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PubMed2004

Epidemiology of breastfeeding: advances and multidisciplinary applications.

Advancing understanding of the importance of breastfeeding (BF) has required advances in application of epidemiologic methods to BF research. This chapter considers, in the context of BF epidemiology, how different research designs complement each other to establish firmer causal inferences, the need for multidisciplinary collaborations, and the application of powerful analytical methods to strengthen epidemiologic studies. A recent global meta-analysis of 47 studies documenting the inverse association between lifetime BF duration and breast cancer risk illustrates the value of longitudinal (cohort) studies to establish the temporal sequence of events and to rule out differential recall biases that can threaten the internal validity of case-control studies. The discovery of the transmission of human immunodeficiency virus (HIV) via human milk has led epidemiologists to provide important hypotheses to be tested at the molecular and cellular level and in turn test hypotheses generated in laboratory studies. Application of powerful statistical methods to BF epidemiology has helped strengthen causal inferences. A retrospective analysis of the 1976--1977 Malaysian Family Life Survey found interactive multivariate statistical models to better understand how different socioeconomic and cultural contexts modify the influence of BF on child health. Further, a study conducted in Cebu City, Philippines, demonstrated how structural equation models can be used to test the pathways through which proximate (e.g., BF) and distal (e.g., socioeconomic status) determinants affect child health after adjusting for reverse causality (i.e., child health influencing maternal BF choice). For ethical reasons, BF randomized controlled trials (RCTs) have seldom been conducted. Recent RCTs examining the link between BF peer counseling and BF outcomes in diverse settings provides a unique opportunity to firmly establish the causal inferences regarding BF and the prevention of diarrheal diseases. The value of rapid assessment anthropologic methods to guide development of peer counseling interventions subsequently tested through RCTs is presented. This chapter also illustrates how Cox regression and logistic regression can be applied to BF research.

Breast Feeding↗
PubMed1999

Predicting audiometric status from distortion product otoacoustic emissions using multivariate analyses.

OBJECTIVES: 1) To determine whether multivariate statistical approaches improve the classification of normal and impaired ears based on distortion product otoacoustic emission (DPOAE) measurements, in comparison with the results obtained with more traditional single-variable applications of clinical decision theory. 2) To determine how well the multivariate predictors, derived from analysis on a training group, generalized to a validation group. 3) To provide a way to apply the multivariate approaches clinically. DESIGN: Areas under the relative operating characteristic (ROC) curve and cumulative distributions derived from DPOAE, DPOAE/Noise, discriminant function (DF) scores and logit function (LF) scores were used to compare univariate and multivariate predictors of audiometric status. DPOAE and Noise amplitudes for 8 f2 frequencies were input to a discriminant analysis and to a logistic regression. These analyses generated a DF and LF, respectively, composed of a linear combination of selected variables. The DF and LF scores were the input variables to the decision theory analyses. For comparison purposes, DPOAE test performance was also evaluated using only one variable (DPOAE or DPOAE/Noise when f2 = audiometric frequency). Analyses were based on data from over 1200 ears of 806 subjects, ranging in age from 1.3 to 96 yr, with thresholds ranging from -5 to >120 dB HL. For statistical purposes, normal hearing was defined as thresholds of 20 dB HL or better. For the multivariate analyses, the database was randomly divided into two groups of equal size. One group served as the "training" set, which was used to generate the DFs and LFs. The other group served as a "validation" set to determine the robustness of the DF and LF solutions. RESULTS: For all test frequencies, multivariate analyses yielded greater areas under the ROC curve than univariate analyses, and greater specificities at fixed sensitivities. Within the multivariate techniques, discriminant analysis and logistic regression yielded similar results and both yielded robust solutions that generalized well to the validation groups. The improvement in test performance with multivariate analyses was greatest for conditions in which the single predictor variable resulted in the poorest performance. CONCLUSIONS: A more accurate determination of auditory status at a specific frequency can be obtained by combining multiple predictor variables. Although the DF and LF multivariate approaches resulted in the greatest separation between normal and impaired distributions, overlap still exists, which suggests that there would be value in continued efforts to improve DPOAE test performance.

Acoustic Stimulation↗
PubMed1999

Retinopathy in diabetic patients aged 15-50 years in the county of Umeå, Sweden.

PURPOSE: To examine the prevalence of diabetic retinopathy and its relation to certain risk factors (glycosylated hemoglobin, blood pressure, serum creatinine, proteinuria, smoking) in a population-based study on a specific age-group of patients with diabetes mellitus in the county of Umeå, Sweden. METHODS: All diabetic patients aged 15-50 years living in the county of Umeå were invited to the study. A standard clinical and eye examination was performed, and seven-field stereoscopic photographs were taken of each eye. Blood and urine samples were collected. Univariate and multivariate statistical analyses were performed. RESULTS: Of the eligible 395 patients 285 (91%) participated in the study. 285 patients (79%) had diabetes mellitus type 1, 71 (20%) subjects had diabetes mellitus type 2, and 3 patients (1%) had secondary diabetes. In the statistical analysis performed on patients with type 1 diabetes mellitus, duration, presence of hypertension, systolic blood pressure, plasma glucose, glycosylated hemoglobin, serum creatinine, proteinuria and smoking all were significantly related to increasing degree of retinopathy when a univariate model was applied. However, when a multivariate analysis was performed only duration, proteinuria, glycosylated hemoglobin and male gender were statistically significantly associated with severeness of retinopathy. CONCLUSION: Increased duration of diabetes, inadequate metabolic control as measured by glycosylated hemoglobin, proteinuria and male gender are factors that are associated with a higher incidence of diabetic retinopathy in diabetes mellitus type 1.

Adolescent↗
PubMedDate not supplied

[Childhood psychoses and organic pathology: results of a study of 144 cases].

The records of 144 patients of Child Psychiatry Units of Alsace (France), with childhood psychosis (CP) or pervasive developmental disorders (PDD) have been systematically screened for previous or associated pathological events. Half of the children studied have been or are still affected by severe somatic disorders, but none of the diagnostic subcategories (referring to DSM III or CFTMEA) appeared significantly more frequently affected. In our population, the severity of organic disorders was positively correlated with: the age of the mother: more severe cases were reported when the mother was younger than 20 or older than 40 at the moment of childbirth; pathological events during pregnancy; early mother-child separation during the first year of life. The most frequent associated disorders however (neonatal pathology 45% of the cases, epilepsy 17% of the cases, neurological or neurosensorial pathology 15% of the cases) were associated neither with a specific diagnostic nor with a clinical and social specific pattern. The only statistically significant correlation was found between neurological pathology and a relatively low level of cognitive and social functioning. All these results were confirmed by multivariate statistical analysis. A main component analysis integrating all quantified data concerning organic pathology was performed: it emphasizes the independence of the different pathological events reported. The factorial analysis including the clinical, diagnostical and somatic event-related data failed to show any statistical profile associating functional features of the children with any particular previous or existing somatic disorders. Our results suggest that a history of organic pathological events is frequent not only in autistic disorders but in any kind of PDD or early CP - associated with moderate to severe mental retardation, in most cases of our study. However, this does not demonstrate that this type of pathological events constitute the direct and unique cause of PDD and CP: the concept of the aetiology of these severe diseases must take account of other factors - such as relational disruption -, also frequently seen in these children.

Adolescent↗
PubMed1988

New control chart for multivariate data with missing values.

A new multivariate statistical quality control method has been developed. It is an extension of the method developed by Kume, which is able to find abnormal values in multivariate biochemical data of a clinical laboratory. The present method makes use of the difference between two sets of data measured from the samples of the same patient obtained on different days. The Mahalanobis' distance between two samples can be calculated from the difference of their observations. If the Mahalanobis' distance of the two data is larger than the critical value decided in advance, the reliability of the measurement is doubtful. The characteristic of the present method is that it can apply to data with missing values by estimating them from measured data. Some numerical examples are shown to demonstrate the availability of the method.

Algorithms↗
PubMed2006

Usual interstitial pneumonia and chronic idiopathic interstitial pneumonia: analysis of CT appearance in 92 patients.

PURPOSE: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic interstitial pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual interstitial pneumonia (UIP) with univariate and multivariate analyses. MATERIALS AND METHODS: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific interstitial pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) (n = 11), desquamative interstitial pneumonia (DIP) (n = 15), or lymphoid interstitial pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. RESULTS: Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). CONCLUSION: UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

Adult↗
PubMed2002

Symbolic discriminant analysis of microarray data in autoimmune disease.

New laboratory technologies such as DNA microarrays have made it possible to measure the expression levels of thousands of genes simultaneously in a particular cell or tissue. The challenge for genetic epidemiologists will be to develop statistical and computational methods that are able to identify subsets of gene expression variables that classify and predict clinical endpoints. Linear discriminant analysis is a popular multivariate statistical approach for classification of observations into groups. This is because the theory is well described and the method is easy to implement and interpret. However, an important limitation is that linear discriminant functions need to be prespecified. To address this limitation and the limitation of linearity, we have developed symbolic discriminant analysis (SDA) for the automatic selection of gene expression variables and discriminant functions that can take any form. In the present study, we demonstrate that SDA is capable of identifying combinations of gene expression variables that are able to classify and predict autoimmune diseases.

Autoimmune Diseases↗
PubMed1998

Neurulation abnormalities secondary to altered gene expression in neural tube defect susceptible Splotch embryos.

The murine mutant Splotch (Sp) is a well-established model for studying neural tube closure defects. In the current investigation, the progression through neural tube closure (NTC) as well as the expression patterns of 12 developmentally regulated genes were examined in the neural tissue of wildtype (+/+), Splotch heterozygous (Sp/+), and Splotch homozygous (Sp/Sp) embryos during neurulation. The overall growth of the embryos, as measured by the number of somite pairs, did not differ significantly between the three genotypes at any of the collection time-points. There was, however, a significant delay in the progression through NTC for both the Sp/+ and Sp/Sp embryos. A univariate analysis on the expression of the 12 candidate genes (bcl-2, FBP-2, Hmx-2, Msx-3, N-cam, N-cad, noggin, p53, Pax-3, Shh, Wee-1, wnt-1) revealed that although 11 were statistically altered, across time or by genotype, there were no significant interactions between gestation age and genotype for any of these genes during NTC. However, a multivariate statistical analysis on the simultaneous expression of these genes revealed interactions at both gestation day (GD) 8:12 (day:hour) and 9:00 among Pax-3, N-cam, N-cad, bcl-2, p53, and Wee-1 that could potentially explain the aberrant NTC. The data from these studies suggest that a disruption in the genes that govern the cell cycle or extracellular matrices of the developing neural tube might play a critical role in the occurrence of the NTDs observed in Splotch embryos.

Animals↗
PubMedDate not supplied

Data reduction of multichannel fields: global field power and principal component analysis.

Electroencephalographic data recorded for topographical analysis constitute multidimensional observations, and the present paper illustrates methods of data analysis of multichannel recordings where components of evoked brain activity are identified quantitatively. The computation of potential field strength (Global Field Power, GFP) is used for component latency determination. Multivariate statistical methods like Principal Component Analysis (PCA) may be applied to the topographical distribution of potential values. The analysis of statistically defined components of visually elicited brain activity is illustrated with data sets stemming from different experiments. With spatial PCA the dimensionality of multichannel data is reduced to only three components that account for more than 90% of the variance. The results of spatial PCA relate to experimental conditions in a meaningful way, and this method may also be used for time segmentation of topographic potential maps series.

Action Potentials↗
PubMed1995

Discriminant classification of motor unit potentials (MUPs) successfully separates neurogenic and myopathic conditions. A comparison of multi- and univariate diagnostical algorithms for MUP analysis.

Multivariate statistical methods may be more appropriate for the multidimensional material of quantitative motor unit potential (MUP) analysis than the multiple univariate tests of the conventional Buchthal analysis. Buchthal analysis was slightly modified before it was used as the gold standard for new multivariate diagnostical algorithms, based on principal component analysis and on MUP discriminant classification: muscle means of continuous variables were related to tolerance limits after adequate transformation. Chi-square tests were used for dichotomized variables, e.g., polyphasia. Sensitivity and specificity of the uni- and multivariate algorithms were compared for 539 muscles from patients with motor neuron diseases, neuropathies and myopathies and for 91 biceps brachii, rectus femoris and tibialis anterior control muscles. False positive results accumulated less than expected by repeat univariate tests for single MUP parameters, due to high correlation. Combination of single parameters to factor scores did not improve specificity. One advantage of factor analysis was that factor matrix and factor scores matched those of previous studies in spite of different input parameters, which may facilitate multicenter comparisons. Discriminant classification successfully separated neurogenic and myopathic conditions, even in myositic muscles and motor neuron diseases, where myopathic and neuropathic MUPs frequently intermingle. Discriminant classification may support expert decisions and add weight to EMG differential diagnosis.

Adult↗
PubMed1992

Could 'objective, experimental' analysis of human motivation really improve psychotherapy?

Cattell is a founding father of modern, multivariate psychological method and his paper is a fine introduction to his views on motivation which have perhaps received less attention in Britain than they deserve. However, it was the unanimous opinion of three referees that it needed to be followed by a dissenting voice. In this counterargument I suggest that Cattell's presentation is: (1) ingenuously confident of the power of multivariate statistical methods; (2) naïve about the interactive nature of the clinical relationship.

Awareness↗
PubMed1993

Prognostic significance of transforming growth factor-alpha in human esophageal carcinoma. Implication for the autocrine proliferation.

BACKGROUND: The authors recently used immunostaining to demonstrate that patients with epidermal growth factor receptor (EGFR) overexpression have poor survival after surgery. However, the clinical significance of transforming growth factor (TGF)-alpha, one of the ligands of EGFR, has not been demonstrated in esophageal carcinoma. METHODS: Immunohistochemical study for TGF-alpha and EGFR was performed on 57 esophageal squamous cell carcinomas using monoclonal antibodies. RESULTS: TGF-alpha expression was positive in 35% of the tumors, and EGFR overexpression, defined as stronger staining in cancer cells than in normal epithelium, was positive in 43% of the tumors, according to the authors' arbitrary criteria. The incidence of TGF-alpha positivity was relatively higher in patients with the EGFR overexpression (EGFR+) than in the patients with non-overexpression (EGFR-). The survival rate was significantly lower in patients with TGF-alpha(+) than in those with TGF-alpha(-) (P < 0.01) and in patients with EGFR(+) than in patients with EGFR(-) (P < 0.01), respectively. Considering TGF-alpha and EGFR expression simultaneously, the survival rate of the patients with TGF-alpha(+)/EGFR(+) tumors was the lowest of the four subgroups, with statistically significant differences noted. These relationships between the immunoreactivities and survival curves were observed in the analysis within patients with node-positive disease. In addition, a multivariate statistical analysis demonstrated that TGF-alpha was the only significant variable, whereas EGFR and nodal status provided no additional information regarding postoperative survival. CONCLUSION: The results presented suggest that TGF-alpha may act as an autocrine growth factor through hyperproducing EGFR and that its expression and EGFR overexpression may prove useful as a valuable prognostic indicator for patients with esophageal carcinoma.

Carcinoma, Squamous Cell↗
PubMed1994

Effect of perioperative blood transfusion on recurrence and survival in 232 primary high-grade extremity sarcoma patients.

BACKGROUND: Allogeneic blood transfusion (BT) has been implicated as an unfavorable factor influencing cancer recurrence and overall survival. METHODS: To investigate this, 232 consecutive localized, high-grade extremity soft tissue sarcoma (STS) patients admitted between January 1, 1983, and December 31, 1989, were analyzed from our prospective database by univariable and Cox multivariable statistical methods. RESULTS: Twenty-eight patients developed a local recurrence (LR). Factors found significantly unfavorable for the rate of developing an LR by uni- and multivariable tests were age > 60 years and positive microscopic margin. Eighty-nine patients developed a distant metastasis (DM) and 72 patients died of their tumor. Median follow-up of survivors was 48 months. Unfavorable factors for DM and tumor mortality (TM) by univariable analysis included large size, deep tumor (that involved or was below the superficial fascia), positive microscopic margin, invasion of a vital structure, operative blood loss, duration of operation, and perioperative BT (whole blood or packed cells -24 to +48 h of curative operation). Multivariable analysis found large size, deep tumor, and positive margin significant independent unfavorable factors for DM and TM. The effect of BT was not a significant independent prognosticator for LR, DM, or TM by multivariable analysis (p = 0.26, 0.56, 0.08, respectively). The only factor that was found to be significant in a multivariable analysis of factors contributing to postmetastasis survival was time < 6 months until metastasis (p = 0.008). BT had no significant impact on postmetastasis survival (p = 0.42). There was a significant association between BT and deep, large tumors. As the size of deep tumors increased from < 5, > or = 5 < 10, > or = 10 < 15, or > or = 15 cm, the amount transfused was 15, 16, 49, and 68% (p < 0.00001). Also, BT was significantly (p < 0.005) associated with low hematocrit at initial diagnosis, blood loss during surgery, and the length of the surgical procedure. CONCLUSIONS: These data emphasize the importance of size, depth, and margin on distant recurrence and death for localized high-grade extremity STS. In the absence of a randomized trial, the impact of allogeneic blood transfusion would appear to be due to its strong association with large size and deep tumor invasion. This study also highlights the importance of a multivariable analysis and long-term follow-up to better define this controversial question.

Blood Transfusion↗
PubMed2003

Gonorrhea and chlamydia screening among young women: stage of change, decisional balance, and self-efficacy.

PURPOSE: To assess perceived sexually transmitted disease (STD) (gonorrhea and chlamdydia) screening behaviors among young women at risk for STDs by evaluating readiness, pros and cons, and self-efficacy to seek STD screening in the absence of symptoms. METHODS: Two hundred forty young urban women (mean 18.8 years +/-1.59) consecutively attending an urban reproductive clinic voluntarily completed a 67-item questionnaire on STD screening behaviors that included the stages of change (SOCs), decisional balance, and self-efficacy as well as sexual practices and partner relationships. The data were analyzed using descriptive statistics, multivariate analyses of variance, Chi-square tests, and Wilcoxon signed rank test. RESULTS: Ninety-five percent of the participants would be willing to obtain STD screening for early disease detection. Participants were further along the SOCs for STD screening following unprotected sex with a change in partner than main partner, (p <.001). Pros and cons of STD screening varied according to the SOCs for STD screening with a change in partner and main partner. Self-efficacy increased linearly along the SOCs for STD screening (p <.001). CONCLUSIONS: Most young women recognize the importance of STD screening but are not currently being tested when at risk for STDs. STD screening behaviors varied according to the partner relationship, which highlights the importance of stage- and partner-matched counseling to promote STD screening particularly when at risk for STDs.

Adolescent↗
PubMed1999

Squamous cell carcinoma of the vulva: study of ploidy, HPV, p53, and pRb.

Seventy-one cases of invasive squamous cell carcinoma (ISCC) of the vulva were compared with 18 cases of vulvar intraepithelial neoplasia (VIN) and 21 cases of lichen sclerosus. Ploidy was studied by image analysis, HPV-DNA by PCR, and p53 and pRb by immunohistochemistry. Univariate and multivariate statistical analyses were performed. The mean age of the patients with ISCC was 70.6 years; only 8.5% were < 60 (range, 43-89) years. For the 43 patients with follow-up, FIGO surgical stages were I in 16.2%, II in 48.8%, III in 27.9%, and IV in 6.9%. The 5-year survival was 90% for the patients with curative surgery (vulvectomy and lymphadenectomy) and 32% for those with tumors in stages III to IV. Previous history of nonneoplastic epithelial alterations was recorded in 54%. Vascular invasion was detected in 4.3% and perineural invasion in 21.4%. Inguinal lymph node metastases were present in 34.9% of the cases. Fifty-one (72%) ISCCs were aneuploid, HPV-DNA-16 was detected in 7 (12.3%) cases, overexpression of p53 was found in 40 (56%), and pRb expression was negative in 15 (21.4%). Fifteen cases (80%) of VIN were aneuploid, 5 (27.7%) contained HPV-DNA, 11 (61%) were positive for p53, and all immunoreacted for pRb. All lichen sclerosus cases were diploid, did not contain HPV-DNA, failed to stain for p53, and were positive for pRb. Our study confirmed the prognostic value of conventional pathological features: stage, lymph node metastasis, histological grade, and vascular and perineural invasion; all were statistically significant for survival in the univariate analysis. Also, ploidy was significant in patients with stages I and II tumors. The only significant variable in the multivariate analysis was stage. p53 overexpression appears as a late event in vulvar carcinogenesis, but it may occur before tumor invasion. Lack of pRb expression can occur in vulvar neoplasia, but it does not seem to play any role in the initiation or prognosis of vulvar ISCC.

Adult↗
PubMed2002

On Wiener filtering and the physics behind statistical modeling.

The closed-form solution of the so-called statistical multivariate calibration model is given in terms of the pure component spectral signal, the spectral noise, and the signal and noise of the reference method. The "statistical" calibration model is shown to be as much grounded on the physics of the pure component spectra as any of the "physical" models. There are no fundamental differences between the two approaches since both are merely different attempts to realize the same basic idea, viz., the spectrometric Wiener filter. The concept of the application-specific signal-to-noise ratio (SNR) is introduced, which is a combination of the two SNRs from the reference and the spectral data. Both are defined and the central importance of the latter for the assessment and development of spectroscopic instruments and methods is explained. Other statistics like the correlation coefficient, prediction error, slope deficiency, etc., are functions of the SNR. Spurious correlations and other practically important issues are discussed in quantitative terms. Most important, it is shown how to use a priori information about the pure component spectra and the spectral noise in an optimal way, thereby making the distinction between statistical and physical calibrations obsolete and combining the best of both worlds. Companies and research groups can use this article to realize significant savings in cost and time for development efforts.

Algorithms↗
PubMed1988

Psychiatric decision making in the emergency room: a research overview.

In an overview of the research on psychiatric decision making in the emergency room, the authors discuss studies done between 1963 and 1977, which suffered from an overreliance on univariate statistical techniques, problems with the reliability and validity of the instruments used for data collection, and the lack of alternatives to hospitalization for emergency room patients. More recent studies of emergency room decision making are then reviewed, with particular attention to those that had multivariate statistical designs. The article concludes with a synthesis of the research findings to date and recommends multivariate approaches and choices of variables for future studies.

Clinical Competence↗
PubMed1997

Markers in cutaneous lupus erythematosus indicating systemic involvement. A multicenter study on 296 patients.

Lupus erythematosus (LE) is an autoimmune disorder, involving the skin and/or other internal organs. As cutaneous variants, chronic discoid LE (CDLE) and subacute cutaneous LE (SCLE) usually have a better prognosis, however, involvement of internal organs with transition into systemic disease may occur. The aim of this study was to assess the significance of some clinical and laboratory criteria that could serve as markers for early recognition of systemic involvement in cutaneous LE. Three hundred and seventy-nine patients with LE, seen in five cooperating Departments of Dermatology during the years 1989-1994, were documented by electronic data processing according to a common protocol. Two hundred and forty-five of these patients had cutaneous LE (CDLE or SCLE), and 51 had systemic LE (SLE) and were included in this study. Forty-nine patients with either CDLE/SCLE or SLE were not evaluated because of incomplete documentation; also, 34 patients suffered from other LE subsets and were likewise excluded from the evaluation. Multivariate statistical analysis was used to assess the value of seven selected variables for distinguishing between the CDLE/SCLE and SLE groups: ESR, titers of antinuclear antibodies, anti-dsDNA-antibodies, photosensitivity, presence of arthralgias, recurrent headaches and signs of nephropathy. Univariate and multivariate analysis of the obtained data showed that signs of nephropathy (proteinuria, hematuria) was the variable with the highest statistical relevance for distinguishing between patients with cutaneous (CDLE/SCLE) and with systemic LE (SLE) in all statistical models tested, followed by the presence of arthralgias and of high ANA titers (> or =1:320). In contrast, low ANA titers as well as anti-dsDNA antibodies showed little or no statistical relevance as a criterion for distinction. It seems, therefore, that cutaneous LE patients showing signs of nephropathy, presence of arthralgias and elevated ANA titers (> or =1:320) should be carefully monitored, because they may be at risk of developing systemic LE involvement.

Adolescent↗