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Retrospective revaluation in humans: learning or memory?

The phenomenon of retrospective revaluation has posed considerable problems for many associative learning theories as it involves a change in the associative strength of a cue on trials on which that cue is absent. The present series of experiments pursues this idea of changes in associative strength between evoked representations of cues, in an effort to establish, de novo, an excitatory connection between two cues simultaneously activated in memory. Given the finding of Dwyer, Mackintosh, and Boakes (1998) that simultaneous activation of absent cues in the memory of rats resulted in learning comparable to that seen in retrospective revaluation, we expected that if retrospective revaluation was found in humans, then excitatory learning due to simultaneous activation would also be seen. This was not the case. The implications of our results are discussed in terms of Dickinson and Burke's (1996) modified SOP model and a version of McLaren's (1993) APECS network. We conclude that many of the effects attributed to learning in retrospective revaluation studies are better thought of as due to changes in the retrievability of items in memory.

Adult↗

Validation study of retrospective recall of disease-targeted function: results from the prostate cancer outcomes study.

OBJECTIVES: This was an ancillary methodological study within the Prostate Cancer Outcomes Study (PCOS) to assess the validity of 6-month retrospective recall of prediagnostic disease-targeted function among men diagnosed with prostate cancer. METHODS: A convenience sample of 133 prostate cancer cases were administered a baseline questionnaire shortly after diagnosis that asked about prediagnostic urinary, sexual, and bowel function. They were surveyed again concerning the same items 6 months later and asked to recall their prediagnostic function. Reports of prediagnostic function obtained at baseline and 6 months are compared, as are measures of change derived from these reports. Percent agreement and weighted kappas are calculated to measure the extent of agreement. RESULTS: Over 70% of the men reported prediagnostic functioning at the highest level on 12 of 17 survey items. For each of these items, recall at 6 months was identical to the baseline survey response for > or =69% of the men. The values of the weighted kappas for changes computed with baseline reports (prospective) and changes computed with 6-month recall (retrospective) ranged from 0.396 to 0.919 for the 17 individual items. Intraclass correlations for the retrospective versus prospective changes in the multi-item function scores were 0.828 for urinary, 0.618 for bowel, and 0.692 for sexual function. CONCLUSIONS: At baseline, men recently diagnosed with prostate cancer report few disease-related problems before diagnosis, and a high percentage of men recall this accurately 6 months later. There is reasonably high agreement between baseline and 6-month estimates of prediagnostic function and between prospective and retrospective measures of change over 6 months.

Aged↗

Retrospective exaggeration of symptoms: vomiting after gastric surgery for obesity.

The possibility that patients may retrospectively exaggerate the severity of complaints that they have experienced has not been systematically investigated. The validity of retrospective reports was called into question by a study of vomiting following gastric bypass surgery for obesity. Such vomiting occurred relatively infrequently--no more than 3.4 times per week, even during the first postoperative month. At a 6-month follow-up, however, some patients reported that they had experienced very high rates of vomiting postoperatively, in direct contradiction to their earlier reports. Such retrospective exaggeration has apparently contributed to the widespread belief that vomiting following gastric bypass surgery is a serious problem. We believe that this report is the first to describe retrospective exaggeration of symptoms. Further research is needed to assess the extent of this problem.

Adult↗

The Prospective and Retrospective Memory Questionnaire (PRMQ): latent structure, normative data and discrepancy analysis for proxy-ratings.

OBJECTIVES: To evaluate the proxy-rating version of the Prospective and Retrospective Memory Questionnaire (PRMQ) and provide norms and methods for score interpretation. DESIGN: Cross-sectional and correlational. METHODS: The PRMQ was administered to a large sample drawn from the general adult population (N=570). Confirmatory factor analysis (CFA) was used to test competing models of its latent structure. Various psychometric methods were applied to provide clinicians with tools for score interpretation. RESULTS: The CFA model with optimal fit specified a general memory factor together with additional prospective and retrospective factors. The reliabilities of the PRMQ were acceptable (.83 to .92), and demographic variables did not influence ratings. Tables are presented for conversion of raw scores on the Total scale and Prospective and Retrospective scales to T scores. In addition, tables are provided to allow users to assess the reliability and abnormality of differences between proxy ratings on the Prospective and Retrospective scales. Finally, tables are also provided to compare proxy-ratings with self-ratings (using data from the present sample and self-rating data from a previous study). CONCLUSIONS: The proxy-rating version of the PRMQ provides a useful measure of everyday memory for use in clinical research and practice.

Adult↗

A comparison between elemental and compound training of cues in retrospective revaluation.

Associative learning theories assume that cue interaction and, specifically, retrospective revaluation occur only when the target cue is previously trained in compound with the to-be-revalued cue. However, there are recent demonstrations of retrospective revaluation in the absence of compound training (e.g., Matute & Pineño, 1998a, 1998b). Nevertheless, it seems reasonable to assume that cue interaction should be stronger when the cues are trained together than when they are trained apart. In two experiments with humans, we directly compared compound and elemental training of cues. The results showed that retrospective revaluation in the elemental condition can be as strong as and, sometimes, stronger than that in the compound condition. This suggests that within-compound associations are not necessary for retrospective revaluation to occur and that these effects can possibly be best understood in the framework of general interference theory.

Association Learning↗

Assessing change in chronic pain severity: the chronic pain grade compared with retrospective perceptions.

BACKGROUND: There is no standard method of measuring change in chronic pain severity. Clinical trials commonly use serial assessment scales, completed at two points in time, to estimate change in pain severity, while clinicians usually ask patients to make a retrospective assessment of change. How the two methods compare is not known. AIM: To assess different methods of measuring change in chronic pain severity, by comparing changes in scores on a serial measure of chronic pain severity using the Chronic Pain Grade (CPG) questionnaire and responders' retrospective perception of change in pain severity. DESIGN OF STUDY: Postal self-completion questionnaires. SETTING: The Grampian region of Scotland. METHOD: Postal questionnaires were sent in March and September 1998 to a random sample of 535 adults with chronic pain, drawn from responders to a postal survey of the region conducted in 1996. RESULTS: Corrected response rates of 87.5% and 90.7% were obtained. Over a six-month period poor levels of agreement were found, with responders' retrospective perceptions mirroring recorded changes in 41.8% of individuals (kappa = 0.081). A low partial correlation coefficient between the two measures (-0.209) was also found. Over a two-year period there were again poor levels of agreement, with responders' retrospective perceptions mirronng recorded changes in 35.2% of individuals (kappa = 0.071). A low partial correlation coefficient (-0.401) was again found. CONCLUSION: There was poor agreement and low correlation between two commonly used methods for assessing change in pain severity over time. This finding has important implications for both service practitioners and researchers.

Adult↗

Cortisol levels and prospective and retrospective memory in humans.

OBJECTIVES: The aim of this study was to examine (i) the influence of cortisol on both prospective and retrospective memory performance and (ii) the role of emotional valence in both types of memory. METHODS: Thirty-four male students participated in a memory task, which measured both prospective and retrospective memory performance. Baseline salivary cortisol levels were assessed. RESULTS: Spearman's rank order correlation analysis showed a significant positive correlation between salivary cortisol levels and retrospective memory performance for neutral words. Cortisol levels were not significantly correlated with prospective memory performance for either negative nor neutral words. CONCLUSIONS: The present results indicate chronic cortisol levels are positively associated with retrospective memory at relatively low concentration ranges, but not prospective memory, in healthy young men. Implications for evaluating the beneficial effects of low-dose cortisol treatment on posttraumatic stress disorder is discussed.

Adult↗

Assessment of life events: retrospective vs concurrent strategies.

The relationship of life events to different disorders continues to be of great interest. Most communications, however, have been based on self-report data gathered retrospectively over lengthy intervals (eg, one to ten years). While recent studies have attempted to ascertain the degree of distortion associated with such procedures, none has provided an appropriate basis for estimating absolute decrements of event reporting over time. This study compares the traditional retrospective procedure with a concurrent assessment procedure covering shorter recall periods (one month). The findings indicate as much as 60% of events may be underreported for even the most recent four-month retrospective period. Additionally, particular types of events (eg, desirable events) may be relatively more susceptible to such reporting distortion. Implications of these results for life events assessment and conceptualization of event-disorder associations are discussed.

Adolescent↗

Retrospective and prospective tumor staging evaluating prognostic factors in operated bronchus carcinoma patients.

Survival, pTN stages, and cell type of patients operated on for bronchus carcinoma were evaluated in a retrospective study and compared with data obtained in a prospective study. One thousand three hundred thirty-two patients with potential curative resected lung carcinoma were included in the retrospective study. Two hundred eighty-two patients with potential curative resected lung carcinoma were analyzed in the prospective study. Data showed similarities in distribution of cell type and relative frequency of pT1 stage in both collectives. Major differences between both studies were obtained in relative frequencies of pT3, and pN0, pN1, and pN2 stages. Survival of patients grouped according to cell type revealed differences between patients suffering from epidermoid-adeno carcinoma and patients suffering from small anaplastic carcinoma--large cell anaplastic carcinoma in both studies. Patients stated as pN0 stages showed more favourable prognosis in the prospective study compared with patients of the retrospective study. Two-year survival rates of patients grouped into a pT1pN0 stage and into a pT2pN0 stage had similar survival rates in both studies. Survival of these cohorts compared with patients staged as pT1pN1 and pT2pN1 was statistically significantly better. The data indicate that patients suffering from pT1pN1 or pT2pN1 tumors should be classified as Stage II tumors.

Age Factors↗

Limitation of annual screening chest radiography for the diagnosis of lung cancer. A retrospective study.

BACKGROUND: The incidence and mortality rates of lung cancer have been increasing in many countries. However, the true effectiveness of screening for lung cancer is still controversial. This study aimed to examine the growth pattern of lung cancer and to evaluate the efficacy of screening. METHODS: The authors linked the records of annual radiologic screening to cancer registry data and conducted a retrospective follow-up study of radiographs in all patients with lung cancer arising in a population undergoing screening. RESULTS: Among a total of 305,934 participants, screening detected 206 lung cancers, 103 of which were Stage I disease. Seventy-one of the 131 adenocarcinomas were Stage I, and 58% of them showed evidence of cancer for 2 years on a retrospective review of radiographs. Presentation as small faint lesions overlapping the normal chest structures delayed the early detection of adenocarcinoma. The overall sensitivity of screening was 70%, 52% for squamous cell carcinoma and 50% for small cell carcinoma. Rapidly growing Stage II-IV tumors without retrospective evidence of cancer on previous radiographs accounted for most of the cancers detected during the intervals between screening. CONCLUSIONS: Both the low detectability of Stage I adenocarcinoma and the late recognition of rapidly growing small cell and squamous cell carcinomas reduced the effectiveness of screening. More effective imaging methods and an antismoking campaign are required to reduce lung cancer mortality.

Adenocarcinoma↗

Retrospective and prospective psychological and physical health as a function of negative affect and attributional style.

Subjects completed questionnaires designed to assess (a) attributions along internal-external, stable-unstable, and global-specific dimensions subsequent to undersirable events; (b) negative affect; and (c) retrospective psychological and physical health. Subjects then kept weekly records, for 12 weeks, of their visits to doctors and days of illness (prospective physical health) and days they experienced emotional problems (prospective psychological health). Multiple regression analyses that used negative affect and attributional variables as predictors showed that negative affect was the best predictor of retrospective health and that global attributions were the best predictors of prospective health. Analysis of the comparative predictive value of the internal, stable, and global attributions revealed that global attributions were the most significant predictors of retrospective and prospective health.

Adult↗

The natural history of breast carcinoma in patients with > or = 10 metastatic axillary lymph nodes before and after the advent of adjuvant therapy: a multiinstitutional retrospective study.

BACKGROUND: The majority of patients with breast carcinoma with > or = 10 metastatic axillary lymph nodes (ALNs) develop recurrent disease within 5 years from diagnosis. The purpose of the current study, performed retrospectively, was to characterize the natural history of this subset of patients, both before and after the advent of adjuvant anthracycline-based chemotherapy and tamoxifen. METHODS: Retrospectively, patients with primary breast carcinoma (N = 882) with > or = 10 metastatic ALNs, treated between 1954 and 1998, were selected from 3 institutions: The University of Texas M. D. Anderson Cancer Center (Houston, TX); the Institut Gustave Roussy (Villejuif, France); and Hospital Clinico Universitario (Valencia, Spain). All patient data had been registered prospectively in clinical databases. One group consisted of 314 patients treated with locoregional therapy alone (no adjuvant therapy) from 1954 to 1983. The second group included 568 patients who received adjuvant anthracycline-based chemotherapy between 1974 and 1998 with or without adjuvant tamoxifen. RESULTS: The median follow-up time was 140 months. Disease-free survival rates at 15 and 20 years for the no adjuvant therapy and adjuvant therapy groups were 17% and 16% versus 26% and 24%, respectively. The overall survival rates at 20 years for the no adjuvant therapy and the adjuvant therapy groups were 9% and 21%, respectively. By multivariate analysis, the independent factors associated with survival in the adjuvant therapy group were tumor size and the number of metastatic lymph nodes. CONCLUSIONS: The retrospective analysis suggested that adjuvant anthracycline-based chemotherapy and hormonal therapy have altered the natural history in this high-risk group of patients. However, despite such improvements, survival rates remained low, and innovative therapeutic approaches are, therefore, needed to improve clinical outcomes.

Anthracyclines↗

Awake Craniotomy for Eloquent Region Glioblastoma Classified by Tumor Location-A Retrospective and Prospective Cohort Study.

INTRODUCTION: The efficacy of awake craniotomy (AC) with intraoperative mapping for glioblastoma (GBM) in eloquent regions remains debated. This study aims to evaluate functional and survival outcomes of GBM patients undergoing AC stratified by tumor locations. METHODS: A combined retrospective (2015-2023, n = 114: 43 AC vs. 71 standard craniotomy) and prospective cohort (2023-2025, n = 28: 13 AC vs. 15 standard craniotomy) of GBM patients with motor/language-eloquent tumors was analyzed. Tumors were classified into motor subtypes (I: precentral gyrus; II: premotor/supplementary motor; III: internal capsule posterior limb; IV: other) and language subtypes (I: Broca's/precentral; II: postcentral/supramarginal gyrus; III: Wernicke's; IV: insular; V: other). Outcomes included extent of resection (EOR), postoperative motor/language recovery, overall survival (OS), and progression-free survival (PFS). RESULTS: The retrospective cohort demonstrated that AC has advantages in functional preservation across various motor/language subtypes. However, AC was associated with significantly deteriorated survival outcomes specifically in precentral gyrus GBMs. A prospective cohort study, enrolling only precentral gyrus GBMs for validation, yielded results consistent with the retrospective findings: worsened OS and PFS (OS: HR = 3.223, p = 0.0450; PFS: HR = 2.374, p = 0.0476); reduced EOR (AC: 74.3% ± 5.3%; standard craniotomy: 86.9% ± 12.3%, p = 0.0470); and better motor recovery. CONCLUSIONS: Functional preservation and survival outcomes of AC in GBM exhibited subtype-specific correlations with tumor locations. AC with intraoperative mapping effectively preserves neurological function in GBM patients. However, for tumors involving the precentral gyrus, the AC approach carries greater risks than benefits and should be considered with caution. TRIAL REGISTRATION: Strategic Intervention on Preserving Motor Function During Awake Craniotomy: NCT05143788. Strategic Intervention on Preserving Language Function During Awake Craniotomy: NCT05143775.

Adult↗

Prognostic importance of cellular DNA content in head-and-neck squamous-cell cancers. A comparison of retrospective and prospective series.

Flow cytometric DNA-ploidy measurements were performed on formalin-fixed tumour specimens from 172 patients with squamous-cell cancers (SCCs) of the head and neck region. One hundred and two samples were chosen retrospectively and a further 70 consecutive patients were analysed prospectively in order to assess the prognostic significance of DNA ploidy and DNA index (DI). There were no statistically significant differences between retrospective and prospective groups in regard to age, sex, TNM stage, ploidy or DI. Sixty-seven percent of patients were aneuploid (65% retrospective; 71% prospective). The proportion of aneuploid tumours was significantly higher among poorly differentiated tumours. Survival analysis using Cox multivariate regression modelling revealed that DNA aneuploidy and increasing DI were significant independent prognostic factors for both relapse-free and overall survival. The relapse and death rates among aneuploid subjects were approximately 3 times as high as those for diploid subjects. Patients with a DI greater than 2.11 (hypertetraploidy) experienced a 6.6-fold higher death rate than diploid subjects. These results provide strong support for the incorporation of DNA ploidy profiles into the clinical management of patients with head and neck cancer.

Adult↗

Long-term efficacy and safety of tolmetin sodium in treatment of geriatric patients with rheumatoid arthritis and osteoarthritis: a retrospective study.

In order to evaluate the effectiveness and safety of tolmetin sodium in the treatment of both rheumatoid arthritis (RA) and osteoarthritis in geriatric patients, a retrospective study was made of patients 65 years and older who participated in long-term, controlled, double-blind and open trials during both the investigational period and since marketing of the drug. Standard entrance criteria, methods of evaluating disease activity, and statistical methods were used in the study of both arthritic diseases. A total of 847 geriatric patients were studied for periods of up to one year; 171 had RA, while 676 had osteoarthritis of large or small joints. Average daily dose of tolmetin sodium was 1141 mg for patients with RA and 953 mg for patients with osteoarthritis. The results of this retrospective study of both RA and osteoarthritis patients show that tolmetin was as effective in geriatric patients as in nongeriatric patients. Symptoms responded rapidly to treatment with tolmetin, and both the inflammatory symptoms of RA and the joint pain and functional parameters of osteoarthritis showed improvement that was both statistically and clinically significant throughout the major course of therapy. Tolmetin was also found to be safe and well tolerated by the elderly patient population. The major complaints were gastrointestinal, but serious or limiting side effects occurred in few patients. The dropout rates due to adverse effects during the entire year of therapy were 15.8 per cent in the RA population and 15.4 per cent in osteoarthritis patients. This retrospective evaluation of tolmetin therapy shows significant relief of the symptoms of both RA and osteoarthritis in a geriatric population and fails to reveal any unusual or serious conditions which would contraindicate its use in the elderly patient. Tolmetin, which is an antiinflammatory agent with a short half-life, can provide adequate, safe therapy in the geriatric population.

Aged↗

Frequency response to retrospectively gated phase-contrast MR imaging: effect of interpolation.

Retrospectively gated phase-contrast (PC) magnetic resonance velocity and volume flow measurements were evaluated in both in vitro and in vivo experiments. The accuracy of these measurements was found to be affected by the interpolation window width required in the reconstruction of retrospectively gated data. Interpolation modified the frequency content of the series of temporal measurements by decreasing the response at higher frequencies. With a series of sinusoidal flow waveforms, the frequency response of one specific implementation of retrospectively gated PC velocity measurements was experimentally determined. The experimental response agreed with the theoretical response predicted from an analysis of the interpolating function (2.2% root-mean-square difference). In vitro experiments with a simulated carotid flow waveform demonstrated errors in the systolic measurements that were a direct result of the modified frequency response. A volunteer study was also undertaken and confirmed the in vitro findings.

Adult↗

Ethical issues related to retrospective drug utilization studies in South Africa.

PURPOSE: The purpose of the manuscript is to discuss the ethical issues related to pharamacoepidemiological research in South Africa, with specific emphasis on three recently performed retrospective drug utilization studies. METHODS: Ethical considerations relating to three retrospective drug utilization studies on hyperlipidaemia, diabetes and tricyclic antidepressants are discussed. RESULTS: Computerized medication records were obtained from three different organizations after formal proposals had been submitted. The information contained in the data sets varied, and in some instances, a fair amount of manual coding had to be performed to make the data useable for research purposes. The research was not sponsored by the private pharmaceutical sector and this minimized the potential for any bias in the studies. Data privacy and confidentiality were maintained at all times. No patient could be traced, and it was also not possible to determine which medical practitioners were involved in the prescribing of the drugs. CONCLUSIONS: Retrospective drug utilization studies are a relatively easy, inexpensive and uncomplicated method to comment on the prescribing of drugs in large patient populations provided that ethical principles related to confidentiality and data privacy are adhered to.

Bioethics↗

Validity of mortality analysis based on retrospective smoking information.

We assess the validity of mortality analysis based on retrospective reporting of smoking habits by subjects and proxies after a time lag of approximately ten years. The analysis is based on 2855 subject respondents and 615 proxy respondents to the NHANES I Epidemiologic Followup Survey (NHEFS), a national followup study of persons examined in the National Health and Nutrition Examination Survey (NHANES I). Persons 45-77 years of age at baseline were selected for analysis. Using three categories of smoking at baseline (current, former, never), the retrospective classification (NHEFS) matched the NHANES I classification for 89 per cent of the subject respondents and 83 per cent of the proxy respondents. Agreement levels were higher for women (92 per cent of subjects and 89 per cent of proxies) than for men (85 and 80 per cent). We used Cox regression models to assess the use of retrospective smoking information in an analysis of the relationship between selected risk factors and mortality for persons 45-64 years of age. There were few substantive differences in results with use of NHEFS smoking data versus NHANES I smoking data. In particular, the effects of age, systolic blood pressure, education, and race on mortality were not sensitive to the source of the smoking data (NHANES I or NHEFS) or the form of the smoking variable (two-, three-, or six-level categorization). The effects of body mass index on mortality were sensitive to the form of the smoking variable but results based on NHANES I and NHEFS were quite similar. These results suggest that smoking information obtained from proxy respondents is adequate for analyses of the risk of total mortality associated with smoking and other risk factors. Further assessment is needed to determine the adequacy of such data for analyses of mortality from specific causes that are sensitive to amount smoked or duration of smoking.

Aged↗