scholarly journals The role of matching when adjusting for baseline differences in the outcome variable of comparative effectiveness studies

2015 ◽  
Vol 4 (4) ◽  
pp. 341-349 ◽  
Author(s):  
Carlos G Grijalva ◽  
Christianne L Roumie ◽  
Harvey J Murff ◽  
Adriana M Hung ◽  
Cole Beck ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Outcome Variable ◽  
Effectiveness Studies

scholarly journals CL3 UNDERSTANDING THE PATIENT VOICE IN COMPARATIVE EFFECTIVENESS STUDIES: THE ROLE OF BENCHMARK COMPARISONS

2019 ◽  
Vol 22 ◽  
pp. S35
Author(s):  
R. Rendas-Baum ◽  
B. Laird ◽  
K. Rychlec ◽  
J.E. Brown ◽  
M. Bayliss
Keyword(s):  
Comparative Effectiveness ◽  
Patient Voice ◽  
Effectiveness Studies

Cognitive Health Counseling 40+

2013 ◽  
Vol 21 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Anne Eschen ◽  
Franzisca Zehnder ◽  
Mike Martin
Keyword(s):  
Outcome Variable ◽  
Pilot Phase ◽  
Subjective Memory ◽  
Cognitive Health ◽  
Health Counseling ◽  
Agents Of Change ◽  
Main Outcome Variable ◽  
Further Development

This article introduces Cognitive Health Counseling 40+ (CH.CO40+), an individualized intervention that is conceptually based on the orchestration model of quality-of-life management ( Martin & Kliegel, 2010 ) and aims at improving satisfaction with cognitive health in adults aged 40 years and older. We describe the theoretically deduced characteristics of CH.CO40+, its target group, its multifactorial nature, its individualization, the application of subjective and objective measures, the role of participants as agents of change, and the rationale for choosing participants’ satisfaction with their cognitive health as main outcome variable. A pilot phase with 15 middle-aged and six older adults suggests that CH.CO40+ attracts, and may be particularly suitable for, subjective memory complainers. Implications of the pilot data for the further development of the intervention are discussed.

scholarly journals Stronger Association between Nucleus Accumbens Density and Body Mass Index in Low-Income and African American Children

2020 ◽  
Vol 5 (2) ◽  
pp. p107
Author(s):  
Shervin Assari
Keyword(s):  
Body Mass Index ◽  
African American ◽  
Nucleus Accumbens ◽  
Body Mass ◽  
Low Income ◽  
Parental Education ◽  
Predictor Variable ◽  
Outcome Variable ◽  
Ses Differences

Background: The nucleus accumbens’ (NAc) size, function, and density influence individuals’ body mass index (BMI). However, little is known about racial and socioeconomic status (SES) differences in the role of NAc density as a predictor of childhood BMI. Objectives: We used the Adolescent Brain Cognitive Development (ABCD) data to investigate racial and SES differences in the effect of NAc density on childhood BMI. Methods: This cross-sectional study included 9497 children between ages 9 and 10. Mixed-effects regression models were used to analyze the data. The predictor variable was NAc density measured using diffusion MRI (dMRI). The outcome variable was BMI, operationalized as a continuous variable. Covariates included sex, age, ethnicity, family structure, and parental education. Race (White, African American, Asian, and Other/mixed) and household income (< 50k, 50-100 k, and 100+ k) were the moderators. Results: High NAc diffusion tension (density) was predictive of higher BMI, net of covariates. However, the positive association between NAc density and BMI was stronger in African Americans than in White, and in low-income than in high-income children. Conclusions: Our findings suggest that although high NAc has implications for children’s BMI, this effect varies across racial and SES groups. More research should be performed on the role of obesogenic environments in altering the effect of NAc on childhood BMI.

THU0620-HPR MEASUREMENT OF LOW DISEASE ACTIVITY USING THE CLINICAL DISEASE ACTIVITY INDEX (CDAI) VERSUS THE DISEASE ACTIVITY SCORE 28 (DAS 28): IMPACT OF INFLAMMATION MARKERS ON THE COMPARATIVE EFFECTIVENESS OF BIOLOGICS FOR THE TREATMENT OF RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 553.1-553
Author(s):  
K. Janke ◽  
K. Biester ◽  
D. Krause ◽  
B. Richter ◽  
C. Schürmann ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Comparative Effectiveness ◽  
Inflammatory Markers ◽  
Activity Index ◽  
Disease Activity Index ◽  
Signs And Symptoms ◽  
Acute Phase Reactants ◽  
Das 28 ◽  
Effectiveness Studies

Background:Biologics for the treatment of rheumatoid arthritis (RA) have different modes of action to target auto-inflammatory processes causing the signs and symptoms of the disease. Different biologics may thus have different effects on inflammatory markers. For instance, previous studies have shown that the interleukin-6-inhibitor tocilizumab (TOC) decreases the level of acute phase reactants (APRs) [1]. Such direct effects on inflammatory markers may lead to an overestimation of clinical response if disease activity is measured via scores including inflammatory markers, such as the Disease Activity Score 28 (DAS 28). The detected changes in disease activity may not adequately reflect the clinical improvement of signs and symptoms.Objectives:In our study, we compared biologics with each other using two different disease activity scores: the DAS 28 including APRs and the clinical disease activity index (CDAI) excluding APRs. The aim of this study was to assess whether the use of the two different scores affects comparative effectiveness studies on biologics for the treatment of RA.Methods:We compared results on the comparative effectiveness of biologics using the corresponding thresholds for low disease activity (LDA) for the DAS 28 (< 3.2) and the CDAI (≤ 10). We performed two separate network meta-analyses (NMAs) after a thorough step-by-step evaluation of the similarity, homogeneity and consistency assumptions of the patient populations and the study data.Our study formed part of a systematic review (including NMAs) that was largely based on clinical study reports and re-analyses of LDA using individual patient data provided by sponsors for studies conducted up to 2017. Thus, the analyses include hitherto unknown data on LDA analysed by means of the CDAI, especially data from older studies. An extensive comparison of DAS 28 and CDAI in different patient populations was possible.Results:For all analysed patient populations, comparisons of TOC versus other biologics yielded remarkable results: advantages for TOC were found in NMAs using the DAS 28, which were not confirmed in NMAs using the CDAI. For methotrexate (MTX)-naïve patients, using the DAS 28, TOC showed a greater benefit than abatacept (ABA), certolizumab pegol (CZP), and etanercept (ETA), which was not confirmed by the CDAI. In contrast, TOC showed less benefit than adalimumab (ADA) and ETA. For patients after MTX failure and using the DAS 28, TOC showed a greater benefit than ABA, ADA, anakinra (ANA), ETA, golimumab (GOL), and infliximab (INF). With the exception of ANA, these advantages were not confirmed by the CDAI. Similar differences between DAS 28 and CDAI were shown in patients treated with biologics in monotherapy or after failure of biologics.Conclusion:In comparative effectiveness studies of biologics, the assessment of LDA using the DAS 28 instead of the CDAI leads to a consistent overestimation of the benefit of TOC in all patient populations, regardless of pre-treatment or combined therapy with MTX. The inclusion of APRs in disease activity scores may thus introduce bias. A score excluding inflammatory markers should therefore be used to ensure valid results.References:[1]Smolen JS, Aletaha D. Interleukin-6 receptor inhibition with tocilizumab and attainment of disease remission in rheumatoid arthritis: the role of acute-phase reactants. Arthritis Rheum 2011; 63(1): 43-52.Disclosure of Interests:Kirsten Janke: None declared, Katharina Biester: None declared, Dietmar Krause Grant/research support from: Pfizer and AbbVie (Abbott), Bernd Richter: None declared, Christoph Schürmann: None declared, Katharina Hirsch: None declared, Beate Wieseler: None declared

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