Detecting a clinically meaningful change in tic severity in Tourette syndrome: a comparison of three methods.
Detecting a clinically meaningful change in tic severity in Tourette syndrome: a comparison of three methods.
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DOI：
10.1016/j.cct.2013.08.012
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发表时间：
2013-11
影响因子：
2.2
通讯作者：
Scahill L
中科院分区：
文献类型：
--
作者：
Jeon S;Walkup JT;Woods DW;Peterson A;Piacentini J;Wilhelm S;Katsovich L;McGuire JF;Dziura J;Scahill L
比较基于维度测量(耶鲁全球抽动严重程度评分[YGTSS])和分类测量(临床总体印象改善[CGI-I])对阳性治疗反应进行分类的三种统计策略。患有抽动症或慢性抽动障碍的受试者(N=232；69.4%男性；年龄9-69岁)参加了两个为期10周的随机对照试验中的一个，比较行为疗法和支持性疗法。YGTSS和CGI-I由临床医生对治疗任务视而不见进行评定。我们检查了YGTSS-TIC总得分(TTS)相对于CGI-I的显著改善或非常显著改善的百分比，计算了信号检测分析(SDA)，并基于YGTSS-TTS的变化建立了混合模型来对维度反应进行分类。YGTSS-TTS的下降25%预示着在试验期间CGI-I的阳性反应。SDA显示，YGTSS-TTS降低25%可为预测阳性反应提供最佳的敏感性(87%)和特异性(84%)。使用不考虑CGI-I的混合模型，维度响应由YGTSS-TTS减少23%(或更多)来定义。行为干预对CGI-I量表阳性反应的优势比(OR=5.68，95%CI=[2.99，10.78])大于维度反应(OR=2.86，95%CI=[1.65，4.99])。YGTSS-TTS降低25%对所有三种分析方法的阳性反应都有很高的预测性。然而，对于训练有素的评分员来说，抽动的严重程度本身并不能推动对积极反应的分类。
To compare three statistical strategies for classifying positive treatment response based on a dimensional measure (Yale Global Tic Severity Scale [YGTSS]) and a categorical measure (Clinical Global Impression-Improvement [CGI-I]). Subjects (N=232; 69.4% male; ages 9-69 years) with Tourette syndrome or chronic tic disorder participated in one of two 10-week, randomized controlled trials comparing behavioral treatment to supportive therapy. The YGTSS and CGI-I were rated by clinicians blind to treatment assignment. We examined the percent reduction in the YGTSS-Total Tic Score (TTS) against Much Improved or Very Much Improved on the CGI-I, computed a signal detection analysis (SDA) and built a mixture model to classify dimensional response based on the change in the YGTSS-TTS. A 25% decrease on the YGTSS-TTS predicted positive response on the CGI-I during the trial. The SDA showed that a 25% reduction in the YGTSS-TTS provided optimal sensitivity (87%) and specificity (84%) for predicting positive response. Using a mixture model without consideration of the CGI-I, the dimensional response was defined by 23% (or greater) reduction on the YGTSS-TTS. The odds ratio (OR) of positive response (OR=5.68, 95% CI=[2.99, 10.78]) on the CGI-I for behavioral intervention was greater than the dimensional response (OR=2.86, 95% CI=[1.65, 4.99]). A twenty five percent reduction on the YGTSS-TTS is highly predictive of positive response by all three analytic methods. For trained raters, however, tic severity alone does not drive the classification of positive response.
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影响因子：
6.4
作者：
Kraft, Janne Tabori;Dalsgaard, Soren;Scahill, Lawrence
通讯作者：
Scahill, Lawrence
影响因子：
3.6
作者：
Storch, EA;Murphy, TK;Goodman, WK
通讯作者：
Goodman, WK
影响因子：
1.9
作者：
Storch, Eric A.;De Nadai, Alessandro S.;Murphy, Tanya K.
通讯作者：
Murphy, Tanya K.
影响因子：
7.2
作者：
Gilchrist, James M.
通讯作者：
Gilchrist, James M.
影响因子：
10.6
作者：
Kumra, Sanjiv;Kranzler, Harvey;Kane, John M.
通讯作者：
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