RESPONSE BIAS AND RISK RATIOS IN EPIDEMIOLOGIC STUDIES

AbstractThe risk ratio effect measure is often the main parameter of interest in epidemiologic studies with a binary outcome. In this paper, the author presents a simple and efficient two-stage approach to estimate the risk ratios directly, which does not directly rely on consistency for an estimate of the baseline risk. This latter property is a key advantage of the approach over existing methods, because, unlike these other methods, the proposed approach obviates the need to restrict the predicted risk probabilities to fall below one, in order to recover efficient inferences about risk ratios. An additional appeal of the approach is that it is easy to implement. Finally, when the primary interest is in the effect of a specific binary exposure, a simple doubly robust closed-form estimator is derived, for the multiplicative effect of the exposure. Specifically, we show how one can adjust for confounding by incorporating a working regression model for the propensity score so that the correct inferences about the multiplicative effect of the exposure are recovered if either this model is correct or a working model for the association between confounders and outcome risk is correct, but both do not necessarily hold.

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Vitamin D Deficiency/Insufficiency and Challenges in Developing Global Vitamin D Fortification and Supplementation Policy in Adults

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000117 ◽

2012 ◽

Vol 82 (4) ◽

pp. 237-259 ◽

Cited By ~ 9

Author(s):

Moshe Ben-Shoshan

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Search Strategy ◽

Epidemiologic Studies ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Societal Burden ◽

Time Period ◽

New Guidelines ◽

In Cis

This review summarizes studies discussing vitamin D status in adults and reveals that vitamin D deficiency/insufficiency is highly prevalent in adults and that current fortification and supplementation policies are inadequate. Background and aims: Studies suggest a crucial role for adequate vitamin D status in various health conditions including bone metabolism, cancer, cardiovascular diseases, and allergies. However, relatively little is known about poor vitamin D status and unmet needs in adults. This report aims to highlight the contribution of epidemiologic studies (through the identification of health effects and societal burden) to the development of vitamin D fortification and supplementation policies and reveal unmet global challenges in adults. Methods: In order to assess worldwide vitamin D status in adults, the search strategy combined the medical literature database MEDLINE (using PubMed) for the time period between January 1, 1980 and February 28, 2011, using the key words vitamin D deficiency and insufficiency, and included articles in which access to full text was possible and in which healthy adults were assessed according to one of four commonly used vitamin D threshold classifications. Results: This report reveals that vitamin D deficiency occurs in 4.10 % [95 % CI (confidence interval), 3.93 %, 4.27 %] to 55.05 % (54.07 %, 56.03 %) of adults, while insufficiency occurs in 26.07 % (24.82 %, 27.33 %) to 78.50 % (77.85 %, 79.16 %), depending on the classification used. However, lack of overlap in CIs and high value of I2 statistics indicate considerable heterogeneity between studies. Further, certain populations (i. e. dark-skinned individuals, immigrants, and pregnant women) may be at higher risk for poor vitamin D status. Conclusion: Current policies for vitamin D supplementation and fortification are inadequate and new guidelines are required to improve vitamin D status in adults.

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A randomized cross-over trial in patients suspected of PAD on diagnostic accuracy of ankle-brachial index by Doppler-based versus four-point oscillometry based measurements

VASA ◽

10.1024/0301-1526/a000808 ◽

2019 ◽

Vol 48 (6) ◽

pp. 516-522 ◽

Cited By ~ 5

Author(s):

Verena Mayr ◽

Mirko Hirschl ◽

Peter Klein-Weigel ◽

Luka Girardi ◽

Michael Kundi

Keyword(s):

Diagnostic Accuracy ◽

Ankle Brachial Index ◽

Area Under The Curve ◽

High Volume ◽

Epidemiologic Studies ◽

Lower Sensitivity ◽

Oscillometric Device ◽

Specificity And Sensitivity ◽

Time Requirements ◽

Peripheral Arterial

Summary. Background: For diagnosis of peripheral arterial occlusive disease (PAD), a Doppler-based ankle-brachial-index (dABI) is recommended as the first non-invasive measurement. Due to limitations of dABI, oscillometry might be used as an alternative. The aim of our study was to investigate whether a semi-automatic, four-point oscillometric device provides comparable diagnostic accuracy. Furthermore, time requirements and patient preferences were evaluated. Patients and methods: 286 patients were recruited for the study; 140 without and 146 with PAD. The Doppler-based (dABI) and oscillometric (oABI and pulse wave index – PWI) measurements were performed on the same day in a randomized cross-over design. Specificity and sensitivity against verified PAD diagnosis were computed and compared by McNemar tests. ROC analyses were performed and areas under the curve were compared by non-parametric methods. Results: oABI had significantly lower sensitivity (65.8%, 95% CI: 59.2%–71.9%) compared to dABI (87.3%, CI: 81.9–91.3%) but significantly higher specificity (79.7%, 74.7–83.9% vs. 67.0%, 61.3–72.2%). PWI had a comparable sensitivity to dABI. The combination of oABI and PWI had the highest sensitivity (88.8%, 85.7–91.4%). ROC analysis revealed that PWI had the largest area under the curve, but no significant differences between oABI and dABI were observed. Time requirement for oABI was significantly shorter by about 5 min and significantly more patients would prefer oABI for future testing. Conclusions: Semi-automatic oABI measurements using the AngER-device provide comparable diagnostic results to the conventional Doppler method while PWI performed best. The time saved by oscillometry could be important, especially in high volume centers and epidemiologic studies.

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Picture Recognition Errors in the Differential Diagnosis of Alzheimer’s Disease

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000263 ◽

2019 ◽

Vol 30 (3) ◽

pp. 157-168

Author(s):

Helmut Hildebrandt ◽

Jana Schill ◽

Jana Bördgen ◽

Andreas Kastrup ◽

Paul Eling

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Differential Diagnosis ◽

Clinical Diagnosis ◽

Response Bias ◽

Recognition Task ◽

Discriminatory Power ◽

False Alarms ◽

Picture Recognition ◽

Recognition Errors

Abstract. This article explores the possibility of differentiating between patients suffering from Alzheimer’s disease (AD) and patients with other kinds of dementia by focusing on false alarms (FAs) on a picture recognition task (PRT). In Study 1, we compared AD and non-AD patients on the PRT and found that FAs discriminate well between these groups. Study 2 served to improve the discriminatory power of the FA score on the picture recognition task by adding associated pairs. Here, too, the FA score differentiated well between AD and non-AD patients, though the discriminatory power did not improve. The findings suggest that AD patients show a liberal response bias. Taken together, these studies suggest that FAs in picture recognition are of major importance for the clinical diagnosis of AD.

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Meta-Analyse zur Wirksamkeit deutscher suchtpräventiver Lebenskompetenzprogramme

Kindheit und Entwicklung ◽

10.1026/0942-5403/a000202 ◽

2016 ◽

Vol 25 (3) ◽

pp. 175-188 ◽

Cited By ~ 6

Author(s):

Anneke Bühler

Keyword(s):

Risk Ratios

Zusammenfassung. Schulbasierte Lebenskompetenzprogramme (LKP) sind ein wichtiger Ansatz der Suchtprävention in Deutschland. Ihre Wirksamkeit wurde bisher nicht meta-analytisch getestet. Resultate von 13 systematisch identifizierten randomisierten und nicht-randomisierten Studien mit deutschsprachigen Zielgruppen wurden quantitativ integriert. Risk Ratios (RR) wurden signifikant für den Einstieg in den Tabakkonsum (RR=.77) bzw. das allgemeine Rauchverhalten (RR=.64) bei GrundschülerInnen, bei SekundarstufenschülerInnen ein Initialeffekt von RR=.44 für den aktuellen Konsum. Effekte für die Lebenszeitprävalenz (RR=.78) und den aktuellen Konsum (RR=.71) von Alkohol wurden zum Posttest signifikant. Die Ergebnisse belegen eine Wirksamkeit der suchtpräventiven LKP mit deutsch(sprachig)en SchülerInnen insofern, als dass sie das Risiko für einen frühzeitigen Konsum, der einen Risikofaktor für späteren Substanzmissbrauch darstellt, verringern.

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The Persnickety Pervasiveness of Rating Enhancement in Personality Assessment

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000610 ◽

2020 ◽

pp. 1-13

Author(s):

Alicia A. Stachowski ◽

John T. Kulas

Keyword(s):

Response Bias ◽

Personality Assessment ◽

Current Paper ◽

Psychological Measurement ◽

Shared Sets ◽

Self Reports ◽

Original Target ◽

Target Profile ◽

Do So ◽

Normative Influences

Abstract. The current paper explores whether self and observer reports of personality are properly viewed through a contrasting lens (as opposed to a more consonant framework). Specifically, we challenge the assumption that self-reports are more susceptible to certain forms of response bias than are informant reports. We do so by examining whether selves and observers are similarly or differently drawn to socially desirable and/or normative influences in personality assessment. Targets rated their own personalities and recommended another person to also do so along shared sets of items diversely contaminated with socially desirable content. The recommended informant then invited a third individual to additionally make ratings of the original target. Profile correlations, analysis of variances (ANOVAs), and simple patterns of agreement/disagreement consistently converged on a strong normative effect paralleling item desirability, with all three rater types exhibiting a tendency to reject socially undesirable descriptors while also endorsing desirable indicators. These tendencies were, in fact, more prominent for informants than they were for self-raters. In their entirety, our results provide a note of caution regarding the strategy of using non-self informants as a comforting comparative benchmark within psychological measurement applications.

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The Effect of Alternative Scoring Procedures on the Measurement Properties of a Self-Administered Depression Scale

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000371 ◽

2019 ◽

Vol 35 (1) ◽

pp. 55-62 ◽

Cited By ~ 1

Author(s):

Noboru Iwata ◽

Akizumi Tsutsumi ◽

Takafumi Wakita ◽

Ryuichi Kumagai ◽

Hiroyuki Noguchi ◽

...

Keyword(s):

Classical Test Theory ◽

Depression Scale ◽

Psychometric Testing ◽

Epidemiologic Studies ◽

Test Theory ◽

Measurement Properties ◽

Irt Model ◽

Response Alternatives ◽

Polytomous Item Response ◽

Θ Point

Abstract. To investigate the effect of response alternatives/scoring procedures on the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D) which has the four response alternatives, a polytomous item response theory (IRT) model was applied to the responses of 2,061 workers and university students (1,640 males, 421 females). Test information functions derived from the polytomous IRT analyses on the CES-D data with various scoring procedures indicated that: (1) the CES-D with its standard (0-1-2-3) scoring procedure should be useful for screening to detect subjects with “at high-risk” of depression if the θ point showing the highest information corresponds to the cut-off point, because of its extremely higher information; (2) the CES-D with the 0-1-1-2 scoring procedure could cover wider range of depressive severity, suggesting that this scoring procedure might be useful in cases where more exhaustive discrimination in symptomatology is of interest; and (3) the revised version of CES-D with replacing original positive items into negatively revised items outperformed the original version. These findings have never been demonstrated by the classical test theory analyses, and thus the utility of this kind of psychometric testing should be warranted to further investigation for the standard measures of psychological assessment.

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Detection of Malingered Neurocognitive Dysfunction Among Patients with Acquired Brain Injuries

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000154 ◽

2013 ◽

Vol 29 (4) ◽

pp. 253-262 ◽

Cited By ~ 6

Author(s):

Omer Hegedish ◽

Dan Hoofien

Keyword(s):

Response Bias ◽

Concurrent Validity ◽

Convergent Validity ◽

Brain Injuries ◽

Neurocognitive Dysfunction ◽

Word Memory Test ◽

Malingered Neurocognitive Dysfunction ◽

Compensation Seeking ◽

Seeking Behavior ◽

Verbal Test

The Word Memory Test (WMT) is one of the most sensitive forced-choice tests available designed to evaluate negative response bias (NRB). Presently there is no valid verbal test designed to evaluate NRB for Hebrew-speaking patients. The aims of the present study were to validate the response bias measures of the WMT among Hebrew-speaking patients with acquired brain injuries and to reveal the malingering base rate among Israeli patients involved in compensation-seeking. Participants were 112 patients. The Test of Memory Malingering (TOMM) was used for convergent validity and injury related variables were used for concurrent validity. A translated version of the WMT had high split-half reliability. Regarding convergent validity, WMT effort measures had high positive correlations with the TOMM. Moreover, based on TOMM cutoff scores for classification, the WMT had reasonable classification rates. Regarding concurrent validity, multivariate logistic regression revealed that failure in the WMT was significantly predicted by normal brainscans and involvement in compensation-seeking behavior. The baserate of probable malingering was 34%. These findings emphasize the universality of the WMT in detecting NRB and establishing a malingered neurocognitive dysfunction baserate among Israeli patients involved in compensation-seeking.

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The Self-Description Questionnaire-1: A Lithuanian Application

European Journal of Psychological Assessment ◽

10.1027/1015-5759.11.1.41 ◽

1995 ◽

Vol 11 (1) ◽

pp. 41-51 ◽

Cited By ~ 8

Author(s):

David Watkins ◽

Anne McCreary Juhasz ◽

Aldona Walker ◽

Nijole Janvlaitiene

Keyword(s):

Eastern Europe ◽

Factor Structure ◽

Response Bias ◽

Internal Consistency ◽

Self Esteem ◽

Cultural Dimensions ◽

The Self ◽

Nigerian Children ◽

Gender Biases ◽

And Gender

Analysis of the responses of 139 male and 83 female Lithuanian 12-14 year-olds to a translation of the Self-Description Questionnaire-1 (SDQ-1; Marsh, 1988 ) supported the internal consistency and factor structure of this instrument. Some evidence of a “positivity” response bias was found, however. Comparison of the Lithuanian responses to those of like-aged Australian, Chinese, Filipino, Nepalese, and Nigerian children indicated the Lithuanians tended to report rather lower self-esteem. The Lithuanian males also tended to report lower self-esteem than their female peers. Interpretation of the results are considered in terms of reactions to the recent upheavals in Eastern Europe, stable cultural dimensions, and possible cultural and gender biases in the items of the SDQ-1.

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