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Evidence of changes in sural nerve conduction mediated by light emitting diode irradiation.

The introduction of light emitting diode (LED) devices as a novel treatment for pain relief in place of low-level laser warrants fundamental research on the effect of LED devices on one of the potential explanatory mechanisms: peripheral neurophysiology in vivo. A randomised controlled study was conducted by measuring antidromic nerve conduction on the peripheral sural nerve of healthy subjects (n=64). One baseline measurement and five post-irradiation recordings (2-min interval each) were performed of the nerve conduction velocity (NCV) and negative peak latency (NPL). Interventional set-up was identical for all subjects, but the experimental group (=32) received an irradiation (2 min at a continuous power output of 160 mW, resulting in a radiant exposure of 1.07 J/cm(2)) with an infrared LED device (BIO-DIO preprototype; MDB-Laser, Belgium), while the placebo group was treated by sham irradiation. Statistical analysis (general regression nodel for repeated measures) of NCV and NPL difference scores, revealed a significant interactive effect for both NCV (P=0.003) and NPL (P=0.006). Further post hoc LSD analysis showed a time-related statistical significant decreased NCV and an increased NPL in the experimental group and a statistical significant difference between placebo and experimental group at various points of time. Based on these results, it can be concluded that LED irradiation, applied to intact skin at the described irradiation parameters, produces an immediate and localized effect upon conduction characteristics in underlying nerves. Therefore, the outcome of this in vivo experiment yields a potential explanation for pain relief induced by LED.

Adolescent↗

Investigating moderator hypotheses in aging research: statistical, methodological, and conceptual difficulties with comparing separate regressions.

Many topics in aging research address questions about group differences in prediction. Such questions can be viewed in terms of interaction or moderator effects, and use of appropriate methods to test these hypotheses are necessary to arrive at accurate conclusions about age differences. This article discusses the conceptual, methodological, and statistical problems in one approach to investigating moderator hypotheses. The subgroup regression approach, in which separate regression analyses are conducted in two or more groups, is widely used in aging research to examine group differences in prediction, but the approach can lead to erroneous conclusions. The moderated regression approach, involving the test of a product term, is described and recommended as an a alternative approach. The question of whether social support has greater beneficial effects for younger or older adults is investigated in a study of 287 recently-bereaved adults ranging in age from 20 to 91. Using the subgroup approach, findings indicated that social support significantly predicted depressive symptoms among younger adults and did not significantly predict depressive symptoms among older adults. The moderated regression analysis, however, indicated no significant age differences in the effect of social support. These results clearly illustrate that the analysis strategy researchers choose may have important bearing on theory in aging research such as conclusions regarding the role of social support across the life span.

Adult↗

A research to develop a predicting system of mammalian subacute toxicity. I. Prediction of subacute toxicity using the biological parameters of acute toxicities.

Predicting equations of subacute toxicity were developed by analyzing rat acute and subacute toxicity data of 56 chemicals of various structures. Minimum or 10% effect level in acute or subacute toxicity was estimated as a "biological parameter". Good regression equations were established between the geometrical means ("combined parameters") of any two of the parameters of acute and subacute toxicities and introduction of log P to the equations improved the correlations with a statistically significant multiple regression coefficient. The lowest predicted effect level of the subacute toxicity, which is selected from the data calculated by the above several correlations, can predict the upper limit of the no observed effect level. In recent years, for research and development of new chemical substances, it becomes one of the important factors that these have a lower environmental load in nature. Eventually, it becomes essential to evaluate not only their acute effects on human or environments, but also their chronic influences when they are to be exposed for a long period of time, and the cost for such verification is becoming a breaking factor for research and development. Thus, the development of a new technique which estimates the environmental load of a chemical substance including toxic effects on human with lower cost is now being attempted. For example, the development of in vitro new alternative methods using cultured cells, the utilization of a data base or software which relates mammalian and environmental toxicities and so on are internationally carried forwards. As for the latter, quantitative structure-activity relationship (QSAR) techniques have been applied practically to decide appropriate toxicity tests needed for regulatory purposes by EPA/TSCA, ITC/TSCA and FDA/FDAA in the USA. In addition, it was concluded recently in a joint meeting of EU and US-EPA that the approach by QSAR techniques was useful to specify the new chemical substances which are to be required toxicological examinations. In these QSAR techniques, however, while there are some considerations about common mechanisms of toxicity among chemicals with a similar structure (Congeneric chemicals, Congeners) for establishing of correlation formulas, for chemicals with various structures (Non-congeneric chemicals, Non-congeners) there often lack such common considerations. In addition, biological or physiological factors which are basic toxic indices are often ignored. In a previous study, we researched acute and subacute oral toxicities of industrial common chemicals in rats and reported the followings; 1) their subacute toxicological spectrum in target organs/tissues and morphologic changes was very limited and specific, 2) the important targets were liver, kidneys, blood (spleen) and stomach and these are considered the sites of dominant exposure due to the kinetics of chemical substances, 3) the morphological changes were hepatocellular hypertrophy, deposition of substance in renal tubules, extramedullary hematopoiesis in spleen and mucous lesion in stomach, and these are implying adaptation such as induction of drug-metabolizing enzymes, overload to renal function, anemia from erythrocyte destruction, and direct reaction, respectively, 4) there seems to occur a series of direct and adaptive reactions to exclude the "foreign compounds" which do not show any specific biological activities, 5) it is also considered that there is a possibility to establish a correlation between toxicological findings or target organs/tissues of both acute and subacute toxicities by their continuity. Therefore, in the present study, a predicting equation of subacute (28-day repeated dose) toxicity is attempted to develop from acute (single dose) toxicity data by considering both common mechanisms and biological factors for non-congeneric industrial chemical substances.

Animals↗

Influence of body composition on physical activity validation studies using doubly labeled water.

This study investigated the influence of two approaches (mathematical transformation and statistical procedures), used to account for body composition [body mass or fat-free mass (FFM)], on associations between two measures of physical activity and energy expenditure determined by doubly labeled water (DLW). Complete data for these analyses were available for 136 African American (44.1%) and Hispanic (55.9%) women (mean age 50 +/- 7.3 yr). Total energy expenditure (TEE) by DLW was measured over 14 days. Physical activity energy expenditure (PAEE) was computed as 0.90 x TEE - resting metabolic rate. During week 2, participants wore an accelerometer for 7 consecutive days and completed a 7-day diary. Pearson's product-moment correlations and three statistical procedures (multiple regressions, partial correlations, and allometric scaling) were used to assess the effect of body composition on associations. The methods-comparison analysis was used to study the effect of body composition on agreement. The statistical procedures demonstrated that associations improved when body composition was included in the model. The accelerometer explained a small but meaningful portion of the variance in TEE and PAEE after body mass was accounted for. The methods-comparison analysis confirmed that agreement with DLW was affected by the transformation. Agreement between the diary (transformed with body mass) and TEE reflected the association that exists between body mass and TEE. These results suggest that the accelerometer and diary accounted for a small portion of TEE and PAEE. Most of the variance in DLW-measured energy expenditure was explained by body mass or FFM.

Adult↗

Near infrared spectroscopy assessment of the glucose solution processed by ultrasonic cavitation.

The near infrared (NIR) absorption was investigated on the glucose aqueous solutions with various optical pathlengths (PLs) and processed by ultrasonic cavitation. In water, the strong absorption peak at a wavelength of 1430 nm, appeared in the case of short PL, was separated into several peaks in the case of wide PL due to increasing the number of H(2)O clusters. In a d(+) glucose solution, it was seen that NIR absorption was reduced at peculiar wavelengths of 970 nm and 1130 nm and its profile changed in a capricious manner in the region from 1300 nm to 1600 nm. The cavitation generated lots of OH(-) ion in water and made the capricious absorption profile regularly graded with the cavitation time toward less-absorptive direction. These effects are supposed to be caused by the dipole moments of H(2)O clusters arranged by the interaction between them and generated basic OH ions. The statistical principal component regression (PCR) and partial least-squares (PLS) regression demonstrated that the treatment of UC was helpful to enhance the glucose sensitivity.

Algorithms↗

An unbiased errors-in-variables approach to detecting unconscious cognition.

Greenwald, Klinger and Schuh (1995) have proposed a regression approach for detecting unconscious cognition. An errors-in-variables approach is presented that corrects for measurement error in the predictor and takes into account that the latent predictor variable is assumed to be non-negative. The new approach requires the same input as the uncorrected regression analysis and provides consistent estimates of regression weights as well as valid statistical tests of their significance. In particular, the method yields a consistent estimate of the regression intercept that provides critical evidence for unconscious cognition. A simulation study illustrates these aspects of the new technique. Several data sets are then reanalysed by means of the new method.

Algorithms↗

Investigations on neurotoxicity of chemical substances at the workplace. V. Determination of the motor and sensory nerve conduction velocity in persons occupationally exposed to lead.

A cross-sectional study was performed in order to investigate the influence of chronic lead-exposure on the peripheral nervous system. We examined 148 male workers of a storage battery manufacturing plant, who had been exposed to lead metal and inorganic lead compounds for 1 to 28 years (mean 11 years). Fifteen workers with non-occupational risks of peripheral neuropathy (former diseases, alcohol abuse, medication) were excluded from the study. The investigation program comprised: case history, physical examination, analyses of blood- and urine-samples and determination of maximal motor, mixed and sensory conduction velocity (NCV) of the ulnar and median nerve of the right forearm. Objectively no worker showed any signs of health effects related to lead exposure. The "Biological Monitoring" included the determination of (1) Blood-lead level (Pb-B), (2) Free erythrocyte porphyrins (FEP), (3) delta-Aminolevulinic acid dehydratase (ALA-D) and (4) delta-Aminolevulinic acid in urine (ALA-U). Further "time-weighted-average (TWA)"-values of Pb-B were calculated on the basis of several determinations over the period 1975-1981. The following "actual" ("TWA") median values resulted: Pb-B 53 micrograms/dl (54 micrograms/dl), ALA-U 5.6 mg/l (8.4 mg/l), FEP 2.0 mg/l (2.0 mg/l). The "Biologischer Arbeitsstoff Toleranz Wert (BAT)" of 70 micrograms/dl for Pb-B was exceeded in 15 workers (11%), and of 15 mg/l for ALA-U in 30 cases (23%). In comparison with age-matched controls, the lead workers showed a mild slowing of NCV with mean values between 0.8 and 2.0 m/s. Multiple stepwise regression analyses revealed statistically significant correlations between the four NCV and age as well as Pb-B. There were better correlations by using "TWA" than "actual" data of Pb-B. Consideration of the results of the regression analyses, together with an evaluation of the individual neurophysiological status as a function of internal lead exposure, a "dose-effect-relationship" was found only in the case of Pb-B exceeding 70 micrograms/dl. From our study it is concluded that chronic lead exposure resulting in blood-lead levels of below 70 micrograms/dl is no occupational risk causing a functionally significant slowing of nerve conduction velocities.

Adult↗

A quantile plot for simultaneous representation of clinical and statistical attributes of probing change: application to early identification of the downhill patient.

When multiple periodontal sites are observed in patients over time there is an intention to identify those sites where there is important change, typically loss of attachment or increase in probing depth. A change may be declared if it: (a) exceeds a threshold level, and/or (b) is determined to be statistically significant (e.g. regression slope different from zero), perhaps after (c) that significance level has been corrected for multiple testing. These criteria are not often considered when clinical or research decisions are made and there is no universal protocol for their evaluation. A quantile (uniform probability) plot, modified to incorporate additional information, is proposed as a graphical method for the display of changes at multiple sites within a mouth. This plot identifies, for each site, clinical changes beyond a threshold, site-wise statistical significance and statistical significance adjusted for multiple testing. These alternative criteria for attachment change are, thereby, made explicit, providing a detailed evaluative context. In addition, this methodology permits incorporation of an estimation procedure for the number of sites for which the null hypothesis of no change is false. This statistic can provide evidence of progressive disease even when no site has significant clinical or statistical change and even if the average change is zero. Use of the quantile plot was elucidated by application to simulated data, and to a clinical dataset using a BASIC program to automate the computational process. In the clinical example presented, the approach appeared more effective in detecting periodontal change than traditional clinical and statistical criteria. Pending technical refinement, this graphical approach may represent a new tool for the early identification of the downhill patient.

Adult↗

Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study.

BACKGROUND: This clinical controlled study was designed to measure the tension of coronally advanced flaps (CAF) performed to treat shallow gingival recessions and to compare the recession reduction (Rec Red) achieved in a test group (flaps with tension) and in a control group (flaps without tension) 3 months after surgery. METHODS: Eleven patients, aged 22 to 41 years, with high levels of oral hygiene (full mouth plaque score <20%) were selected for the study. Each patient showed 2 bilateral Miller Class I maxillary or mandibular gingival recessions located on homologous teeth. A total of 22 recessions were treated. The recession depth at the right site was similar to that at the left site (difference < or =1 mm). For each patient, the 2 recessions underwent CAF procedure in the same surgical session. Before suturing, the residual tension (FTens) of both right and left flaps was measured with a dynamometer. Then, one site was randomly assigned to the test group and the contralateral site to the control group. In the test site the flap was sutured. In the control site the flap was further relaxed, the tension was measured again, and the flap was sutured. RESULTS: In the test group (with tension) the initial mean recession depth was 2.82 +/- 0.64 mm and mean FTens was 6.5 g, while in the control group (without tension) the initial mean recession depth was 2.68 +/- 0.81 mm and mean FTens was 0.4 g. Three months later, the test group showed a mean recession reduction of 2.18 +/- 0.60 mm, a mean percent root coverage of 78 +/- 15%, and complete root coverage was achieved on 2 teeth (18%). In the control group the mean recession reduction was 2.32 +/- 0.81 mm and mean percent root coverage was 87 +/- 13%. Complete root coverage was obtained on 5 teeth (45%). The difference of recession reduction between the test and control group was not statistically significant (P = 0.3911). In the test group, linear regression analysis showed a statistically significant association between recession reduction and both recession depth at baseline (P= 0.0001) and mean of the 3 tensions recorded on the test side (MFTens) (P = 0.0009). CONCLUSIONS: This study shows that minimal flap tension does not influence recession reduction after 3 months when shallow recessions are treated by means of CAF. In the test group (with tension), the statistical analysis suggests that the higher the flap tension, the lower the recession reduction.

Adult↗

p53 and bcl-2 expression in invasive and pre-invasive uterine papillary serous carcinoma and atrophic endometrium.

INTRODUCTION: Uterine papillary serous carcinoma (UPSC), a high-grade tumour, is known to be associated in some cases with an identifiable intraepithelial neoplasia (IEN) component. Biomarker studies incorporating this latter component are not well documented. One aim of the present study was to compare levels of immunohistochemical (IHC) expression of p53 tumour suppressor gene and bcl-2 oncoprotein between UPSC and IEN, as well as normal endometrium to determine its biologic significance. The other major aim was to determine if these IHC results have any bearing on survival data in this tumour. MATERIALS AND METHODS: An immunoreactivity score was assigned for examination of p53 and bcl-2 expression in a total of 21 cases of UPSC, 9 with an evaluable IEN component and 11 with associated non-neoplastic endometrium. Statistical analysis of IHC results was performed, in addition to correlation with survival data and disease stage. RESULTS: p53 was identified in 16/21 cases of UPSC (76%) and 8/9 cases of IEN (89%), and no cases of normal endometrium. By contrast, bcl-2 was positive in all normal endometria with less expression in UPSC leaving 15/21 (71%) cases positive, and in IEN, leaving 5/9 (55%) of cases positive. Differences in immunoreactive scores for both p53 and bcl-2 between UPSC and benign glands, as well as between IEN and benign glands reached statistical significance with P values of 0.006 and 0.014 for p53, and 0.003 and 0.027 for bcl-2 respectively. There was no statistical significance between values for UPSC and IEN. Cox regression analysis found no statistically significant relationship between patient survival time in early and late stages of disease, and p53 and bcl-2 immunoscores. CONCLUSIONS: The lack of a significant difference between the bcl-2 and p53 values for both UPSC and IEN suggests that these molecular alterations occur at an early stage of tumour pathogenesis. A potential advantage of the use of immunohistochemical markers is their application to routinely processed surgical specimens. In this case, bcl-2 and p53 were applied in UPSC to determine any potential significance, but neither marker proved to be a useful predictor of survival time or disease stage.

Atrophy↗

Circulating cytokines in relation to bone mineral density changes in patients with acromegaly.

OBJECTIVES: Elevated cytokines levels were observed as a marker of increased bone resorption in certain diseases. The aim was to assess serum levels of selected cytokines in acromegaly, regarding to different disease's stages, gonadal function, gender and character of BMD change. METHODS: The study was carried out in 62 patients with acromegaly (40 women, 22 men) aged 26-75 years in various stages of the disease. The controls were 30 healthy, age- and sex-matched subjects. Serum cytokines concentration was assessed using ELISA method. RESULTS: We have shown higher (p=0.044) concentrations of TGF-beta in male patients with active acromegaly than in cured males. When the influence of all cytokines studied on BMD using multiple regression analysis was carried out, the borderline (p=0.099) statistical significance was achieved (regression coefficient B=0.68271) according to TGF-beta and trochanter major BMD. IL-6 and TNF-alpha were higher (p=0.062, and p=0.098, respectively) in these acromegalic patients, in which gain of trochanter major BMD occurred. IL-1beta levels were lower in patients with ultradistal radius and 1/3 distal radius BMD gain (p=0.007, and p=0.009, respectively). Lower TGF-beta levels (p=0.077) were shown in patients with 1/3 distal radius gain. IL-6 levels were higher in patients with total body BMD gain (p=0.059). CONCLUSIONS: The relations between TGF-beta and acromegaly activity in men, and trochanter major BMD in both sexes were documented. Concentrations of all cytokines studied correlated with the BMD changes in different bone sites. Noteworthy is homogeneity of the secretory character of cytokines studied according to BMD changes within particular skeleton sites.

Absorptiometry, Photon↗

Screening and diagnosis when within-individual observations are Markov-dependent.

The statistical model currently used for determining the amount of regression to the mean that will occur in a screening study includes an assumption that repeat observations within the same subject are mutually independent. This assumption has been used in the determination of the number of repeat observations within an individual that is required to reduce the amount of regression to the mean or the probability of misclassification to a given value. In this paper the model is extended to the case in which repeat observations within an individual are Markov-dependent. New expressions are given for the regression to the mean, based on the time delay between screening and re-examination, and on the use of an average of several measurements for both screening and re-examination. The extended model is used to describe the conditional distribution of the long-term mean of an individual, given several measurements, and this distribution is suggested as a diagnostic tool. A method is presented for estimation of the autocorrelation coefficient in very short time series observed in several individuals. The autocorrelation in diastolic blood pressure is estimated from a set of repeat observations, one day apart, on a group of subjects.

Blood Pressure↗

Laboratory test results as predictors of recurrent coronary artery stenosis following angioplasty.

A retrospective study has been conducted to examine the potential value of a battery of selected clinical laboratory tests as predictors of recurrent coronary artery stenosis following angioplasty. Data from 443 patients (including 325 men and 118 women) who had undergone coronary angioplasty were analyzed. Total men, total women, aspirin-treated men, and aspirin-treated women received separate statistical treatment. The only statistically significant difference in mean laboratory values between success (no recurrent stenosis) and recurrence groups was for serum cholesterol in aspirin-treated women, where the recurrence group showed a higher value than the success group. Multiple logistic regression showed a statistically significant association between elevated mean cholesterol and low mean hemoglobin concentration and recurrence in the female aspirin-treated group. Although only a small number of the laboratory test results fell outside normal laboratory reference ranges, we noted that for some tests, patients with extreme values predominantly developed recurrent stenosis while for certain other tests they were mainly successful. For example, seven of eight male diabetics with plasma glucose concentrations above 9.4 mmol/L (170 mg/dL) developed recurrence, while recurrent stenosis did not occur in any of six men with a bleeding time greater than twice normal. The results of these studies do not support the hypothesis that lipoprotein, coagulation, and platelet factors influence the development of recurrent stenosis in the majority of patients, although abnormalities in certain of these parameters may contribute to the process in specific cases.

Aged↗

[A study of factors influencing on health promoting lifestyle in the elderly--application of Pender's health promotion model].

PURPOSE: The purpose of this study was to investigate the factors influencing health promoting lifestyle in the elderly. METHOD: The subject of this study was 305 elderly person over the age of 60, living in rural and urban, Korea. For the analysis of collected data, descriptive statistics, t-test, analysis of variance and stepwise multiple regression were used for statistical analysis with SPSS statistical program. RESULTS: The average item score for the health promoting lifestyle was 2.46. The higher score on the subscale was nutrition(2.65). The lowest score on the subscale were physical activity(2.36) and stress management(2.36). General characteristics showing statistically significant difference in health promoting lifestyle were age, residential district, live together spouse, education, religion and pocket money in the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of health promoting lifestyle in the elderly was prior related behavior(R2=.554). A combination of prior related behavior, perceived benefits of action, perceived self-efficacy, commitment to a plan of action, and interpersonal influences accounted for 64.3% of the variance in health promoting lifestyle in the elderly. CONCLUSION: The factors influencing on health promoting lifestyle for elderly were prior related behavior, perceived benefits of action, perceived self-efficacy, commitment to a plan of action, and interpersonal influences.

Aged↗

Combining the performance strengths of the logistic regression and neural network models: a medical outcomes approach.

The assessment of medical outcomes is important in the effort to contain costs, streamline patient management, and codify medical practices. As such, it is necessary to develop predictive models that will make accurate predictions of these outcomes. The neural network methodology has often been shown to perform as well, if not better, than the logistic regression methodology in terms of sample predictive performance. However, the logistic regression method is capable of providing an explanation regarding the relationship(s) between variables. This explanation is often crucial to understanding the clinical underpinnings of the disease process. Given the respective strengths of the methodologies in question, the combined use of a statistical (i.e., logistic regression) and machine learning (i.e., neural network) technology in the classification of medical outcomes is warranted under appropriate conditions. The study discusses these conditions and describes an approach for combining the strengths of the models.

Artificial Intelligence↗

Time-series analysis of the risk factors for haemorrhagic fever with renal syndrome: comparison of statistical models.

Three conventional regression models were compared using the time-series data of the occurrence of haemorrhagic fever with renal syndrome (HFRS) and several key climatic and occupational variables collected in low-lying land, Anhui Province, China. Model I was a linear time series with normally distributed residuals; model II was a generalized linear model with Poisson-distributed residuals and a log link; and model III was a generalized additive model with the same distributional features as model II. Model I was fitted using least squares whereas models II and III were fitted using maximum likelihood. The results show that the correlations between the HFRS incidence and the independent variables measured (i.e. difference in water level, autumn crop production and density of Apodemus agrarius) ranged from -0.40 to 0.89. The HFRS incidence was positively associated with density of A. agrarius and crop production, but was inversely associated with difference in water level. The residual analyses and the examination of the accuracy of the models indicate that model III may be the most suitable in the assessment of the relationship between the incidence of HFRS and the independent variables.

Animals↗

Efficiency of regression estimates for clustered data.

Statistical methods for clustered data, such as generalized estimating equations (GEE) and generalized least squares (GLS), require selecting a correlation or convariance structure to specify the dependence between observations within a cluster. Valid regression estimates can be obtained that do not depend on correct specification of the true correlation, but inappropriate specifications can result in a loss of efficiency. We derive general expressions for the asymptotic relative efficiency of GEE and GLS estimators under nested correlation structures. Efficiency is shown to depend on the covariate distribution, the cluster sizes, the response variable correlation, and the regression parameters. The results demonstrate that efficiency is quite sensitive to the between- and within-cluster variation of the covariates, and provide useful characterizations of models for which upper and lower efficiency bounds are attained. Efficiency losses for simple working correlation matrices, such as independence, can be large even for small to moderate correlations and cluster sizes.

Anti-Inflammatory Agents, Non-Steroidal↗

Evaluating cholesterol screening. The importance of controlling for regression to the mean.

OBJECTIVES: To determine the overall impact of a voluntary cholesterol screening program and to assess the importance of controlling for regression to the mean when evaluating the impact on higher-risk subgroups. DESIGN: Longitudinal study comparing baseline survey and cholesterol results with those obtained 17 months later, with adjustment for regression to the mean. SETTING: Participants were seen at three sites: an academic teaching hospital, an intermediate-care hospital, and a suburban community center. PARTICIPANTS: One thousand fifty-three participants were enrolled in a voluntary cholesterol screening program. MEASUREMENTS/MAIN RESULTS: Of 1053 study enrollees, 785 (75%) completed a follow-up questionnaire and 656 (62%) returned for follow-up cholesterol tests. Among all participants at high risk, measured cholesterol levels were 0.66 mmol/L (25.5 mg/dL) lower at follow-up, but 58% of this apparent change (0.38 mmol/L [14.7 mg/dL]) was attributable to the statistical phenomenon of regression to the mean. Among all participants at increased (both high and moderate) risk, after controlling for regression to the mean, reductions in cholesterol levels were significant for those younger than 60 years (-0.28 mmol/L [-10.8 mg/dL]; 95% confidence interval, -0.43 to -0.13; n = 390) but not for those 60 years or older (+0.007 mmol/L [+0.3 mg/dL]; 95% confidence interval, -0.16 to +0.17; n = 266). CONCLUSIONS: For subjects found at high risk in a cholesterol screening program, more than half of the apparent beneficial change in cholesterol level is attributable to regression to the mean. For participants older than 60 years, no clear benefit of cholesterol screening was documented.

Adult↗

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