Longitudinal multivariate normative comparisons

2020 ◽  
Author(s):  
Zheng Wang ◽  
Yu Cheng ◽  
Eric C. Seaberg ◽  
Leah H. Rubin ◽  
Andrew J. Levine ◽  
...  
2007 ◽  
Vol 45 (11) ◽  
pp. 2534-2542 ◽  
Author(s):  
Hilde M. Huizenga ◽  
Harriet Smeding ◽  
Raoul P.P.P. Grasman ◽  
Ben Schmand

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta

Abstract Background and Aims Kidney transplantation can help in mitigating neuropsychological (NP) impairments in end-stage renal disease (ESRD). Evidences have shown mixed responses on the the nature of cognitive function in patients who have undergone renal transplantation.Present study looked into the factors impacting cognitive domains and impact post transplant. Method 43 patients who were stable ESRD on thrice a week hemodialysis were investigated 6 months pre and post transplant using a battery of neurophysiological testing assessing attention–concentration, psychomotor ability and memory. Formal kinetic modelling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was assessed on regular interval and following a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant were reassessed Results Within-subject comparisons showed statistically significant improvement in memory performance after kidney transplant. Other NP measures (attention– concentration and psychomotor abilities) showed non-significant improvements. Normative comparisons showed NP impairments on dialysis, which were not apparent after transplant Conclusion These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis


2009 ◽  
Vol 15 (3) ◽  
pp. 426-437 ◽  
Author(s):  
DINO MUSLIMOVIĆ ◽  
BART POST ◽  
JOHANNES D. SPEELMAN ◽  
ROB J. DE HAAN ◽  
BEN SCHMAND

AbstractThis controlled prospective study examined the evolution and predictors of cognitive decline in Parkinson’s disease (PD). Consecutive patients diagnosed at baseline with PD (n = 89), established PD (EPD) patients (n = 52) with a mean disease duration of 6.5 years, and healthy control subjects (n = 64) underwent extensive neuropsychological assessment twice, approximately 3 years apart. A standardized regression-based method, normative data, and multivariate normative comparisons were used to assess the cognitive course of PD. Cognitive performance of newly diagnosed patients decreased significantly over time, particularly on measures of psychomotor speed and attention and to a lesser extent on tests of memory, visuospatial skills, and executive functions. About 50% of the patients showed cognitive decline and 9% developed dementia. Similar results were observed in EPD patients. None of the baseline features predicted cognitive change in newly diagnosed patients, whereas age at disease onset and axial impairment (postural and gait disorders) contributed to decline in established patients. We conclude that within few years after diagnosis, PD patients show faster rate of cognitive decline than matched healthy subjects, particularly in domains of attention and psychomotor speed. Selection bias probably led to underestimation of the true extent of cognitive decline in established patients. (JINS, 2009, 15, 426–437.)


Author(s):  
Matthew Kelleher ◽  
Benjamin Kinnear ◽  
Dana R. Sall ◽  
Danielle E. Weber ◽  
Bailey DeCoursey ◽  
...  

Abstract Introduction Narrative assessment data are valuable in understanding struggles in resident performance. However, it remains unknown which themes in narrative data that occur early in training may indicate a higher likelihood of struggles later in training, allowing programs to intervene sooner. Methods Using learning analytics, we identified 26 internal medicine residents in three cohorts that were below expected entrustment during training. We compiled all narrative data in the first 6 months of training for these residents as well as 13 typically performing residents for comparison. Narrative data were blinded for all 39 residents during initial phases of an inductive thematic analysis for initial coding. Results Many similarities were identified between the two cohorts. Codes that differed between typical and lower entrusted residents were grouped into two types of themes: three explicit/manifest and three implicit/latent with six total themes. The explicit/manifest themes focused on specific aspects of resident performance with assessors describing 1) Gaps in attention to detail, 2) Communication deficits with patients, and 3) Difficulty recognizing the “big picture” in patient care. Three implicit/latent themes, focused on how narrative data were written, were also identified: 1) Feedback described as a deficiency rather than an opportunity to improve, 2) Normative comparisons to identify a resident as being behind their peers, and 3) Warning of possible risk to patient care. Discussion Clinical competency committees (CCCs) usually rely on accumulated data and trends. Using the themes in this paper while reviewing narrative comments may help CCCs with earlier recognition and better allocation of resources to support residents’ development.


2019 ◽  
Vol 25 (7) ◽  
pp. 678-687
Author(s):  
J.A. Agelink van Rentergem ◽  
N.R. de Vent ◽  
H.M. Huizenga ◽  
J.M.J. Murre ◽  
B.A. Schmand ◽  
...  

AbstractObjective: Parkinson’s disease with mild cognitive impairment (PD-MCI) is a risk factor for progression to PD dementia (PDD) at a later stage of the disease. The consensus criteria of PD-MCI use a traditional test-by-test normative comparison. The aim of this study was to investigate whether a new multivariate statistical method provides a more sensitive tool for predicting dementia status at 3- and 5-year follow-ups. This method allows a formal evaluation of a patient’s profile of test scores given a large aggregated database with regression-based norms. Method: The cognitive test results of 123 newly diagnosed PD patients from a previously published longitudinal study were analyzed with three different methods. First, the PD-MCI criteria were applied in the traditional way. Second, the PD-MCI criteria were applied using the large aggregated normative database. Last, multivariate normative comparisons (MNCs) were made using the same aggregated normative database. The outcome variable was progression to dementia within 3 and 5 years. Results: The MNC was characterized by higher sensitivity and higher specificity in predicting progression to PDD at follow-up than the two PD-MCI criteria methods, although the difference in classification accuracy did not reach statistical significance. Conclusion: We conclude that MNCs could allow for a more accurate prediction of PDD than the traditional PD-MCI criteria, because there are encouraging trends in both increased sensitivity and increased specificity. (JINS, 2019, 25, 678–687)


2020 ◽  
Vol 34 (6) ◽  
pp. 750-763 ◽  
Author(s):  
Jenny Macfie ◽  
Gretchen Kurdziel

Child maltreatment is an etiological factor in borderline personality disorder (BPD), which may be transmitted to the children of mothers with BPD. We assessed maltreatment in 36 children aged 4–7 whose mothers have BPD and in 34 normative comparisons. Children whose mothers have BPD were more likely to have experienced sexual abuse, physical abuse, and neglect than were normative comparisons. Mothers’ self-reported borderline features were significantly correlated with children's maltreatment. Neglect was associated with mothers’ affective instability, identity disturbance, negative relationships, and self-harm; sexual abuse was associated with mothers’ identity disturbance, and negative relationships; and physical abuse was associated with mothers’ self-harm. Maltreatment mediated the relationship between all four of mothers’ borderline features and children's narrative representations of the caregiver–child relationship, which included fear of abandonment, role reversal, and mother–child relationship expectations. The authors discuss results in the context of risk for developing BPD in early adulthood and early preventive interventions targeting children's representations.


PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173218 ◽  
Author(s):  
Joost A. Agelink van Rentergem ◽  
Jaap M. J. Murre ◽  
Hilde M. Huizenga

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