Practical Guide to Understanding Multivariable Analyses, Part B

Neely, J. Gail; Lieu, Judith E. C.; Sequeira, Sunitha M.; Graboyes, Evan M.; Paniello, Randal C.; Nussenbaum, Brian; Grindler, David J.; Voelker, Courtney C. J.

doi:10.1177/0194599812471500

Cited by 7 publications

(14 citation statements)

References 11 publications

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“…Conjunctive consolidation, a method of stratifying the data within clusters using cross-table analysis based on statistical isometry, was used post hoc to show the composite effect sizes of combined demographic variables on the primary outcome. 24,25 Through this method of stratified analysis, trends in the data are used to assess potential factors associated with high rates of DC. The composite effect size in conjunctive consolidation is a way of exploring interaction outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The association between demographic categories or quantities and the primary outcome (present or absent DC) was measured as proportion difference or median difference with the corresponding 95% CI. Conjunctive consolidation, a method of stratifying the data within clusters using cross-table analysis based on statistical isometry, was used post hoc to show the composite effect sizes of combined demographic variables on the primary outcome . Through this method of stratified analysis, trends in the data are used to assess potential factors associated with high rates of DC.…”

Section: Methodsmentioning

confidence: 99%

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Patients’ Views of Shared Decision-making and Decisional Conflict in Otolaryngologic Surgery During the COVID-19 Pandemic

Wamkpah

Gerndt

Kallogjeri

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE A patient's decision to undergo surgery may be fraught with uncertainty and decisional conflict. The unpredictable nature of the COVID-19 pandemic warrants further study into factors associated with patient decision-making.OBJECTIVE To assess decisional conflict and patient-specific concerns for people undergoing otolaryngologic surgery during the pandemic. DESIGN, SETTING, PARTICIPANTSThis prospective cross-sectional survey study was conducted via telephone from April 22 to August 31, 2020. English-speaking adults scheduled for surgery from a single academic surgical center were invited to participate. Individuals who were non-English speaking, lacked autonomous medical decision-making capacity, scheduled for emergent surgery, or had a communication disability were excluded. For race and ethnicity reporting, participants were classified dichotomously as White according to the Behavioral Risk Factor Surveillance System from the Centers for Disease Control and Prevention or non-White as a collective term including Black or African American, American Indian or Alaska Native, Asian, or Pacific Islander race and ethnicity.EXPOSURES The SURE Questionnaire (sure of myself, understand information, risks/benefits ratio, and encouragement) was used to screen for decisional conflict, with a total score greater than or equal to 3 indicating clinically significant decisional conflict. Participants were asked to share their specific concerns about having surgery. MAIN OUTCOME AND MEASURESDecisional conflict and patient demographic data were assessed via bivariate analyses, multivariable logistic regression and conjunctive consolidation. Patient-specific concerns were qualitatively analyzed for summative themes. RESULTSOf 444 patients screened for eligibility, 182 (40.9%) respondents participated. The median age was 60.5 years (interquartile range, 48-70 years). The racial and ethnic identity of the participants was classified as binary White (84% [153 of 182]) and non-White (16% [29 of 182]). The overall prevalence of decisional conflict was 19% (34 of 182). Decisional conflict was more prevalent among non-White than White participants (proportion difference 18.8%, 95% CI, 0.6%-37.0% and adjusted odds ratio 3.0; 95% CI, 1.2-7.4). Combining information from multiple variables through conjunctive consolidation, the group with the highest rate of decisional conflict was non-White patients with no college education receiving urgent surgery (odds ratio, 10.8; 95% CI, 2.6-45.0). Intraoperative and postoperative concerns were the most common themes expressed by participants. There was a clinically significant difference in the proportion of participants who screened positive for decisional conflict (30%) and expressed postoperative concerns than those who screened negative for decisional conflict (17%) (proportion difference, 13%; 95% CI, 1%-25%). Among patients reporting concerns about COVID-19, most screened positive for decisional conflict.CONCLUSIONS AND RELEVANCE Results of this cross-sectional survey study suggest t...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Patients’ Views of Shared Decision-making and Decisional Conflict in Otolaryngologic Surgery During the COVID-19 Pandemic

Wamkpah

Gerndt

Kallogjeri

et al. 2021

JAMA Otolaryngol Head Neck Surg

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show abstract

“…Conjunctive consolidation was performed to incorporate multiple variables and stratify data into a clinically meaningful classification system . This statistical technique created a classification predictive of poor posttreatment swallow function.…”

Section: Methodsmentioning

confidence: 99%

Predictors of swallow function after transoral surgery for locally advanced oropharyngeal cancer

et al. 2019

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Objective: Transoral surgery (TOS) for oropharyngeal carcinoma (OPC) is steadily becoming more routine. Expected posttreatment swallow function is a critical consideration for preoperative counseling. The objective of this study was to identify predictors of swallow dysfunction following TOS for advanced tumor (T)-stage (T3-T4) OPC.Methods: A retrospective review from 1997 to 2016 at a single institution was performed. Eighty-two patients who underwent primary transoral resection of locally advanced OPCs with at least 1 year of postoperative follow-up were included. The primary outcome measure was swallow function, as measured by the Functional Outcomes Swallowing Scale (FOSS) at 1 year postoperatively. Operative reports were reviewed, and the extent of resection and type of reconstruction were documented. Conjunctive consolidation was then performed to incorporate multiple variables and their impact on swallow function into a clinically meaningful classification system.Results: Fifty-six patients (68%) had acceptable swallowing at 1 year. T4 tumor stage and receipt of adjuvant chemoradiation therapy (CRT) were strongly associated with poor swallowing but did not reach statistical significance. Only base of tongue (BOT) resection ≥50% (odds ratio [OR] 3.19, 95% confidence interval [CI] 1.21-8.43) and older age (OR 1.06, 95% CI 1.00-1.12) were significantly associated. Utilizing T-stage, adjuvant CRT, and BOT resection, a conjunctive consolidation was performed to develop a classification system for swallow dysfunction at 1 year.Conclusion: This study provides risk stratification for swallow function at 1 year following primary transoral resection of locally advanced OPCs. BOT resection ≥50%, especially when coupled with T4 tumor stage or adjuvant CRT, was associated with poor long-term swallow outcomes.

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“…A method used sometimes, such as conjunctive consolidation, arranges data into clusters in a semi‐automated way (introducing knowledge of the investigator). It has been named ‘multivariable analysis’ because it uses data from multiple variables to ‘explain’ the behaviour of a very small number of outcomes (Neely et al ., ). In general, however, investigators aim at having an automatic way to construct clusters of relevant biological importance.…”

Section: Statistical Approachesmentioning

confidence: 99%

“…This is often displayed as involving matrices made of p items endowed of q qualities (commonly named variables), with p usually very large (or in ‘omics’ data often with q >> p as well). A good many multivariate analysis approaches exist to explore this type of data (Lebart et al ., ; Neely et al ., , ). Their role is to provide a statistical procedure to explore the data in a pertinent way.…”

Section: Statistical Approachesmentioning

confidence: 99%

No wisdom in the crowd: genome annotation in the era of big data – current status and future prospects

Danchin

Ouzounis

Tokuyasu

et al. 2018

Microbial Biotechnology

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SummaryScience and engineering rely on the accumulation and dissemination of knowledge to make discoveries and create new designs. Discovery‐driven genome research rests on knowledge passed on via gene annotations. In response to the deluge of sequencing big data, standard annotation practice employs automated procedures that rely on majority rules. We argue this hinders progress through the generation and propagation of errors, leading investigators into blind alleys. More subtly, this inductive process discourages the discovery of novelty, which remains essential in biological research and reflects the nature of biology itself. Annotation systems, rather than being repositories of facts, should be tools that support multiple modes of inference. By combining deduction, induction and abduction, investigators can generate hypotheses when accurate knowledge is extracted from model databases. A key stance is to depart from ‘the sequence tells the structure tells the function’ fallacy, placing function first. We illustrate our approach with examples of critical or unexpected pathways, using MicroScope to demonstrate how tools can be implemented following the principles we advocate. We end with a challenge to the reader.

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Practical Guide to Understanding Multivariable Analyses, Part B

Cited by 7 publications

References 11 publications

Patients’ Views of Shared Decision-making and Decisional Conflict in Otolaryngologic Surgery During the COVID-19 Pandemic

Patients’ Views of Shared Decision-making and Decisional Conflict in Otolaryngologic Surgery During the COVID-19 Pandemic

Predictors of swallow function after transoral surgery for locally advanced oropharyngeal cancer

No wisdom in the crowd: genome annotation in the era of big data – current status and future prospects

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