Analysis of repeated categorical data using generalized estimating equations

Lipsitz, Stuart R.; Kim, KyungMann; Zhao, Lueping

doi:10.1002/sim.4780131106

Cited by 398 publications

(283 citation statements)

References 17 publications

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“…Thus, erosion was more likely to be detected at 6 years if bone edema had been scored at baseline (OR 6.5, 95% CI 2.78-18.1). A more stringent repeated-measures analysis (22), which allowed for correlation between sites in the same person, still found baseline bone edema to be significantly predictive of erosion at 6 years (P ϭ 0.02). Examples of baseline bone edema proceeding to erosion at 6 years are shown in Figure 4.…”

Section: Resultsmentioning

confidence: 99%

Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis

McQueen¹,

Benton²,

Perry³

et al. 2003

Arthritis & Rheumatism

385

225

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Objective. Magnetic resonance imaging (MRI) is capable of revealing synovitis and tendinitis in early rheumatoid arthritis (RA), as well as bone edema and erosion. These features are visible before radiographic joint damage occurs. We sought to examine whether MRI of one body region (the wrist) can be used to predict whole-body radiography scores reflecting joint damage at 6 years.Methods. We conducted a 6-year prospective study of a cohort of patients who fulfilled the criteria for RA at presentation, using clinical parameters, radiographs, and MRI scans of the dominant wrist. Of the 42 patients enrolled at baseline, full MRI, radiographic, and clinical data were available for 31 at 6-year followup. MRI scans were scored by 2 radiologists, using a validated scoring system. Radiographs of the hands and feet were graded using the modified Sharp scoring method. MRI and radiography scores obtained at baseline and 6 years were compared, and baseline MRI scores were examined for their ability to predict radiographic outcome at 6 years.Results. At 6 years, the total Sharp score correlated significantly with the total MRI score and the MRI erosion score (r ‫؍‬ 0.81, P < 0.0001 and r ‫؍‬ 0.79, P < 0.0001, respectively). The 6-year Sharp score also correlated with the baseline total MRI and MRI erosion scores (r ‫؍‬ 0.56, P < 0.0001 and r ‫؍‬ 0.33, P ‫؍‬ 0.03, respectively). MRI synovitis and bone edema scores remained constant for the group as a whole over 6 years, but bone erosion scores progressed (P ‫؍‬ 0.0001), consistent with radiographic deterioration. Erosions on 6-year MRI scans were frequently preceded by MRI bone edema at baseline (odds ratio 6.5, 95% confidence interval 2.78-18.1). Regression models indicated that the baseline MRI bone edema score was predictive of the 6-year total Sharp score (P ‫؍‬ 0.01), as was the C-reactive protein (CRP) level (P ‫؍‬ 0.0002). Neither shared epitope status nor swollen or tender joint counts predicted radiographic outcome in this cohort. A model incorporating baseline MRI scores for erosion, bone edema, synovitis, and tendinitis plus the CRP level and the erythrocyte sedimentation rate explained 59% of the variance in the 6-year total Sharp score (R 2 ‫؍‬ 0.59, adjusted R 2 ‫؍‬ 0.44). Conclusion. MRI scans performed at the first presentation of RA can be used to help predict future radiographic damage, allowing disease-modifying therapy to be targeted to patients with aggressive disease.

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Section: Resultsmentioning

confidence: 99%

Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis

McQueen¹,

Benton²,

Perry³

et al. 2003

Arthritis & Rheumatism

385

225

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“…For this reason, a secondary repeated measures analysis was performed for each of the five items using a proportional odds model for the ordered multinomial response fit with generalized estimating equations implemented with an across-time working independence correlation structure (35)(36)(37). Each model included the stratification factors (number of jaws operated and presence of a genioplasty), visit (1 month, 3 months, and 6 months), the visit-by-exercise group interaction, as well as the primary explanatory variable, exercise group.…”

Section: Discussionmentioning

confidence: 99%

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Phillips

Essick

Preisser

et al. 2007

Journal of Oral and Maxillofacial Surgery

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Purpose-The primary research hypothesis was that the magnitude and duration of the perceived burden from altered sensation reported by patients following bilateral sagittal split osteotomy (BSSO) and trauma to the third division of the trigeminal nerve is lessened when facial sensory retraining exercises are performed in conjunction with standard opening exercises as compared to standard opening exercises alone.Subjects and Methods-186 subjects were enrolled in a multi-center double-blind two parallel group stratified block randomized clinical trial. Oral and facial pain, unusual sensations, numbness and loss of sensitivity, were scored from "no problem" to "serious problem" before surgery, 1,3, and 6 months after surgery.Analysis-A proportional odds model for the ordered multinomial response was used to compare the responses of the two exercise groups.Results-The two exercise groups did not differ significantly at any postsurgical time in the perceived problem level from mouth or face pain. The difference between the two groups at each visit was not statistically significant for unusual sensations although the trend was for the sensory retraining group to have a higher likelihood of reporting fewer problems. By 6 months, the likelihood of a subject reporting lower problem or interference level related to numbness or less lip sensitivity was significantly higher in the sensory-retraining group, approximately twice that of the opening exercise only group.Corresponding Author: Ceib Phillips, Professor, Department of Orthodontics, CB 7450, University of North Carolina, Chapel Hill, NC 27599, Telephone:(919)966-2763, Fax: (919)843-8864, Email: ceib_phillips@dentistry.unc.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

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“…As reported previously, for continuous variables (Somatic Distress, Mood Disturbance), an unbalanced, repeated measures mixed effects model was utilized, 16,17 whereas for ordinal variables (Activity), a generalized estimating equations model (GEE) was utilized. 17,18 In both models, time in weeks (ie weeks pre-or post transplant) is treated as a categorical variable. In the mixed model analyses, the main effects of time, predictor variable, and the interaction of predictor variable with time were examined.…”

Section: Methodsmentioning

confidence: 99%

Acute health-related quality of life in children undergoing stem cell transplant: II. Medical and demographic determinants

Phipps

Dunavant

Lensing

et al. 2002

Bone Marrow Transplant

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Summary:Medical and demographic variables were examined as predictors of acute health-related quality of life (HRQL), specifically, somatic distress, mood disturbance and activity levels, during the period of bone marrow transplant (BMT) hospitalization, and the transition phase in the months following hospital discharge. The responses of 153 children undergoing BMT were assessed by both parent report and patient self-report in a prospective longitudinal design. Type of transplant, diagnosis, age, gender, and socio-economic status (SES) were examined as predictor variables of patient outcome. Type of transplant, patient age, and SES emerged as significant determinants of patient response. Children undergoing unrelated donor (MUD) transplants experiencing the highest levels of distress, followed by those undergoing matched-sibling BMT, while those undergoing autologous transplant experienced the lowest levels of distress. Younger patients experienced lower levels of distress and better HRQL than older children and adolescents. Although patients from different SES backgrounds appeared very similar at the time of hospital admission, those from lower SES backgrounds demonstrated greater distress and disturbance in HRQL subsequently, and throughout the first 6 months post BMT. These findings help to target specific subgroups of patients that may be in greater need of preventive interventions or more aggressive supportive care. Bone Marrow Transplantation (2002) 29, 435-442. DOI: 10.1038/sj/bmt/1703376 Keywords: bone marrow transplant; children; hospitalization; distress; mood disturbance; quality of life It has been suggested that all of the necessary research regarding patient psychosocial and quality of life outcomes following bone marrow or stem cell transplantation (BMT)

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Analysis of repeated categorical data using generalized estimating equations

Cited by 398 publications

References 17 publications

Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis

Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis

Sensory Retraining After Orthognathic Surgery: Effect on Patients’ Perception of Altered Sensation

Acute health-related quality of life in children undergoing stem cell transplant: II. Medical and demographic determinants

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