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PubMedDate not supplied

Predicting student attrition in a baccalaureate curriculum.

A longitudinal study of enrollment data of the Universtiy of Wisconsin--Madison School of Nursing identified several trends in student attrition over a six-year period and formed the basis for the development of a model to predict student attrition. The model proposed to satisfy the need for more precise measures of probable student retention and attrition for counseling and planning purposes in the school's new curriculum. To arrive at a means for predicting student attrition, scores of random samples of continuing and dropout student on achievement, learning style, and psychologial variables obtained during the first three years of the new curriculum were examined using a discriminant analysis technique. A significant differentiation between continuing and dropout students (p less than .000) resulted and allowed a predictive function to be developed. Using a conservative method of identification with student scores transformed by this function, predictions of successful and nonsuccessful students were obtained.

Curriculum↗
PubMed1986

Early placebo response in anxious and depressed patients.

Specific subgroups of anxiety disorder patients (N = 130) and depression patients (N = 105), defined according to DSM-III criteria, were given 1 week of placebo treatment as part of ongoing clinical drug trials. Placebo responses and dropout rates were assessed at the end of the placebo trial period. The results indicate a comparable dropout rate between depression and anxiety disorder groups due to positive placebo response, negative placebo response, and "nonsymptomatic" reasons. In addition, male anxiety disorder patients dropped out at a significantly higher rate than male depression patients.

Adolescent↗
PubMed1987

Implications of restrictive diagnosis for compliance to antidepressant drug therapy: alprazolam versus imipramine.

Early dropouts from a double-blind comparison of the therapeutic efficacy of alprazolam and imipramine were examined. The dropout rate across the total sample of 99 analyzable outpatients with major depression was 3 times higher in the imipramine treatment group. Although essentially all patients met DSM-III criteria for major depressive episode, only two thirds of the total sample met the restrictive Feighner criteria for primary depressive disorder. Early termination in the imipramine group was concentrated in the group of depressed outpatients who failed to satisfy the Feighner criteria. Implications of these and other recently reported results for choice of drug treatment for depressed psychiatric outpatients are discussed.

Alprazolam↗
PubMed1987

[Psychological disorders of students and university results].

Many epidemiological studies demonstrate the importance of psychological disorders among college and university students. Those disorders have an impact upon the academic performance and may lead to dropping out. The aim of this research is to study the possible relations between the incidence of psychological troubles and the evolution of the academic performance. The sample is constituted by 45 first year students of the Université du Québec à Trois-Rivières. Each subject has answered the psychological and psychiatric inventory built up by Bernot et al. (1969) (Psychorater). The academic performance evolution has been scored by comparing, for each student, the mark means obtained at the first three sessions. Cross-sessions comparisons have made possible to divide the sample into four subgroups: "in regression", "with relatively stable performances", "in progression" and "dropouts". The results show a statistically significative relation between, on the one hand, the university adaptation difficulties leading to dropping out and, on the other hand, the "impulsivity-instability" dimension and the "family, professional and social adaptation troubles". Excluding the dropout subjects, it is not possible, however, to correlate the variations in the academic performance and the incidence of psychological troubles found with the Psychorater.

Achievement↗
PubMed1987

Attrition in an undergraduate program in allied health education.

The present study compared the characteristics of allied health professionals who completed a bachelor's degree program in allied health education with those who failed to complete the program, in order to develop recommendations for a retention program. The data base included all graduates and dropouts for the period September 1972 to August 1986. Analyses indicated that alumni and those who dropped out were remarkedly similar with regard to demographic characteristics such as age, sex, ethnicity, and prior academic achievement. Fifty percent of the dropouts occurred within the first semester, although attrition continued to occur over a five-year period. The reasons for dropping out were varied, and few were recorded for academic reasons. It was concluded that adult allied health professionals pose difficult problems for retention because motivation and commitment variables appear more important than academic ability or social/academic integration factors. These findings were consistent with research on attrition in higher education, and with the literature on adult learning.

Achievement↗
PubMed1986

[Incomplete child and adolescent psychiatric studies].

Of the 5029 clients seen for the first time between 1973 and 1983, 229 (4.6%) dropped out before diagnostic evaluation could be completed. Data analysis showed above-average dropout rates for the items "adolescent," "only child," "job problems" and "drug abuse." A follow-up study was conducted in which those dropouts first seen during 1982-83 (N = 46) were questioned about the reasons for no longer coming.

Adolescent↗
PubMed1979

Status of hypertension treatment in Israel.

A review of the records of 17 family practices in the Tel Aviv area showed that 31% of charts had no record of blood pressure readings. In other studies, only 45% of subjects with prescribed medication remained on treatment. Some of the patients who had started medication stopped going to the doctor of their own accord. Only 32% of those who remained on treatment had their blood pressure under control. Poor compliance, inadequate therapeutic regimen and high dropout rate explain the picture in Israel. A screening program for hypertension will fail if not accompanied by high-quality medical care and careful follow-up. When specially trained nurses joined doctors in the management of high blood pressure patients, a follow-up of 726 patients originally treated by a doctor alone and then by a doctor-nurse team for one year showed that the percentage of controlled hypertensives rose from 39.2 to 72.8% and the dropout rate fell from 30 to 0.65%. The adoption, on a national scale, of a doctor-nurse team approach for controlling hypertension is, therefore, strongly recommended.

Adult↗
PubMed1993

Recruitment and retention in a clinical trial for low birth weight, premature infants.

We report on recruiting and retaining a sample of low birth weight, premature infants for a clinical trial as well as results of tests evaluating sampling and retention biases. A total of 4551 infants were screened, and 1302 were found eligible. Consent was obtained for 1028 infants. After randomization and the presentation of group assignment, the number of infants enrolled was 985 (75.7% of those eligible). Of these, 92.7% completed the 3-year study. Tests to evaluate recruitment bias revealed significant relationships between nonenrollment and site, maternal race, and infant birth weight. Tests to evaluate retention bias revealed a significant relationship between dropout and maternal education. Additionally, infant birth weight and maternal age interacted with treatment in predicting dropout. Despite these statistically significant recruitment and retention biases, there was no evidence of problems with sample representativeness to the population of interest or of treatment group differences on study-relevant background variables.

Bias↗
PubMed1994

An application of maximum likelihood and generalized estimating equations to the analysis of ordinal data from a longitudinal study with cases missing at random.

Data are analysed from a longitudinal psychiatric study in which there are no dropouts that do not occur completely at random. A marginal proportional odds model is fitted that relates the response (severity of side effects) to various covariates. Two methods of estimation are used: generalized estimating equations (GEE) and maximum likelihood (ML). Both the complete set of data and the data from only those subjects completing the study are analysed. For the completers-only data, the GEE and ML analyses produce very similar results. These results differ considerably from those obtained from the analyses of the full data set. There are also marked differences between the results obtained from the GEE and ML analysis of the full data set. The occurrence of such differences is consistent with the presence of a non-completely-random dropout process and it can be concluded in this example that both the analyses of the completers only and the GEE analysis of the full data set produce misleading conclusions about the relationships between the response and covariates.

Age Factors↗
PubMed1997

Evaluation of growth monitoring programme in children in Kinshasa.

A high dropout rate was noted at the under five clinic of the University of Kinshasa Teaching Hospital. A preliminary study carried out in March 1984 on 197 children indicated that none of them had completed the five year period of the growth monitoring programme. Five hundred mothers of children attending the under five year clinic were then randomly selected from the 1224 who registered between September 1983 and August 1984. They were interviewed at home during a six week period. This paper confirms the dropout problem. It discusses whether mothers should abandon the visits early. It concludes that health workers should be trained to advise mothers to bring their children to the programme up to five years though the attendance frequency may be reduced from the second year onwards.

Adult↗
PubMed1997

CAPD in southern Brazil: an epidemiological study.

There are many studies on the performance of continuous ambulatory peritoneal dialysis (CAPD) in developed countries, but studies in the third world are scarce. The aim of this study is to analyze CAPD experience in the southernmost state of Brazil (Rio Grande do Sul, RS). Records were obtained from the Health Secretary of RS to assemble a cohort of all patients treated with CAPD. Another cohort study followed all patients initiating treatment for uremia in 1993 in the state capital, Porto Alegre, and compared CAPD, hemodialysis, and transplanted patients. In RS, 1316 patients (50.4% male, mean age 45.9 years) were treated in 40 CAPD programs. Despite the initial growth of the CAPD population, it subsequently leveled off. Survival was 78.6% and 40.7% in years 1 and 5, being worse for initial patients of each program, infants, and elders. Technique survival was 57.4% and 10.1% at years 1 and 5. Patients interrupting treatment for any reason had a higher chance of dropout. In Porto Alegre, 294 patients started dialysis during 1993; 21 performed CAPD, 44 had a transplant, and the others were hemodialyzed. Children were treated mostly by CAPD. CAPD patients had less diabetes and ischemic heart disease and received more transplants. Their adjusted actuarial survival (100% year 1; 67% year 3) was no different than hemodialysis. CAPD is not a popular form of renal therapy in RS, and dropout rates are significant.

Adolescent↗
PubMed1997

Project Support: engaging children and families in the educational process.

The literature on dropout prevention reveals that a triumvirate of support--from the family, the school, and the community--is necessary to engage children in the educational process. This paper describes Project Support, a federally funded five-year program for at-risk youths that focused on alcohol, drug, and dropout prevention in four low-income, high-minority public school districts in the suburbs of New York City. Of several avenues taken, two were very effective: a school-based mentoring program designed for middle school students and the Outdoor and Environmental Education program that took place during summers and intermittently throughout the school year. The sense of achievement, bonding, and success experienced by participants was acknowledged by administrators, evaluators, parents, and other observers.

Child↗
PubMed1984

Retinal microangiopathy. Correlation of OCTOPUS perimetry with fluorescein angiography.

The capillary perfusion of 14 eyes with nonproliferative diabetic retinopathy and 14 eyes with retinal branch vein occlusion was assessed by wide-angle fluorescein angiography. Regional perfusion was directly correlated with visual sensitivity determined by OCTOPUS-automated static perimetry. Visual function was found to correlate linearly with capillary perfusion in both diseases. Occasional foci of decreased visual sensitivity that corresponded to a region of good capillary perfusion were found in the central fields of diabetics. Although capillary dropout appears to be the major cause of decreased visual sensitivity in microangiopathy, local metabolic factors may also play a role. Further studies are required to determine whether foci of decreased function are predictive of future capillary dropout or neovascularization.

Adult↗
PubMed1993

Maintenance drug treatment for panic disorder. II. Short- and long-term outcome after drug taper.

Forty-eight patients with panic disorder completing 8 months of maintenance treatment with alprazolam (mean dose, 5.2 mg [n = 27]), imipramine hydrochloride (mean dose, 175 mg [n = 11]), or placebo (mean dose, 8.0 pills [n = 10]) underwent a gradual taper from medication over a 4-week period. A withdrawal syndrome was observed in almost all alprazolam-treated patients but in only a few imipramine- or placebo-treated patients. The clinical worsening of withdrawal symptoms after discontinuation tended to subside over the course of 3 medication-free weeks, but 33% of alprazolam-treated patients were unable to discontinue their medication regimen successfully. Severity of panic attacks at baseline but not daily alprazolam dose appeared as a significant independent predictor of taper difficulty. Forty-nine percent of the total study population continue to receive drug therapy: 82% alprazolam and 18% imipramine. Among patients who received alprazolam during study treatment and at follow-up, the mean daily dose was substantially reduced (6.1 vs 1.6 mg [n = 14]). At follow-up, after 1 year of naturalistic treatment for panic symptoms and combining 8-month completers and study dropouts, there were no significant differences in remission (68% to 71%) or in antipanic medication intake (39% to 56%) at follow-up for the three original treatment groups. However, 8-month study completers compared with study dropouts had a significantly higher remission rate (85% vs 55%).

Adult↗
PubMed2006

Injectable, sustained-release naltrexone for the treatment of opioid dependence: a randomized, placebo-controlled trial.

CONTEXT: Oral naltrexone can completely antagonize the effects produced by opioid agonists. However, poor compliance with naltrexone has been a major obstacle to the effective treatment of opioid dependence. OBJECTIVE: To evaluate the safety and efficacy of a sustained-release depot formulation of naltrexone in treating opioid dependence. DESIGN AND SETTING: Randomized, double-blind, placebo-controlled, 8-week trial conducted at 2 medical centers. PARTICIPANTS: Sixty heroin-dependent adults. INTERVENTIONS: Participants were stratified by sex and years of heroin use (> or = 5 vs < 5) and then were randomized to receive placebo or 192 or 384 mg of depot naltrexone. Doses were administered at the beginning of weeks 1 and 5. All participants received twice-weekly relapse prevention therapy, provided observed urine samples, and completed other assessments at each visit. MAIN OUTCOME MEASURES: Retention in treatment and percentage of opioid-negative urine samples. RESULTS: Retention in treatment was dose related, with 39%, 60%, and 68% of patients in the placebo, 192 mg of naltrexone, and 384 mg of naltrexone groups, respectively, remaining in treatment at the end of 2 months. Time to dropout had a significant main effect of dose, with mean time to dropout of 27, 36, and 48 days for the placebo, 192 mg of naltrexone, and 384 mg of naltrexone groups, respectively. The percentage of urine samples negative for opioids, methadone, cocaine, benzodiazepines, and amphetamine varied significantly as a function of dose. When the data were recalculated without the assumption that missing urine samples were positive, a main effect of group was not found for any drugs tested except cocaine, where the percentage of cocaine-negative urine samples was lower in the placebo group. Adverse events were minimal and generally mild. This formulation of naltrexone was well tolerated and produced a robust, dose-related increase in treatment retention. CONCLUSION: These data provide new evidence of the feasibility, efficacy, and tolerability of long-lasting antagonist treatments for opioid dependence.

Adolescent↗
PubMed2005

Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials.

CONTEXT: Atypical antipsychotic medications are widely used to treat delusions, aggression, and agitation in people with Alzheimer disease and other dementia; however, concerns have arisen about the increased risk for cerebrovascular adverse events, rapid cognitive decline, and mortality with their use. OBJECTIVE: To assess the evidence for increased mortality from atypical antipsychotic drug treatment for people with dementia. DATA SOURCES: MEDLINE (1966 to April 2005), the Cochrane Controlled Trials Register (2005, Issue 1), meetings presentations (1997-2004), and information from the sponsors were searched using the terms for atypical antipsychotic drugs (aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone), dementia, Alzheimer disease, and clinical trial. STUDY SELECTION: Published and unpublished randomized placebo-controlled, parallel-group clinical trials of atypical antipsychotic drugs marketed in the United States to treat patients with Alzheimer disease or dementia were selected by consensus of the authors. DATA EXTRACTION: Trials, baseline characteristics, outcomes, all-cause dropouts, and deaths were extracted by one reviewer; treatment exposure was obtained or estimated. Data were checked by a second reviewer. DATA SYNTHESIS: Fifteen trials (9 unpublished), generally 10 to 12 weeks in duration, including 16 contrasts of atypical antipsychotic drugs with placebo met criteria (aripiprazole [n = 3], olanzapine [n = 5], quetiapine [n = 3], risperidone [n = 5]). A total of 3353 patients were randomized to study drug and 1757 were randomized to placebo. Outcomes were assessed using standard methods (with random- or fixed-effects models) to calculate odds ratios (ORs) and risk differences based on patients randomized and relative risks based on total exposure to treatment. There were no differences in dropouts. Death occurred more often among patients randomized to drugs (118 [3.5%] vs 40 [2.3%]. The OR by meta-analysis was 1.54; 95% confidence interval [CI], 1.06-2.23; P = .02; and risk difference was 0.01; 95% CI, 0.004-0.02; P = .01). Sensitivity analyses did not show evidence for differential risks for individual drugs, severity, sample selection, or diagnosis. CONCLUSIONS: Atypical antipsychotic drugs may be associated with a small increased risk for death compared with placebo. This risk should be considered within the context of medical need for the drugs, efficacy evidence, medical comorbidity, and the efficacy and safety of alternatives. Individual patient analyses modeling survival and causes of death are needed.

Antipsychotic Agents↗
PubMedDate not supplied

Model-based approaches to analysing incomplete longitudinal and failure time data.

Since Wu and Carroll (Biometrics 44, 175-188) proposed a model for longitudinal progression in the presence of informative dropout, several researchers have developed and studied models for situations where both a vector of repeated outcomes and an event time is available for each subject. These models have been developed for either longitudinal studies with dropout or for survival studies in which a random, time-varying covariate is measured repeatedly across time. When inference about the longitudinal variable is of interest, event times are treated as covariates and are often incomplete due to censoring. If survival or event time is the primary endpoint, repeated outcomes observed prior to the event are viewed as covariates; this covariate process is often incomplete, measured with error, or observed at unscheduled times during the study. We review several models which are used to handle incomplete response and covariate data in both survival and longitudinal studies.

Algorithms↗
PubMed1997

Statistical methods for two-sequence three-period cross-over designs with incomplete data.

In clinical trials, and in bioavailability and bioequivalence studies, one often encounters replicate cross-over designs such as a two-sequence three-period cross-over design to assess treatment and carry-over effects of two formulations of a drug product. Because of the potential dropout (or for some administrative reason), however, the observed data set from a replicate cross-over design is incomplete or unbalanced so that standard statistical methods for a cross-over design may not apply directly. For inference on the treatment and carry-over effects, we propose a method based on differences of the observations that eliminates the random subject effects and thus does not require any distributional condition on the random subject effects. When no datum is missing, this method provides the same results as the ordinary least squares method. When there are missing data, the proposed method still provides exact confidence intervals for the treatment and carry-over effects, as long as the dropout is independent of the measurement errors. We provide an example for illustration.

Clinical Trials as Topic↗