Abstract:
OBJECTIVE:Both randomized and observational studies commonly examine composite end points, but the literature on model development and criticism in this setting is limited. STUDY DESIGN AND SETTING:We examined approaches for evaluating heterogeneity in the effects of risk factors for different components of the end point, and determining the impact of heterogeneity on the ability to predict the composite end point. A specific example considered the composite cardiovascular disease end point in the Physicians' Health Study that occurred in 1,542 (myocardial infarction, n = 716; stroke, n = 557; cardiovascular death, n = 269) of 16,688 participants with complete information on baseline covariates. The strategy compared alternative polytomous logistic regression models assuming different effects of risk factors on components of the end point and a comparable logistic model assuming common effects. RESULTS:Likelihood ratio tests identified heterogeneity in the effects of age, alcohol consumption, and diabetes across components of the outcome, but comparability in the effects of other risk factors. However, a model assuming uniform effects explained over 90% of the log-likelihood change in the best polytomous model, and the two models also performed similarly based on a comparison of ROC curves. CONCLUSION:The overall strategy may be helpful for evaluating the validity of a composite end point analysis and identifying heterogeneity in risk factors.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Glynn RJ,Rosner Bdoi
10.1016/j.jclinepi.2003.02.001subject
Has Abstractpub_date
2004-02-01 00:00:00pages
113-22issue
2eissn
0895-4356issn
1878-5921pii
S0895435603003135journal_volume
57pub_type
杂志文章abstract:OBJECTIVE:To evaluate a self-report version of the Home Falls and Accidents Screening Tool (HOME FAST-SR). STUDY DESIGN AND SETTING:The HOME FAST-SR was designed using expert review, pretesting and piloting. Agreement of self-reported home hazard ratings and ratings by health professionals was evaluated using the kapp...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2010.02.013
更新日期:2011-02-01 00:00:00
abstract::The objective of this study was to assess whether trials with a positive (i.e., statistically significant) outcome are cited more often than negative trials. We reviewed 530 randomized clinical trials on hepato-biliary diseases published in 11 English-language journals indexed in MEDLINE from 1985-1996. From each tria...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(01)00513-3
更新日期:2002-04-01 00:00:00
abstract::We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90075-k
更新日期:1991-01-01 00:00:00
abstract::This study reports the use of psychotropic drugs and pregnancy outcome in a prospective survey carried out in northern Finland in 1985-1986, consisting of 7933 pregnant women and their 8030 births. Of the mothers, 120 (1.5%) used psychotropic drugs during pregnancy and of them 26 (0.3% of the total) used these drugs b...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(96)00203-x
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of applying a problem assessment versus a pure symptom urinary incontinence (UI) caseness definition in etiologic research. SUBJECTS:A random population sample of 2613 women aged 30-59 years, who responded to a postal questionnaire. MAIN PARAMETERS: One-year period prevalence of the...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(97)00130-3
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To demonstrate how decision analytic models (DAMs) can be used to quantify impact of using a (diagnostic or prognostic) prediction model in clinical practice and provide general guidance on how to perform such assessments. STUDY DESIGN AND SETTING:A DAM was developed to assess the impact of using the HEART s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.07.010
更新日期:2019-11-01 00:00:00
abstract::To have the "power" of avoiding undersized clinical trials, the customary statistical strategy used in the past few decades is aimed at rejecting both a null stochastic hypothesis and a contradictory alternative hypothesis. This approach gives a trial the "power" to confirm the "insignificance" of differences much sma...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00029-8
更新日期:1998-07-01 00:00:00
abstract::The relation between alcoholic beverage consumption and bladder cancer risk was investigated using data from a case-control study conducted between 1985 and 1992 in two areas of northern Italy. Cases were 727 patients with incident, histologically confirmed bladder cancer, and controls 1,067 patients admitted to the s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0895-4356(02)00397-9
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To test unidimensionality and local independence of a set of shoulder functional status (SFS) items, develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (theta(IRT)...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.08.006
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:To evaluate how the rank probabilities obtained from network meta-analysis (NMA) change with the use of increasingly stringent criteria for the relative effect comparing two treatments which ranks one treatment better than the other. STUDY DESIGN AND SETTING:Systematic survey and reanalysis of published dat...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.02.008
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Traditionally, measures have been developed using classical test theory (CTT). This study examines the psychometrics of the PedsQL 4.0 Generic Core Scales (parent report) using a modern psychometric approach (i.e., Rasch analysis) to determine if further insight regarding the behavior of the measure can be ga...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2012.04.014
更新日期:2012-10-01 00:00:00
abstract::The Program on the Surgical Control of the Hyperlipidemias (POSCH) was a secondary atherosclerosis intervention trial employing partial ileal bypass surgery as the intervention modality. For this report, we analyzed 105 subgroups in 35 variables in POSCH, chosen predominantly for their potential relationship to the ri...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0895-4356(94)00145-g
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:To present a new method to estimate a "minimal important change" (MIC) of health-related quality of life (HRQOL) scales, based on predictive modeling, and to compare its performance with the MIC based on receiver operating characteristic (ROC) analysis. To illustrate how the new method deals with variables t...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.03.015
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to identify determinants of external validity of prognostic models. STUDY DESIGN AND SETTING:We systematically searched for studies reporting prognostic models of heart failure (HF) and examined their performance for predicting 30-day death in a cohort of consecutive 3,452 acu...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2020.01.011
更新日期:2020-05-01 00:00:00
abstract::Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90009-x
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:New evidence continues to emerge and requires attention after the release of a clinical practice guideline (CPG). The objective of this article is to describe the Document Assessment and Review (DAR) strategy designed to ensue that the CPGs remain current and their quality maintained and to present the resul...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.06.013
更新日期:2014-12-01 00:00:00
abstract::Information concerning people's relative preferences for health care outcomes is usually obtained using questionnaires which ask subjects to imagine health states of various kinds. When using illness- or treatment-specific states, elaborate descriptions of patients' quality of life may adequately convey to the rater a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90083-y
更新日期:1992-03-01 00:00:00
abstract::The uses of hypothesis in scientific medicine and in clinical medicine are broadly similar; but they differ in subtle but important logical details. The key distinction is that scientific medicine deals with broad ("public") hypotheses about entire populations; and the predominant problem of inference is statistics in...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(89)90028-0
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to identify factors affecting the use of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, specifically authors' attitudes toward and experiences with it. STUDY DESIGN AND SETTING:An online survey was distributed to authors of observa...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.07.019
更新日期:2019-12-01 00:00:00
abstract::The importance of using risk-adjusted mortality rates to measure quality of care is well-established. However, mortality rates may be an insensitive measure of quality for surgical patients since death is a relatively rare outcome. This study used Medicare files to identify, through chart abstraction, clinical postope...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)00165-m
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:We aimed to determine to what extent covariate adjustment could affect power in a randomized controlled trial (RCT) of a heterogeneous population with traumatic brain injury (TBI). STUDY DESIGN AND SETTING:We analyzed 14-day mortality in 9,497 participants in the Corticosteroid Randomization After Significan...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2011.08.012
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:Calibration is often thought to assess the bias of a clinical prediction rule. In particular, if the rule is based on a linear logistic model, it is often assumed that an overestimation of all coefficients results in a calibration slope less than 1 and an underestimation in a slope larger than 1. STUDY DESI...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.06.003
更新日期:2013-11-01 00:00:00
abstract::Studies predicting mortality after myocardial infarction (MI) usually rely on in-hospital data, and combine patients admitted for the first MI with recurrent MI patients. Since treatment decisions are often made or modified at the first outpatient clinic visit, this study was designed to evaluate the importance of pos...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(96)00221-1
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:Regression discontinuity (RD) is a quasi-experimental design that may provide valid estimates of treatment effects in case of continuous outcomes. We aimed to evaluate validity and precision in the RD design for dichotomous outcomes. STUDY DESIGN AND SETTING:We performed validation studies in three large ran...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.02.015
更新日期:2018-06-01 00:00:00
abstract::This paper reports a prospective study, carried out in elderly patients hospitalized for acute illness, designed to evaluate the effectiveness of medical treatment from the point of view of quality of life (QoL). Patient's autoperception and satisfaction with health, the most relevant subjective estimates of QoL, were...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)00237-k
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:This cohort study investigated potential clinical and biochemical predictors of subsequent preterm birth in women presenting with threatened preterm labor. STUDY DESIGN AND SETTING:Subjects were 218 pregnant women admitted to hospital with a diagnosis of threatened preterm labor at 22-36 weeks gestation. Exc...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.06.015
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2018.08.018
更新日期:2018-12-01 00:00:00
abstract::Administrative databases are increasingly used for studying outcomes of medical care. Valid inferences from such data require the ability to account for disease severity and comorbid conditions. We adapted a clinical comorbidity index, designed for use with medical records, for research relying on International Classi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90133-8
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVES:Understanding patterns of maternity care requires knowing which women have given birth previously, but this information is typically unavailable in administrative hospital data sets. We assessed how well parity can be derived using linked historical records. STUDY DESIGN AND SETTING:Using Hospital Episode S...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.10.011
更新日期:2014-05-01 00:00:00
abstract::A study was performed to determine the misclassification of information on exposure when surrogate informants are interviewed. Information from nondementia patients admitted to a geriatric ward was compared with that obtained from the patients' family members or friends (informants). Thirty-seven patients were recruit...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(96)00134-5
更新日期:1996-10-01 00:00:00