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PubMed2000

Application of a generalized random effects regression model for cluster-correlated longitudinal data to a school-based smoking prevention trial.

In cluster-randomized trials, groups of subjects (clusters) are assigned to treatments, whereas observations are taken on the individual subjects. Since observations on subjects in the same cluster are typically more similar than observations from different clusters, analyses of such data must take intracluster correlation into account rather than assuming independence among all observations. Random effects models are useful for this purpose. The problem becomes more complicated if, in addition, repeated observations are taken on subjects over time. This introduces intraindividual correlation, which is typical for longitudinal studies. The Waterloo Smoking Prevention Project, study 3 (WSPP3), 1989-1996, is a study giving rise to cluster-correlated longitudinal data, where schools were randomized to either a smoking intervention program or to a control condition. Smoking status was assessed on grade 6 students in these schools, with annual follow-up observations throughout elementary and high school years. The authors illustrate the use of a generalized random effects model for analyzing this type of data. This model obtains appropriate estimates and standard errors for both individual-level covariates and those at the level of the cluster.

Adolescent↗

PubMed2001

An exact trend test for correlated binary data.

The problem of testing a dose-response relationship in the presence of exchangeably correlated binary data has been addressed using a variety of models. Most commonly used approaches are derived from likelihood or generalized estimating equations and rely on large-sample theory to justify their inferences. However, while earlier work has determined that these methods may perform poorly for small or sparse samples, there are few alternatives available to those faced with such data. We propose an exact trend test for exchangeably correlated binary data when groups of correlated observations are ordered. This exact approach is based on an exponential model derived by Molenberghs and Ryan (1999) and Ryan and Molenberghs (1999) and provides natural analogues to Fisher's exact test and the binomial trend test when the data are correlated. We use a graphical method with which one can efficiently compute the exact tail distribution and apply the test to two examples.

Abnormalities, Drug-Induced↗

PubMed2005

A new SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data.

Correlating the activation foci identified in functional imaging studies of the human brain with structural (e.g., cytoarchitectonic) information on the activated areas is a major methodological challenge for neuroscience research. We here present a new approach to make use of three-dimensional probabilistic cytoarchitectonic maps, as obtained from the analysis of human post-mortem brains, for correlating microscopical, anatomical and functional imaging data of the cerebral cortex. We introduce a new, MATLAB based toolbox for the SPM2 software package which enables the integration of probabilistic cytoarchitectonic maps and results of functional imaging studies. The toolbox includes the functionality for the construction of summary maps combining probability of several cortical areas by finding the most probable assignment of each voxel to one of these areas. Its main feature is to provide several measures defining the degree of correspondence between architectonic areas and functional foci. The software, together with the presently available probability maps, is available as open source software to the neuroimaging community. This new toolbox provides an easy-to-use tool for the integrated analysis of functional and anatomical data in a common reference space.

Brain↗

PubMed1995

A generalized estimating equations approach for spatially correlated binary data: applications to the analysis of neuroimaging data.

This paper proposes a generalized estimating equations approach for the analysis of spatially correlated binary data when there are large numbers of spatially correlated observations on a moderate number of subjects. This approach is useful when the scientific focus is on modeling the marginal mean structure. Proper modeling of the spatial correlation structure is shown to provide large efficiency gains along with precise standard error estimates for inference on mean structure parameters. Generalized estimating equations for estimating the parameters of both the mean and spatial correlation structure are proposed. The use of semivariogram models for parameterizing the correlation structure is discussed, and estimation of the sample semivariogram is proposed as a technique for choosing parametric models and starting values for generalized estimating equations estimation. The methodology is illustrated with neuroimaging data collected as part of the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Data Bank. A simulation study demonstrates the importance of accurate modeling of the spatial correlation structure in data with large numbers of spatially correlated observations such as those found in neuroimaging studies.

Brain↗

PubMed1997

A latent process regression model for spatially correlated count data.

This paper proposes a regression model for spatially correlated count data that generalizes the work of Zeger (1988, Biometrika 75, 621-629) developed in a time-series setting. In this approach, spatial correlation is introduced through a latent process, and the marginal mean function may contain spatial trends and covariates. Generalized estimating equations are used to estimate and perform marginal inference on the spatial trend and covariate effects. The feasibility of this approach is demonstrated using an example of the distribution of neuronal cell counts in a laboratory culture dish.

Animals↗

PubMed1999

Latent model for correlated binary data with diagnostic error.

We propose a methodology for modeling correlated binary data measured with diagnostic error. A shared random effect is used to induce correlations in repeated true latent binary outcomes and in observed responses and to link the probability of a true positive outcome with the probability of having a diagnosis error. We evaluate the performance of our proposed approach through simulations and compare it with an ad hoc approach. The methodology is illustrated with data from a study that assessed the probability of corneal arcus in patients with familial hypercholesterolemia.

Adult↗

PubMed1990

Prediction of cancer potency using a battery of mutation and toxicity data.

Correlations between the carcinogenic potencies of 146 known mouse carcinogens and potency estimates determined from (i) Ames test results, (ii) a battery of mutation test results, and (iii) a battery of mutation and toxicity data are presented. The lowest correlation was found using Salmonella mutagenic potency (r = 0.37). The highest correlations were found using the battery of mutation and toxicity data to predict the potency of lung carcinogens (r = 0.94) and liver carcinogens (r = 0.91). The results suggest that short-term batteries which include tests for both mutagenicity and toxicity will be able to predict carcinogenic potency better than current batteries relying solely on mutagenicity tests.

Animals↗

PubMed1995

A quantifiable approach in the comparison of isokinetic assessment data--new correlation equations for the Johnson antishear device and standard shin pad in the isokinetic assessment of the knee.

The rehabilitation of the knee with a deficient anterior cruciate ligament (ACL) always presents a great challenge. Isokinetic assessment allows muscle performance to be quantified. The antishear device, introduced by Johnson, has the distinct advantage of minimizing the anterior translation force during isokinetic exercise. In a previous report, there was a significant difference between the Johnson double pad antishear device and the standard single pad device in knee extension. The main purpose of this study was to define a correlation equation such that data generated in the use of the two different devices can be compared for assessment. Ten subjects were tested with the Cybex isokinetic dynamometer with a randomly selected sequence of test speeds. Correlation coefficient (r), regression analysis and paired t tests (P) were performed to estimate the correlation and difference between the two devices. It is concluded that a significant difference in the data generated between the two devices indicated that a single device should be selected to carry out a series of comparisons on a particular subject. However, if the two devices are used in a series of testings, a set of correlation equations has been defined to facilitate such comparison. The findings in this study will widen the application of comparison of isokinetic data in the quantitative approach of rehabilitation of the knee with a deficient anterior cruciate ligament.

Adult↗

PubMed1998

The analysis of correlated panel data using a continuous-time Markov model.

We consider the analysis of correlated panel data in which two or more correlated multistate processes are periodically observed on each individual and the exact transition times between states are unknown. We describe a procedure that models each process marginally under a time-homogeneous Markov model allowing for covariates. The resulting estimators are shown to be asymptotically jointly normal with a covariance matrix that can be consistently estimated. Simultaneous inference procedures are also proposed. Methods are illustrated using data from an AIDS clinical trial to compare the toxic effects of two treatments on two hematologic variables, hemoglobin and absolute neutrophil count.

AIDS-Related Opportunistic Infections↗

PubMed2004

The contribution of epidermal growth factor receptor (EGFR) signaling pathway to radioresistance in human gliomas: a review of preclinical and correlative clinical data.

PURPOSE: The epidermal growth factor receptor (EGFR) pathway is frequently upregulated in high-grade gliomas via gene amplification and by specific mutations that render EGFR constitutively active (EGFRvIII). METHODS AND MATERIALS: This review highlights EGFR's role in mediating radiation resistance in gliomas: underlying molecular mechanisms, with discussion of relevant preclinical and clinical correlative data. RESULTS: Preclinical and emerging clinical data suggest that EGFR signaling plays a potentially important role in mediating radiation resistance in human gliomas. CONCLUSIONS: Targeting EGFR alone, or in combination with its downstream mediators, represents a promising new approach for the management of glioma patients.

Animals↗

PubMed1996

A jackknife estimator of variance for Cox regression for correlated survival data.

Studies in the health sciences often give rise to correlated survival data. Wei, Lin, and Weissfeld (1989, Journal of the American Statistical Association 84, 1065-1073) and Lee, Wei, and Amato (1992, in Survival Analysis: State of the Art) showed that, if the marginal distributions of the correlated survival times follow a proportional hazards model, then the estimates from Cox's partial likelihood (Cox, D.R., 1972, Journal of the Royal Statistical Society, Series B 24, 187-220), naively treating the correlated survival times as independent, give consistent estimates of the relative risk parameters. However, because of the correlation between survival times, the inverse of the information matrix may not be a consistent estimate of the asymptotic variance. Wei et al. (1989) and Lee et al. (1992) proposed a robust variance estimate that is consistent for the asymptotic variance. We show that a "one-step" jackknife estimator of variance is asymptotically equivalent to their variance estimator. The jackknife variance estimator may be preferred because an investigator needs only to write a simple loop in a computer package instead of a more involved program to compute Wei et al. (1989) and Lee et al.'s (1992) estimator.

Acquired Immunodeficiency Syndrome↗

PubMed1986

Should a central fusion stimulus be used on the disparometer?

Clinical measurements of fixation disparity made with the disparometer have used a 1.5 degree diameter peripheral fusion stimulus. The addition of a central fusion stimulus decreases the variability of test measurements and more closely simulates everyday visual tasks. However, this also changes the fixation disparity measurement, associated phoria, slope of the curve, and possibly the curve type. Normative data and correlation data to other clinical tests are not available for the central fusional measurements as they are for the peripheral fusional measurements. More importantly, the peripheral fusional measurements have been shown to correlate with patient symptoms, whereas such studies have yet to be performed with the central stimulus. Until normative and discriminative information data are available for the central fusional stimulus, the peripheral stimulus is more useful clinically.

Fixation, Ocular↗

PubMed2006

A score test for zero-inflation in correlated count data.

To account for the preponderance of zero counts and simultaneous correlation of observations, a class of zero-inflated Poisson mixed regression models is applicable for accommodating the within-cluster dependence. In this paper, a score test for zero-inflation is developed for assessing correlated count data with excess zeros. The sampling distribution and the power of the test statistic are evaluated by simulation studies. The results show that the test statistic performs satisfactorily under a wide range of conditions. The test procedure is further illustrated using a data set on recurrent urinary tract infections.

Aged↗

PubMed1985

Interpretation of cell toxicity data for the estimation of potential irritation.

Three cytotoxicity assays were evaluated using 57 chemicals of various classes (inorganic and organic metal salts, solvents, detergents, reagents, drugs) which have widely different mechanisms of cytotoxicity. Baby hamster kidney fibroblasts (BHK-21/C13) and early (Keller) and late (MRC-5) passage human fibroblasts were used to measure cell detachment, cloning efficiency, and growth inhibition under subconfluent culture conditions. For the majority of chemicals, for which comparisons were made, the ranking order was roughly the same in all three tests and with all three cell types. However, for some chemicals specific growth effects could either be detected or excluded because the relationship between the data from the detachment assay and that from one of the growth assays was characteristically altered. The ranking order resulting from our in vitro data correlated better with threshold limit values for human workroom air (TLV/TWA) than with LD50 values (rat, oral). Correlations with data from Draize skin and eye irritation tests were not determined since the available in vivo values were derived using various different scoring systems. However, when our in vitro data were used to divide the chemicals into three crude classes, (i) non-irritant, (ii) mild to moderate irritant, or (iii) strong irritant or corrosive, and the results were compared with the known irritation potential for skin and mucous membranes derived from human exposure data, the in vitro data were more than 80% predictive of the in vivo classifications.

Animals↗

PubMed1998

Gastrointestinal hemorrhage in patients with systemic sclerosis and CREST syndrome.

OBJECTIVES: Systemic sclerosis (SSc) and calcinosis, Raynaud's phenomenon, esophageal disease, sclerodactyly, telangiectasia (CREST) syndrome present distinctive microvasculature lesions that are thought to be responsible for tissue damage and disease progression. Involvement of the gastrointestinal tract may lead to the occurrence of profuse hemorrhage. We performed a study to assess the incidence and characteristics of gastrointestinal hemorrhage in a large group of patients with SSc and CREST syndrome. METHODS: We reviewed the medical records of 144 patients with SSc/CREST seen at our institution during the period 1985-1996. Endoscopic findings and clinical data were correlated. Data are expressed as means +/- SD. RESULTS: Twenty-two of 144 (15.2%) patients had at least one episode of gastrointestinal hemorrhage (16 women, 6 men; mean age, 59.4 +/- 17.6 yr). Eight patients (8/22; 36%) had multiple episodes and four (4/22; 18%) required chronic transfusion therapy. Mucosal telangiectasias were the most common cause of bleeding (9/22; 40.9%), followed by peptic ulcer disease (7/22; 31.8%) and erosive gastritis (3/22; 13.6%). Bleeding telangiectasias occurred in the entire gastrointestinal tract, including oral cavity (n = 1), esophagus (n = 1), stomach (n = 3), duodenum (n = 1), ileum (n = 1), cecum (n = 2), and colon (n = 2). Mortality was 22.7% in patients with gastrointestinal bleeding, compared with 7.3% in patients without bleeding. CONCLUSIONS: Patients with SSc/CREST syndrome are at risk of developing severe gastrointestinal hemorrhage. This complication is associated with frequent hospitalization, blood transfusions, and increased mortality. Mucosal telangiectasias are the most common source of bleeding. Appropriate endoscopic intervention is recommended in evaluating and preventing bleeding in patients with SSc/CREST.

Adolescent↗

PubMed1993

Abbott AxSYM random and continuous access immunoassay system for improved workflow in the clinical laboratory.

We describe a new clinical laboratory instrument, the Abbott AxSYM, which provides random- and continuous-access testing for immunoassays, 20 onboard reagents, primary tube sampling, and a throughput of 80 to 120 tests per hour. The AxSYM incorporates three separate analytical technologies for processing immunoassays: microparticle enzyme immunoassay, fluorescence polarization immunoassay, and a novel technology known as ion-capture immunoassay. The system incorporates both common and technology-specific subsystems controlled by a real-time software scheduling processor. Tests can be processed in one- or two-step sandwich or competitive formats, with variable pipetting steps, incubation periods, optical read formats, and wash sequences. Menu capabilities include tests for hepatitis, retrovirus, tumor markers, fertility markers, thyroid functions, and therapeutic drugs. The time to first result is approximately 15-25 min for most routine assays and < or = 15 min for stat assays (i.e., creatine kinase MB isoenzyme, human chorionic gonadotropin beta subunit, and therapeutic drugs). AxSYM assay performance for 23 assays was comparable with that of the Abbott IMx and TDx analyzers; specimen correlation data had correlation coefficients ranging from 0.97 to 0.99 and slopes ranging from 0.99 to 1.10. Within-run imprecision (CV) was 1.5% to 11.4%, with most assays (19 of 23) demonstrating CVs < or = 8.0%.

Autoanalysis↗

PubMed1996

[Fluorescence polarization immunoassay and microparticle enzyme immunoassay].

We describe a new clinical laboratory instrument, the Abbott AxSYM, which provides random- and continuous-access testing for immunoassays, 20 onboard reagents, primary tube sampling, and a throughput of 80 to 120 tests per hour. The AxSYM incorporates three separate analytical technologies for processing immunoassays: microparticle enzyme immunoassay, fluorescence polarization immunoassay, and a novel technology known as ion-capture immunoassay. The system incorporates both common and technology-specific subsystems controlled by a real-time software scheduling processor. Tests can be processed in one- or two-step sandwich or competitive formats, with variable pipetting steps, incubation periods, optical read formats, and wash sequences. Menu capabilities include test for hepatitis, retrovirus, tumor markers, fertility markers, thyroid functions, and therapeutic drugs. The time to first result is 15 approximately 25 min for most routine assay and < or = 15 min for stat assays (i.e., creatine kinase MB isoenzyme, human chorionic gonadotropin beta subunit, and therapeutic drugs). AxSYM assay performance for 23 assays was comparable with that of the Abbott IMx and TDx analyzers; specimen correlation data had correlation from 0.99 to 1.10. Within-run imprecision (CV) was 1.5% to 11.4%, with most assays (19 of 23) demonstrating CVs < or = 8.0%.

Fluorescence Polarization Immunoassay↗

PubMed1991

Problem of between-eye correlation for statistical hypothesis testing: rabbit corneal thickness.

The two eyes of a subject often yield correlated data. Statistical analysis which treats correlated data as if it were independent is most likely to be biased toward statistical significance; that is, the probability of a type I error is likely to be inflated. To illustrate the importance of lack of independence to the inferential process, data from an experimental design commonly used in optometric research are used to demonstrate (1) the potential magnitude of between-eye correlation, (2) the statistical bias toward a significant outcome when the between-eye correlation is ignored via inappropriate analysis, and (3) simple ways by which the bias can be avoided. The researcher must be aware of the between-eye correlation which exists for the particular effect under study, and the statistical bias that ensues from the correlation when the data are not handled correctly.

Animals↗