Multiparameter evidence synthesis in epidemiology and medical decision-making: current approaches

Summary.  Alongside the development of meta-analysis as a tool for summarizing research literature, there is renewed interest in broader forms of quantitative synthesis that are aimed at combining evidence from different study designs or evidence on multiple parameters. These have been proposed under various headings: the confidence profile method, cross-design synthesis, hierarchical models and generalized evidence synthesis. Models that are used in health technology assessment are also referred to as representing a synthesis of evidence in a mathematical structure. Here we review alternative approaches to statistical evidence synthesis, and their implications for epidemiology and medical decision-making. The methods include hierarchical models, models informed by evidence on different functions of several parameters and models incorporating both of these features. The need to check for consistency of evidence when using these powerful methods is emphasized. We develop a rationale for evidence synthesis that is based on Bayesian decision modelling and expected value of information theory, which stresses not only the need for a lack of bias in estimates of treatment effects but also a lack of bias in assessments of uncertainty. The increasing reliance of governmental bodies like the UK National Institute for Clinical Excellence on complex evidence synthesis in decision modelling is discussed.     

Netzwerken: Reflexionen und Erfahrungen am Beispiel eines TrainerInnen und BeraterInnen-Netzwerkes

How are social networks organized and how much structure and openess do they have? The ambiguity of networking and the grade of organization are discussed and described theoretically and with an authentic example.     

Design optimization using ANOVA

This paper describes the design optimization of a robot sensor used for locating 3-D objects employing the Taguchi method in a computer simulation scenario. The location information from the sensor is to be utilized to control the movements of an industrial robot in a 'pick-and-place' or assembly operation. The Taguchi method, which is based on the Analysis-of-Variance (ANOVA) approach, is utilized to improve the performance of the sensor over a wider operating range. A review of the Taguchi method is presented along with step-by-step implementation details to identify and optimize the design parameters of the sensor. The method allows us to gauge the impact of various interactions present in the sensor system exclusively and permits us to single out those factors that have a dominant influence on the overall performance of the sensor. The investigation suggests that the Taguchi method is a more structured and efficient approach for achieving a robust design compared with the classical full factorial design approach.     

Still-births among the offspring of male radiation workers at the Sellafield nuclear reprocessing plant: detailed results and statistical aspects

Summary. This study investigates whether there was evidence of increasing risk of still-birth with increasing paternal exposure to ionizing radiation received during employment at the Sellafield nuclear installation before the child was conceived. A significant positive association is found between the total paternal preconceptional exposure to external ionizing radiation and the risk of still-birth (after adjustment for year of birth, social class, birth order and paternal age, odds ratio at 100 mSv 1.24 (95% confidence interval 1.04–1.45)). A summary of the principal scientific findings of this study has been published in the Lancet . This paper describes in detail the statistical methods that were used in the investigation and presents the results in full.     

Führung durch Selbstführung

This paper outlines the conceptual bases, strategies, and psychological attributes of leadership by self-leadership. In addition, relations to other theories of leadership are drawn. Dimensions and correlates of self-leadership competence are described and discussed. Various approaches for developing self-leadership competence are discussed as well.     

Spatial variation in soil inorganic nitrogen across an arid urban ecosystem

We explored variations in inorganic soil nitrogen (N) concentrations across metropolitan Phoenix, Arizona, and the surrounding desert using a probability-based synoptic survey. Data were examined using spatial statistics on the entire region, as well as for the desert and urban sites separately. Concentrations of both NO₃-N and NH₄-N were markedly higher and more heterogeneous amongst urban compared to desert soils. Regional variation in soil NO₃-N concentration was best explained by latitude, land use history, population density, along with percent cover of impervious surfaces and lawn, whereas soil NH₄-N concentrations were related to only latitude and population density. Within the urban area, patterns in both soil NO₃-N and NH₄-N were best predicted by elevation, population density and type of irrigation in the surrounding neighborhood. Spatial autocorrelation of soil NO₃-N concentrations explained 49% of variation among desert sites but was absent between urban sites. We suggest that inorganic soil N concentrations are controlled by a number of ‘local’ or ‘neighborhood’ human-related drivers in the city, rather than factors related to an urban-rural gradient.     

Sample sizes for estimation in clinical research

A sample size justification should be given for all clinical investigations. However, sometimes the objective of a trial is to estimate an effect with a view to planning a later definitive study. This paper describes the calculations for designing studies where one wishes to adopt an estimation approach through using confidence intervals around the overall response. Calculations are given for data anticipated to take a Normal form. Copyright © 2004 John Wiley & Sons, Ltd.     

Simple detection of outlying short time series

Sets of relatively short time series arise in many situations. One aspect of their analysis may be the detection of outlying series. We examine the performance of standard normal outlier tests applied to the means, or to simple functions of the means, of AR(1) series, not necessarily of equal lengths. Although unequal lengths of series implies that the means have unequal variances, that are only known approximately, it is shown that nominal significance levels hold good under most circumstances. Thus a standard outlier test can usefully be applied, avoiding the complication of estimating the time series' parameters. The test's power is affected by unequal lengths, being higher when the slippage occurs in one of the longer series