Treatment Choice With Trial Data: Statistical Decision Theory Should Supplant Hypothesis Testing

Abstract

A central objective of empirical research on treatment response is to inform treatment choice. Unfortunately, researchers commonly use concepts of statistical inference whose foundations are distant from the problem of treatment choice. It has been particularly common to use hypothesis tests to compare treatments. Wald’s development of statistical decision theory provides a coherent frequentist framework for use of sample data on treatment response to make treatment decisions. A body of recent research applies statistical decision theory to characterize uniformly satisfactory treatment choices, in the sense of maximum loss relative to optimal decisions (also known as maximum regret). This article describes the basic ideas and findings, which provide an appealing practical alternative to use of hypothesis tests. For simplicity, the article focuses on medical treatment with evidence from classical randomized clinical trials. The ideas apply generally, encompassing use of observational data and treatment choice in nonmedical contexts.     

Symptoms of Eating Disorders Among Females in Drug Addiction Treatment

The aim of this study is to measure and describe symptoms of eating disorders among females in treatment for drug addiction in Norway. Previous clinical and epidemiological studies have revealed coprevalence between eating disorders and substance use or abuse. However, few studies have measured eating disorders in drug-using samples and even fewer within the context of drug treatment. In this study, 29 females with drug use disorder in residential treatment were tested with the Eating Disorder Inventory–2. A subgroup of 9 females (31%) with significant symptoms of eating disorders was identified. The characteristics of this group and possible clinical consequences are discussed.     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

马克思主义教育实效分析——以武汉工业学院为例

通过对高校思想政治理论课教学的评价、学生对该课的参与程度,以及该课教学中存在的问题、改进意见和建议等情况进行调查,结果显示,教学内容、教师素质、教学方式是影响当前高校思想政治理论课教学效果的三个主要方面。     

基于超总体模型的设计效应分解

本文基于超总体模型研究抽样调查中设计效应的计算问题。首先以随机效应模型为基础，明确了简单随机、二阶段、不等概率和分层抽样对应的超总体模型，进而通过所给模型推导出分层、类集、加权单因素设计效应的计算公式和多因素组合的设计效应计算公式并给出了对应估计量，公式表明：多因素同时存在的组合设计效应等于对应单因素设计效应的乘积。最后，对设计效应的理论值、估计值和真实值之间的关系进行了蒙特卡洛仿真，并利用相对偏倚、相对均方误进行了评价。本文的研究，对复杂抽样设计中正确计算、使用设计效应具有指导意义。     

Robustness to non-normality and autocorrelation of individuals control charts

This paper studies the effects of non-normality and autocorrelation on the performances of various individuals control charts for monitoring the process mean and/or variance. The traditional Shewhart X chart and moving range (MR) chart are investigated as well as several types of exponentially weighted moving average (EWMA) charts and combinations of control charts involving these EWMA charts. It is shown that the combination of the X and MR charts will not detect small and moderate parameter shifts as fast as combinations involving the EWMA charts, and that the performana of the X and MR charts is very sensitive to the normality assumption. It is also shown that certain combinations of EWMA charts can be designed to be robust to non-normality and very effective at detecting small and moderate shifts in the process mean and/or variance. Although autocorrelation can have a significant effect on the in-control performances of these combinations of EWMA charts, their relative out-of-control performances under independence are generally maintained for low to moderate levels of autocorrelation.     

A fistful of euros: Is the German one‐euro job workfare scheme effective for participants?

Hohmeyer K, Wolff J. A fistful of euros: is the German one‐euro job workfare scheme effective for participants? Welfare reforms have constituted a major policy issue in many OECD countries in recent decades. In Germany, a major reform in 2005 emphasised the activation of welfare recipients and introduced a workfare programme –‘One‐Euro Jobs’– on a large scale. In the present study, the impact of one‐euro jobs on the employment prospects of different groups of participants was estimated. The analysis was conducted on a large sample of welfare recipients using propensity score matching. The sample of one‐euro job participants and other welfare recipients was drawn from administrative records comprising all those who started their participation in the programme in early 2005. Our results showed that participation slightly improved the medium‐term employment prospects for women but not for men. Participation reduced the employment rate of participants younger than 25 years but raised it for some of the older participant groups. In conclusion, one‐euro jobs are effective for participants who have been jobless for several years but ineffective for participants who were recently employed.     

《雷雨》人物对话研究

戏剧《雷雨》中有大量的人物对话,在刻画人物性格,表现人物内心世界,推进戏剧冲突方面起到了关键作用。文章主要以周萍为主线,考察他同繁漪、鲁侍萍的对话,对戏中人物对话进行审美分析。     

宗教、邪教与文化的挤占效应分析

从历史经验看,中国古代传统主流文化存在"信仰缺乏症",带有宗教特征的巫文化与主流文化结合,部分地满足了人们的宗教信仰需求,表现出对传统主流文化的占位效应。在当下中国,由于大量具有宗教情结人口的存在,宗教信仰作为一项次好的选择,能够发挥对邪教的文化挤出效应。     

An Additive–Multiplicative Restricted Mean Residual Life Model

The mean residual life measures the expected remaining life of a subject who has survived up to a particular time. When survival time distribution is highly skewed or heavy tailed, the restricted mean residual life must be considered. In this paper, we propose an additive–multiplicative restricted mean residual life model to study the association between the restricted mean residual life function and potential regression covariates in the presence of right censoring. This model extends the proportional mean residual life model using an additive model as its covariate dependent baseline. For the suggested model, some covariate effects are allowed to be time‐varying. To estimate the model parameters, martingale estimating equations are developed, and the large sample properties of the resulting estimators are established. In addition, to assess the adequacy of the model, we investigate a goodness of fit test that is asymptotically justified. The proposed methodology is evaluated via simulation studies and further applied to a kidney cancer data set collected from a clinical trial.