Best Practices for Using Median Splits, Artificial Categorization, and their Continuous Alternatives

Methodologists have long discussed the costs and benefits of using medians or other cut points to artificially turn continuous variables into categorical variables. The current paper attempts to provide a perspective on this literature that will be of practical use to experimental psychopathologists. After discussing the reasons that clinical researchers might use artificial categorization, we summarize the arguments both for and against this procedure. We then provide a number of specific suggestions related to the use of artificial categorization, including our thoughts on when researchers should use artificial categories, how their use can be justified, what continuous alternatives are available, and how the continuous alternatives should be used

Prenatal diagnosis of congenital toxoplasmosis: A multicenter evaluation of different diagnostic parameters

OBJECTIVE: Our purpose was to evaluate different methods of diagnosing congenital toxoplasmosis prenatally by amniocentesis and cordocentesis. STUDY DESIGN: In a retrospective multicenter study, we investigated consecutive women who had seroconversion for Toxoplasma gondii during pregnancy and who underwent either amniocentesis or cordocentesis or both to obtain a prenatal diagnosis of fetal toxoplasmosis. Data were obtained from 122 patients recruited in 6 different European Toxoplasma reference centers. Infants born to these mothers were followed up until 1 year of age to confirm or exclude congenital toxoplasmosis. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for the following parameters: (1) detection of the parasite in amniotic fluid by mouse inoculation, (2) detection of the parasite in amniotic fluid by in vitro cell culture, (3) detection of Toxoplasma deoxyribonucleic acid in amniotic fluid by a polymerase chain reaction assay, (4) detection of the parasite in fetal blood by mouse inoculation, (5) detection of specific immunoglobulin M antibodies in fetal blood, and (6) detection of specific immunoglobulin A antibodies in fetal blood. RESULTS: The polymerase chain reaction test performed on amniotic fluid had the highest level of sensitivity (81%) and also a high level of specificity (96%). The combination of the polymerase chain reaction test and mouse inoculation of amniotic fluid increased sensitivity to 91%. The sensitivity of immunoglobulins M and A in fetal blood was 47% and 38%, respectively. In congenitally infected fetuses a negative correlation was observed between positive serologic parameters and gestational age at the time of maternal infection and at prenatal diagnosis. CONCLUSION: Congenital toxoplasmosis is best predicted by prenatal examination with the combination of T gondii polymerase chain reaction and mouse inoculation of amniotic fluid. The role of cordocentesis in the diagnosis of congenital toxoplasmosis is limited.SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Staphylococcus aureus density on lesional and nonlesional skin is strongly associated with disease severity in atopic dermatitis

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Prise en charge de la douleur chronique en Belgique : organisation et financement

L’organisation et le financement par les pouvoirs publics des soins de santé concernant la gestion de la douleur chronique ont débuté en Belgique il y a une dizaine d’années. Plusieurs projets pilotes successifs ont été mis en place, évalués et adaptés. Actuellement, trois types d’équipes collaborent en réseau : (a) dans chaque hôpital général, une équipe algologique multidisciplinaire a principalement une fonction d’information et de formation du personnel soignant, (b) 35 centres multidisciplinaires de traitement de la douleur chronique proposent une approche biopsychosociale aux patients souffrant de douleur subaiguë ou chronique, (c) 13 équipes spécialisées en douleur pédiatrique ont une mission de sensibilisation et de formation des soignants concernant la douleur chez l’enfant. Une analyse préliminaire du rapport d’activité 2014 de ces équipes montre certaines difficultés. Cependant, la motivation des professionnels est élevée et ils considèrent que les projets sont bien adaptés aux besoins cliniques, notamment en améliorant l’accompagnement biopsychosocial des patients. Les besoins de formation de tous les soignants dans le domaine de la douleur, ainsi qu’une meilleure collaboration avec les médecins généralistes, sont soulignés.[Chronic pain management in Belgium: Organization and funding] The organization and funding of chronic pain management by public authorities began in Belgium about 10 years ago. Several successive pilot projects have been set up, evaluated and adapted. Nowadays, three types of teams are collaborating in network: (a) in every general hospital, an algologic multidisciplinairy team is mainly devoted to information and education of caregivers; (b) 35 multidisciplinary centres for chronic pain treatment offer a biopsychosocial approach to patients suffering from subacute or chronic pain; (c) 13 teams specialized in paediatric pain have a function of caregivers’ sensibilisation and education about pain in children. A preliminary analysis of the 2014 activity report of these teams shows some difficulties. However, the motivation of healthcare professionals is high and they consider the current projects to be well suited to the clinical needs, for example by improving the biopsychosocial accompaniment of the patients. Educational needs of every caregiver in the domain of pain are high, and a better collaboration with the general practitioners is recommended

A 4-days-on and 3-days-off maintenance treatment strategy for adults with HIV-1 (ANRS 170 QUATUOR): a randomised, open-label, multicentre, parallel, non-inferiority trial

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