Method Development of Agreement Measures and Applications in Mental Health

描述(由申请人提供)：生物医学研究的一个基本和最重要的目标是建立对感兴趣的临床疾病的准确、有效的测量。这种疾病测量的准确性和有效性通常是通过评估多个观察者/时间点对对象进行的测量之间的相似性或通过与一些黄金标准(最佳可用的)测量进行比较来确定的。虽然评估测量准确性的方法学基础已经形成，但许多重要和具有挑战性的统计问题尚未解决，特别是在心理健康研究中。这些问题包括：(1)大多数现有方法仅适用于完整的未经审查的数据；(2)这些方法仅适用于在相同尺度上进行的两种测量；(3)这些方法不能广泛用于构造新的仪器或制定仪器的解释标准。 受心理健康研究的启发，我们首先提出了新的一致性测量方法，用于在存在不完整或被审查的观察的情况下评估一致性。与侧重于生存时间的现有衡量标准不同，新的指数是根据双变量风险函数或生存过程定义的，以满足处理审查的特殊需要，并回答关于一致的时间模式的问题(目标1)。在第二个目标中，我们建议扩大协议的概念，从而能够评估不同比额或不同类型文书之间的对应关系。我们将开发创新的统计方法来衡量当(A)两个标度是连续的和(B)一个标度是连续的而另一个是顺序的(目标2)时的广义一致性。在目标2开发的方法的基础上，我们将开发以下方法：(A)根据分类量表找到连续量表的可解释的切入点，以及(B)通过在现有工具中找到项目的最佳线性组合来开发新的心理工具，以便更准确地诊断糖尿病患者的主要抑郁(目标3)。最后，我们将通过开发方便用户的软件和创建一个网站来张贴出版物和带有用户手册的软件，向研究界传播我们的工作(目标4)。 这项建议旨在通过开发新的方法论、整合现有方法论并将这一努力瞄准重要的科学精神健康研究来改进精神健康研究的分析方法。这些发展将直接惠及心理健康研究，但它们的普遍性足以为统计实践做出普遍有用的贡献。公共卫生相关性：拟议的研究项目将开发新的分析方法，以提高心理健康研究中测量的准确性。我们开发了新的方法来创造新的工具，这些工具易于用于筛查抑郁症。我们还开发了分析方法，以确定昂贵、耗时的工具是否可以被廉价、易用的工具取代，用于诊断抑郁症。

DESCRIPTION (provided by applicant): A fundamental and foremost objective in biomedical research is to establish accurate, valid measurements of the clinical disease of interest. The accuracy and validity of such disease measurements are commonly established by assessing similarity between measurements made on a subject by multiple observers/time points or by comparing with some gold standard (best available) measurement. Although the foundation of the methodology for assessing accuracy of measurements has been formulated, many important and challenging statistical issues have not yet been resolved, particularly in mental health studies. These include: (1) most current methods are derived only for complete uncensored data, (2) the methods are applicable only when both measurements are made on the same scale, and (3) the methods are not widely used for constructing new instruments or developing interpretation criteria of instruments. Motivated by studies in mental health, we first propose new agreement measures for assessing agreement in the presence of incomplete or censored observations. Unlike existing measures that focus on survival times, the new indices are defined based on bivariate hazard functions or survival processes to address the special needs for handling censoring and to answer questions regarding the temporal pattern of agreement (Aim 1). In the second Aim, we propose to broaden the concept of agreement, thereby allowing for the assessment of the correspondence between instruments on different scales or of different types. We will develop innovative statistical methods to measure the broad sense agreement when (a) both scales are continuous and (b) one scale is continuous and the other is ordinal (Aim 2). Based on the methods developed in Aim 2, we will develop methods for (a) finding interpretable cut-points of a continuous scale in terms of a categorical scale and (b) developing a new psychological instrument by finding an optimal linear combination of items in an existing instrument for more accurate diagnosis of major depression among diabetes patients (Aim 3). Finally, we will disseminate our work to research communities by developing user-friendly software and creating a web site to post publications and software with user manuals (Aim 4). This proposal is designed to improve analytic methods for mental health research by developing new methodology, incorporating existing methodology and by targeting this effort toward important scientific mental health studies. These developments will directly benefit mental health research, but they are ubiquitous enough to be generally useful contributions to statistical practice. PUBLIC HEALTH RELEVANCE: The proposed research project will develop new analytical methods for improving the accuracy of measurements in mental health studies. We develop methods for creating new instruments that are easy to use for screening depression. We also develop analytic methods to determine whether expensive, time consuming instrument can be replaced by inexpensive, easy-to-use instrument for diagnosing depression.