20 results on '"Rogier T"'
Search Results
2. Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial
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Huijbers, Marloes J., Spinhoven, Philip, Spijker, Jan, Ruhé, Henricus G., van Schaik, Digna J.F., van Oppen, Patricia, Nolen, Willem A., Ormel, Johan, Kuyken, Willem, van der Wilt, Gert Jan, Blom, Marc B.J., Schene, Aart H., Donders, A. Rogier T., and Speckens, Anne E.M.
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- 2015
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3. The effects of economic status and recent experience on innovative behavior under environmental variability: An experimental approach
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van Rijnsoever, Frank J., Meeus, Marius T.H., and Donders, A. Rogier T.
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- 2012
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4. Colchicine et inflammation oculaire non sévère hors maladie de Behcet : 16 cas et revue de la littérature.
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Rogier, T., Auvens, C., Thibault, T., Mouries-Martin, S., Muller, G., El Hssaini, N., Turcu, A., Besancenot, J.-F., Bielefeld, P., and Devilliers, H.
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COLCHICINE , *CORTICOSTEROIDS , *INFLAMMATION , *BEHCET'S disease , *SCLERITIS - Abstract
La colchicine est un médicament à marge thérapeutique étroite qui n'a pas les effets indésirables des corticoïdes et des immunosuppresseurs. Son utilisation dans les atteintes oculaires inflammatoires non sévères hors de la maladie de Behcet n'a pas été étudiée. Nous avons inclus les patients vus dans le service de médecine interne du CHU de Dijon consécutivement entre septembre 2020 et septembre 2021 s'ils avaient reçu de la colchicine au cours de leur pathologie. Les patients suspects de maladie de Behçet étaient exclus. L'efficacité du traitement a été étudiée chez les patients pour lesquels la maladie évoluait depuis au moins un an et qui avaient reçu plus d'un an de colchicine. Le succès du traitement était défini par une diminution de 50 % du nombre de poussées annuelles sous colchicine. Seize patients ont été inclus (9 femmes et 7 hommes). Il s'agissait d'uvéites antérieures récidivantes (n = 10), de sclérites récidivantes (n = 5) et d'une uvéite intermédiaire. Les atteintes ophtalmologiques n'étaient ni sévères ni compliquées. Tous patients confondus, le ratio annuel de poussées (IIQ) passait de 1,8 (0,8 – 3,5) à 0,3 (0 – 1,6), (p = 0,06). La colchicine était considérée comme efficace chez trois patients sur 10 analysables. Chez un seul patient, le traitement a été arrêté pour effets indésirables au bout de six semaines. Au vu du rapport bénéfice risque intéressant de la colchicine, il semble opportun de s'intéresser à cette molécule dans les uvéites antérieures non granulomateuses et sclérites récidivantes non sévères. Colchicine is a narrow therapeutic margin drug that does not have the adverse effects of corticosteroids and immunosuppressants. Its use in non-severe ocular inflammatory disease excluding Behcet's disease has not been studied. We included patients seen in the internal medicine department of Dijon University Hospital consecutively between September 2020 and September 2021 if they had received colchicine during their pathology. Patients with suspected Behçet's disease were excluded. Treatment efficacy was studied in patients with at least one year of disease progression who had received more than one year of colchicine. Successful treatment was defined as a 50 % reduction in the number of annual relapses on colchicine. Sixteen patients were included (9 women and 7 men). They had recurrent anterior uveitis (n = 10), recurrent scleritis (n = 5) and intermediate uveitis. Opthalmological involvement was neither severe nor complicated. All patients combined, the annual relapse ratio (ARR) decreased from 1.8 (0.8–3.5) to 0.3 (0–1.6), (P = 0.06). Colchicine was considered effective in three of 10 analyzable patients. In only one patient, treatment was stopped for adverse effects after six weeks. In view of the interesting benefit-risk ratio of colchicine, it seems appropriate to focus on this molecule in non-granulomatous anterior uveitis and non-severe recurrent scleritis. [ABSTRACT FROM AUTHOR]
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- 2022
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5. A Head-On Ordinal Comparison of the Composite Time Trade-Off and the Better-Than-Dead Method.
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Roudijk, Bram, Donders, A. Rogier T., and Stalmeier, Peep F.M.
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COMPARATIVE studies , *ECONOMIC aspects of diseases , *HEALTH status indicators , *RESEARCH methodology , *MEDICAL cooperation , *MENTAL health , *QUALITY of life , *RESEARCH , *TIME , *ACTIVITIES of daily living , *ATTITUDES toward death , *EVALUATION research ,RESEARCH evaluation - Abstract
Objectives: The valuation of health states worse than dead is challenging. Currently used time trade-off methods face problems in (1) detecting time-dependent preferences and (2) insensitivity toward severity for states worse than dead. The better-than-dead (BTD) method has the potential to detect time-dependent preferences. This study compares the BTD and composite time trade-off (cTTO) methods at the ordinal level.Methods: An experiment was conducted in a convenience sample in which respondents (N = 200) valued the same set of 7 health states in the BTD method and cTTO method. Binary BTD responses were used, with response categories of better than dead and worse than dead. Ternary cTTO responses were used, with the additional equal-to-dead response category. Polychoric correlations were used to determine the agreement between these methods. Consistency and test-retest reliability were assessed within methods.Results: Overall agreement between the cTTO and BTD method equaled 77.1% and differed between health states and respondents. For both methods, there were few inconsistencies, and the test-retest reliability was comparable (88%). Health states were more often considered worse than dead in the BTD method (BTD: 54.7%, cTTO: 37.2%).Conclusions: The high agreement between both methods and the comparable amount of inconsistencies and test-retest reliability suggest that the methods have similar measurement properties. The BTD method yielded higher frequencies of worse-than-dead responses while essentially asking respondents to make similar choices. This accounts for part of the disagreement between the methods. Several explanations are offered for this difference, yet more research is needed to explain this phenomenon. [ABSTRACT FROM AUTHOR]- Published
- 2020
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6. Efficacité de l’éculizumab comme traitement de la microangiopathie thrombotique induite par la gemcitabine : à propos d’un cas.
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Rogier, T., Gerfaud-Valentin, M., Pouteil-Noble, C., Taleb, A., Guillet, M., Noel, A., Broussolle, C., and Sève, P.
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Résumé Introduction La microangiopathie thrombotique induite par la gemcitabine est un événement rare dont le traitement n’est pas consensuel. L’éculizumab pourrait avoir un intérêt thérapeutique. Observation Une femme de 68 ans recevait une chimiothérapie adjuvante par gemcitabine pour un adénocarcinome pancréatique. À 2 mois de traitement, elle développait une anémie hémolytique mécanique, une thrombopénie et une hypertension artérielle menant au diagnostic de microangiopathie thrombotique. La gemcitabine était arrêtée. Des échanges plasmatiques étaient initiés secondairement du fait de l’aggravation hématologique et néphrologique. L’efficacité étant insuffisante, l’éculizumab était débuté à la dose de 900 mg/semaine 4 fois, puis 1200 mg tous les 14 jours. Après 7 perfusions, la pression artérielle, le syndrome œdémateux, l’anémie et l’insuffisance rénale se corrigeaient. Conclusion L’éculizumab peut être proposé pour le traitement de la microangiopathie thrombotique induite par la gemcitabine, en cas d’atteinte hématologique ou rénale grave et de réponse insuffisante aux échanges plasmatiques. Introduction Gemcitabine-induced thrombotic microangiopathy is a rare event whose management is not yet consensual. The use of eculizumab could be of interest. Case report A 68-year-old woman was treated by gemcitabine as adjuvant chemotherapy of a pancreatic adenocarcinoma. Two months later, the patient presented with mechanical hemolytic anemia, thrombocytopenia and high blood pressure that led to the diagnosis of thrombotic microangiopathy. Gemcitabine was stopped. Plasma exchange therapy was introduced since hematological and renal parameters had worsened. As clinical efficacy was insufficient, eculizumab was introduced at a dose of 900 mg per week 4 times, then 1200 mg every 2 weeks. Symptoms along with hematological and nephrological analysis were back to physiological standards after 7 intravenous injections. Conclusion Eculizumab seems to be an effective treatment against gemcitabine-induced thrombotic microangiopathy in case of severe hematological and renal injuries associated with a lack of response to plasma exchange therapy. [ABSTRACT FROM AUTHOR]
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- 2016
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7. Missing covariate data in medical research: To impute is better than to ignore
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Janssen, Kristel J.M., Donders, A. Rogier T., Harrell, Frank E., Vergouwe, Yvonne, Chen, Qingxia, Grobbee, Diederick E., and Moons, Karel G.M.
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MEDICAL research , *MISSING data (Statistics) , *MULTIPLE imputation (Statistics) , *VENOUS thrombosis diagnosis , *LOGISTIC regression analysis , *LEG injuries , *RECEIVER operating characteristic curves - Abstract
Abstract: Objective: We compared popular methods to handle missing data with multiple imputation (a more sophisticated method that preserves data). Study Design and Setting: We used data of 804 patients with a suspicion of deep venous thrombosis (DVT). We studied three covariates to predict the presence of DVT: d-dimer level, difference in calf circumference, and history of leg trauma. We introduced missing values (missing at random) ranging from 10% to 90%. The risk of DVT was modeled with logistic regression for the three methods, that is, complete case analysis, exclusion of d-dimer level from the model, and multiple imputation. Results: Multiple imputation showed less bias in the regression coefficients of the three variables and more accurate coverage of the corresponding 90% confidence intervals than complete case analysis and dropping d-dimer level from the analysis. Multiple imputation showed unbiased estimates of the area under the receiver operating characteristic curve (0.88) compared with complete case analysis (0.77) and when the variable with missing values was dropped (0.65). Conclusion: As this study shows that simple methods to deal with missing data can lead to seriously misleading results, we advise to consider multiple imputation. The purpose of multiple imputation is not to create data, but to prevent the exclusion of observed data. [Copyright &y& Elsevier]
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- 2010
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8. The Voice Handicap of Student-Teachers and Risk Factors Perceived to Have a Negative Influence on the Voice.
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Thomas, George, Kooijman, Piet G.C., Donders, A. Rogier T., Cremers, Cor W.R.J., and de Jong, Felix I.C.R.S.
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Summary: A cross-sectional questionnaire survey was performed. The objectives of the study were to assess the psychosocial impact of current voice complaints as perceived by student-teachers with voice complaints in comparison with student-teachers without voice complaints, and to observe the pattern of risk factors in relation to their voice handicap. Subjects in the general population without a voice-demanding profession were selected as a reference group for limited comparison with the total group of student-teachers (future professional voice users). The respondents to the questionnaires were anonymous. Among the student-teachers, 17.2% reported current voice complaints in comparison with 9.7% of the reference group, and the odds ratio was 1.94, which showed the relative risk. Student-teachers had significantly greater total Voice Handicap Index (VHI) scores than the reference group (P = 0.034). The VHI subscale scores were not significantly different (P > 0.05). Student-teachers who reported current voice complaints had a significantly higher total VHI and subscale scores than student teachers without voice complaints (P < 0.001). Of the student-teachers without voice complaints, 17.0% had VHI scores greater than the 75th percentile. These persons may be neglecting their voice handicap and probably represent the false-negative cases in the estimation of voice complaints. Logistic regression analysis of each of the given risk factors with the VHI as the independent variable showed that the perceived negative influence of the given risk factors on their voices was significantly greater with increasing VHI scores across the VHI range. A significant correlation was observed between the number of perceived risk factors and increasing VHI scores across the VHI range. An increased awareness of risk factors in relation to their voice handicap would serve to motivate student-teachers to change factors that contributed to their voice problem. Attention to all risk factors, which the subjects perceive to be a risk, would aid in effective management of their voice handicap. [Copyright &y& Elsevier]
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- 2007
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9. Review: A gentle introduction to imputation of missing values
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Donders, A. Rogier T., van der Heijden, Geert J.M.G., Stijnen, Theo, and Moons, Karel G.M.
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MULTIPLE imputation (Statistics) , *MISSING data (Statistics) , *ERRORS , *CONFIDENCE intervals - Abstract
Abstract: In most situations, simple techniques for handling missing data (such as complete case analysis, overall mean imputation, and the missing-indicator method) produce biased results, whereas imputation techniques yield valid results without complicating the analysis once the imputations are carried out. Imputation techniques are based on the idea that any subject in a study sample can be replaced by a new randomly chosen subject from the same source population. Imputation of missing data on a variable is replacing that missing by a value that is drawn from an estimate of the distribution of this variable. In single imputation, only one estimate is used. In multiple imputation, various estimates are used, reflecting the uncertainty in the estimation of this distribution. Under the general conditions of so-called missing at random and missing completely at random, both single and multiple imputations result in unbiased estimates of study associations. But single imputation results in too small estimated standard errors, whereas multiple imputation results in correctly estimated standard errors and confidence intervals. In this article we explain why all this is the case, and use a simple simulation study to demonstrate our explanations. We also explain and illustrate why two frequently used methods to handle missing data, i.e., overall mean imputation and the missing-indicator method, almost always result in biased estimates. [Copyright &y& Elsevier]
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- 2006
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10. Penalized maximum likelihood estimation to directly adjust diagnostic and prognostic prediction models for overoptimism: a clinical example
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Moons, K.G.M., Donders, A. Rogier T., Steyerberg, E.W., and Harrell, F.E.
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REGRESSION analysis , *ASSIMILATION (Sociology) , *STANDARDIZATION , *CALIBRATION - Abstract
Abstract: Background and objective: There is growing interest in developing prediction models. The accuracy of such models when applied in new patient samples is commonly lower than estimated from the development sample. This may be because of differences between the samples and/or because the developed model was overfitted (too optimistic). Various methods, including bootstrapping techniques exist for afterwards shrinking the regression coefficients and the model''s discrimination and calibration for overoptimism. Penalized maximum likelihood estimation (PMLE) is a more rigorous method because adjustment for overfitting is directly built into the model development, instead of relying on shrinkage afterwards. PMLE has been described mainly in the statistical literature and is rarely applied to empirical data. Using empirical data, we illustrate the use of PMLE to develop a prediction model. Methods: The accuracy of the final PMLE model will be contrasted with the final models derived by ordinary stepwise logistic regression without and with shrinkage afterwards. The potential advantages and disadvantages of PMLE over the other two strategies are discussed. Results: PMLE leads to smaller prediction errors, provides for model reduction to a user-defined degree, and may differently shrink each predictor for overoptimism without sacrificing much discriminative accuracy of the model. Conclusion: PMLE is an easily applicable and promising method to directly adjust clinical prediction models for overoptimism. [Copyright &y& Elsevier]
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- 2004
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11. COVID-19 ou non COVID-19 ? Comparaison des caractéristiques des patients hospitalisés pour une suspicion de COVID-19.
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Eberl, I., Rogier, T., Sixt, T., Moretto, F., Abdallahoui, M., Coussement, A., Behague, L., Chavanet, P., Blot, M., and Piroth, L.
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COVID-19 - Abstract
La propagation du Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) responsable de la Coronavirus Disease 2019 (COVID-19) a provoqué une crise sanitaire majeure. Si les signes cliniques, biologiques et scanographiques du COVID-19 ont été largement rapportés, on manque d'informations sur les patients ayant une suspicion de COVID-19 qui s'est révélée négative. L'utilisation de techniques de diagnostic avec un résultat rapide permet une orientation de plus en plus précoce, mais leur non-disponibilité et/ou les potentiels faux négatifs rendent nécessaires une meilleure distinction des patients avec une suspicion de COVID-19 non confirmée (SCNC) de ceux atteints de COVID-19. L'objectif de cette étude est de décrire et de comparer ces deux populations. Ceci doit permettre d'optimiser l'orientation et la gestion des patients suspects de COVID-19 requérant une hospitalisation pour limiter le risque de perte de chances. Une partie des patients avec indication d'hospitalisation pour suspicion de COVID-19 a été incluse rétrospectivement, du 23 février au 28 avril 2020. Le statut de SCNC était retenu lorsque la RT-PCR COVID-19 était négative et que le diagnostic final retenu était autre. Les données cliniques, biologiques et scanographiques, ainsi que les diagnostics finaux ont été recueillis. Ces données ont été comparées à celles des patients COVID-19 hospitalisés sur la même période. Parmi les 152 patients SCNC hospitalisés inclus, la moitié avait plus de 70 ans. Les comorbidités principales étaient l'hypertension artérielle (n = 63 ; 41,5 %), les maladies pulmonaires chroniques (n = 32 ; 21,1 %) et les cardiopathies ischémiques (n = 21 ; 13,8 %). Parmi les diagnostics finaux, 65 avaient une maladie infectieuse (42,7 %) : 38 infections respiratoires (25 %), 12 bactériémies (7,9 %) et 7 infections urinaires (4,6 %). Treize avaient une décompensation cardiaque (8,6 %). Ils avaient eu en moyenne 1,3 (0,7) RT-PCR. Comparés aux 222 patients COVID-19, les patients SCNC étaient plus souvent fumeurs (n = 28 [27,2 %] vs n = 8 [4,4 %], p < 0,001). Ils présentaient cliniquement moins de fièvre (n = 78 [51,3 %] vs n = 169 [76,1 %], p < 0,001), moins de toux (n = 76 [50,7 %] vs n = 146 [63,8 %], p < 0,003) et moins de signes digestifs (n = 18 [11,8 %] vs n = 66 [29,7 %], p < 0,001). Les taux de fibrinogène (g/L) et de CRP (mg/L) étaient significativement plus bas chez les SCNC avec des médianes respectives à 5,3 (4–6,5) vs 6,0 (5,3–6,8), p < 0,001, et 57,3 (13–126) vs 83,7 (37,7–127), p = 0,008. Leur taux médian de lymphocytes (G/L) était plus haut : 1,1 (0,7–1,7) vs 0,9 (0,6–1,4), p = 0,03. Il s'agit, à notre connaissance, de la première étude observationnelle comparative des patients avec indication d'hospitalisation pour suspicion de COVID-19. L'absence de symptomatologie respiratoire, de fièvre et de signes digestifs doit faire rechercher un diagnostic différentiel. Les signes respiratoires « isolés » associés au tabagisme chronique pourraient expliquer la surreprésentation des fumeurs chez des sujets fragiles faisant redouter par excès une COVID-19, plus qu'un rôle protecteur intrinsèque. La perte de chance engendrée par la suspicion de COVID-19 doit être explorée plus largement. [ABSTRACT FROM AUTHOR]
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- 2020
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12. Analyse de classification des uvéites secondaires aux inhibiteurs de check-points et aux inhibiteurs de la voie MAP-kinase (inhibiteurs de BRAF et MEK) à partir des cas issus de la base nationale de pharmacovigilance.
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Thibault, T., Auvens, C., Rogier, T., Muller, G., Turcu, A., Lecluse, J., Mouries-Martin, S., El Hssaini, N., Rajillah, A., Besancenot, J.F., Dautriche, A., Grandvuillemin, A., and Devilliers, H.
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Les uvéites d'origine médicamenteuse sont rares et représentent environ 0,3 à 0,5 % des cas d'uvéites. Depuis les années 2010, les inhibiteurs de check-points (ICI) et les inhibiteurs de la voie MAP-kinase (MAPKi), comprenant les inhibiteurs de BRAF (BRAFi) et les inhibiteurs de MEK (MEKi), expliquent la grande majorité des déclarations d'uvéites médicamenteuses. Or, ces molécules sont souvent associées les unes avec les autres au cours de la prise en charge du mélanome. Mettre en évidence des différences sémiologiques entre les atteintes secondaires à ces différentes molécules pourrait apporter des arguments importants au clinicien en cas d'atteinte menaçant le pronostic visuel et nécessitant l'arrêt du traitement responsable. L'objectif principal de notre étude était donc de comparer la sémiologie des uvéites secondaires aux MAPKi (BRAFi/MEKi) et aux ICI grâce à une analyse de classification. Une étude rétrospective multicentrique a été conduite à partir des cas enregistrés dans la base nationale de pharmacovigilance française. Cette base est alimenté depuis 1985 après collecte, analyse et validation de chaque observation par les médecins et pharmaciens de chacun des 31 centres régionaux de pharmacovigilance. Nous avons inclus les cas imputés à au moins un ICI ou à au moins un MAPKi (BRAFi/MEKi) et dont l'effet était enregistré sous les termes « uvéite », « choroïdite », « rétinite », « choriorétinine », « iritis », « iridocyclite », « pars planite » ainsi que les termes faisant référence à des complications directes des uvéites tels que « vascularite rétinienne », « décollement séreux-rétinien (DSR) », « œdème maculaire », « œdème papillaire » ou « papillite ». Les cas pour lesquels au moins un ICI et un MAPKi étaient imputables en même temps ont été exclus. Nous avons ensuite réalisé une analyse de classification ascendante hiérarchique sur la base des données sémiologiques ophtalmologiques comprenant : la latéralité, la localisation du segment atteint (antérieur, intermédiaire, postérieur, panuvéite), la présence de signes particuliers au niveau du segment postérieur (œdème papillaire, œdème maculaire, vascularite rétinienne, décollement séreux-rétinien), et le délai d'apparition depuis le début du traitement. Au total, 113 patients répondaient aux critères d'inclusion, dont 46 cas secondaires à un ICI et 67 cas secondaires à un MAPKi (BRAFi et/ou MEKi). L'âge médian (IQR) était de 61 (54–70) années. Tous les cas secondaires à un BRAFi/MEKi étaient traités pour un mélanome alors que pour le groupe des cas secondaires aux ICI l'indication était un mélanome dans 61 % des cas et un cancer broncho-pulmonaire dans 17 % des cas. Dans le groupe des ICI, la classe thérapeutique la plus souvent suspecte était un anti-PD1 alors que dans le groupe des MAPKi, les deux classes (BRAFi et MEKi) étaient toutes les deux suspectes dans 62 % des cas. L'atteinte était bilatérale dans plus de 80 % des cas. On observait une atteinte du segment antérieur dans 38 % des cas, du segment intermédiaire dans 8,9 % des cas (le plus souvent associée à une atteinte postérieure), du segment postérieur dans 38 % des cas et une panuvéite dans 31 % des cas. L'atteinte était décrite comme granulomateuse dans 9,7 % des cas et synéchiante dans 18 % des cas. Il y avait plus souvent une vascularite rétinienne (8,7 % vs 1,5 %) et un œdème papillaire (20 % vs 1,5 %) en cas d'atteinte secondaire à un ICI qu'en cas d'atteinte secondaire à un MAPKi. Quatre groupes homogènes de patients ont été définis par l'analyse de classification. Le groupe 1 (n = 44) correspondait à des uvéites antérieures associées aux ICI et aux BRAFi avec un délai médian (IQR) de 75 (36–152) jours. Le groupe 2 (n = 25) correspondait à des panuvéites associées aux ICI et aux BRAFi avec un délai médian (IQR) de 88 (35–168) jours. Le groupe 3 (n = 11) correspondait à des uvéites postérieures avec manifestations inflammatoires importantes (hyalite, œdème maculaire, vascularite rétinienne, neuropathie optique) associées aux ICI avec un délai médian (IQR) de 153 (62–428) jours. Le groupe 4 (n = 33) correspondait à des DSR bilatéraux associées aux MEKi, sans aucun autre signe ophtalmologique et de survenue très précoce avec un délai médian (IQR) de 20 (5–45) jours. Les ICI induisent des uvéites antérieures, mais aussi des panuvéites et des uvéites postérieures qui sont toutes deux associées à de franches complications inflammatoires (œdème maculaire, neuropathie optique et vascularite rétinienne). Les BRAFi sont associés à la survenue d'uvéites antérieures, difficilement différentiables de celles induites par les ICI. On retrouve aussi des panuvéites associées aux BRAFi mais qui se compliquent rarement de vascularite rétinienne et de neuropathie optique, contrairement aux ICI. Enfin, les MEKi sont responsables de DSR de survenue très précoce après le début du traitement. [ABSTRACT FROM AUTHOR]
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- 2022
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13. Updating meta-analyses leads to larger type I errors than publication bias
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Borm, George F. and Donders, A. Rogier T.
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META-analysis , *ESTIMATES , *CLINICAL trials , *MEDICAL errors , *MEDICAL publishing , *ERROR analysis in mathematics - Abstract
Abstract: Objective: To estimate the extent to which the practice of periodically updating meta-analyses causes inflation of the type I error and then to compare the estimate with the inflation caused by publication bias. We also present a simple method to adjust for the inflation associated with updating meta-analyses. Study Design and Setting: Simulations were used to estimate the error rates. Results: In general, updating meta-analyses caused 2- to 5-fold inflation of the type I error rates, which exceeded the inflation caused by publication bias. As a rule of thumb, the results of a meta-analysis are robust up to 5, 10, 15, or 22 updates, if the P-value multiplied by 4, 6, 8, or 10 remains below the desired significance level. Conclusion: Meta-analyses are likely to be updated until a clear conclusion is reached. Therefore, it is important to take the inflation of the error rate into account to interpret the results correctly. [Copyright &y& Elsevier]
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- 2009
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14. Adapted Bland-Altman method was used to compare measurement methods with unequal observations per case.
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Hofman, Cynthia S., Melis, Rene J. F., and Donders, A. Rogier T.
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WELL-being , *BLAND-Altman plot , *HEALTH outcome assessment , *REGRESSION analysis , *COMPARATIVE studies - Abstract
Objectives To describe an adjustment of the Bland-Altman approach to evaluate possible patterns of discord between two measurement methods with an unequal number of observations per case. Study Design and Setting Two methods of adaptation were compared using self-assessed general well-being scores (one individual rater) and scores given by multiple external raters for illustration. Both empirical data derived from the Older Person's Relevant Outcome of Care Score study and simulated data were used. Results When the mean of a number of assessments [View the MathML source[X] is compared with a single assessment [Y ], the variation [View the MathML source - Y ] (vertical axis) will be correlated with the mean of View the MathML source X and Y (horizontal axis) because the means of scores given by a larger group of raters tend to be less extreme than the scores given by individual raters. In contrast, in the absence of discord patterns, the variation [View the MathML source - Y] will not be correlated with the mean of all observations Xi and Yj made irrespective of who made them as denominator in the Bland-Altman plot. Thus, the second approach should be used for the valuation. Conclusion The Bland-Altman approach needs correct adaptations, else artificial biases may occur. [ABSTRACT FROM AUTHOR]
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- 2015
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15. Placebo Effects on Itch: A Meta-Analysis of Clinical Trials of Patients with Dermatological Conditions.
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van Laarhoven, Antoinette I M, van der Sman-Mauriks, Ineke M, Donders, A Rogier T, Pronk, Mathilde C, van de Kerkhof, Peter C M, and Evers, Andrea W M
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PLACEBOS , *ITCHING , *META-analysis , *CLINICAL trials , *DERMATOLOGY , *ATOPIC dermatitis - Abstract
Although placebo contributes to the effects of treatment for various symptoms and conditions, its effect on itch has rarely been investigated. In this meta-analysis, the magnitude of the placebo effect on itch was systematically investigated in clinical trials including patients with chronic itch due to atopic dermatitis, psoriasis, or chronic idiopathic urticaria. From searches in four databases, 34 articles were included in the quantitative analyses. Placebo treatment significantly decreased itch (1.3 out of 10, 95% confidence interval 1.02-1.61) compared with baseline itch (effect size 0.55), indicating that placebo effects have a considerable role in these patients' treatment. [ABSTRACT FROM AUTHOR]
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- 2015
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16. Efficacy and safety of palliative chemotherapy for patients with advanced breast cancer pretreated with anthracyclines and taxanes: a systematic review
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Oostendorp, Linda JM, Stalmeier, Peep FM, Donders, A Rogier T, van der Graaf, Winette TA, and Ottevanger, Petronella B
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BREAST cancer treatment , *CANCER chemotherapy , *PALLIATIVE treatment , *ANTHRACYCLINES , *SYSTEMATIC reviews , *DRUG efficacy , *ANTINEOPLASTIC agents - Abstract
Summary: No standard monotherapy or combination palliative chemotherapy currently exists for patients with advanced breast cancer pretreated with anthracyclines and taxanes. In this systematic review we assess the current knowledge on the efficacy and safety of palliative single-agent chemotherapy drugs—capecitabine, vinorelbine, gemcitabine, and liposomal doxorubicin—commonly used in daily clinical practice. We identified 22 studies, of which ten investigated capecitabine, nine investigated vinorelbine, three investigated gemcitabine, and one investigated liposomal doxorubicin. The greatest amount of information was available for capecitabine and vinorelbine. These two drugs showed good efficacy. The disease control rate differed significantly between the four drugs, which is relevant in terms of how well tumour symptoms can be improved and whether quality of life can be maintained or even improved. To obtain more evidence of the efficacy and safety of chemotherapeutic agents used in this pretreated population of advanced breast cancer patients, randomised comparisons of the various drugs, as monotherapy and in combination with targeted agents, are needed. [ABSTRACT FROM AUTHOR]
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- 2011
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17. Unpredictable bias when using the missing indicator method or complete case analysis for missing confounder values: an empirical example
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Knol, Mirjam J., Janssen, Kristel J.M., Donders, A. Rogier T., Egberts, Antoine C.G., Heerdink, E. Rob, Grobbee, Diederick E., Moons, Karel G.M., and Geerlings, Mirjam I.
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MISSING data (Statistics) , *EMPIRICAL research , *MULTIPLE imputation (Statistics) , *ETIOLOGY of diseases , *HEALTH facilities , *EPIDEMIOLOGY , *BIOMETRY - Abstract
Abstract: Objective: Missing indicator method (MIM) and complete case analysis (CC) are frequently used to handle missing confounder data. Using empirical data, we demonstrated the degree and direction of bias in the effect estimate when using these methods compared with multiple imputation (MI). Study Design and Setting: From a cohort study, we selected an exposure (marital status), outcome (depression), and confounders (age, sex, and income). Missing values in “income” were created according to different patterns of missingness: missing values were created completely at random and depending on exposure and outcome values. Percentages of missing values ranged from 2.5% to 30%. Results: When missing values were completely random, MIM gave an overestimation of the odds ratio, whereas CC and MI gave unbiased results. MIM and CC gave under- or overestimations when missing values depended on observed values. Magnitude and direction of bias depended on how the missing values were related to exposure and outcome. Bias increased with increasing percentage of missing values. Conclusion: MIM should not be used in handling missing confounder data because it gives unpredictable bias of the odds ratio even with small percentages of missing values. CC can be used when missing values are completely random, but it gives loss of statistical power. [Copyright &y& Elsevier]
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- 2010
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18. Is there a need to widely prescribe antibiotics in patients hospitalized with COVID-19?
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Moretto, F., Sixt, T., Devilliers, H., Abdallahoui, M., Eberl, I., Rogier, T., Buisson, M., Chavanet, P., Duong, M., Esteve, C., Mahy, S., Salmon-Rousseau, A., Catherine, F., Blot, M., and Piroth, L.
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COVID-19 , *MULTIVARIATE analysis , *PROPENSITY score matching , *COVID-19 treatment , *INTENSIVE care units - Abstract
• Antibiotics were prescribed to may patients with coronavirus disease 2019 during the first wave of the pandemic. • Bacterial co-infection seems to be rare, especially in patients who do not require transfer to an intensive care unit. • This study investigated the role of antibiotic therapy and its impact on prognosis. • Patients with more severe infection were often prescribed antibiotic therapy, but this had no impact on prognosis. • Antibiotic therapy should not be widely prescribed. Debate continues regarding the usefulness and benefits of wide prescription of antibiotics in patients hospitalized with coronavirus disease 2019 (COVID-19). All patients hospitalized in the Infectious Diseases Department, Dijon University Hospital, Dijon, France between 27 February and 30 April 2020 with confirmed COVID-19 were included in this study. Clinical, biological and radiological data were collected, as well as treatment and outcome data. An unfavourable outcome was defined as death or transfer to the intensive care unit. Patient characteristics and outcomes were compared between patients who did and did not receive antibiotic therapy using propensity score matching. Among the 222 patients included, 174 (78%) received antibiotic therapy. The univariate analysis showed that patients who received antibiotic therapy were significantly older, frailer and had more severe presentation at admission compared with patients who did not receive antibiotic therapy. Unfavourable outcomes were more common in patients who received antibiotic therapy [hazard ratio (HR) 2.94, 95% confidence interval (CI) 1.07–8.11; P = 0.04]. Multi-variate analysis and propensity score matching indicated that antibiotic therapy was not significantly associated with outcome (HR 1.612, 95% CI 0.562–4.629; P = 0.37). Antibiotics were frequently prescribed in this study and this was associated with more severe presentation at admission. However, antibiotic therapy was not associated with outcome, even after adjustment. In line with recent publications, such data support the need to streamline antibiotic therapy in patients with COVID-19. [ABSTRACT FROM AUTHOR]
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- 2021
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19. L'augmentation du pourcentage de lymphocytes Th17 est associée à un risque d'évolution vers une forme grave d'infection à SARS-CoV-2.
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Samson, M., Nicolas, B., Guilhem, A., Greigert, H., Ciudad, M., Cladiere, C., Straub, C., Blot, M., Piroth, L., Rogier, T., Devilliers, H., Manckoundia, P., Ghesquiere, T., Francois, S., Lakomy, D., Audia, S., and Bonnotte, B.
- Abstract
Depuis décembre 2019, plus de 20 millions de français ont été infectés par le SARS-CoV-2 et plus de 130 000 en sont décédés. La physiopathologie de cette infection n'est pas totalement élucidée. Il a été démontré qu'elle provoquait une importante sécrétion de cytokines pro-inflammatoires, en particulier d'interleukine-6 (IL-6) [1]. Lorsque les patients infectés sont hospitalisés, ils reçoivent généralement de la dexaméthasone et parfois un traitement anti-infectieux. Si la maladie s'aggrave, le tocilizumab peut être ajouté [2]. Actuellement, seule l'évolution clinique incite à débuter le tocilizumab, mais parfois trop tardivement. Il manque aux cliniciens un marqueur précoce leur permettant de prédire le risque d'aggravation de la maladie. Cette étude, menée chez des patients hospitalisés pour infection à SARS-CoV-2 pendant la 2e vague, avait pour objectif de rechercher un marqueur d'aggravation de la maladie en comparant la réponse lymphocytaire entre les patients évoluant vers une forme grave et les autres. Les patients hospitalisés pour infection à SARS-CoV-2 prouvée par RT-PCR datant de moins d'une semaine ont été inclus prospectivement dans cette étude monocentrique. Une infection grave était définie par un transfert en soins intensifs, en réanimation ou le décès. Des prélèvements sanguins ont été obtenus à l'admission à l'hôpital et avant de débuter la corticothérapie afin d'étudier les sous-populations lymphocytaires par cytométrie en flux et doser l'IL-6 plasmatique par immunofluorimétrie. Les données sont exprimées en nombre (%) ou médiane (espace inter-quartile). De septembre à décembre 2020, 37 patients (18 hommes, 19 femmes) hospitalisés pour infection à SARS-Cov2 ont été inclus : âge = 81,7 (70,3–87,5) ans, IMC = 25,7 (23,7–29) kg/m2, hypertension artérielle (54 %), diabète (24 %), dyslipidémie (35 %), tabagisme (24 %), cardiopathie ischémique (8 %), maladie cérébrovasculaire (11 %). La durée de suivi était de 10 (8–15) jours. Parmi les 37 patients inclus, 11 (30 %) ont présenté une infection à SARS-CoV-2 grave dont 4 transferts en réanimation et 8 décès. À l'admission, les patients ayant une infection évoluant vers une forme grave étaient plus âgés (p = 0,021), avaient une créatininémie plus élevée (p = 0,003) et une diminution du pourcentage de lymphocytes B (p = 0,04), de lymphocytes T (p = 0,009) et de lymphocytes T CD4+ (p = 0,004) circulants parmi les lymphocytes totaux comparativement aux patients dont l'évolution était favorable. Parmi les sous-populations lymphocytaires T étudiées (mémoires, naïfs, Th1, Th2, Th17, Treg, Tc1, Tc17, T CD8 cytotoxiques), il n'y avait pas de différence significative entre les deux groupes en dehors du pourcentage de lymphocytes Th17 à l'admission qui était deux fois plus élevé chez les patients dont l'infection évoluait vers une forme grave (0,44 vs 0,23 % des LT CD4 totaux ; p = 0,028). Chez les patients ayant une infection évoluant vers une forme grave, l'IL-6 plasmatique à l'admission était plus élevée (39 vs 13,1 pg/mL ; p = 0,018) et la CRP à l'admission avait tendance à être plus élevée sans atteindre le seuil de significativité (58 vs 18,5 mg/L ; p = 0,17). En analyse multivariée (régression logistique binaire comprenant les variables : âge, créatininémie, CRP, hémoglobine, lymphocytes T CD4, Th17, Treg activés (CD4 + CD45RA-FoxP3high), lymphocytes B, IL-6 sérique), la seule variable associée au risque d'évolution vers une forme grave de l'infection était le pourcentage de lymphocytes Th17 circulants (p = 0,034). L'aire sous la courbe de la courbe ROC évaluant la sensibilité et la spécificité du pourcentage de lymphocytes Th17 pour prédire une forme grave d'infection à SARS-CoV-2 chez un patient hospitalisé était de 0,75 (intervalle de confiance à 95 % : 0,56–0,95). Enfin, le fait d'avoir un pourcentage de lymphocytes Th17 > 0,435 % des lymphocytes T CD4 totaux au moment de l'admission en hospitalisation était associé à une moins bonne survie (p = 0,024). Cette étude suggère qu'une élévation du pourcentage de lymphocytes Th17 chez des patients hospitalisés pour infection à SARS-CoV-2 augmente significativement le risque d'évolution vers une forme grave de la maladie. Ce résultat est cohérent avec le fait qu'il a été démontré que le tocilizumab, qui est efficace dans le traitement des formes graves de COVID-19 [2] , inhibe la réponse lymphocytaire Th17 [3]. Ces données méritent d'être confirmées chez un plus grand nombre de patients afin de confirmer ce résultat car cette mesure pourrait permettre de mieux cibler la population de patients à qui proposer précocement un traitement par tocilizumab pour diminuer le risque d'évolution vers une forme grave d'infection à SARS-CoV-2. [ABSTRACT FROM AUTHOR]
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- 2022
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20. Anal human papillomavirus DNA in women at a colposcopy clinic
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D’Hauwers, Kathleen W.M., Cornelissen, Tine, Depuydt, Christophe E., Bogers, Johannes, Donders, A. Rogier T., Leuridan, Elke, Van Damme, Pierre, and Tjalma, Wiebren A.A.
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PAPILLOMAVIRUS diseases , *COLPOSCOPY , *DISEASE prevalence , *CYTOLOGY , *CERVICAL cancer , *CANCER in women , *POLYMERASE chain reaction - Abstract
Abstract: Objectives: To describe the type-specific prevalence of anal and cervical human papillomavirus (HPV) infections and the cytology in HIV-negative women without a history of cervical cancer, attending a colposcopy clinic. To examine if an HPV positive anal smear is related to anal pathology and consequently indicative for further examinations (high resolution anoscopy, anal biopsy). Study design: From 149 consecutive women an anal swab and a cervical swab were taken, using the Cervex-Brush®. The presence of 18 different HPV genotypes was determined using TaqMan-based real-time quantitative PCR targeting type-specific sequences of viral genes. From the fluid containing the cellular material, a liquid-based cytology sample was prepared of both collections with the robotic BD PrepStain™ Slide Processor. All slides were pre-screened by BD FocalPoint™ system and categorized from quintiles 1 to 5 and afterwards screened using targeted microscopic interpretation of selected suspicious fields using FocalPoint® guided screening review stations. The 2001 Bethesda System Terminology was used for the anal slides. Results: Ninety-six anal samples and all 149 cervical samples were adequate. Overall presence of HPV in the anus was 56.3% and in the cervix 53.7%. Overall, cytological abnormalities were found in 10.8% of anal smears and in 32.8% of cervical smears. HPV genotypes were identified in 47 samples on both sites: partial or complete concordance was found in 85.1%. HPV types 6, 16 and 18 were found in 27.9% and in 26.6% of the anal and cervical samples, respectively. The top three HPV types in the anus were 16, 51 and 39; in the cervix 16, 39, 51 and 56 (a shared 3rd place). HPV type 11 was not found. Conclusions: The presence of HPV genotypes is clearly multifocal in this study population of women attending a colposcopy clinic, with high concordance of genotypes. The number of anal HPV infections is high. Although cytological abnormalities are rare, the presence of HPV may lead to anal lesions later in life. From this perspective, complementary medical history and clinical examination of the anal region are advised. [Copyright &y& Elsevier]
- Published
- 2012
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