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1.
本文的目的是介绍m∶n配对设计二值资料一水平多重Logistic回归分析方法。首先,介绍了需要了解的基本概念;其次,介绍了构建此类回归模型的基本原理;最后,通过一个实例介绍了使用SAS实现计算的全过程。在此过程中,获得了如下四点启示:其一,有必要确保所获得的科研资料是值得分析的;其二,有必要基于定量自变量产生派生变量;其三,有必要同时采用"逐步法""前进法"和"后退法"筛选自变量;其四,有必要采用多种方法评价不同回归模型对资料的拟合优度。  相似文献   

2.
本文目的是介绍高维表资料的种类及其对应的统计分析方法。基于结果变量的资料类型,常见的高维表资料可分为以下三类,即结果变量为二值变量、多值名义变量和多值有序变量。高维表资料的统计分析方法主要有两大类,第一类为广义差异性分析,内容包括"加权χ~2检验""CMH χ~2检验"和"Meta分析";第二类为回归分析,内容包括"对数线性回归模型分析""Logistic回归模型分析""Probit回归模型分析"和"离散选择模型分析"。  相似文献   

3.
本文目的是介绍非配对设计多值名义资料多水平多重logistic回归模型的构建与求解方法。首先介绍了有关的基本概念,涉及“多值名义结果变量”“分层或多水平数据结构”和“扩展的多重logistic回归模型”;其次,呈现了一个具有二水平结构的横断面调查资料,该资料涉及多个影响因素和一个多值有序的结果变量(在本文中,将其视为多值名义结果变量);最后,借助SAS中的两个过程(即GLIMMIX和NLMIXED)对给定的资料进行统计分析,即构建和求解“非配对设计多值名义资料多水平多重logistic回归模型”,并对相关结果进行比较和解释。  相似文献   

4.
非配对设计二值资料一水平多重Logistic回归分析   总被引:1,自引:0,他引:1       下载免费PDF全文
本文的目的是介绍非配对设计二值资料一水平多重Logistic回归模型的构建与求解方法。基于SAS软件分别对以列联表和数据库形式呈现的定性资料进行全面分析,并得出了4个对提高模型拟合优度很有价值的结论:第一,若资料以列联表形式呈现,应拟合"加权"Logistic回归模型;第二,若资料中包含定量自变量,不适合将其定性化;第三,若资料中包含定量自变量,应依据定量自变量和二值自变量产生出派生自变量;第四,若资料中有定性自变量时,必须将多值名义或有序自变量进行哑变量变换,不需要依据二值自变量产生出派生自变量。  相似文献   

5.
本文目的是介绍如何结合多水平模型分析,合理地进行多重Logistic回归分析的方法。第一,介绍了与多水平模型分析有关的4个基本概念。第二,介绍了构建多水平模型的3个步骤。第三,通过一个多中心药物临床试验的实例,介绍了如何用SAS软件进行分析的全过程,其内容如下:①检验各中心优势比之间是否具有齐性;②对试验中心产生哑变量后构建多重Logistic回归模型;③将试验中心视为分层变量构建多重Logistic回归模型;④构建随机截距多水平多重Logistic回归模型;⑤构建随机截距和随机斜率多水平多重Logistic回归模型。得到的结论是,当具有二值结果变量的各层级资料间存在差异时,最合适的做法是构建多水平多重Logistic回归模型。  相似文献   

6.
本文目的是介绍配对设计四格表资料的McNemar's χ~2检验及SAS和R软件实现。首先,提出配对设计四格表资料存在3种情形,即(1)特设"金标准"的配对设计四格表资料,值得进行统计分析;(2)缺乏"金标准"的配对设计四格表资料,不值得进行统计分析;(3)隐含"金标准"的配对设计四格表资料,值得进行统计分析。其次,以第1种情形的"问题与数据"为统计分析的对象,分别采用SAS与R软件进行差异性分析,得出了计算结果,对结果作了解释,并给出了统计和专业结论。  相似文献   

7.
本文目的是介绍非配对设计多值名义资料一水平多重logistic回归分析的基本原理、建模策略及注意事项。结合实例,应用SAS 9.4构建未经变量筛选和经变量筛选的多值名义资料多重logistic回归模型。通过回归分析的计算结果可知,同一变量的回归系数在不同logit函数中存在代数关系。多值名义多重logistic回归分析可以用来处理结果变量为多值名义变量的回归建模问题,并可以结合SAS实现对自变量的筛选,以获得简洁的回归模型。  相似文献   

8.
本文目的是介绍非配对设计二值资料多水平多重logistic回归模型的构建与求解方法。首先介绍模型的有关概念及模型的构建原理,基于实例使用SAS软件对列联表资料进行分析,以proc glimmix和proc nlmixed过程构建和求解模型,并对相关结果进行解释和比较。  相似文献   

9.
本文目的是介绍非配对设计多值有序资料一水平多重logistic回归模型的构建与求解方法。本文详细介绍了构建累积logistic回归模型的原理和具体方法,并结合实例介绍如何使用SAS软件中的LOGISTIC过程来拟合此回归模型,并对逐步回归法的输出结果进行了解释;其次讨论了有关构建累积logistic回归模型的过程中自变量筛选、模型评价以及拟合模型时需注意的问题。  相似文献   

10.
本文目的是介绍如何结合ROC曲线分析,合理地进行多重Logistic回归分析的方法。第一,介绍了与ROC曲线分析有关的两组基本概念,即常用诊断指标的统计描述和诊断资料的ROC曲线分析方法。第二,介绍了ROC曲线分析中的核心内容,即ROC曲线下面积的计算和多条ROC曲线下面积的比较。第三,通过一个诊断试验的实例,介绍了如何用SAS软件进行分析的全过程,内容如下:①仅采用多重Logistic回归分析;②基于多重Logistic回归分析,再结合ROC曲线分析。得到的结论是,对于诊断试验资料,将多重Logistic回归分析与ROC曲线分析结合起来,可以获得更丰富、更合理的统计分析结果。  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
Diagnostic Difficulties and Treatment Implications   总被引:1,自引:0,他引:1  
Robert J. Gumnit 《Epilepsia》1987,28(S3):S9-S13
Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.  相似文献   

13.
Cognitive Dysfunction Associated with Antiepileptic Drug Therapy   总被引:7,自引:5,他引:2  
Eileen P.G. Vining 《Epilepsia》1987,28(S2):S18-S22
Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.  相似文献   

14.
B. J. Wilder 《Epilepsia》1987,28(S2):S1-S7
Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.  相似文献   

15.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

16.
Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.  相似文献   

17.
Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.  相似文献   

18.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

19.
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.  相似文献   

20.
Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity   总被引:5,自引:1,他引:4  
G. Trube  R. Netzer 《Epilepsia》1994,35(S5):S62-S67
Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.  相似文献   

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