PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “multiple testing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources

Dual controls, p-value plots, and the multiple testing issue in carcinogenicity studies.

The interpretation of statistically significant findings in a carcinogenicity study is difficult, in part because of the large number of statistical tests conducted. Some scientists who believe that the false positive rates in these experiments are unreasonably large often suggest that the use of multiple control groups will provide important insight into the operational false positive rates. The purpose of this paper is 2-fold: to present results from two carcinogenicity studies with dual control groups, and to present and illustrate a new graphical technique potentially useful in the analysis and interpretation of tumor data from carcinogenicity studies. The experimental data analyzed show that statistically significant differences between identically treated groups will occur with regular frequency. Such data, however, do not provide strong evidence of extrabinomial variation in tumor rates. The p-value plot is advocated as a graphical method that can be used to assess visually the ensemble of p values for neoplasm data from an entire study. This technique is then illustrated using several examples. Through computer simulation, we present p-value plots generated with and without treatment effects present. On average, the plots look substantially different depending on the presence or absence of an effect. We also evaluate decision rules motivated by the p-value plots. Such rules appear to have good power to detect treatment effects (i.e., have low false negative rates) while still controlling false positive rates.

Animals↗

How many bloods will a 'HIVCHEK' check? Multiple tests for HIV antibody for a single screening kit.

Detection of HIV infection in blood donors or populations is usually by testing sera for antibodies to HIV-1 and HIV-2. Screening tests are now highly sensitive and specific, but still expensive and scarce in Africa. We tested the commercially available kits 'HIVCHEK 1 + 2' in two field laboratories, on specimens from blood donors and antenatal women in rural Zaire. We describe a method of using one test kit for up to five serum samples, saving money and time. In 491 antenatal mothers in Eastern Zaire, among whom the HIV seroprevalence was 3.3%, we compared 'HIVCHEK' results with results obtained by ELISA and Western blot. The 'HIVCHEK' multiple-sample method had a sensitivity of 82% and a specificity of 99.6%. In an area with an HIV seroprevalence of < 4%, using 'HIVCHEK' by the multiple sample method would lead to a saving of about 2,400 pounds for every 1000 individuals tested.

AIDS Serodiagnosis↗

Older and younger adults' strategy choices in multiplication: testing predictions of ASCM using the choice/no-choice method.

The choice/no-choice method provides a means of obtaining unbiased estimates of the performance characteristics of strategies. The three experiments in the study illustrate the method's usefulness for testing predictions of alternative models of strategy choice. The experiments focused on 20- and 70-year-olds' choices among mental calculation, use of a calculator, and use of pencil and paper as strategies for solving multidigit multiplication problems. As predicted by the Adaptive Strategy Choice Model (ASCM), (a) differences in the speed and accuracy yielded by the strategies were the strongest predictors of the frequency with which each strategy was chosen on a given problem; (b) features of problems exerted an additional independent influence; and (c) having a choice resulted in better performance than not having one. These results held true for both older and younger adults. Potential extensions of the choice/no-choice method and of ASCM are discussed.

Adolescent↗

Assessing visual attention in young children and adolescents with severe mental retardation utilizing conditional-discrimination tasks and multiple testing procedures.

To effectively reduce overselective attention, a fine-grained analysis of the control exhibited by compound training cues is first needed. Computer software was developed in this study to administer two different stimulus control-testing procedures to assess how three young children of normal development and three adolescents with severe mental retardation attended to stimulus compounds when conditional-discrimination tasks were provided. One test assessed stimulus control by determining response accuracy for each component of the S+ compounds. The other testing procedure measured the response topographies of the compound stimuli using a touch screen attached to a computer monitor screen. After pretraining each stimulus component, all three children attended simultaneously to two elements in a conditional-discrimination task with few errors occurring. The adolescents with mental retardation eventually attended to both elements simultaneously but required more pretraining and exposure to the conditional-discrimination tasks before simultaneous attention occurred. Since the adolescents with severe mental retardation learned to simultaneously attend to multiple cues in the conditional-discrimination tasks, this demonstrated that restricted attention is not an unmodifiable perceptual characteristic among individuals with developmental disabilities. Recording response topographies with a touch screen was also discovered to be a sensitive measure of stimulus preferences for both groups. Utilizing touch-screen technology may prove to be critical for accurately identifying stimulus preferences and contribute to the understanding and treatment of overselective attention in students with attentional deficits.

Adolescent↗

Estimating significance level and power comparisons for testing multiple endpoints in clinical trials.

Clinical trials generally include several outcome measures of interest for assessing treatment efficacy and harm. Traditionally a single measure, the primary outcome, is selected and used as the basis for the design, including sample size and power. Secondary outcomes are then generally ordered with respect to their clinical relevance and importance. While this has become the traditional paradigm, recent trials have suggested the need for additional approaches. In this setting, two outcomes are viewed as key, either one being sufficient for proof of efficacy, but with an ordering of preference. The basic question, in such cases, is how to control the overall significance level for the trial. We describe and compare two methods for testing primary and secondary endpoints, accounting for their hierarchical nature-the ordering preference. Both methods are sequential, in the sense that the secondary endpoint is only tested when the primary outcome fails to reach significance. The first method uses a global test for the combination of the primary and secondary endpoints, while the second uses a partial Bonferroni correction. Simulation results indicate that the Bonferroni adjustment method performs as well as the global test method in most cases, and even better in some cases.

Clinical Trials as Topic↗

Gene flow in complex landscapes: testing multiple hypotheses with causal modeling.

Predicting population-level effects of landscape change depends on identifying factors that influence population connectivity in complex landscapes. However, most putative movement corridors and barriers have not been based on empirical data. In this study, we identify factors that influence connectivity by comparing patterns of genetic similarity among 146 black bears (Ursus americanus), sampled across a 3,000-km(2) study area in northern Idaho, with 110 landscape-resistance hypotheses. Genetic similarities were based on the pairwise percentage dissimilarity among all individuals based on nine microsatellite loci (average expected heterozygosity=0.79). Landscape-resistance hypotheses describe a range of potential relationships between movement cost and land cover, slope, elevation, roads, Euclidean distance, and a putative movement barrier. These hypotheses were divided into seven organizational models in which the influences of barriers, distance, and landscape features were statistically separated using partial Mantel tests. Only one of the competing organizational models was fully supported: patterns of genetic structure are primarily related to landscape gradients of land cover and elevation. The alternative landscape models, isolation by barriers and isolation by distance, are not supported. In this black bear population, gene flow is facilitated by contiguous forest cover at middle elevations.

Animals↗

Speech, impedance, and auditory brainstem response audiometry in brainstem tumors. Importance of a multiple-test strategy.

Speech, impedance, and auditory brainstem response audiometric data were determined for four patients with intracranial tumor. Although the results of any individual measure may be ambiguous, consideration of the overall pattern of results on all three measures, in combination with audiometric sensitivity level, can lead to relatively precise site localization of brainstem auditory disorders.

Acoustic Impedance Tests↗

Serum creatine kinase in the detection of Duchenne muscular dystrophy carriers: effects of season and multiple testing.

The usefulness of serum creatine kinase (CK) activity in the detection of Duchenne muscular dystrophy (DMD) carriers is dependent upon a reliable control distribution. In controls there is a small but reproducible seasonal variation in CK activity, with a statistically significant variation in the upper 95th percentile (78 IU/liter in May, 53 IU/liter in November, as compared with 67 IU/liter for the whole calendar year). Because CK values in DMD heterozygotes are higher in November than in May, the carrier detection rate may be highest in November. Failure to consider this seasonal variation in controls may cause misclassification of too many normal subjects. If tests are conducted throughout the year, however, the seasonal influence can be reduced by serial testing at intervals of several months. In this case, use of the highest of the results obtained in 3 tests compared with the normal range of single measurements misclassifies too many normal subjects. Use of the mean of 3 determinations provides more accurate classification.

Adult↗

Multiple testing in fetal gender determination from maternal blood by polymerase chain reaction.

Fetal male DNA can be identified in maternal blood by polymerase chain reaction (PCR) amplification of Y-specific sequences. This technology has not reached a satisfactory accuracy and reproducibility in fetal gender determination because of the very low concentration of fetal cells. Our purpose was to evaluate the possibility of improving the reliability of this test by setting up a repeated amplification system. We amplified, by nested PCR of the Y-specific sequence DYS14, 137 DNA samples extracted from maternal peripheral blood (93 from male-bearing and 44 from female-bearing pregnancies ranging from the 6th to the 36th gestational week). Each maternal DNA sample was tested doubly, in two different PCR sessions, with a total of four amplifications. We obtained discordant results in the four amplifications in 82/137 (60%) samples. The best interpretation of these discordant results was obtained by applying a positivity cutoff of at least two positive amplifications for considering a DNA sample as belonging to a male-bearing pregnancy. We obtained a sensitivity of 83%, a specificity of 93%, a positive predictive value of 96% and a negative predictive value of 72% in fetal male gender diagnosis. By applying this quadruple testing system, we significantly improved PCR accuracy and predictive values compared with single and double testing of the same samples. We conclude that, for future investigations of fetal DNA retrieved from maternal blood, the application of a quadruple testing system is better than the single PCR test.

DNA↗

Delirium in liver transplantation candidates: discriminant analysis of multiple test variables.

We report the results of electroencephalograms, Mini-Mental State exam, Trailmaking Tests A and B, and serum albumin levels in 108 consecutive liver transplantation candidates. We compared test results to a clinical DSM-III diagnosis of delirium. Although each variable could differentiate between the two groups (delirium n = 18; nondelirium n = 90) at a statistically significant level, a discriminant analysis involving either all variables or only three particular variables (Trailmaking B, EEG code, and albumin) resulted in the highest specificity (97.8%) and sensitivity (83.3%), with a correct classification of 95.4% of subjects. The analysis also generates an equation that can be applied to clinical situations to enhance the accurate recognition of delirium. In addition, to explain abnormal Trailmaking B scores and/or EEGs in subjects who did not otherwise meet DSM-III criteria for delirium, we suggest the presence of a "subclinical delirium."

Adolescent↗