Visual Field Progression in Glaucoma: Estimating the Overall Significance of Deterioration with Permutation Analyses of Pointwise Linear Regression (PoPLR)
Visual Field Progression in Glaucoma: Estimating the Overall Significance of Deterioration with Permutation Analyses of Pointwise Linear Regression (PoPLR)
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DOI：
10.1167/iovs.12-10049
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发表时间：
2012-10-01
影响因子：
4.4
通讯作者：
Artes, Paul H.
中科院分区：
文献类型：
--
作者：
O'Leary, Neil;Chauhan, Balwantray C.;Artes, Paul H.
目的。建立一种从个体患者数据中估计视野退化的总体统计意义的方法，并将其性能与点线性回归进行比较。截断乘积法用于计算统计S，该统计S结合了视野中各个测试位置的恶化证据。视野退化的总体统计学意义（P值）是通过对比S和其排列分布推断出来的，这是由视野序列的重复重排得出的。对青光眼患者（944眼，中位平均偏差-2.9 dB，四分位数间距：-6.3,-1.2 dB）随访4年以上（8年中位10次检查）的数据进行点线性回归（PoPLR）和点线性回归的排列评估。从该数据集的随机重新排序序列中估计假阳性率，并从原始序列中估计命中率（明显恶化的眼睛的比例）。PoPLR的假阳性率与相应的名义显著性水平难以区分，并且与基线视野损害和随访时间无关。在P < 0.05的情况下，PoPLR在第5次、第8次和期末的准确率分别为12%、29%和42%，在匹配特异性上均高于点线性回归。与基于人群的进展分析相比，PoPLR为特定患者的视野恶化提供了连续的统计显著性估计。这允许对特异性进行严密控制，这对于在临床实践和临床试验中监测患者至关重要。（Invest Ophthalmol Vis Sci. 2012; 53:6776-6784） DOI:10.1167/iovs.12-10049
PURPOSE. To establish a method for estimating the overall statistical significance of visual field deterioration from an individual patient's data, and to compare its performance to pointwise linear regression.METHODS. The Truncated Product Method was used to calculate a statistic S that combines evidence of deterioration from individual test locations in the visual field. The overall statistical significance (P value) of visual field deterioration was inferred by comparing S with its permutation distribution, derived from repeated reordering of the visual field series. Permutation of pointwise linear regression (PoPLR) and pointwise linear regression were evaluated in data from patients with glaucoma (944 eyes, median mean deviation -2.9 dB, interquartile range: -6.3, -1.2 dB) followed for more than 4 years (median 10 examinations over 8 years). False-positive rates were estimated from randomly reordered series of this dataset, and hit rates (proportion of eyes with significant deterioration) were estimated from the original series.RESULTS. The false-positive rates of PoPLR were indistinguishable from the corresponding nominal significance levels and were independent of baseline visual field damage and length of follow-up. At P < 0.05, the hit rates of PoPLR were 12, 29, and 42%, at the fifth, eighth, and final examinations, respectively, and at matching specificities they were consistently higher than those of pointwise linear regression.CONCLUSIONS. In contrast to population-based progression analyses, PoPLR provides a continuous estimate of statistical significance for visual field deterioration individualized to a particular patient's data. This allows close control over specificity, essential for monitoring patients in clinical practice and in clinical trials. (Invest Ophthalmol Vis Sci. 2012; 53:6776-6784) DOI:10.1167/iovs.12-10049