A number of statistical textbooks recommend using an analysis of covariance (ANCOVA) to control for the effects of extraneous factors that might influence the dependent measure of interest. However, it is not generally recognized that serious problems of interpretation can arise when the design contains comparisons of participants sampled from different populations (classification designs). Designs that include a comparison of younger and older adults, or a comparison of musicians and non-musicians are examples of classification designs. In such cases, estimates of differences among groups can be contaminated by differences in the covariate population means across groups. A second problem of interpretation will arise if the experimenter fails to center the covariate measures (subtracting the mean covariate score from each covariate score) whenever the design contains within-subject factors. Unless the covariate measures on the participants are centered, estimates of within-subject factors are distorted, and significant increases in Type I error rates, and/or losses in power can occur when evaluating the effects of within-subject factors. This paper: (1) alerts potential users of ANCOVA of the need to center the covariate measures when the design contains within-subject factors, and (2) indicates how they can avoid biases when one cannot assume that the expected value of the covariate measure is the same for all of the groups in a classification design.

Background: Little research has focused on implementation of electronic Patient Reported Outcomes (e-PROs) for meaningful use in patient management in 'real-world' oncology practices. Our quality improvement collaborative used multi-faceted implementation strategies including audit and feedback, disease-site champions and practice coaching, core training of clinicians in a person-centered clinical method for use of e-PROs in shared treatment planning and patient activation, ongoing educational outreach and shared collaborative learnings to facilitate integration of e-PROs data in multi-sites in Ontario and Quebec, Canada for personalized management of generic and targeted symptoms of pain, fatigue, and emotional distress (depression, anxiety). Patients and methods: We used a mixed-methods (qualitative and quantitative data) program evaluation design to assess process/implementation outcomes including e-PROs completion rates, acceptability/use from the perspective of patients/clinicians, and patient experience (surveys, qualitative focus groups). We secondarily explored impact on symptom severity, patient activation and healthcare utilization (Ontario sites only) comparing a pre/post population cohort not exposed/exposed to our implementation intervention using Mann Whitney U tests. We hypothesized that the iPEHOC intervention would result in a reduction in symptom severity, healthcare utilization, and higher patient activation. We also identified key implementation strategies that sites perceived as most valuable to uptake and any barriers.

While speakers have been shown to adapt to the knowledge state of their addressee in choosing referring expressions, they often also show some egocentric tendencies. The current paper aims to provide an explanation for this "mixed" behavior by presenting a model that derives such patterns from the probabilistic combination of both the speaker's and the addressee's perspectives. To test our model, we conducted a language production experiment, in which participants had to refer to objects in a context that also included a visually misleading object (e.g., a crayon shaped like a Lego brick) whose function was either known to both partners, or known just to the speaker but not the addressee. Modeling results indicate that the experimental findings cannot be explained by assuming that speakers tailor a referring expression solely to their own perspective or to the perspective of their addressee. Instead, accounting for the behavioral pattern requires an approach where both perspectives influence the choice of referring expressions. Nevertheless, in our situation, speakers consider their partner's perspective more than their own.

A central claim in research on interactive conversation is that listeners use the knowledge assumed to be shared with a conversational partner to guide their understanding of utterances from the earliest moments of processing. In the present study we investigated whether this claim extends to cases where shared vs. private knowledge is discrepant in terms of the identity assigned to a mutually seen object that could be misidentified on the basis of its appearance. Eye movement measures were used to evaluate listeners' ability to integrate a speaker's perspective as they identified the referent for an unfolding expression. The results reconfirmed previous findings showing that listeners can rapidly take into account a speaker's awareness of the existence/presence of a referential object. In contrast, however, listeners showed strong consideration of their private knowledge about the identity of an object during referential processing. Strikingly, this tendency was found even when speaker-produced discourse reinforced the way in which the speaker's understanding of the object's identity differed from that of the listener. Together, the results reveal clear and important differences in the way in which distinct types of perspective-based cues are integrated in real-time communicative interaction.

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