Comparing the effects of two treatments on two ordinal outcome variables

When evaluating whether the effect of one treatment is larger than that of another the first step in the comparison is to decide what should be understood by the statement that one patient has achieved a greater effect than has another patient. When the outcome variable is quantitative, measured on a ratio scale, absolute or relative effects are the most commonly used effect measures; however, such effects are usually not meaningful for ordinal outcome variables. In order to answer the question whether one of two treatments acts more effectively on one of two outcome variables and the other treatment more efficiently on the other we shall present a method of comparing the treatment effects of patients that is based on pair-wise comparisons between patients in analogy with many non-parametrical methods. These comparisons use only the ordinal properties of the outcome variables. We shall even define a measure of the difference between the treatment effects and demonstrate how confidence intervals can be constructed

Self-rated health among very old people in European countries : An explorative study in Latvia and Sweden

Publisher Copyright: © The Author(s) 2015.Objectives: To explore and gain insight into factors related to self-rated health (SRH) among very old people in two European countries. Methods: The study was based on Latvian (n = 301) and Swedish (n = 397) data from the baseline of the Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing Survey Study. Besides descriptive statistics, ordinal regression analysis was used to analyze demographic, physical and mental health-related, functional and environmental factors related to SRH in each sample. Results: In both samples, participants with worse perceived physical mobility and more symptoms were significantly more likely to have worse SRH. There were more diverse results regarding other factors in terms of opposite relations to SRH, comparing the two samples. Discussion: Preventive measures and health care should focus on improving and supporting mobility and physical health among older people. Especially in countries with low scores on indicators of health such as Latvia, to minimize health inequalities. More attention should be paid to factors to improve the general health status of the population.publishersversionPeer reviewe

Alterations of prolyl endopeptidase activity in the plasma of children with autistic spectrum disorders

BACKGROUND: Prolyl Endopeptidase (PEP, EC 3.4.21.26), a cytosolic endopeptidase, hydrolyses peptide bonds on the carboxyl side of proline residue in proteins with a relatively small molecular weight. It has been shown that altered PEP activity is associated with various psychological diseases such as schizophrenia, mania and depression. Autistic Spectrum Disorders (ASD) are neuropsychiatric and behavioural syndromes affecting social behaviours and communication development. They are classified as developmental disorders. The aim of this study was to examine the hypothesis that PEP activity is also associated with ASDs. METHODS: Fluorometric assay was used to measure PEP activity in EDTA plasma in children with ASD (n = 18) aged 4–12 years (mean ± SD: 7.9 ± 2.5). These results were then compared to PEP activity in a control group of non-ASD children (n = 15) aged 2–10 years (mean ± SD: 6.4 ± 2.2). RESULTS: An alteration in PEP activity was found in the children with ASD compared to the control group. There was much greater variation of PEP activity in the group of ASD children when compared to the controls (SD= 39.9 and SD 9.6, respectively). This variation was significant (p < 0.0005), although the mean level of PEP activity in the group of ASD children was slightly higher than in the control group (124.4 and 134.1, respectively). CONCLUSION: Our preliminary finding suggests a role for PEP enzyme in the pathophysiology of autism but further research should be conducted to establish its role in the aetiology of psychiatric and neurological disorders, including autism and related spectrum disorders

On confidence regions induced by the Wilcoxon rank sum test

In the process of constructing a confidence region induced by the Wilcoxon two-sample test ties always appear. We show that, for various ways of handling ties, the confidence region will be an interval

On confidence regions induced by the Wilcoxon rank sum test

In the process of constructing a confidence region induced by the Wilcoxon two-sample test ties always appear. We show that, for various ways of handling ties, the confidence region will be an interval.Wilcoxon's rank sum test Ties Test-induced confidence region

Adjustment of a sparse and irregular reference rate matrix

Regional sex-specific rates of a rare disease often show conspicuous fluctuations over conventional strata of age and calendar time. In a cohort study, when such rates are used as references in the calculation of the expected number of cases, the accumulated person-time of the study cohort may somewhat haphazardly contribute to the result. For example, only the person-time observed in the strata with at least one reference case registered contnbutes to the expected number of cases. It may therefore be important to evaluate whether the regional rates seem to differ systematically from the more stable national rates. When such differences may be indicated, a fairly simple method is proposed for smoothing rates. This method aims to produce rates that better reflect the underlying, supposedly smooth, rate pattern over age and calendar time in a population of interest. The present paper illustrates the technique by considering right-sided colon cancer incidence rates from a regional male population, which the authors use to calculate the expected number of such cases in an occupational cohort

Occurrence of Depression in Families with Frontotemporal Dementia: A Family History Study.

Background: There are clinical similarities between frontotemporal dementia (FTD) and depression. The aim is to study co-aggregation of depression in families with FTD, indicating the existence of common aetiological factors. Methods: The study included 74 index patients with FTD and their 540 first-degree relatives above the age of 15 years. Occurrence of depression was studied at 3 different levels. Results: The incidence of depression in first-degree relatives of FTD patients was not higher than that of a general population. Occurrence of depression was not higher in families where parents had FTD compared to families with parents having no indications of FTD. Individuals with FTD had not suffered from depression to a greater extent than those without FTD. Conclusions: The hypothesis of a common aetiological factor of FTD and depression was not supported