This presentation discusses the question of whether it is possible to compare scores from two dermatology-specific outcome measures, the PsoriQoL and the QoLIAD.
Matching is a design approach used in case-control studies to address confounding. It involves selecting controls that are similar to cases based on specified attributes. Individual matching matches each case to a control, while frequency matching matches on distributions of attributes between cases and controls. Matching increases precision by balancing distributions across strata. It requires a matched analysis to account for the matching. While it improves control of confounding, matching can be time-consuming and decrease efficiency if overused. The odds ratio is commonly used to measure exposure effects in individually matched case-control studies.
Smith, D., Crocker, L., Staton, C., Gillaspy, A., & Charlton, S. (2010). Psychometric properties of the Outcome Rating Scale in a non-clinical sample. Poster presentation at the Heart and Soul of Change Conference, New Orleans.
Nowadays Scientists using laboratory animals are under increasing pressure to justify their sample sizes using a ‘‘power analysis’’ to improve study reproducibility and from ethical point of view too.
In this presentation, I review the three methods currently used to determine sample size: ‘‘tradition’’ or ‘‘common sense’’, the ‘‘resource equation’’ and the ‘‘power analysis’’.
Application of the Rasch Model in Assessing and Streamlining an Instrument Me...SherwinBalbuena1
This document describes applying the Rasch model to assess and streamline a depression inventory for university students. It analyzed data from two student surveys using the partial credit Rasch model. Several misfitting persons and items were identified and removed to improve the instrument. The revised scale demonstrated good reliability and targeting. Thresholds were established to classify students' depression levels. The procedure was deemed replicable across datasets and can help evaluate other psychological instruments.
This document provides an introduction to various psychotherapies. It discusses psychodynamic therapies including Freudian psychoanalysis and object relations theory. It covers humanistic therapies developed by Rogers and Maslow. Family systems therapies such as structural therapy and strategic therapy are outlined. The document also summarizes cognitive-behavioral therapy and its foundations in classical and operant conditioning. It provides brief biographies of important psychotherapists such as Freud, Jung, Adler, Winnicott, and Beck. Common factors across therapies like the therapeutic relationship are also mentioned.
This document discusses selective outcome reporting bias (ORB), which occurs when researchers select a subset of original outcomes to report based on statistical significance. ORB threatens the validity of systematic reviews and meta-analyses. The document describes different types of ORB and methods to assess risk of bias. It proposes the ORBIT classification system to code incomplete outcome reporting in trials. Sensitivity analyses can estimate the potential impact of ORB on review conclusions. While awareness of ORB is growing, more needs to be done to address this issue through improved trial registration, reporting and access to protocols and outcomes.
Matching is a design approach used in case-control studies to address confounding. It involves selecting controls that are similar to cases based on specified attributes. Individual matching matches each case to a control, while frequency matching matches on distributions of attributes between cases and controls. Matching increases precision by balancing distributions across strata. It requires a matched analysis to account for the matching. While it improves control of confounding, matching can be time-consuming and decrease efficiency if overused. The odds ratio is commonly used to measure exposure effects in individually matched case-control studies.
Smith, D., Crocker, L., Staton, C., Gillaspy, A., & Charlton, S. (2010). Psychometric properties of the Outcome Rating Scale in a non-clinical sample. Poster presentation at the Heart and Soul of Change Conference, New Orleans.
Nowadays Scientists using laboratory animals are under increasing pressure to justify their sample sizes using a ‘‘power analysis’’ to improve study reproducibility and from ethical point of view too.
In this presentation, I review the three methods currently used to determine sample size: ‘‘tradition’’ or ‘‘common sense’’, the ‘‘resource equation’’ and the ‘‘power analysis’’.
Application of the Rasch Model in Assessing and Streamlining an Instrument Me...SherwinBalbuena1
This document describes applying the Rasch model to assess and streamline a depression inventory for university students. It analyzed data from two student surveys using the partial credit Rasch model. Several misfitting persons and items were identified and removed to improve the instrument. The revised scale demonstrated good reliability and targeting. Thresholds were established to classify students' depression levels. The procedure was deemed replicable across datasets and can help evaluate other psychological instruments.
This document provides an introduction to various psychotherapies. It discusses psychodynamic therapies including Freudian psychoanalysis and object relations theory. It covers humanistic therapies developed by Rogers and Maslow. Family systems therapies such as structural therapy and strategic therapy are outlined. The document also summarizes cognitive-behavioral therapy and its foundations in classical and operant conditioning. It provides brief biographies of important psychotherapists such as Freud, Jung, Adler, Winnicott, and Beck. Common factors across therapies like the therapeutic relationship are also mentioned.
This document discusses selective outcome reporting bias (ORB), which occurs when researchers select a subset of original outcomes to report based on statistical significance. ORB threatens the validity of systematic reviews and meta-analyses. The document describes different types of ORB and methods to assess risk of bias. It proposes the ORBIT classification system to code incomplete outcome reporting in trials. Sensitivity analyses can estimate the potential impact of ORB on review conclusions. While awareness of ORB is growing, more needs to be done to address this issue through improved trial registration, reporting and access to protocols and outcomes.
This document outlines the concepts and methods of multiple-treatments meta-analysis (MTM). MTM allows for the simultaneous comparison of multiple interventions for a condition by combining both direct and indirect evidence from randomized controlled trials. Key advantages of MTM include the ability to rank treatments, comprehensively use all available data, and compare interventions not directly compared in trials. The document discusses MTM approaches using frequentist meta-regression and Bayesian statistics.
This document provides an overview of basic hypothesis testing concepts. It defines key terms like the null hypothesis, type I and type II errors, significance levels, and p-values. It explains how hypothesis tests are used to determine if there is a statistically significant difference between two groups, with the goal of rejecting or failing to reject the null hypothesis. Examples are given around comparing the effectiveness of two drugs and testing if reindeer can fly. Both parametric and non-parametric statistical tests are introduced.
Title:
Adventure Therapy: Treatment Effectiveness and Applications with Australian Youth
Abstract:
This final seminar reviews the original contribution of Bowen’s (2016) PhD thesis to the field of adventure therapy. This thesis advances understanding of the therapeutic uses and treatment effectiveness of adventure therapy by systematically reviewing the efficacy of adventure therapy programs internationally (Study 1), providing an up-to-date profile of Australian outdoor adventure intervention programs for youth (Study 2), examining the efficacy of the Wilderness Adventure Therapy® model of clinical treatment for Australian youth (Study 3), and examining the efficacy of the PCYC Bornhoffen Catalyst program for Australian youth-at-risk (Study 4). Findings from this thesis strongly support the assertion that adventure therapy should be in the suite of therapeutic interventions that operate in diverse service settings across Australia. For more information, see http://www.danielbowen.com.au/research/PhD
Primary supervisor: Assistant Professor James Neill
Supervisory panel member: Professor Anita Mak
Overview of systematic review and meta analysisDrsnehas2
Systematic reviews and meta-analyses aim to summarize research evidence on a topic. This document provides an overview of how to conduct systematic reviews and meta-analyses, including formulating a question, identifying relevant studies, extracting data, assessing bias, synthesizing data through meta-analysis if appropriate, interpreting results, and updating reviews. Key steps involve developing eligibility criteria, searching multiple databases, assessing risk of bias, addressing heterogeneity, and evaluating for publication bias. Conducting reviews using standardized methods helps provide reliable conclusions to inform clinical practice and policy-making.
Re-analysis of the Cochrane Library data and heterogeneity challengesEvangelos Kontopantelis
Heterogeneity issues and a re-analysis of the Cochrane Library data. Presented in the 35th Annual Conference of the International Society for Clinical Biostatistics (ISCB35) in Vienna
Section: high-dimensional statistics at Bernoulli-IMS One World Symposium 2020, August 24th to August 28th 2020, https://www.worldsymposium2020.org/
Two small-data n << p case studies: hydroxycholoroquine, Marseilles and Meijel. A March 2020 preprint by the famous Marseilles group of Didier Raoult caused international interest and controversy. It promoted a treatment for early Covid-19 infection centred on the anti-malarial drug hydroxychloroquine (HCQ). The study was an observational study with a treatment group and a control group of altogether 42 patients. An early HCQ adopter was the Dutch GP (and alternative medicine practitioner) Rob Elens, whose practice is in a village right in the middle of the initial Dutch Corona hotspot. He collected a very similar dataset, and in his case the treatment was almost randomised: at a certain point the Netherlands health inspectorate forbade the use of HCQ, so the treatment given to his patients was entirely determined by outside events: first the publication of Gautret et al., and then the Dutch government ukase. In my talk I will present some analyses by logistic regression, both frequentist and Bayesian, including a solution to the n << p problem, of the two data sets. How strong was this evidence was in support of HCQ?
The document summarizes data from surveys of psychologists enrolled in PracticeNet regarding their demographics, practice patterns, and client characteristics. It finds that most psychologists are white females in private practice seeing clients primarily for mood disorders like depression. Early career psychologists tend to work more hours in organizational settings than private practice. The surveys also examine treatment approaches, interventions, diagnoses and problematic life domains of clients.
P-values the gold measure of statistical validity are not as reliable as many...David Pratap
This is an article that appeared in the NATURE as News Feature dated 12-February-2014. This article was presented in the journal club at Oman Medical College , Bowshar Campus on December, 17, 2015. This article was presented by Pratap David , Biostatistics Lecturer.
5. Calculate samplesize for case-control studiesAzmi Mohd Tamil
This document discusses sample size calculations for case-control studies. It provides an example comparing the rate of diabetes mellitus (DM) between patients with cataracts (cases) and those with normal vision (controls). Based on literature finding a 50% DM rate in cases and 8% in controls, the required sample size is 17 cases and 17 controls to detect this difference with 80% power and 5% type 1 error rate. Manual calculations and online calculators can both be used to determine sample size for case-control studies. Prior information is needed on exposure rates in cases and controls to perform these calculations.
This document summarizes a simulation study comparing the performance of different meta-analysis methods when assumptions of normality are violated. The study generated simulated datasets with various distributions for true effects and degrees of heterogeneity. It then compared methods like fixed effects, DerSimonian-Laird, maximum likelihood, and permutations in terms of coverage, power, and confidence interval estimation. The results showed that some methods are more robust to non-normal data, with profile likelihood and permutations generally performing best, while other methods like fixed effects and DerSimonian-Laird showed poorer performance.
Network meta-analysis with integrated nested Laplace approximationsBurak Kürsad Günhan
This document discusses network meta-analysis (NMA) models for combining data from multiple treatment comparisons. It provides an overview of NMA terminology and models, including the Lu-Ades and Jackson models. It also demonstrates the application of these models to sample datasets on tuberculosis vaccine trials and smoking cessation interventions using Bayesian inference with integrated nested Laplace approximations (INLA). The key contributions are the INLA implementation of the Jackson NMA model and an R function for fitting various pairwise and network meta-analysis models.
Of Dodo birds and common factors: A scoping review of direct comparison trial...Will Dobud
Background: Adventure therapy (AT) is a term that includes therapies such as wilderness therapy and adventure-based counseling. With growing empirical support for AT, the diversity of studies make it difficult to attribute outcomes to specific treatment factors.
Objectives: Researchers explored whether AT, often perceived as an alternative therapy, works because of AT's unique components, or whether factors shared by all therapies were responsible.
Methods: A scoping review was undertaken utilizing a search of major databases, unpublished disser- tations, and a hand search for direct comparison trials matching AT with another therapeutic intervention.
Results: 881 publications were identified. 105 quantitative studies were included following a title and abstract review. Only 13 met the full inclusion criteria. Little to no differences were found to isolate specific therapeutic factors.
Conclusions: We discuss the implications of these results considering the movement toward evidence- based practice and recommend future research to eclipse our current understanding of AT.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
- Cluster randomization trials are experiments where intact social units like medical practices, communities, or hospitals are randomly assigned to intervention groups rather than independent individuals. This is done when the intervention is naturally applied at a cluster level or to avoid treatment contamination between groups.
- Challenges of cluster randomization trials include having a unit of randomization that differs from the unit of analysis and reduced power due to intracluster correlation. Statistical methods like mixed models that account for clustering are needed to properly analyze results.
- Proper sample size calculations are also more complex in cluster randomization trials due to the need to adjust for the intracluster correlation coefficient and design effect. Ensuring enough clusters are enrolled is important to maintain adequate power
This document outlines the steps involved in conducting a systematic review and meta-analysis on the prevalence of elder abuse. It discusses how 52 studies from around the world were analyzed using comprehensive meta-analysis software. The key findings were that the pooled prevalence of elder abuse was 15.7%. While systematic reviews have strengths like being comprehensive and transparent, they also have limitations such as reliance on the quality of primary studies and risk of publication bias.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The document discusses nonparametric tests that can be used when the data distribution is unknown or non-normal. It provides examples of the Wilcoxon signed-rank test to compare two related samples, the Wilcoxon rank-sum test to compare two independent samples, the Kruskal-Wallis H test to compare more than two independent samples, and the Friedman test to compare blocks of data. Multiple comparison tests are also discussed to determine the specific groups that differ when overall differences are found.
This document provides tips and guidance for disabled or less mobile air passengers on their rights to assistance during air travel. It outlines the legal rights to free assistance at airports and on flights within Europe. It emphasizes the importance of informing airlines in advance of any special needs or mobility equipment and confirming assistance arrangements at each stage of the journey. It also provides advice on what to do if assistance is not provided as promised.
The importance of quality in item generation; a prerequisite for Rasch analysisStephen McKenna
The quality of a patient reported outcome scale depends on: a coherent and valid measurement model, quality item generation, and a simple response format.
After these criteria are met, we can think about fit to the Rasch model.
This document outlines the concepts and methods of multiple-treatments meta-analysis (MTM). MTM allows for the simultaneous comparison of multiple interventions for a condition by combining both direct and indirect evidence from randomized controlled trials. Key advantages of MTM include the ability to rank treatments, comprehensively use all available data, and compare interventions not directly compared in trials. The document discusses MTM approaches using frequentist meta-regression and Bayesian statistics.
This document provides an overview of basic hypothesis testing concepts. It defines key terms like the null hypothesis, type I and type II errors, significance levels, and p-values. It explains how hypothesis tests are used to determine if there is a statistically significant difference between two groups, with the goal of rejecting or failing to reject the null hypothesis. Examples are given around comparing the effectiveness of two drugs and testing if reindeer can fly. Both parametric and non-parametric statistical tests are introduced.
Title:
Adventure Therapy: Treatment Effectiveness and Applications with Australian Youth
Abstract:
This final seminar reviews the original contribution of Bowen’s (2016) PhD thesis to the field of adventure therapy. This thesis advances understanding of the therapeutic uses and treatment effectiveness of adventure therapy by systematically reviewing the efficacy of adventure therapy programs internationally (Study 1), providing an up-to-date profile of Australian outdoor adventure intervention programs for youth (Study 2), examining the efficacy of the Wilderness Adventure Therapy® model of clinical treatment for Australian youth (Study 3), and examining the efficacy of the PCYC Bornhoffen Catalyst program for Australian youth-at-risk (Study 4). Findings from this thesis strongly support the assertion that adventure therapy should be in the suite of therapeutic interventions that operate in diverse service settings across Australia. For more information, see http://www.danielbowen.com.au/research/PhD
Primary supervisor: Assistant Professor James Neill
Supervisory panel member: Professor Anita Mak
Overview of systematic review and meta analysisDrsnehas2
Systematic reviews and meta-analyses aim to summarize research evidence on a topic. This document provides an overview of how to conduct systematic reviews and meta-analyses, including formulating a question, identifying relevant studies, extracting data, assessing bias, synthesizing data through meta-analysis if appropriate, interpreting results, and updating reviews. Key steps involve developing eligibility criteria, searching multiple databases, assessing risk of bias, addressing heterogeneity, and evaluating for publication bias. Conducting reviews using standardized methods helps provide reliable conclusions to inform clinical practice and policy-making.
Re-analysis of the Cochrane Library data and heterogeneity challengesEvangelos Kontopantelis
Heterogeneity issues and a re-analysis of the Cochrane Library data. Presented in the 35th Annual Conference of the International Society for Clinical Biostatistics (ISCB35) in Vienna
Section: high-dimensional statistics at Bernoulli-IMS One World Symposium 2020, August 24th to August 28th 2020, https://www.worldsymposium2020.org/
Two small-data n << p case studies: hydroxycholoroquine, Marseilles and Meijel. A March 2020 preprint by the famous Marseilles group of Didier Raoult caused international interest and controversy. It promoted a treatment for early Covid-19 infection centred on the anti-malarial drug hydroxychloroquine (HCQ). The study was an observational study with a treatment group and a control group of altogether 42 patients. An early HCQ adopter was the Dutch GP (and alternative medicine practitioner) Rob Elens, whose practice is in a village right in the middle of the initial Dutch Corona hotspot. He collected a very similar dataset, and in his case the treatment was almost randomised: at a certain point the Netherlands health inspectorate forbade the use of HCQ, so the treatment given to his patients was entirely determined by outside events: first the publication of Gautret et al., and then the Dutch government ukase. In my talk I will present some analyses by logistic regression, both frequentist and Bayesian, including a solution to the n << p problem, of the two data sets. How strong was this evidence was in support of HCQ?
The document summarizes data from surveys of psychologists enrolled in PracticeNet regarding their demographics, practice patterns, and client characteristics. It finds that most psychologists are white females in private practice seeing clients primarily for mood disorders like depression. Early career psychologists tend to work more hours in organizational settings than private practice. The surveys also examine treatment approaches, interventions, diagnoses and problematic life domains of clients.
P-values the gold measure of statistical validity are not as reliable as many...David Pratap
This is an article that appeared in the NATURE as News Feature dated 12-February-2014. This article was presented in the journal club at Oman Medical College , Bowshar Campus on December, 17, 2015. This article was presented by Pratap David , Biostatistics Lecturer.
5. Calculate samplesize for case-control studiesAzmi Mohd Tamil
This document discusses sample size calculations for case-control studies. It provides an example comparing the rate of diabetes mellitus (DM) between patients with cataracts (cases) and those with normal vision (controls). Based on literature finding a 50% DM rate in cases and 8% in controls, the required sample size is 17 cases and 17 controls to detect this difference with 80% power and 5% type 1 error rate. Manual calculations and online calculators can both be used to determine sample size for case-control studies. Prior information is needed on exposure rates in cases and controls to perform these calculations.
This document summarizes a simulation study comparing the performance of different meta-analysis methods when assumptions of normality are violated. The study generated simulated datasets with various distributions for true effects and degrees of heterogeneity. It then compared methods like fixed effects, DerSimonian-Laird, maximum likelihood, and permutations in terms of coverage, power, and confidence interval estimation. The results showed that some methods are more robust to non-normal data, with profile likelihood and permutations generally performing best, while other methods like fixed effects and DerSimonian-Laird showed poorer performance.
Network meta-analysis with integrated nested Laplace approximationsBurak Kürsad Günhan
This document discusses network meta-analysis (NMA) models for combining data from multiple treatment comparisons. It provides an overview of NMA terminology and models, including the Lu-Ades and Jackson models. It also demonstrates the application of these models to sample datasets on tuberculosis vaccine trials and smoking cessation interventions using Bayesian inference with integrated nested Laplace approximations (INLA). The key contributions are the INLA implementation of the Jackson NMA model and an R function for fitting various pairwise and network meta-analysis models.
Of Dodo birds and common factors: A scoping review of direct comparison trial...Will Dobud
Background: Adventure therapy (AT) is a term that includes therapies such as wilderness therapy and adventure-based counseling. With growing empirical support for AT, the diversity of studies make it difficult to attribute outcomes to specific treatment factors.
Objectives: Researchers explored whether AT, often perceived as an alternative therapy, works because of AT's unique components, or whether factors shared by all therapies were responsible.
Methods: A scoping review was undertaken utilizing a search of major databases, unpublished disser- tations, and a hand search for direct comparison trials matching AT with another therapeutic intervention.
Results: 881 publications were identified. 105 quantitative studies were included following a title and abstract review. Only 13 met the full inclusion criteria. Little to no differences were found to isolate specific therapeutic factors.
Conclusions: We discuss the implications of these results considering the movement toward evidence- based practice and recommend future research to eclipse our current understanding of AT.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
- Cluster randomization trials are experiments where intact social units like medical practices, communities, or hospitals are randomly assigned to intervention groups rather than independent individuals. This is done when the intervention is naturally applied at a cluster level or to avoid treatment contamination between groups.
- Challenges of cluster randomization trials include having a unit of randomization that differs from the unit of analysis and reduced power due to intracluster correlation. Statistical methods like mixed models that account for clustering are needed to properly analyze results.
- Proper sample size calculations are also more complex in cluster randomization trials due to the need to adjust for the intracluster correlation coefficient and design effect. Ensuring enough clusters are enrolled is important to maintain adequate power
This document outlines the steps involved in conducting a systematic review and meta-analysis on the prevalence of elder abuse. It discusses how 52 studies from around the world were analyzed using comprehensive meta-analysis software. The key findings were that the pooled prevalence of elder abuse was 15.7%. While systematic reviews have strengths like being comprehensive and transparent, they also have limitations such as reliance on the quality of primary studies and risk of publication bias.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The document discusses nonparametric tests that can be used when the data distribution is unknown or non-normal. It provides examples of the Wilcoxon signed-rank test to compare two related samples, the Wilcoxon rank-sum test to compare two independent samples, the Kruskal-Wallis H test to compare more than two independent samples, and the Friedman test to compare blocks of data. Multiple comparison tests are also discussed to determine the specific groups that differ when overall differences are found.
This document provides tips and guidance for disabled or less mobile air passengers on their rights to assistance during air travel. It outlines the legal rights to free assistance at airports and on flights within Europe. It emphasizes the importance of informing airlines in advance of any special needs or mobility equipment and confirming assistance arrangements at each stage of the journey. It also provides advice on what to do if assistance is not provided as promised.
The importance of quality in item generation; a prerequisite for Rasch analysisStephen McKenna
The quality of a patient reported outcome scale depends on: a coherent and valid measurement model, quality item generation, and a simple response format.
After these criteria are met, we can think about fit to the Rasch model.
Now is a very exciting time for charitable fundraising. Not only is economic confidence slowly recovering,
there has also been a fundamental change in the way causes are promoted which is having a massive
impact on public donations.
Comparison of the CAMPHOR and SF-36 for Pulmonary Hypertension (PH) patientsStephen McKenna
The CAMPHOR and SF-36 patient reported outcome measures are compared with regards to their psychometric quality for Pulmonary Hypertension (PH) patients.
This document repeatedly discusses Geiper communication and wireless communication. It focuses on the topic of wireless communication by Geiper, mentioning it across 10 paragraphs without providing any further details about the company, technologies, or applications of their wireless communication work.
Rasch analysis of the Dermatology Life Quality Questionnaire (DLQI)Stephen McKenna
The document discusses a Rasch analysis of the Dermatology Life Quality Questionnaire (DLQI), a 10-item patient-reported outcome measure used to assess quality of life for patients with various skin conditions. The analysis identified several issues with the DLQI, including misfitting items, disordered response thresholds, and differential item functioning. This suggests problems with the scale's development methodology and raises concerns about its use in clinical trials and treatment decisions. The document advocates for improved scale development using modern psychometric methods like Rasch analysis and qualitative research with patients.
Building face and content validity into health outcome measures in the contex...Stephen McKenna
The quality of patient reported outcome scales depends on factors such as a coherent and valid measurement model, quality item generation, face validity (for patients), content validity, acceptability to patients and fit to the Rasch model.
La sémiologie et les signes utilisés par le Médecin Régulateur du SAMU sont tres pauvres par rapport a ceux du Diagnostic Clinique. Les Syndromes sont différents de ceux de la Clinique.
Development of health measurement scales - part 1Rizwan S A
This document outlines the basic steps involved in developing health measurement scales. It discusses devising items, scaling responses, selecting items, and addressing biases. The key steps covered are:
1. Devising items by exploring various sources like focus groups, interviews, clinical observations, and existing scales. Items must demonstrate content validity.
2. Scaling responses by determining the level of measurement (nominal, ordinal, interval, ratio) and using methods like Likert scales, visual analogue scales, and paired comparisons.
3. Selecting items by assessing reliability using techniques like internal consistency and validity through face, content, construct, and criterion assessments.
The document provides an overview of the fundamental concepts and processes in developing
Chapter 2
Study Designs
Learning Objectives
• List and define the components of a good
study design
• Compare and contrast observational and
experimental study designs
• Summarize the advantages and disadvantages
of alternative study designs
Learning Objectives
• Describe the key features of a randomized
controlled trial
• Identify the study designs used in public health
and medical studies
Study Designs
• Observational Studies
– Case-series study
– Cross-sectional (prevalence) survey
– Case-control study
– Cohort study
• Experimental Studies
– Randomized Controlled (Clinical) Trial
Inferences
• Observational studies – inferences limited to descriptions
and associations; with carefully designed analysis can
make stronger inferences (statistical adjustment)
• Experimental studies – cause and effect
In ALL studies – need careful definition of disease
(outcome) and exposure (risk factor)
Which Design is Best
• Depends on the study question
• What is current knowledge on topic
• How common is disease (and risk factors)
• How long would study take, what are costs
• Ethical issues
Case Report/Case Series
• Observational study
• Case report: Detailed report of specific
features of case
• Case series: Systematic review of common
features of a small number of cases
• Advantage: Cost-efficient
• Disadvantages: No comparison group, no
specific research question
Case-Series
• Simplest design – description of interesting
observations in a small number of individuals
• Usually case-series do not involve control patients
(i.e., patients free of disease)
• Usually lead to generation of hypotheses for more
formal testing
• Criticisms: not planned – no research hypotheses
Case-Series
• Gottleib (1981) studied 5 young homosexual
men with rare form of pneumonia and other
unusual infections
• Initial report was followed by more series (26
cases in NY and CA; “cluster” in southern CA;
34 cases among Haitians, etc.)
• Condition termed AIDS in 1982
Cross-Sectional Survey
• Observational study conducted at a point in
time
• Advantages: Cost-efficient, easy to implement,
ethical
• Disadvantages: No temporal information, non-
response bias
Cross-Sectional Survey
• Is there an association between diabetes and
cardiovascular disease (CVD)?
Patients
with
Diabetes
Patients without
Diabetes
Patients with
CVD
Prospective Cohort Study
• Observational study involving a group (cohort)
of individuals who meet inclusion criteria
followed prospectively in time for risk factor
and outcome information
• Advantages: Can assess temporal relationships
• Disadvantages: Need large numbers for rare
outcomes, confounding
Cohort Study
• Is there an association between hypertension and
cardiovascular disease?
CVD
Hypertension
No CVD
Cohort
CVD
No Hypertension
No CVD
Study Start Time
Cohort Studies
• Identify a group of individuals that meet
inclusion crit ...
1. Social and economic factors may have changed between the time periods studied, such as increases in unemployment, poverty, or family disruption, which could impact rates of psychiatric morbidity.
2. Changes may have occurred in how psychiatric disorders are diagnosed and classified between 1977 and 1985 that could influence prevalence findings.
3. Increased awareness, destigmatization of mental health issues, and expansion of treatment services between the periods may have impacted help-seeking behaviors and the proportion of cases identified.
Health Related Quality of Life with Children of Autism Spectrum Disorder in B...farhana safa
Research done by Dr. Farhana Safa about Autism Spectrum Disorder in Bangladesh. This was done during my MPH program under the course no.: MPH5040 at American International University, Bangladesh (AIUB).
This document provides an introduction to choosing regression models. It discusses basic considerations like determining the purpose of the model, choosing appropriate predictors, and whether predictors or the outcome need transformation. Temporal sequence and prior knowledge are important factors in choosing predictors. The type of data, case ascertainment, and results of model fitting also influence predictor choice. Transforming predictors or the outcome can improve the model fit in some cases. The key is using statistical tools together with experience and understanding, not as a substitute for scientific insight.
2017 CSUSM Annual Psychology Research Fair Oral PresentationAdrian Price
Price, S.L. (2017, April). Refining a self-report instrument for measuring subjective emptiness. Oral presentation at the 24th Annual Psychology Research Fair, California State University San Marcos, San Marcos, CA.
Critical appraisal.docx IMPORTAN TO HEALTH SCIENCE STUDENTSMulugetaAbeneh1
Critical appraisal is the process of systematically examining evidence to assess its validity, results, and relevance before using it to inform decisions. This document discusses tools for critically appraising different types of studies, including systematic reviews, guidelines, and primary studies. It provides examples of appraising systematic reviews using the AMSTAR tool and appraising randomized controlled trials using the JBI critical appraisal checklist. The document concludes that plastic wraps effectively prevent hypothermia in preterm and low birth weight infants compared to standard care, as shown in multiple systematic reviews and randomized trials.
The document summarizes a study that examined work-related stress among physicians in primary healthcare (PHC) and hospitals in Bahrain. The study found that hospital physicians reported significantly higher levels of stress than PHC physicians. Stress was also found to be higher among physicians who were younger, male, smokers, and specialists (vs consultants). Sources of stress included high job demands, lack of control, and poor relationships. The study aimed to identify differences in stress levels and factors between PHC and hospital physicians to inform efforts to reduce occupational stress.
Understanding patient-reported outcome measures in Huntington disease: at wha...Huntington Study Group
Understanding patient-reported outcome measures in Huntington disease: at what point is cognitive impairment related to poor measurement reliability, presented by Nicole Carlozo, PhD, University of Michigan, HSG 2016
This document provides an overview of scientific research methods used in psychology, including descriptive research methods like surveys, naturalistic observation, and case studies as well as experimental research. It discusses advantages and disadvantages of these methods and provides examples. The document also summarizes controversies in attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment, and reviews ethics considerations for research involving human and animal subjects.
A tutorial session on the basics of systematic reviews. Covers the the why, how and so what of systematic reviews. Part of a series of public health skills sessions put on for Nottingham City Council Staff.
See linked exercises
Measuring the right outcomes in mental healthJohn Brazier
This talk presents the findings of an MRC study on whether the generic health measures of EQ-5D and SF-36 are valid in mental health. It uses mixed methods research (including interviews with service users) to show that these measures miss important ways in which mental health impacts on people's lives. It proposes 7 themes that seem to capture the important domains of recovery for people with mental health problems that provide the basis for a new generic outcome measure for mental health.
N.B. These slides were presented at the 20th Anniversary of the Centre for Mental and Physical Health Economics, 7th November 2013.
This document discusses key concepts in biostatistics used in biomedical research. It covers topics like types of variables, measures of central tendency and dispersion, distributions of data, statistical tests for different situations, hypotheses testing and errors, measures of association, diagnostic tests, and regression analysis. Understanding biostatistics is important for evidence-based medicine and improving patient lives through rigorous research. Sample size, confidence intervals, and avoiding bias and confounding are important considerations in study design and interpretation.
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Co-calibrating scores from two dermatology-specific patient reported outcome measures.
1. Co-calibrating scores from two dermatology-specific
patient reported outcome measures
James Twiss,
Rebecca Crawford, Stephen McKenna
Galen Research Ltd, Manchester, UK
Email: jtwiss@galen-research.com
2. Objectives
• To co-calibrate scores from two different
dermatology-specific outcome measures:
- Psoriasis Quality of Life Scale (PSORIQoL)
- Quality of Life in Atopic Dermatitis (QoLIAD)
3. Introduction
• Some interventions may be used for more than
one disease
• Dermatology studies frequently combine
together patients with different kinds of skin
conditions
• Generic outcome measures traditionally used in
these circumstances (e.g. SF-36/NHP)
4. Generic outcome measures
Pros Cons
Thought to be able to compare across
diseases
Less sensitive than disease-specific
measures
No need to develop separate scales
for each disease
May miss important issues
Older scales often have poor
measurement properties
Evidence of DIF by disease
5. Dermatology Life Quality Index (DLQI)
• Generic dermatology measure used in a
large number of skin conditions
• Evidence of poor fit to Rasch model
- Overall misfit
- Poor measurement range
- Disordered response thresholds
- Several items showed DIF by disease (psoriasis
vs. atopic dermatitis)
6. Aims
• To assess whether it is possible to compare
scores from two dermatology-specific
outcome measures
- Psoriasis Quality of Life Scale (PSORIQoL)
- Quality of Life in Atopic Dermatitis (QoLIAD)
7. Methods
• Analyses conducted using RUMM2030
• The two scales were analysed separately for fit
to the Rasch model
• Problems were resolved
• The two scales were co-calibrated using a
common item design
• Item pool analysed for fit to the Rasch model
• Common items analysed for DIF by disease
8. Questionnaire comparison
• PsoriQoL – psoriasis-specific QoL measure
• QoLIAD – atopic dermatitis QoL measure
• Both based on the Needs-based model of QoL
• Content for both from patient interviews
• Both developed using Rasch analysis
• 25 items in each
• Yes/no response format in each
• 5 common items
9. Common Items
• I have no self confidence
• I just want to shut myself away
• I worry that other people will not accept
me
• I am embarrassed about my appearance
• I can’t bear anyone touching me
10. Sample
Psoriasis
(n = 146)
Atopic Dermatitis
(n = 146)
Gender (%)
Male 73 (50) 73 (50)
Female 73 (50) 73 (50)
Age (Years)
Mean (SD) 44.4 (14.7) 45.5 (16.6)
Range 66 (17-83) 62 (20-82)
Duration (years)
Mean (SD) 20.9 (13.5) 28.2 (17.5)
Range 67 (2-69) 76 (0-76)
11. Fit to the Rasch model
Item-Trait
Interaction
Chi2
PSI Item-Person interaction Unidimensionality
(CI)
Items Persons
Mean SD Mean SD
PSORIQoL 0.25 0.94 -0.22 1.12 -0.36 0.82 0.045 (0.008 – 0.082)
QoLIAD 0.28 0.91 -0.25 1.12 -0.162 0.54 0.095 (0.057 - 0.133)
12. Residual correlations
• Evidence of local dependency in QoLIAD between:
Item 4: ‘I get embarrassed when I am with people I don’t know
very well’
&
Item 6: ‘I feel tense all the time’
Item 4: ‘I get embarrassed when I am with people I don’t know
very well’
&
Item 17: ‘I can’t concentrate on anything else’
• Item 4 was removed improving model fit statistics
13. Additional fit statistics
• One item in each scale removed due to a high fit
residual
- PsoriQoL item 17 (fit residual = 2.84)
‘It interferes with my close relationships’
- QoLIAD item 16 (fit residual = 3.15)
‘I find it hard to relax’
• Minimal evidence of DIF by age or gender
• Items had good logit coverage in each scale
14. Fit to the Rasch model – combined items
Item-Trait
Interaction
Chi2
PSI Item-Person interaction
Items Persons
Mean SD Mean SD
Combined 0.056 0.88 -0.28 0.98 -0.27 0.67
15. DIF analysis of common items
• One of the 5 common items showed DIF by disease (p = 0.00098)
‘I worry that people will not accept me’
16. Logit position of common items
Item Logit position
I just want to shut myself away 2.51
I can’t bear anyone touching me 2.03
I have no self confidence 1.23
I worry that other people will not accept me 0.42
I am embarrassed about my appearance -0.85
17. Final fit to the Rasch model – combined items
Item-Trait
Interaction
Chi2
PSI Item-Person interaction
Items Persons
Mean SD Mean SD
Final items 0.123 0.89 -0.271 1.01 -0.27 0.66
19. Conclusions
• Items were successfully co-calibrated
• This study moves the debate about disease-specific
vs. generic outcome measures
forward
• Over 20 disease-specific measures available
based on the needs-based model of QoL
20. References
McKenna SP, Cook SA, Whalley D, Doward LC, Richards HL, Griffiths CEM,
Van Assache D (2003). Development of the PSORIQoL, a psoriasis-specific
measure of quality of life designed for use in clinical practice and trials. Br J
Dermatol; 149: 323-331.
Whalley D, McKenna SP, Dewar AL, Erdman RA, Kohlman T, Niero M, Cook
SA, Crickx B, Herdman MJ, Frech F, van Assche D, A New Instrument for
Assessing Quality of Life in Atopic Dermatitis (QoLIAD). British Journal of
Dermatology 2004; 150: 274-83
Twiss J, Meads DM, Preston EP, Crawford SR, McKenna SP. Can we rely on
the Dermatology Life Quality Index (DLQI) as a measure of the impact of
psoriasis or atopic dermatitis? Journal of Investigative Dermatology. (2012);
132(1):76-84.
Editor's Notes
Need to add information relating to the development of each questionnaire
PSORIQoL – developed with Rasch using a clear theoretical model
DLQI – not developed with Rasch and no clear theoretical model
Measure different things
Galen Research – we develop disease specific patient reported outcome measures to measure the impact of disease from the patients perspective
These are used widely in clinical practice and in clinical trials
We have been using Rasch analysis for a number of years as a company to improve the measurement properties of our scales
This has provided us the opportunity to co-calibrate scores from the measures to allow direct comparison of scores
The question may be asked – why bother doing this at all?
We conducted a study recently to evaluate the measurement properties of the DLQI
Rasch analysis can provide new perspective on this debate
Rasch analysis can be used to co-calibrate scores from two different dermatology-specific outcome measures
This study has the potential to move forward the debate on this issue.
This study has the potential to move forward the debate on this issue.
Life gains its quality by the ability of each person to meet their needs
Each illness impacts on patients ability to meet their needs in different ways
It isn’t necessarily the symptoms or functional limitations that are important but how these impact on patients ability to meet their needs
Psoriasis sample from the Manchester Psoriasis Service at Hope Hospital
Atopic Dermatitis sample from the National Eczema society
Atopic dermatitis sample from a trial
When we applied
Which items?
4. ‘I get embarrassed when I am with people I don’t know very well’
6. ‘I feel tense all the time’
17. ‘I can’t concentrate on anything else’
As the two items that misfit only showed misfit by one of the fit statistics we decided to keep these
Items cost several thousand pounds each to develop
In addition, we wanted to keep the theoretical structure of the measure as much as possible
Item 24 showed DIF by gender in the QoLIAD
Overall fit to the Rasch model
We decided to remove this item as it was fundamental to the calibration of the items
The scale showed overall fit to the Rasch model
Two items continued to show misfit
4 items removed if we remove these items
There are still some persons who are not covered at the extremities but overall a good coverage
It is possible to be able to take the best of both
We can get specific information about each disease
We can compare across diseases using Rasch analysis