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Gepubliceerd in: Quality of Life Research 10/2011

01-12-2011

Data mining for response shift patterns in multiple sclerosis patients using recursive partitioning tree analysis

Auteurs: Yuelin Li, Carolyn E. Schwartz

Gepubliceerd in: Quality of Life Research | Uitgave 10/2011

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Abstract

Aims

To examine evidence of QOL response shift in patients with multiple sclerosis (MS) using recursive partitioning tree analysis (RPART) technique.

Methods

Subjects: MS patients from the NARCOMS registry assessed an average of 6 times at a median interval of 6 months. Outcomes: SF-12v2 Physical & Mental Component Scores (PCS, MCS). Covariates: Patient-determined disease steps, Performance Scales, and symptomatic therapies. RPART trees were fitted separately by 3 disease-trajectory groups: (1) relapsing (n = 1,582); (2) stable (n = 787); and (3) progressive (n = 639). The resulting trees were interpreted by identifying salient terminal nodes that showed the unexpected quantitative patterns of contrasting MCS and PCS scores (e.g., PCS deteriorates but MCS is stable or improves), using a minimally important difference of at least 5 points on the SF-12v2. Qualitative indicators of response shift were different thresholds (recalibration), content (reconceptualization), and order (reprioritization) of disability domains in predicting PCS change by group.

Results

Overall, 20% of patients demonstrated response shift quantitatively, with 10% in the “progressive” cohort, 8% in the “relapsing” cohort, and 2% in the “stable” cohort. RPART trees differed qualitatively across disease-trajectory groups in patterns suggestive of recalibration, reprioritization, and reconceptualization. Disability subscales, but not symptom management, distinguished homogenous groups.

Conclusions

PCS and MCS change scores are obfuscated by response shifts. The contingent true scores for PCS change scores are not comparable across patient groups.
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Metagegevens
Titel
Data mining for response shift patterns in multiple sclerosis patients using recursive partitioning tree analysis
Auteurs
Yuelin Li
Carolyn E. Schwartz
Publicatiedatum
01-12-2011
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 10/2011
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-011-0004-7