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PubMed2004

Accounting for misclassification error in retrospective smoking data.

Recent waves of major longitudinal surveys in the US and other countries include retrospective questions about the timing of smoking initiation and cessation, creating a potentially important but under-utilized source of information on smoking behavior over the life course. In this paper, we explore the extent of, consequences of, and possible solutions to misclassification errors in models of smoking participation that use data generated from retrospective reports. In our empirical work, we exploit the fact that the National Longitudinal Survey of Youth 1979 provides both contemporaneous and retrospective information about smoking status in certain years. We compare the results from four sets of models of smoking participation. The first set of results are from baseline probit models of smoking participation from contemporaneously reported information. The second set of results are from models that are identical except that the dependent variable is based on retrospective information. The last two sets of results are from models that take a parametric approach to account for a simple form of misclassification error. Our preliminary results suggest that accounting for misclassification error is important. However, the adjusted maximum likelihood estimation approach to account for misclassification does not always perform as expected.

Data Interpretation, Statistical↗

PubMedDate not supplied

MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

Adult↗

PubMed2002

Utility of retrospective pretest ratings of patient satisfaction with health status.

Outcomes assessment is often difficult to accomplish in evaluation research studies in situations where the gathering of pretest data is impossible or prohibitively expensive. The purpose of this longitudinal study was to investigate the substitutability of retrospective pretest ratings for actual pretest ratings in indexing change in patient satisfaction with health status. The sample consisted of 251 women receiving medical treatment for breast cancer enrolled in the Self-Help Intervention Project (SHIP). ANOVA, ordinary least-squares regression, and pooled time-series regression analysis revealed that retrospective assessments were not significantly different from their prospective counterparts in means and variances and that they differed from current assessments taken at the same time (p<.01). In addition, prospective assessments emerged as a significant independent predictor of corresponding retrospective scores (p<.01), accounting for up to 30% of the recall scores. These findings have implications for inclusion of retrospective pre-post comparisons in outcomes evaluation research.

Analysis of Variance↗

PubMed2005

Retrospective analysis of case-control studies when the population is in Hardy-Weinberg equilibrium.

Association analysis of genetic polymorphisms has been mostly performed in a case-control setting in connection with the traditional logistic regression analysis. However, in a case-control study, subjects are recruited according to their disease status and their past exposures are determined. Thus the natural model for making inference is the retrospective model. In this paper, we discuss some retrospective models and give maximum likelihood estimators of exposure effects and estimators of asymptotic variances, when the frequency distribution of exposures in controls contains information about the parameters of interest. Two situations about the control population are considered in this paper: (a) the control population or its subpopulations are in Hardy-Weinberg equilibrium; and (b) genetic and environmental factors are independent in the control population. Using the concept of asymptotic relative efficiency, we shall show the precision advantages of such retrospective analysis over the traditional prospective analysis. Maximum likelihood estimates and variance estimates under retrospective models are simple in computation and thus can be applied in many practical applications. We present one real example to illustrate our methods.

Alcohol Dehydrogenase↗

PubMed1981

Therapy of symptomatic pericarditis after myocardial infarction: retrospective and prospective studies of aspirin, indomethacin, prednisone, and spontaneous resolution.

We studied the efficacy of aspirin and indomethacin therapy in relieving the discomfort of postmyocardial infarction pericarditis (PMIP) in two studies: (1) a retrospective evaluation of patients with symptomatic PMIP during a 5-year period and (2) a prospective, randomized, single-blind comparison of aspirin and indomethacin in similar patients. In the retrospective study, 36 episodes of symptomatic PMIP in 34 patients were identified; in the prospective study, 25 episodes of PMIP in 24 patients occurred. Relief from the discomfort of PMIP was noted within 48 hours in almost all patients with either indomethacin or aspirin therapy. Minor gastrointestinal bleeding developed in two patients in the retrospective study and in two patients in the prospective study. In the retrospective study, mild discomfort of PMIP abated within 48 hours in five of eight patients who received either no treatment or minor analgesic therapy. Aspirin and indomethacin are equally efficacious in relieving the discomfort of PMIP.

Adult↗

PubMed1996

A comparison of prospective and retrospective assessments of sleep.

The main purpose of this study was to evaluate the correlations between retrospective and prospective assessments of sleep. Subjective reports of sleep characteristics and sleep quality were obtained from 146 young (20-40 years, average age 29.15) healthy men (n = 43), nonpregnant (n = 70) and pregnant women (n = 33). Three types of subjective sleep reports were obtained: (1) general estimates of sleep habits (retrospective measures); (2) sleep logs completed upon awakening on three successive workdays (prospective measures); and (3) general sleep complaints. Men showed the greatest stability in the sleep log reports, followed by nonpregnant women, with pregnant women showing the least stability. Significant positive correlations between prospective (log reported) and retrospective (general estimates) sleep measures were found only for men. However, for measures of sleep quality, such as feelings of fatigue upon awakening, women showed greater agreement between their general estimates and three nightly reports. The limitations of using retrospective estimates in sleep surveys are discussed.

Adult↗

PubMed2005

Retrospective use of alcohol and other substances by college students: psychometric properties of a new measure.

Using a new retrospective measure, interviews regarding alcohol and other substance use for the 5-year period preceding entry to college were conducted twice (with a 3-week interval) among 111 college students. Test-retest reliability was uniformly high across alcohol and substance use items (mean of Pearson correlations=.85), as were intraclass correlation coefficients (mean=.81) and kappa coefficients. A latent growth model (LGM) was specified and evaluated to test a hypothesized linear trend in alcohol use across the 5-year interval referenced by the retrospective measure. Furthermore, convergent and discriminant validity were provided as the slope (or rate of acceleration) parameter associated with the retrospective assessment predicted current alcohol disorders but not other disorders (e.g., depressive or anxiety disorders). The intercept predicted both current substance disorders (principally marijuana disorders) and anxiety disorders. Findings were discussed with regard to the use of this retrospective interview measure to screen for serious alcohol and other substance use prior to new students entering college, thereby affording opportunity for early interventions.

Adolescent↗

PubMed2004

Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community.

OBJECTIVES: We sought to determine the annual incidence of sudden cardiac death (SCD) in the general population using a prospective approach. To assess the validity of retrospective surveillance, a simultaneous comparison was made with a death certificate-based method of determining SCD incidence. BACKGROUND: Accurate surveillance and characterization of SCD in the general population is likely to significantly facilitate current and future community-based preventive and therapeutic interventions. METHODS: We performed a prospective evaluation of SCD among all residents of Multnomah County, Oregon (population 660,486) using multiple sources of surveillance. A comprehensive analysis of circumstances of death, medical records, and available autopsy data was performed. Comparisons were made with a retrospective, death certificate-based determination of SCD incidence using International Classification of Diseases-Version 10 codes and location of death. RESULTS: Between February 1, 2002, and January 31, 2003, 353 residents suffered SCD (incidence 53 of 100,000; median age 69 years, 57% male) accounting for 5.6% of overall mortality. Of these, 75 cases (21%) were identified using sources other than first responders. Resuscitation was attempted in 237 cases (67%) and successful (survival to hospital discharge) in 28 (8%). The retrospective death certificate-based review yielded 1,007 cases (incidence 153 of 100,000; median age 81 years, 51% male), and the positive predictive value of this methodology was 19%. CONCLUSIONS: Sudden cardiac death accounts for 5.6% of annual mortality, and prospective evaluation in the general population appears to be feasible. The use of multiple sources of ascertainment and information significantly enhances phenotyping of SCD cases. Retrospective death certificate-based surveillance results in significant overestimation of SCD incidence.

Adolescent↗

PubMed2003

Is there progression from irritability/dyscontrol to major depressive and manic symptoms? A retrospective community survey of parents of bipolar children.

BACKGROUND: Although previous studies have discussed age-related changes in the presentation of early onset bipolar illness, the developmental progression of early symptoms remains unclear. The current study sought to trace parents' retrospective report of yearly occurrence of symptoms in a sample of children with and without a diagnosis of bipolar disorder in the community. METHODS: Parents retrospectively rated the occurrence of 37 activated and withdrawn symptoms causing dysfunction for each year of their child's life (mean age 12.6 +/- 6.9). Children were divided into three groups based on parent report of diagnosis by a community clinician: bipolar (n=78); non-bipolar diagnosis (n=38); and well (no psychiatric diagnosis) (n=82). Principal components analysis was performed to understand the relationship among the symptom variables and their potential differences among the three groups as a function of age. RESULTS: Four symptom components were derived and these began to distinguish children with bipolar disorder from the other groups at different ages. Component II (irritability/dyscontrol), which included temper tantrums, poor frustration tolerance, impulsivity, increased aggression, decreased attention span, hyperactivity and irritability, began to distinguish bipolar children from the others the earliest (i.e., from ages 1 to 6). The other components (I, III, and IV) which included symptoms more typical of adult depression (I), mania (III), and psychosis (IV), distinguished the children with a bipolar diagnosis from the others much later (between ages 7 and 12). LIMITATIONS: The data were derived from retrospective reports by parents of their children's symptoms on a yearly symptom check list instrument which has not been previously utilized. Parents' ratings were not validated by an outside rater. Moreover, the children were diagnosed in the community and a formal diagnostic interview was not given. CONCLUSIONS: By parental report, the cluster of symptoms in the irritability/dyscontrol component may characterize the earliest precursors to an illness eventually associated with more classic manic and depressive components that are diagnosed and treated as bipolar disorder in the community. These retrospective survey data suggesting a longitudinal evolution of symptom clusters in childhood bipolar-like illness identify a number of areas for prospective research and validation.

Adolescent↗

PubMed1997

Incidence of percutaneous injuries at a dental school: a 4-year retrospective study.

BACKGROUND: Infection control training for predoctoral dental students, dental hygiene students, and dental assistant students has assumed an important role in the educational process at our institution. As part of an ongoing review of the curriculum at our school, we conducted a retrospective analysis of reported percutaneous injuries during the years 1991 through 1994 to determine whether the increase in infection control training introduced at the school in 1990 has had an effect on our rate of percutaneous injuries. METHODS: The population examined in this retrospective study consisted of predoctoral and postdoctoral dental students, dental hygiene students, dental assistant students, and staff. The data for this retrospective study were obtained from annual reports of occupational exposures incurred by students and staff. These annual reports were generated by compiling and summarizing all percutaneous injury incident reports that were prepared for that year. RESULTS: Our results indicate, that except for an increase in 1992, the total number and incidence of reported percutaneous injuries decreased from 1991 to 1994. Statistically significant decreases were seen in the total number of reported percutaneous injuries for all students, staff, and all groups combined. On the basis of data available for 1993 and 1994, the incidence of reported percutaneous injuries per 1000 procedures was fairly constant over these 2 years. Distribution of percutaneous injuries by source varied during the 4-year period. CONCLUSIONS: As part of the outcomes assessment program at our institution, we conducted a retrospective study of reported percutaneous injuries from 1991 to 1994. This study demonstrated that, although the total number of injuries decreased significantly, the rates within certain individual groups remained unchanged. On the basis of this observation, increased emphasis in the prevention of percutaneous injuries through additional training is indicated for these groups.

Curriculum↗

PubMedDate not supplied

Retrospective versus prospective self-rating of anxiety symptoms and cognitions.

The discrepancy between retrospective and prospective rating of anxiety symptoms and cognition was examined in 20 agoraphobics. Subjects were required to complete a checklist of symptoms and cognitions during exposure to an agoraphobic situation. and then to complete a similar set retrospectively. More cognitions were rated retrospectively than prospectively, with the discrepancy especially evident for cognitions about physical catastrophe. In contrast, there was no discrepancy between anxiety symptoms rated prospectively versus retrospectively. This may be because anxiety symptoms are easier for patients to identify than cognitions. require less introspection. or are less affected by context than cognition. Implications of the findings are discussed and suggestions for future research are made.

Adult↗

PubMed1997

Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach.

OBJECTIVE: To examine the relation between responsiveness coefficients derived directly from a calculation of average change resulting from a treatment intervention (Responsiveness-Treatment or RT) and those derived from retrospective analysis of changed and unchanged groups (Responsiveness Retrospective or RR) based on a global measure of change. METHOD: Two approaches were used. First, we used simulation methods to examine the analytical relationship between the RT and RR coefficients. We then located eight studies where it was possible to compute both RT and RR coefficients. As anticipated from theoretical arguments, the RR coefficients were larger than the RT coefficients (1.50 versus 0.41, p < .0001). Within study there was no predictable relationship between the two indices. Across studies, the magnitude of the RR coefficient was strongly related to the correlation with the retrospective global scale, and unrelated to the magnitude of the RT coefficient. The simulated curves fit well with the observed data, and substantiated the observation that the relation between RT and RR coefficients is complex and only weakly related to the size of the treatment effect. CONCLUSION: Retrospective methods of computing responsiveness yield little information about the ability of an instrument to detect treatment effects, and should not be used as a basis for choice of an instrument for applications to clinical trials.

Computer Simulation↗

PubMed1998

Comparison of diary and retrospective measures for recording alcohol consumption and sexual activity.

This study examines issues in the measurement of HIV risk factors, using daily diaries to collect data on both alcohol use and sexual behavior. Seventy-nine adolescents and young adults recruited from an STD clinic and from a university campus were studied. Participants gave daily reports of their drinking, drug use, and sexual activities for 4 weeks. Respondents then completed a retrospective questionnaire asking about the frequencies of these behaviors during the preceding period. Diary reports of behavior were strongly correlated with retrospective reports. More frequent drinking was reported on the diary measure than the retrospective measure, and this discrepancy was larger for more frequent drinkers. Frequency of sexual activity was overreported on the retrospective measure only among adolescents. Errors in the measurement of alcohol use, sexual behavior, or their co-occurrence could affect estimations of the relationship of alcohol use to sexual behavior. The types of error inherent in these measures may differ, resulting in different tendencies toward over- or underreporting of alcohol use and sexual behavior, depending on frequency of the behavior and the characteristics of the subject population.

Adolescent↗

PubMedDate not supplied

Inter- and intrarater reliability of retrospective drug utilization reviewers.

OBJECTIVE: To assess inter- and intrarater reliability among 23 pharmacist and physician retrospective drug utilization reviewers and to assess interrater reliability after a reviewer training session. DESIGN: Exploratory study. SETTING: Maryland Medicaid's retrospective drug utilization review (DUR) program. PARTICIPANTS: 23 physician and pharmacist retrospective drug utilization reviewers. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Profiles rated as "intervention indicated" or "intervention not indicated." Cochran's Q test, overall percent agreement, and the unweighted kappa statistic were used in the analysis of review consistency. RESULTS: Intrarater reliability showed substantial consistency among the 23 reviewers; the percent agreement was 82.9% with kappa = 0.66. Interrater reliability, however, was poor, with an overall agreement of 69.6% and kappa = 0.16. Interrater reliability was also poor after a one-hour reviewer training session (agreement 81.8%, kappa = -0.19). CONCLUSION: The implicit review process used in the retrospective DUR program that we evaluated was unreliable. Since reliability is a necessary but not sufficient condition for validity of an indicator of inappropriate drug use, the validity of the DUR implicit review process is in question.

Data Interpretation, Statistical↗

PubMed1998

Retrospective diagnosis of dementia using an informant interview based on the Brief Cognitive Rating Scale.

The accuracy of a dementia diagnosis by specialist physicians, as verified at an autopsy, is greater than 90% in many series. Donations of brains to the Maritime Brain Tissue Bank (MBTB) by individuals who did not have expert dementia diagnoses before death led us to investigate whether clinical features could also be detected retrospectively. Informants for 36 individuals whose brains were in the MBTB (18 women, mean age = 79 years; pathologic diagnoses: 75% Alzheimer's disease [AD]; 8.4% vascular or mixed dementia) were interviewed by specialist physicians using a semistructured retrospective interview based on the Brief Cognitive Rating Scale (BCRS) (range = 1 [no impairment] to 7 [terminal dementia]). The mean duration of dementia was 8.5 +/- 12.8 years based on proxy reports, and most cases suggested severe dementia--(stage 6 [severe] or 7 [terminal])--on the retrospective BCRS (RetroBCRS) before death. A score of 4 or more on the RetroBCRS had 100% sensitivity and specificity in detecting dementia. The RetroBCRS score correlated moderately with duration (.51). In linear and logistic regression models adjusted for age and sex, RetroBCRS staging helped explain 93% of the variation in duration. The accuracy of the retrospective diagnosis of the cause of dementia, compared with autopsy, was 92%. The RetroBCRS used by an expert physician with a reliable informant is a valid method of detecting dementia and determining whether AD was present.

Aged↗

PubMed1998

Feasibility of retrospective assessments of behavioral symptoms in Alzheimer's disease: a preliminary study of postmortem caregiver reports.

Studies of the behavioral symptoms in Alzheimer's disease (AD) would be facilitated if reliable reports could be obtained retrospectively, especially about symptoms in the final months of life when concurrent assessment is often not feasible. To evaluate such a method, we compared results of a telephone interview conducted after the patient's death with information provided by the same informant earlier, while the patient was living. Agreement between in-life and retrospective assessments was higher for psychotic symptoms than for depressive behaviors, suggesting that retrospective assessment of specific behavioral symptoms in AD is not uniformly reliable. More symptoms were retrospectively reported as the length of time between the last in-life evaluation and date of death increased, suggesting that there may be increased variety of behavioral symptoms observed by caregivers in the final stages of the disease.

Aged↗

PubMed2000

Peroperative cardiovascular stability during brainstem surgery. The use of high-dose methylprednisolone compared to dexamethasone. A retrospective analysis.

BACKGROUND: In neurosurgical procedures within brainstem structures, corticosteroids are routinely administered to prevent oedema and to reduce intraoperative trauma. After replacing the routine administration of dexamethasone (DX) by high-dose methylprednisolone (MP) during surgery for tumours within brainstem structures, a decreased incidence of intraoperative haemodynamic instability events was observed. To test this hypothesis, a retrospective analysis was performed. METHODS: Peroperative data of 62 surgical procedures of brainstem tumours were retrospectively analysed with respect to haemodynamic instability requiring changes in surgical strategy and/or emergence medication with vasoactive drugs. Severe changes in haemodynamic parameters were defined as a significant increase or decrease in heart rate and/or mean arterial blood pressure greater than 30% compared to baseline values. From 1988 to 1994, intravenous dexamethasone was given peroperatively in 33 patients. After a bolus of 1 mg kg(-1) body weight (BW) 30 min preoperatively, 0.2 mg kg(-1) were given every 4 h. From 1994 until now, methylprednisolone was administered instead of dexamethasone in 29 patients. After an initial bolus of 30 mg kg(-1) BW immediately before surgery, 5.4 mg kg(-1) h(-1) were given 23 h postoperatively. RESULTS: The results of this retrospective analysis suggest that the number of operations with episodes of bradycardia, arterial hypotension (P<0.05), tachycardia and arterial hypertension (P<0.005) was significantly decreased in the group of patients treated with high-dose methylprednisolone. CONCLUSION: The retrospective analysis of the clinical data showed that the routine use of high-dose methylprednisolone was associated with a decreased incidence of haemodynamic instability in a selected group of patients undergoing brainstem surgery. This finding has to be proven in prospective double-blind controlled studies.

Adolescent↗

PubMed1992

Neuroticism and selective encoding and recall of symptoms: evidence from a combined concurrent-retrospective study.

The association between Neuroticism (N) and elevated symptom reporting has been attributed to differences in the encoding but not in the recall of illness episodes. If high-N persons are selective only at the encoding of illness information, then retrospective reports should be no more exaggerated than concurrent reports. This study uses a concurrent-retrospective design to examine selectivity in concurrent and retrospective reports of symptoms. Concurrent daily reports gathered over 2 months were only moderately correlated with retrospective symptom reports covering the same time period. The direct path from N to recalled symptoms was larger than the indirect path from N through concurrent to recalled symptoms for 3 out of 4 symptoms. Discussion concerns implications of using recollection-based measures, suggestions for reducing selective memory effects, and explanations regarding how and why N relates to selective information processing about the self.

Adult↗