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Cao W, Chu H, Hanson T, Siegel L. A Bayesian nonparametric meta-analysis model for estimating the reference interval. Stat Med 2024; 43:1905-1919. [PMID: 38409859 DOI: 10.1002/sim.10001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/24/2023] [Accepted: 12/17/2023] [Indexed: 02/28/2024]
Abstract
A reference interval represents the normative range for measurements from a healthy population. It plays an important role in laboratory testing, as well as in differentiating healthy from diseased patients. The reference interval based on a single study might not be applicable to a broader population. Meta-analysis can provide a more generalizable reference interval based on the combined population by synthesizing results from multiple studies. However, the assumptions of normally distributed underlying study-specific means and equal within-study variances, which are commonly used in existing methods, are strong and may not hold in practice. We propose a Bayesian nonparametric model with more flexible assumptions to extend random effects meta-analysis for estimating reference intervals. We illustrate through simulation studies and two real data examples the performance of our proposed approach when the assumptions of normally distributed study means and equal within-study variances do not hold.
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Affiliation(s)
- Wenhao Cao
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Haitao Chu
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
- Statistical Research and Data Science Center, Pfizer Inc., New York, New York, USA
| | - Timothy Hanson
- Enterprise CRMS, Medtronic Plc, Mounds View, Minnesota, USA
| | - Lianne Siegel
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
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Lu J, Zhou H, Shi Y, Choe J, Shen M, Wang L, Chen K, Zhang Q, Feuer WJ, Gregori G, Rosenfeld PJ, Wang RK. Interocular asymmetry of choroidal thickness and vascularity index measurements in normal eyes assessed by swept-source optical coherence tomography. Quant Imaging Med Surg 2022; 12:781-795. [PMID: 34993118 DOI: 10.21037/qims-21-813] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the symmetry of interocular choroidal thickness and vascularity index measurements in normal eyes using swept-source optical coherence tomography (SS-OCT). Cross-sectional and observational study. This study included 244 eyes of 122 normal adults with ages uniformly distributed from 19 to 89 years. METHODS SS-OCT imaging was performed using a scanning pattern of 12×12 mm. Mean choroidal thickness (MCT) and choroidal vascularity index (CVI) measurements in the entire scanning region were obtained using a validated and published automatic method. The correlation and differences (including signed and absolute differences) between bilateral MCT and CVI measurements were analyzed at the following 6 regions: 3 concentric circles centered on the fovea with diameters of 2.5, 5, and 11 mm; the inner rim from 2.5 to 5 mm circle; the outer rim from 5 to 11 mm circle; and the entire 12×12-mm scan region, respectively. Comparison of interocular MCT and CVI measurements. RESULTS MCT measurements in right and left eyes were strongly correlated in all regions [all intraclass correlation (ICC) >0.73], but MCT measurements in right eyes were significantly thicker than in left eyes. CVI measurements in right and left eyes were moderately correlated in all regions (all ICC >0.46), but CVI measurements in right eyes were significantly smaller than that in left eyes in the macular subregions (2.5 mm circle, 5 mm circle, and the inner rim). Neither signed nor absolute interocular differences in MCT were correlated with corresponding CVI interocular differences. CONCLUSIONS Choroidal differences exist between normal fellow eyes in adults in the absence of obvious pathology. This study is useful in assisting clinicians and researchers in distinguishing asymmetric changes that are to be expected in normal eyes versus changes that could be associated with diseases.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Yingying Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James Choe
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Mengxi Shen
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Liang Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kelly Chen
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - William J Feuer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Gregori
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Philip J Rosenfeld
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Leong DP, Teo KK, Rangarajan S, Kutty VR, Lanas F, Hui C, Quanyong X, Zhenzhen Q, Jinhua T, Noorhassim I, AlHabib KF, Moss SJ, Rosengren A, Akalin AA, Rahman O, Chifamba J, Orlandini A, Kumar R, Yeates K, Gupta R, Yusufali A, Dans A, Avezum Á, Lopez-Jaramillo P, Poirier P, Heidari H, Zatonska K, Iqbal R, Khatib R, Yusuf S. Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. J Cachexia Sarcopenia Muscle 2016; 7:535-546. [PMID: 27104109 PMCID: PMC4833755 DOI: 10.1002/jcsm.12112] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/16/2016] [Accepted: 02/14/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. METHODS HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. RESULTS HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th-75th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported. CONCLUSIONS Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.
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Affiliation(s)
- Darryl P Leong
- The Population Health Research Institute McMaster University and Hamilton Health Sciences Hamilton ON Canada
| | - Koon K Teo
- The Population Health Research Institute McMaster University and Hamilton Health Sciences Hamilton ON Canada
| | - Sumathy Rangarajan
- The Population Health Research Institute McMaster University and Hamilton Health Sciences Hamilton ON Canada
| | - V Raman Kutty
- Health Action by People, 'Chemmanam', Navarangam Lane Medical College Post Office Trivandrum India
| | | | - Chen Hui
- Medical Research & Biometrics Center National Center for Cardiovascular Diseases, FuWai Hospital Beijing China
| | - Xiang Quanyong
- Jiangsu Provincial Center for Disease Control &12 Prevention Nanjing City China
| | - Qian Zhenzhen
- Jiangxinzhou community health service center Nanjing City China
| | | | - Ismail Noorhassim
- Universiti Kebangsaan Malaysia Medical Center(UKMMC) Kuala Lumpur Malaysia
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center College of Medicine, King Saud University Riyadh Saudi Arabia
| | - Sarah J Moss
- North-West University Physical activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences Potchefstroom South Africa
| | | | - Ayse Arzu Akalin
- Department of Family Medicine and Department of Medical Education Yeditepe University Medical Faculty Atasehir, Istanbul Turkey
| | - Omar Rahman
- Independent University Bangladesh Bangladesh
| | - Jephat Chifamba
- University of Zimbabwe College of Health Sciences Department of Physiology Harare
| | | | | | - Karen Yeates
- Department of Medicine Queen's University Kingston ON Canada
| | | | | | - Antonio Dans
- College of Medicine University of the Philippines - Manila Malate Philippines
| | - Álvaro Avezum
- Dante Pazzanese Institute of Cardiology São Paulo Brazil
| | - Patricio Lopez-Jaramillo
- Fundacion Oftalmologica de Santander (FOSCAL) Universidad de Santander (UDES) Bucaramanga Colombia
| | - Paul Poirier
- Institut universitaire de cardiologie et de pneumologie de Québec Québec Canada
| | - Hosein Heidari
- Cardiac Rehabilitation Research Center Isfahan University of Medical Sciences Isfahan Iran
| | | | - Romaina Iqbal
- Departments of Community Health Sciences and Medicine Aga Khan University Pakistan
| | - Rasha Khatib
- Institute of Community and Public Health Birzeit University Ramallah Palestine
| | - Salim Yusuf
- The Population Health Research Institute McMaster University and Hamilton Health Sciences Hamilton ON Canada
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