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At least 919 records · Page 51Linked to original sources
PubMed2001

Consensus evidence evaluation in resuscitation research: analysis of Type I and Type II errors.

OBJECTIVE: This paper addresses the following statistical question: 'if genuine improvements in cardiopulmonary resuscitation (CPR) were discovered that doubled the probability of resuscitation success in a series of randomized clinical trials, would they be recognized and incorporated into consensus guidelines?'. METHODS: Statistical powers for hypothetical individual clinical trials comparing experimental and control CPR were computed as a function of the study N when the true probabilities for immediate survival, 24 h survival, and discharge survival in the experimental group were twice those in the control group. Next, the binomial distributions describing the numbers of statistically significant studies in a series of equally powered trials of the same intervention were determined. These were compared with varying criteria for consensus among expert reviewers, expressed in terms of the number of 'positive' studies showing a statistically significant difference that reviewers would require before approving the experimental method. RESULTS: False-negative evaluations (i.e. failures to approve a technique that actually doubled survival) were extremely common under a wide range of realistic assumptions and consensus criteria, especially when simulated long-term survival data were considered. Similar methods showed that false-positive evaluations would be extremely rare, provided that at least two of the clinical trials in a series showed a statistically significant benefit of the experimental method. CONCLUSIONS: Optimization of evidence evaluation can and should be carried out to make better use of available data in creating resuscitation guidelines. One simple approach is the 'two and one quarter test': if at least two well-conducted studies in a series are significantly positive (P<0.05) comprising at least one-quarter of all studies in the series, a positive effect can be inferred with small Type I and Type II errors. In addition, greater reliance on modern, unbiased methods such as cumulative meta-analysis is needed to increase the sensitivity of evidence evaluation for detecting useful innovations in resuscitation.

Clinical Protocols↗
PubMed1998

The correlation between the ASTRO Consensus Panel definition of biochemical failure and clinical outcome for patients with prostate cancer treated with external beam irradiation. American Society of Therapeutic Radiology and Oncology.

PURPOSE: We reviewed our institution's experience treating patients with external beam irradiation (RT) to determine if the ASTRO Consensus Panel definition of biochemical failure (BF) following radiation therapy correlates with clinical distant metastases free survival (DMFS), disease-free survival (DFS), cause-specific survival (CSS), and local control (LC). METHODS AND MATERIALS: Between 1/1/87 and 12/31/92, 568 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital (median total dose 66.6 Gy; range: 60-70.4 Gy). Biochemical failure was defined as three consecutive increases in post-treatment prostate specific antigen (PSA) after achieving a nadir. Biochemical failure was recorded as the time midway between the nadir and the first rising PSA. Five-year actuarial rates of clinical DMFS, DFS, CSS, and LC were calculated for patients who were biochemically controlled (BC) versus those who failed biochemically. Median follow-up was 56 months (range: 24-118 months). RESULTS: Five-year actuarial rates of DMFS, DFS, CSS, and LC were significantly greater in patients who were biochemically controlled versus those who were not (p < 0.001). In patients who were BC, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 99%, 99%, 98%, and 99% respectively. For patients who failed biochemically, the 5-year actuarial rates of DMFS, DFS, CSS, and LC were 74%, 64%, 89%, and 86% respectively. When stratifying by pretreatment PSA, Gleason score, and T stage these differences remained significant for DMFS, DFS, and CSS. The Cox proportional hazards model demonstrated that BC was the single most important predictor of clinical outcome for DMFS, DFS, CSS, and LC. Pretreatment PSA and Gleason score were also independent predictors of outcome for DMFS and DFS. CONCLUSIONS: The ASTRO Consensus Panel definition of BF following radiation therapy correlates well with clinical DMFS, DFS, and CSS. These findings suggest that the Consensus Panel definition may be a surrogate for clinical progression and survival and should be considered a valid endpoint for separating successful versus unsuccessful treatment. Additional studies with longer follow-up will be needed to corroborate these findings.

Actuarial Analysis↗
PubMedDate not supplied

Evaluation of the serologic response against two consensus V3 loop peptides from human immunodeficiency virus-1 in Cuban patients.

OBJECTIVES: A retrospective study was conducted to evaluate the antibody response of Cuban patients infected with human immunodeficiency virus (HIV)-1 against two consensus peptides from the third variable domain (V3) loop of glycoprotein gp120. METHODS: The study included sera from 10 individuals at different stages of disease. Two 15-meric synthetic peptides designed from a consensus sequence, belonging to group B or C of HIV-1, were used to determine antibody titers and avidity indexes in an indirect enzyme-linked immunoassay. RESULTS: A high reactivity against both peptides was detected, with 80% of the sera reacting with at least one of the peptides. The antibody titers and avidity indexes did not correlate with disease progression. Additionally, for one of the patients from whom the virus had been isolated, a higher avidity index was found against the homologous peptide. CONCLUSIONS: This study showed high reactivity against two consensus peptides from the V3 loop of gp120 among patients with HIV. Large scale studies are needed to determine whether the titers or avidity of anti-V3 antibodies, at the early stages of infection, are predictive of disease progression. Both peptides are candidates for inclusion in experimental vaccines.

Antibodies, Viral↗
PubMed2003

Diagnosis of drug-induced liver injury in Japanese patients by criteria of Consensus Meetings in Europe.

Eighty-five Japanese patients with drug-induced liver injury were assessed by criteria of Consensus Meetings in Europe on causality assessment of drug-induced liver injury. Histopathological investigation was performed for all patients to confirm the diagnosis. We divided these patients into two groups by the date of disease onset. Cases before 1989 were defined as past cases, and those after 1990 as recent cases, because the clinical-pathological characteristics of drug-induced liver injury have changed due to the ability to diagnose hepatitis C virus infection since 1990. Fifty-seven patients with drug-induced liver injury were enrolled as past cases, and 28 as recent cases. For past cases, the results of assessment by the criteria of Consensus Meetings in Europe were as follows: 'very likely': 14 patients (25%), 'likely': 23 patients (40%), 'possible': 15 patients (26%), 'dubious': five patients (9%), and 'unlikely': none (0%). For recent cases, the results were as follows: 'very likely': six patients (22%), 'likely': 14 patients (42%), 'possible': six patients (22%), 'dubious': two patients (7%), and 'unlikely': none (0%). There were no differences between the past and recent cases in distribution of assessment. More than 90% of patients were assessed as 'possible' or more, and the remaining seven patients were assessed as 'dubious'. No patients were assessed as 'unlikely'. Five of seven patients assessed as 'dubious' had long-term cholestasis, and two had alcohol consumption. These results indicated that the criteria of Consensus Meetings in Europe were useful for diagnosing drug-induced liver injury in Japanese patients.

Journal Article↗
PubMed2005

Primary dysmenorrhea consensus guideline.

METHODS: Members of this consensus group were selected based on individual expertise to represent a range of practical and academic experience both in terms of location in Canada and type of practice, as well as subspecialty expertise along with general gynaecology backgrounds. The consensus group reviewed all available evidence through the English and French medical literature and available data from a survey of Canadian women. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. RESULTS: This document provides a summary of up-to-date evidence regarding the diagnosis, investigations, and medical and surgical management of dysmenorrhea. The resulting recommendations may be adapted by individual health care workers when serving women who suffer from this condition. CONCLUSIONS: Dysmenorrhea is an extremely common and sometimes debilitating condition for women of reproductive age. A multidisciplinary approach involving a combination of lifestyle, medications, and allied health services should be used to limit the impact of this condition on activities of daily living. In some circumstances, surgery is required to offer the desired relief. OUTCOMES: This guideline discusses the various options in managing dysmenorrhea. Patient information materials may be derived from these guidelines in order to educate women in terms of their options and possible risks and benefits of various treatment strategies. Women who find an acceptable management strategy for this condition may benefit from an improved quality of life.

Diagnosis, Differential↗
PubMedDate not supplied

Molecular similarity analysis and virtual screening by mapping of consensus positions in binary-transformed chemical descriptor spaces with variable dimensionality.

A novel compound classification algorithm is described that operates in binary molecular descriptor spaces and groups active compounds together in a computationally highly efficient manner. The method involves the transformation of continuous descriptor value ranges into a binary format, subsequent definition of simplified descriptor spaces, identification of consensus positions of specific compound sets in these spaces, and iterative adjustments of the dimensionality of the descriptor spaces in order to discriminate compounds sharing similar activity from others. We term this approach Dynamic Mapping of Consensus positions (DMC) because the definition of reference spaces is tuned toward specific compound classes and their dimensionality is increased as the analysis proceeds. When applied to virtual screening, sets of bait compounds are added to a large screening database to identify hidden active molecules. In these calculations, molecules that map to consensus positions after elimination of most of the database compounds are considered hit candidates. In a benchmark study on five biological activity classes, hits for randomly assembled sets of bait molecules were correctly identified in 95% of virtual screening calculations in a source database containing more than 1.3 million molecules, thus providing a measure of the sensitivity of the DMC technique.

Journal Article↗
PubMedDate not supplied

2D QSAR consensus prediction for high-throughput virtual screening. An application to COX-2 inhibition modeling and screening of the NCI database.

Using classification (SOM, LVQ, Binary, Decision Tree) and regression algorithms (PLS, BRANN, k-NN, Linear), this paper details the building of eight 2D-QSAR models from a 266 COX-2 inhibitor training set. The predictive performances of these eight models were subsequently compared using an 88 COX-2 inhibitor test set. Each ligand is described by 52 2D descriptors expressed as van der Waals Surface Areas (P_VSA) and its COX-2 binding IC50. One of our best predictive models is the neural network model (BRANN), which is able to select a subset, from the 88 ligand test set, that contains 94% COX-2 active inhibitors (pIC50>7.5) and detects 71% of all the actives. We then introduce a QSAR consensus prediction protocol that is shown to be more predictive than any single QSAR model: our C3 consensus approach is able to select a subset from the 88 ligand test set that contains 94% active inhibitors and 83% of all the actives. The 2D QSAR consensus protocol was finally applied to the high-throughput virtual screening of the NCI database, containing 193,477 organic compounds.

Cyclooxygenase 2↗
PubMedDate not supplied

The use of consensus scoring in ligand-based virtual screening.

A new consensus approach has been developed for ligand-based virtual screening. It involves combining highly disparate properties in order to improve performance in virtual screening. The properties include structural, 2D pharmacophore and property-based fingerprints, scores derived using BCUT descriptors, and 3D pharmacophore approaches. Different approaches for the combination of all or some of these methods have been tested. Logistic regression and sum ranks were found to be the most advantageous in different pharmaceutical applications. The three major reasons consensus scoring appears to enrich data sets better than single scoring functions are (1) using multiple scoring functions is similar to repeated samplings, in which case the mean is closer to the true value than any single value, (2) due to the better clustering of actives, multiple sampling will recover more actives than inactives, and (3) different methods seem to agree more on the ranking of the actives than on the inactives. Furthermore, consensus results are not only better but are also more consistent across receptor systems.

Journal Article↗
PubMed2004

Consensus kNN QSAR: a versatile method for predicting the estrogenic activity of organic compounds in silico. A comparative study with five estrogen receptors and a large, diverse set of ligands.

Quantitative structure-activity relationships (QSARs) have proved increasingly useful for predicting the biological activities of molecules (e.g., their binding affinities to different receptors) and can be used in environmental chemistry as a preliminary tool for screening the activities of untested molecules, producing valuable information on which compounds should be tested more thoroughly with experimental affinity assays or in animals. The predictive ability of the consensus kNN QSAR method is corroborated here using a diverse set of 245 compounds, which have been assayed for their relative binding affinities to the estrogen receptor of four species: human (ER alpha and ER beta), calf, mouse, and rat. Leave-one-out cross-validation (LOO-CV) and gamma-randomization tests were applied to the QSAR models for internal validation, and separate training and test sets were used for external validation. The internal predictive abilities of the consensus models for all five data sets were convincing, with cross-validated correlation coefficients (LOO-CV q2 values) varying from 0.69 (human ER beta data) to 0.79 (human ER alpha data). The external predictive abilities were also encouraging, as the predictive r2 scores (pr-r2 values) varied from 0.62 (human ER beta data) to 0.77 (calf and mouse data). The results indicate that consensus kNN QSAR is a feasible method for rapid screening of the estrogenic activity of organic compounds.

Animals↗
PubMed1998

The rodent alphaA-crystallin gene: mutagenesis of a non-consensus 5'-splice site to study alternative splicing in vivo.

alphaA-Crystallin is a member of the small heat shock protein family that is abundantly expressed as a structural component in the vertebrate eye lens. In lenses of rodents and some other mammals, there occurs a minor variant of alphaA-crystallin, which has an insertion of 23 amino acid residues. This variant, alphaA(ins)-crystallin, results from differential integration of an optional exon into a small fraction of the mRNA. We have studied whether this alternative splicing is caused by a non-consensus cytosine in the 5' splice site adjacent to the optional exon. After replacement of the aberrant cytosine in the hamster alphaA-crystallin gene by a consensus thymine, and transient transfection of this gene in Chinese Hamster Ovary cells, the optional exon is indeed almost completely spliced into the mature mRNA. In contrast, replacement of the cytosine by adenine or guanine completely abolishes the splicing of the optional exon. Our results confirm that alternative splicing of the alphaA-crystallin primary transcript is mainly due to a non-consensus 5' splice site nucleotide. However, we conclude that the small size of the optional exon is probably an additional contributing factor and therefore it seems that the splicing mechanism is based on recognition of exons rather than introns.

Alternative Splicing↗
PubMed2006

[Family health nursing in Germany: a process of consensus finding as basis].

The "Project design- and consensus phase for implementation of the Family Health Nurse in Germany" ordered by the German professional association for nurses (DBfK) was realized by the Institute of Nursing Science at the University of Witten/Herdecke. Aim of this study was to find out if there is a consensus between eleven stakeholders from ten different institutions of the German health care system before starting the real "pilot project for the feasibility of the Family Health Nurse in Germany", which should strengthen the prevention and the health promotion in Germany corresponding to the WHO's policy framework "Health 21". The investigation included also the identification of the need and the complexity of the new role for nurses and midwives. Furthermore, a statement should be made about the virtual feasibility. Methodically, multi-level analyses were used. First, the stakeholders were interviewed about the possible role of the Family Health Nurse in Germany. All their statements were determined by qualitative content analyses. From these results different areas of responsibilities for the Family Health Nurse in Germany were developed by using the scenario technique. These scenarios were discussed by the stakeholders in focus groups and revised several times until five consented scenarios could be developed. The contents of the scenarios were generalized and structured to according the variables target group, reason for care, need, access, skills, settlement and financing. Like that, the characteristic features of the new areas of responsibilities for the Family Health Nurse in Germany could be defined. Finally, all stakeholders formulated the consensus for the implementation of the planned pilot project with an integrated educational course for nurses and midwives, which immediately has started in autumn 2005 with an accompanying research evaluation.

Family Nursing↗
PubMed1983

"Company motivates the miserable": the impact of consensus information on help seeking for psychological problems.

Based on an attribution theory analysis, it was predicted that normal individuals (people who do not evidence a particular target problem) would be least motivated to seek help for a psychological problem when they believe that the problem is actuarially common (i.e., high consensus). Based on an analysis of how target problem people evaluate their psychological problem, however, it was predicted that such individuals (unlike normal individuals) should be maximally motivated to seek help when they believe that the problem is common. To test these predictions, target problem and normal individuals (high vs. average test anxious females) were given feedback that they possessed a problem (test anxiety). Individuals were then told that their problem was either common, uncommon, or given no consensus information. As predicted, the higher consensus information led to the least help-seeking behavior for the normal individuals and to the most help-seeking behavior for the target problem individuals.

Anxiety Disorders↗
PubMed1988

Attributional style, depression, and perceptions of consensus for events.

This study examined differences between depressed and nondepressed individuals' implicit perceptions of consensus, which may contribute to differences in their attributional styles. Subjects rated the extent to which positive, negative, and neutral events happen to themselves and to the average college student and completed measures of depth of depression and attributional style. Perceptions of consensus were highly correlated with all components of attributional style for negative and positive events. Hierarchical regression analyses revealed that ratings of others explained variance in attributional style beyond that explained by ratings of the self for positive but not for negative events. Path analyses, however, indicated that the indirect path from perceptions of consensus to depression mediated through attributional style was nonsignificant for positive events, although it was significant for negative events. These findings are discussed in terms of the role of perceptions of others as precursors of attributional style and depression.

Cognition↗
PubMed1988

Consensus in personality judgments at zero acquaintance.

This research focused on the target effect on a perceiver's judgments of personality when the perceiver and the target are unacquainted. The perceiver was given no opportunity to interact with the target, a condition we refer to as zero acquaintance. We reasoned that in order to make personality judgments, perceivers would use the information available to them (physical appearance). Consensus in personality judgments would result, then, from shared stereotypes about particular physical appearance characteristics. Results from three separate studies with 259 subjects supported this hypothesis. On two of the five dimensions (extraversion and conscientiousness) on which subjects rated each other, a significant proportion of variance was due to the stimulus target. Consensus on judgments of extraversion appears to have been largely mediated by judgments of physical attractiveness. Across the three studies there was also evidence that the consensus in judgments on these two dimensions had some validity, in that they correlated with self-judgments on those two dimensions.

Beauty↗
PubMed1992

Consensus at zero acquaintance: replication, behavioral cues, and stability.

That observers tend to agree in their ratings of a target even if they have never interacted with that target has been called consensus at zero acquaintance. The basic finding that consensus is highest for judgments concerning a target's degree of extraversion (EV) and somewhat weaker for judgments of conscientiousness is replicated. Several potential observable cues that might be used by judges when rating targets are examined. The finding that ratings of physical attractiveness correlate with judgments of EV is replicated. In Study 1, rapid body movements and smiling were also found to correlate with EV judgments. The level of consensus declined when initially unacquainted Ss interacted one-on-one (Study 2), but did not decline--and even increased--when Ss interacted in a group (Study 3). Ss judged as extraverted at zero acquaintance were also seen as extraverted after interacting with others.

Adult↗
PubMed1997

Cross-cultural consensus in personality judgments.

Building on recent research demonstrating consensus and accuracy in interpersonal perception based on minimal information, the present studies examined American and Chinese participants' within- and cross-cultural judgments. In Study 1, the authors used the zero-acquaintance paradigm in the People's Republic of China and found consensus on all personality dimensions. In Study 2, Chinese and American participants judged each other on the basis of photographs, and consensus was found among Americans' judgments of Chinese and Chinese participants' judgments of Americans. Further, by correlating target effects based on within-culture zero-acquaintance judgments and cross-cultural photographic judgments, the authors found agreement in the judgments of individuals by members of their own culture and the other culture for both Chinese and Americans.

China↗
PubMed1997

Longitudinal changes in consensus as a function of acquaintance and agreement in liking.

By using a round-robin design, groups of freshmen reported their impressions of dormmates at 4 different times during the year. Consensus on W. T. Norman's Big Five (1963) did not increase over the year, even though reported acquaintance did increase. Agreement in liking predicted agreement in the trait ratings, such that groups that agreed in their evaluations of one another were more likely to agree in their trait impressions of one another, and vice versa. These patterns, obtained by using trait ratings, were replicated with open-ended descriptions of the targets. Correlations with self-judgments did not increase with acquaintance. The data suggest that increased acquaintance does not produce increased consensus. Instead, the role of agreement in evaluations is explored as a determining factor in the level of obtained consensus.

Cross-Sectional Studies↗
PubMed1991

A general model of consensus and accuracy in interpersonal perception.

Consensus refers to the extent to which 2 judges agree in their ratings of a common target. A general model of interpersonal perception based on Anderson's (1981) weighted-average model is developed. The model shows that increased acquaintance does not always lead to large changes in consensus. Degree of overlap between the target behaviors observed by the judges and similarity of meaning systems are key but neglected parameters. The model can also be used as a basis for determining the accuracy of person perception. In some cases, accuracy can increase with greater acquaintance, whereas consensus may not.

Humans↗