scholarly journals Bivariate Random Effects Meta-Analysis of Diagnostic Studies Using Generalized Linear Mixed Models

2009 ◽  
Vol 30 (4) ◽  
pp. 499-508 ◽  
Author(s):  
Haitao Chu ◽  
Hongfei Guo ◽  
Yijie Zhou

Bivariate random effect models are currently one of the main methods recommended to synthesize diagnostic test accuracy studies. However, only the logit transformation on sensitivity and specificity has been previously considered in the literature. In this article, the authors consider a bivariate generalized linear mixed model to jointly model the sensitivities and specificities, and they discuss the estimation of the summary receiver operating characteristic curve (ROC) and the area under the ROC curve (AUC). As the special cases of this model, the authors discuss the commonly used logit, probit, and complementary log-log transformations. To evaluate the impact of misspecification of the link functions on the estimation, they present 2 case studies and a set of simulation studies. Their study suggests that point estimation of the median sensitivity and specificity and AUC is relatively robust to the misspecification of the link functions. However, the misspecification of link functions has a noticeable impact on the standard error estimation and the 95% confidence interval coverage, which emphasizes the importance of choosing an appropriate link function to make statistical inference.

2010 ◽  
Vol 49 (01) ◽  
pp. 54-64 ◽  
Author(s):  
J. Menke

Summary Objectives: Meta-analysis allows to summarize pooled sensitivities and specificities from several primary diagnostic test accuracy studies. Often these pooled estimates are indirectly obtained from a hierarchical summary receiver operating characteristics (HSROC) analysis. This article presents a generalized linear random-effects model with the new SAS PROC GLIMMIX that obtains the pooled estimates for sensitivity and specificity directly. Methods: Firstly, the formula of the bivariate random-effects model is presented in context with the literature. Then its implementation with the new SAS PROC GLIMMIX is empirically evaluated in comparison to the indirect HSROC approach, utilizing the published 2 x 2 count data of 50 meta-analyses. Results: According to the empirical evaluation the meta-analytic results from the bivariate GLIMMIX approach are nearly identical to the results from the indirect HSROC approach. Conclusions: A generalized linear mixed model with PROC GLIMMIX offers a straightforward method for bivariate random-effects meta-analysis of sensitivity and specificity.


2020 ◽  
pp. 1-37
Author(s):  
Tal Yarkoni

Abstract Most theories and hypotheses in psychology are verbal in nature, yet their evaluation overwhelmingly relies on inferential statistical procedures. The validity of the move from qualitative to quantitative analysis depends on the verbal and statistical expressions of a hypothesis being closely aligned—that is, that the two must refer to roughly the same set of hypothetical observations. Here I argue that many applications of statistical inference in psychology fail to meet this basic condition. Focusing on the most widely used class of model in psychology—the linear mixed model—I explore the consequences of failing to statistically operationalize verbal hypotheses in a way that respects researchers' actual generalization intentions. I demonstrate that whereas the "random effect" formalism is used pervasively in psychology to model inter-subject variability, few researchers accord the same treatment to other variables they clearly intend to generalize over (e.g., stimuli, tasks, or research sites). The under-specification of random effects imposes far stronger constraints on the generalizability of results than most researchers appreciate. Ignoring these constraints can dramatically inflate false positive rates, and often leads researchers to draw sweeping verbal generalizations that lack a meaningful connection to the statistical quantities they are putatively based on. I argue that failure to take the alignment between verbal and statistical expressions seriously lies at the heart of many of psychology's ongoing problems (e.g., the replication crisis), and conclude with a discussion of several potential avenues for improvement.


Author(s):  
Judith Rösler ◽  
Stefan Georgiev ◽  
Anna L. Roethe ◽  
Denny Chakkalakal ◽  
Güliz Acker ◽  
...  

AbstractExoscopic surgery promises alleviation of physical strain, improved intraoperative visualization and facilitation of the clinical workflow. In this prospective observational study, we investigate the clinical usability of a novel 3D4K-exoscope in routine neurosurgical interventions. Questionnaires on the use of the exoscope were carried out. Exemplary cases were additionally video-documented. All participating neurosurgeons (n = 10) received initial device training. Changing to a conventional microscope was possible at all times. A linear mixed model was used to analyse the impact of time on the switchover rate. For further analysis, we dichotomized the surgeons in a frequent (n = 1) and an infrequent (n = 9) user group. A one-sample Wilcoxon signed rank test was used to evaluate, if the number of surgeries differed between the two groups. Thirty-nine operations were included. No intraoperative complications occurred. In 69.2% of the procedures, the surgeon switched to the conventional microscope. While during the first half of the study the conversion rate was 90%, it decreased to 52.6% in the second half (p = 0.003). The number of interventions between the frequent and the infrequent user group differed significantly (p = 0.007). Main reasons for switching to ocular-based surgery were impaired hand–eye coordination and poor depth perception. The exoscope investigated in this study can be easily integrated in established neurosurgical workflows. Surgical ergonomics improved compared to standard microsurgical setups. Excellent image quality and precise control of the camera added to overall user satisfaction. For experienced surgeons, the incentive to switch from ocular-based to exoscopic surgery greatly varies.


Author(s):  
Amy L Petry ◽  
Nichole F Huntley ◽  
Michael R Bedford ◽  
John F Patience

Abstract In theory, supplementing xylanase in corn-based swine diets should improve nutrient and energy digestibility and fiber fermentability, but its efficacy is inconsistent. The experimental objective was to investigate the impact of xylanase on energy and nutrient digestibility, digesta viscosity, and fermentation when pigs are fed a diet high in insoluble fiber (>20% neutral detergent fiber; NDF) and given a 46-d dietary adaptation period. Three replicates of 20 growing gilts were blocked by initial body weight, individually housed, and assigned to 1 of 4 dietary treatments: a low-fiber control (LF) with 7.5% NDF, a 30% corn bran high-fiber control (HF; 21.9% NDF), HF+100 mg xylanase/kg [HF+XY, (Econase XT 25P; AB Vista, Marlborough, UK)] providing 16,000 birch xylan units/kg; and HF+50 mg arabinoxylan-oligosaccharide (AXOS) product/kg [HF+AX, (XOS 35A; Shandong Longlive Biotechnology, Shandong, China)] providing AXOS with 3-7 degrees of polymerization. Gilts were allowed ad libitum access to fed for 36-d. On d 36, pigs were housed in metabolism crates for a 10-d period, limit fed, and feces were collected. On d 46, pigs were euthanized and ileal, cecal, and colonic digesta were collected. Data were analyzed as a linear mixed model with block and replication as random effects, and treatment as a fixed effect. Compared with LF, HF reduced the apparent ileal digestibility (AID), apparent cecal digestibility (ACED), apparent colonic digestibility (ACOD), and apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), crude protein (CP), acid detergent fiber (ADF), NDF, and hemicellulose (P<0.01). Relative to HF, HF+XY improved the AID of GE, CP, and NDF (P<0.05), and improved the ACED, ACOD, and ATTD of DM, GE, CP, NDF, ADF, and hemicellulose (P<0.05). Among treatments, pigs fed HF had increased hindgut DM disappearance (P=0.031). Relative to HF, HF+XY improved cecal disappearance of DM (162 vs. 98g; P=0.008) and NDF (44 vs. 13g; P<0.01). Pigs fed xylanase had a greater proportion of acetate in cecal digesta and butyrate in colonic digesta among treatments (P<0.05). Compared with LF, HF increased ileal, cecal, and colonic viscosity, but HF+XY decreased ileal viscosity compared with HF (P<0.001). In conclusion, increased insoluble corn-based fiber decreases digestibility, reduces cecal fermentation, and increases digesta viscosity, but supplementing xylanase partially mitigated that effect.


2020 ◽  
pp. 1471082X2096691
Author(s):  
Amani Almohaimeed ◽  
Jochen Einbeck

Random effect models have been popularly used as a mainstream statistical technique over several decades; and the same can be said for response transformation models such as the Box–Cox transformation. The latter aims at ensuring that the assumptions of normality and of homoscedasticity of the response distribution are fulfilled, which are essential conditions for inference based on a linear model or a linear mixed model. However, methodology for response transformation and simultaneous inclusion of random effects has been developed and implemented only scarcely, and is so far restricted to Gaussian random effects. We develop such methodology, thereby not requiring parametric assumptions on the distribution of the random effects. This is achieved by extending the ‘Nonparametric Maximum Likelihood’ towards a ‘Nonparametric profile maximum likelihood’ technique, allowing to deal with overdispersion as well as two-level data scenarios.


2018 ◽  
Vol 147 ◽  
Author(s):  
A. Aswi ◽  
S. M. Cramb ◽  
P. Moraga ◽  
K. Mengersen

AbstractDengue fever (DF) is one of the world's most disabling mosquito-borne diseases, with a variety of approaches available to model its spatial and temporal dynamics. This paper aims to identify and compare the different spatial and spatio-temporal Bayesian modelling methods that have been applied to DF and examine influential covariates that have been reportedly associated with the risk of DF. A systematic search was performed in December 2017, using Web of Science, Scopus, ScienceDirect, PubMed, ProQuest and Medline (via Ebscohost) electronic databases. The search was restricted to refereed journal articles published in English from January 2000 to November 2017. Thirty-one articles met the inclusion criteria. Using a modified quality assessment tool, the median quality score across studies was 14/16. The most popular Bayesian statistical approach to dengue modelling was a generalised linear mixed model with spatial random effects described by a conditional autoregressive prior. A limited number of studies included spatio-temporal random effects. Temperature and precipitation were shown to often influence the risk of dengue. Developing spatio-temporal random-effect models, considering other priors, using a dataset that covers an extended time period, and investigating other covariates would help to better understand and control DF transmission.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Nicolaas P. Pronk ◽  
A. Lauren Crain ◽  
Jeffrey J. VanWormer ◽  
Brian C. Martinson ◽  
Jackie L. Boucher ◽  
...  

Objective.To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.Methods.As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.Results.At baseline, study participants underreported their weight by an average of 2.06 (se=0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.Conclusions.The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.


2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A1-A2
Author(s):  
T Liebich ◽  
L Lack ◽  
G Micic ◽  
K Hansen ◽  
B Zajamsek ◽  
...  

Abstract Introduction Well-controlled studies of wind farm noise (WFN) on sleep are lacking despite complaints and known effects of other noise types on sleep. This laboratory-based study investigated the impact of continuous full-night WFN exposure replicated from field recordings on polysomnography-measured (objective) and sleep diary-determined (subjective) sleep efficiency compared to a quiet control night. Methods Based on residential location and self-report data, 50 participants were categorised into three groups (14 living <10km from a wind farm and self-reporting sleep disturbance; 19 living <10km from a wind farm and self-reporting no sleep disturbance and 18 controls living in a quiet rural area). Participants underwent full in-laboratory polysomnography during exposure to continuous WFN (25 dB(A)) throughout the night and a quiet control night (background noise 19 dB(A)) in random order. Group and noise condition effects were examined via linear mixed model analysis. Results Participants (30 females) were aged (mean±SD) 54.9±17.6 range: 18–80 years. Sleep efficiency in the control condition was (median [interquartile range]) objective: 85.5 [77.4 to 91.2]%; subjective: 85.7 [69.2 to 92.7]%) versus the WFN condition (objective: 86.1 [78.6 to 91.7]% subjective: 85.8 [66.2 to 93.8]%) with no significant main or interaction effects of group or noise condition (all p’s >0.05). Conclusion These results do not support that WFN at 25 dB(A) significantly impacts objective or subjective sleep efficiency in participants with or without prior WFN exposure or self-reported WFN-related sleep disturbance. Further analyses to investigate potential sleep micro-structural changes remain warranted.


2018 ◽  
Vol 4 (1) ◽  
pp. 16-23
Author(s):  
Fitri Haryanti ◽  
Mohammad Hakimi ◽  
Yati Sunarto ◽  
Yayi S Prabandari

Background: Although the WHO strategy integrated management of childhood illness (IMCI) for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies.Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004.Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities  (nutritionist, pharmacist, laboratory) in Cut Nyak Dien (CND) Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis.Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up.  The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster.Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a rebuilding process.  The program requires strong management support and the emergency phase to be subsided.  Other pre-requisites include the existence of standard operating procedures, adequate physical facilities and support for staff morale and well-being.  Improving the quality of paediatric care requires more than just training and clinical guidelines; internal motivation and health worker support are essential.


2020 ◽  
Author(s):  
Amanda Lee ◽  
Meggan Graves ◽  
Andrea Lear ◽  
Sherry Cox ◽  
Marc Caldwell ◽  
...  

AbstractPain management should be utilized with castration to reduce physiological and behavioral changes. Transdermal application of drugs require less animal management and fewer labor risks, which can occur with oral administration or injections. The objective was to determine the effects of transdermal flunixin meglumine on meat goats’ behavior post-castration. Male goats (N = 18; mean body weight ± standard deviation: 26.4 ± 1.6 kg) were housed individually in pens and randomly assigned to 1 of 3 treatments: (1) castrated, dosed with transdermal flunixin meglumine; (2) castrated, dosed with transdermal placebo; and (3) sham castrated, dosed with transdermal flunixin meglumine. Body position, rumination, and head- pressing were observed for 1 h ± 10 minutes twice daily on days −1, 0, 1, 2, and 5 around castration. Each goat was observed once every 5-minutes (scan samples) and reported as percentage of observations. Accelerometers were used to measure standing, lying, and laterality (total time, bouts, and bout duration). A linear mixed model was conducted using GLIMMIX. Fixed effects of treatment, day relative to castration, and treatment*day relative to castration and random effect of date and goat nested within treatment were included. Treatment 1 goats (32.7 ± 2.8%) and treatment 2 goats (32.5 ± 2.8%) ruminated less than treatment 3 goats (47.4 ± 2.8%, P = 0.0012). Head pressing was greater on day of castration in treatment 2 goats (P < 0.001). Standing bout duration was greatest in treatment 2 goats on day 1 post-castration (P < 0.001). Lying bout duration was greatest in treatment 2 goats on day 1 post-castration compared to treatment 1 and treatment 3 goats(P < 0.001). Transdermal flunixin meglumine improved goats’ fluidity of movement post-castration and decreased head pressing, indicating a mitigation of pain behavior.


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