scholarly journals Confounding adjustment performance of ordinal analysis methods in stroke studies

2019 ◽  
Author(s):  
T.P. Zonneveld ◽  
A. Aigner ◽  
R.H.H. Groenwold ◽  
A. Algra ◽  
P.J. Nederkoorn ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Propensity Score ◽  
Coverage Probability ◽  
Ordinal Logistic Regression ◽  
Point Estimate ◽  
Confounding Variable ◽  
Application Range ◽  
Confounding Variables ◽  
Coverage Probabilities ◽  
Confounding Adjustment

AbstractBackgroundIn acute stroke studies, ordinal logistic regression (OLR) is often used to analyze outcome on the modified Rankin Scale (mRS), whereas the non-parametric Mann-Whitney measure of superiority (MWS) has also been suggested. It is unclear how these perform comparatively when confounding adjustment is warranted. Our aim is to quantify the performance of OLR and MWS in different confounding variable settings.MethodsWe set up a simulation study with three different scenarios; (1) dichotomous confounding variables, (2) continuous confounding variables, and (3) confounding variable settings mimicking a study on functional outcome after stroke. We compared adjusted ordinal logistic regression (aOLR) and stratified Mann-Whitney measure of superiority (sMWS), and also used propensity scores to stratify the MWS (psMWS). For comparability, OLR estimates were transformed to a MWS. We report bias, the percentage of runs that produced a point estimate deviating by more than 0.05 points (point estimate variation), and the coverage probability.ResultsIn scenario 1, there was no bias in both sMWS and aOLR, with similar point estimate variation and coverage probabilities. In scenario 2, sMWS resulted in more bias (0.04 versus 0.00), and higher point estimate variation (41.6% versus 3.3%), whereas coverage probabilities were similar. In scenario 3, there was no bias in both methods, point estimate variation was higher in the sMWS (6.7%) versus aOLR (1.1%), and coverage probabilities were 0.98 (sMWS) versus 0.95 (aOLR). With psMWS, bias remained 0.00, with less point estimate variation (1.5%) and a coverage probability of 0.95.ConclusionsThe bias of both adjustment methods was similar in our stroke simulation scenario, and the higher point estimate variation in the MWS improved with propensity score based stratification. The stratified MWS is a valid alternative for adjusted OLR only when the ratio of number of strata versus number of observations is relatively low, but propensity score based stratification extends the application range of the MWS.

scholarly journals Global Sensory Impairment Independently Predicts Decreased Social Function Over Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 414-414
Author(s):  
Anna Huang ◽  
Kristen Wroblewski ◽  
Ashwin Kotwal ◽  
Linda Waite ◽  
Martha McClintock ◽  
...  
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Cognitive Function ◽  
Social Engagement ◽  
Social Function ◽  
Ordinal Logistic Regression ◽  
Sensory Function ◽  
Sensory Impairment ◽  
Over Time

Abstract The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.

scholarly journals Effect of fluid administration on scene to traffic accident patients by EMS personnel: a propensity score-matched study using population-based ambulance records and nationwide trauma registry in Japan

2021 ◽  
Author(s):  
Yusuke Katayama ◽  
Tetsuhisa Kitamura ◽  
Kosuke Kiyohara ◽  
Kenichiro Ishida ◽  
Tomoya Hirose ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Regression Model ◽  
Traffic Accident ◽  
Logistic Regression Model ◽  
Cardiopulmonary Arrest ◽  
Population Based ◽  
Fluid Administration ◽  
Secondary Outcome

Abstract Purpose The aim of this study was to assess the effect of fluid administration by emergency life-saving technicians (ELST) on the prognosis of traffic accident patients by using a propensity score (PS)-matching method. Methods The study included traffic accident patients registered in the JTDB database from January 2016 to December 2017. The main outcome was hospital mortality, and the secondary outcome was cardiopulmonary arrest on hospital arrival (CPAOA). To reduce potential confounding effects in the comparisons between two groups, we estimated a propensity score (PS) by fitting a logistic regression model that was adjusted for 17 variables before the implementation of fluid administration by ELST at the scene. Results During the study period, 10,908 traffic accident patients were registered in the JTDB database, and we included 3502 patients in this study. Of these patients, 142 were administered fluid by ELST and 3360 were not administered fluid by ELST. After PS matching, 141 patients were selected from each group. In the PS-matched model, fluid administration by ELST at the scene was not associated with discharge to death (crude OR: 0.859 [95% CI, 0.500–1.475]; p = 0.582). However, the fluid group showed statistically better outcome for CPAOA than the no fluid group in the multiple logistic regression model (adjusted OR: 0.231 [95% CI, 0.055–0.967]; p = 0.045). Conclusion In this study, fluid administration to traffic accident patients by ELST was associated not with hospital mortality but with a lower proportion of CPAOA.

Analysis on application level based on ordinal logistic regression and best of advanced manufacturing technologies (AMT) selection based on fuzzy-TOPSIS integration approach

2021 ◽  
pp. 1-11
Author(s):  
Guilian Wang ◽  
Liyan Zhang ◽  
Jing Guo
Keyword(s):  
Logistic Regression ◽  
Organizational Factors ◽  
Fuzzy Topsis ◽  
Ordinal Logistic Regression ◽  
Industrial Robots ◽  
Policy Implications ◽  
Market Pricing ◽  
Factors Affecting ◽  
Pricing Power ◽  
The Core Competence

This paper try to fully reveal the key factors affecting the the level of AMT application in micro- and small enterprises (MSEs) from its organizational factors by ordinal logistic regression. The results show that MSEs have a relatively high level of AMT application as a whole due to the maturity and cost reduction of basic technologies such as artificial intelligence, digital manufacturing and industrial robots. In this paper we propose manufacturing world analysis at Application using Logistic Regression and best AMT selection using Fuzzy-TOPSIS Integration approach.Considering the influence mechanism of each factor, the important factors that affect the application level of AMT are the enterprise’s market pricing power, the main production types, technical, market and management capabilities, organization development incentives and the interaction with external stakeholders. Based on the results above, the following policy implications are proposed: further expanding the customized production in MSEs to gradually improve the market pricing power, expanding the core competence of enterprises, enhancing the employee autonomy, and strengthening the interaction with industry organizations.

scholarly journals Effect of Preoperative Urodynamic Study on Urinary Outcomes after Transobturator Sling

2021 ◽  
Author(s):  
Pedro Rincon Cintra da Cruz ◽  
Aderivaldo Cabral Dias Filho ◽  
Gabriel Nardi Furtado ◽  
Rhaniellen Silva Ferreira ◽  
Ceres Nunes Resende
Keyword(s):  
Logistic Regression ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Propensity Score ◽  
Urinary Continence ◽  
Urodynamic Study ◽  
Transobturator Sling ◽  
Continence Status ◽  
And Performance

Abstract Objective To evaluate whether performing preoperative urodynamic study influences postoperative urinary symptoms of women with stress urinary incontinence that underwent transobturator sling. Methods Retrospective analysis of patients treated for stress urinary incontinence by transobturator sling from August 2011 to October 2018. Predictor variables included preoperative urodynamic study, age, incontinence severity, body mass index, preoperative storage symptoms and previous anti-urinary incontinence procedure. Outcome variables were postoperative subjective continence status, storage symptoms and complications. Logistic regression after propensity score was employed to compare outcomes between patients who underwent or not pre-operative urodynamic study. Results The present study included 88 patients with an average follow-up of 269 days. Most patients (n = 52; 59.1%) described storage symptoms other than stress urinary incontinence, and 38 patients (43.2%) underwent preoperative urodynamic studies. Logistic regression after propensity score did not reveal an association between urinary continence outcomes and performance of preoperative urodynamic study (odds ratio 0.57; confidence interval [CI]: 0.11–2.49). Among women that did not undergo urodynamic study, there was a subjective improvement in urinary incontinence in 92% of the cases versus 87% in those that underwent urodynamic study (p = 0.461). Furthermore, postoperative storage symptoms were similar between women who did not undergo urodynamic study and those who underwent urodynamic study, 13.2% versus 18.4%, respectively (p = 0.753). Conclusion Preoperative urodynamic study had no impact on urinary incontinence cure outcomes as well as on urinary storage symptoms after the transobturator sling in women with stress urinary incontinence.

Depression as a Risk Factor for Denture Dissatisfaction

2007 ◽  
Vol 86 (9) ◽  
pp. 852-856 ◽  
Author(s):  
M.T. John ◽  
W. Micheelis ◽  
J.G. Steele
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Full Range ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Population Based ◽  
Ordinal Logistic Regression ◽  
Unit Increase ◽  
Impaired Health ◽  
Simple Logistic

Depression is associated with impaired health outcomes. This study investigated whether there is a significant association between depression and dissatisfaction with dentures in older adults. In a population-based study (1180 adults aged 65–74 yrs), depression was measured by an abbreviated Geriatric Depression Scale. Denture dissatisfaction was assessed with a five-point Likert-type question ("very dissatisfied" to "very satisfied"). The depression-denture dissatisfaction association was analyzed with simple (dissatisfied vs. not dissatisfied outcome) and ordinal logistic regression (based on outcome’s full range). For each unit increase on the 15-point depression scale, the probability of denture dissatisfaction increased by 24% [95% confidence interval, 15–34%, P < 0.001 (simple logistic regression)] and the probability for higher levels on the five-point dissatisfaction scale increased by 16% [95% CI, 11–22%, P < 0.001 (ordinal logistic regression)], adjusted for potential confounding variables. The likely causal association in older adults has major implications for the evaluation of treatment effects and the demand for prosthodontic therapy.

Attributable Cost of Clostridium difficile Infection in Pediatric Patients

2017 ◽  
Vol 38 (12) ◽  
pp. 1472-1477 ◽  
Author(s):  
Preeti Mehrotra ◽  
Jisun Jang ◽  
Courtney Gidengil ◽  
Thomas J. Sandora
Keyword(s):  
Logistic Regression ◽  
Clostridium Difficile ◽  
Propensity Score ◽  
Regression Model ◽  
Generalized Linear Model ◽  
Logistic Regression Model ◽  
Propensity Scores ◽  
Healthcare Research ◽  
Design And Methods ◽  
Inpatient Database

OBJECTIVESThe attributable cost of Clostridium difficile infection (CDI) in children is unknown. We sought to determine a national estimate of attributable cost and length of stay (LOS) of CDI occurring during hospitalization in children.DESIGN AND METHODSWe analyzed discharge records of patients between 2 and 18 years of age from the Agency for Healthcare Research and Quality (AHRQ) Kids’ Inpatient Database. We created a logistic regression model to predict CDI during hospitalization based on demographic and clinical characteristics. Predicted probabilities from the logistic regression model were then used as propensity scores to match 1:2 CDI to non-CDI cases. Charges were converted to costs and compared between patients with CDI and propensity-score–matched controls. In a sensitivity analysis, we adjusted for LOS as a confounder by including it in both the propensity score and a generalized linear model predicting cost.RESULTSWe identified 8,527 pediatric hospitalizations (0.53%) with a diagnosis of CDI and 1,597,513 discharges without CDI. In our matched cohorts, the attributable cost of CDI occurring during a hospitalization ranged from $1,917 to $8,317, depending on whether model was adjusted for LOS. When not adjusting for LOS, CDI-associated hospitalizations cost 1.6 times more than non-CDI associated hospitalizations. Attributable LOS of CDI was approximately 4 days.CONCLUSIONSClostridium difficile infection in hospitalized children is associated with an economic burden similar to adult estimates. This finding supports a continued focus on preventing CDI in children as a priority. Pediatric CDI cost analyses should account for LOS as an important confounder of cost.Infect Control Hosp Epidemiol 2017;38:1472–1477

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