]
Abstract
This study aims to explore associations between physical activity intensity and well-being (i.e., positive and negative affect) in adolescents. A secondary aim was to determine if associations were moderated by sex. Grade 8 students from 14 government-funded secondary schools in low socio-economic areas of Western Sydney (Australia) were assessed. Data from three timepoints (baseline, 7-8 months, and 14-15 months) were combined to increase the sample size. Physical activity was objectively assessed for 1-week at each timepoint using Actigraph accelerometers. Time (minutes/day) in light, moderate and vigorous physical activity was estimated. The short form Positive and Negative Affect Scale for Children was used to measure well-being. Quantile regression was used to analyse the data. A total of 3140 observations were collected from 1223 students (mean age at baseline: 12.9(0.54); 55.1% male). Light and moderate physical activity was not associated with well-being. Higher levels of vigorous physical activity were associated with more positive affect [β(SE) = 0.307 (0.06), p < 0.001], to an estimated vigorous physical activity turning point [Point(95%CI) = 36.48 min/day (31.39-41.59)]. Similarly, higher levels of vigorous physical activity were associated with less negative affect [β(SE) = -0.250 (0.06), p < 0.001] up to the estimated vigorous physical activity turning point [Point(95%CI) = 37.35 min/day (31.27-43.44)]. The negative association between vigorous physical activity and negative affect was more pronounced in females than in males. Our findings highlight the importance of adolescents engaging in vigorous physical activity to improve positive affect and reduce negative affect.
Collapse
Affiliation(s)
- Sarah A Costigan
- Priority Research Centre in Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Newcastle, NSW, Australia; Deakin University, Geelong, School of Exercise and Nutrition Sciences, Australia.
| | - David R Lubans
- Priority Research Centre in Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Newcastle, NSW, Australia
| | - Chris Lonsdale
- Institute for Positive Psychology, Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
| | - Taren Sanders
- Institute for Positive Psychology, Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
| | - Borja Del Pozo Cruz
- Institute for Positive Psychology, Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
| |
Collapse
|
4
|
Chen DN, Fan L, Wu YX, Zhou Q, Chen W, Yu XQ. A Predictive Model for Estimation Risk of Proliferative Lupus Nephritis. Chin Med J (Engl) 2018; 131:1275-1281. [PMID: 29786038 PMCID: PMC5987496 DOI: 10.4103/0366-6999.232809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Lupus nephritis (LN) is classified by renal biopsy into proliferative and nonproliferative forms, with distinct prognoses, but renal biopsy is not available for every LN patient. The present study aimed to establish an alternate tool by building a predictive model to evaluate the probability of proliferative LN. METHODS In this retrospective cohort with biopsy-proven LN, 382 patients in development cohort, 193 in internal validation cohort, and 164 newly diagnosed patients in external validation cohort were selected. Logistic regression model was established, and the concordance statistics (C-statistics), Akaike information criterion (AIC), integrated discrimination improvement, Hosmer-Lemeshow test, and net reclassification improvement were calculated to evaluate the performance and validation of models. RESULTS The prevalence of proliferative LN was 77.7% in the whole cohort. A model, including age, gender, systolic blood pressure, hemoglobin, proteinuria, hematuria, and serum C3, performed well on good-of-fit and discrimination in the development chohort to predict the risk of proliferative LN (291 for AIC and 0.84 for C-statistics). In the internal and external validation cohorts, this model showed good capability for discrimination and calibration (0.84 and 0.82 for C-statistics, and 0.99 and 0.75 for P values, respectively). CONCLUSION This study developed and validated a model including demographic and clinical indices to evaluate the probability of presenting proliferative LN to guide therapeutic decisions and outcomes.
Collapse
Affiliation(s)
- Dong-Ni Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong 510080, China
| | - Li Fan
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong 510080, China
| | - Yu-Xi Wu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong 510080, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong 510080, China
| | - Xue-Qing Yu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong 510080, China
- Guangdong Medical University, Zhanjiang, Guangdong 524023, China
| |
Collapse
|
5
|
Cartiaux O, Jenny JY, Joskowicz L. Accuracy of Computer-Aided Techniques in Orthopaedic Surgery: How Can It Be Defined, Measured Experimentally, and Analyzed from a Clinical Perspective? J Bone Joint Surg Am 2017; 99:e39. [PMID: 28419041 DOI: 10.2106/jbjs.15.01347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Surgical accuracy is multifactorial. Therefore, it is crucial to consider all influencing factors when investigating the accuracy of a surgical procedure, such as the surgeon's experience, the assistive technologies that may be used by the surgeon, and the patient factors associated with the specific anatomical site. For in vitro preclinical investigations, accuracy should be linked to the concepts of trueness (e.g., distance from the surgical target) and precision (e.g., variability in relation to the surgical target) to gather preclinical, quantitative, objective data on the accuracy of completed surgical procedures that have been performed with assistive technologies. The clinical relevance of improvements in accuracy that have been observed experimentally may be evaluated by analyzing the impact on the risk of failure and by taking into account the level of tolerance in relation to the surgical target (e.g., the extent of the safety zone). The International Organization for Standardization (ISO) methodology enables preclinical testing of new assistive technologies to quantify improvements in accuracy and assess the benefits in terms of reducing the risk of failure and achieving surgical targets with tighter tolerances before the testing of clinical outcomes.
Collapse
Affiliation(s)
- Olivier Cartiaux
- 1Computer Assisted and Robotic Surgery, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium 2Centre de Chirurgie Orthopédique et de la Main, Les Hôpitaux Universitaires de Strasbourg, Illkirch, France 3The Rachel and Selim Benin School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | |
Collapse
|
6
|
Smith JR, Zimmer N, Bell E, Francq BG, McConnachie A, Mactier R. A Randomized, Single-Blind, Crossover Trial of Recovery Time in High-Flux Hemodialysis and Hemodiafiltration. Am J Kidney Dis 2016; 69:762-770. [PMID: 28024931 PMCID: PMC5438239 DOI: 10.1053/j.ajkd.2016.10.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 10/15/2016] [Indexed: 12/12/2022]
Abstract
Background The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. Study Design Randomized patient-blinded crossover trial. Settings & Participants 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom. Intervention 8 weeks of HD followed by 8 weeks of online postdilution HDF or vice versa. Outcomes Posttreatment recovery time, symptomatic hypotension events, dialysis circuit clotting events, and biochemical parameters. Measurements Patient-reported recovery time in minutes, incidence of adverse events during treatments, hematology and biochemistry results, quality-of-life questionnaire. Results There was no overall difference in recovery time between treatments (medians for HDF vs HD of 47.5 [IQR, 0-240] vs 30 [IQR, 0-210] minutes, respectively; P = 0.9). During HDF treatment, there were significant increases in rates of symptomatic hypotension (8.0% in HDF vs 5.3% in HD; relative risk [RR], 1.52; 95% CI, 1.2-1.9; P < 0.001) and intradialytic tendency to clotting (1.8% in HDF vs 0.7% in HD; RR, 2.7; 95% CI, 1.5-5.0; P = 0.002). Serum albumin level was significantly lower during HDF (3.2 vs 3.3 g/dL; P < 0.001). Health-related quality-of-life scores were equivalent. Limitations Single center; mean achieved HDF convection volume, 20.6 L. Conclusions Patients blinded to whether they were receiving HD or HDF in a randomized controlled crossover study reported similar posttreatment recovery times and health-related quality-of-life scores.
Collapse
Affiliation(s)
- James R Smith
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom; Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
| | - Norica Zimmer
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom
| | - Elizabeth Bell
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom
| | - Bernard G Francq
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Robert Mactier
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom
| |
Collapse
|