Regression analysis of mean quality-adjusted survival time based on pseudo-observations

Regression models for the mean quality-adjusted survival time are specified from hazard functions of transitions between two states and the mean quality-adjusted survival time may be a complex function of covariates. We discuss a regression model for the mean quality-adjusted survival (QAS) time based on pseudo-observations, which has the advantage of directly modeling the effect of covariates in the QAS time. Both Monte Carlo Simulations and a real data set are studied. Copyright (C) 2009 John Wiley & Sons, Ltd.

Wavelet regression with correlated errors on a piecewise Holder class

This paper generalizes the methodology of Cat and Brown [Cai, T., Brown, L.D., 1998. Wavelet shrinkage for nonequispaced samples. The Annals of Statistics 26, 1783-1799] for wavelet shrinkage for nonequispaced samples, but in the presence of correlated stationary Gaussian errors. If the true function is a member of a piecewise Holder class, it is shown that, even for long memory errors, the rate of convergence of the procedure is almost-minimax relative to the independent and identically distributed errors case. (c) 2008 Elsevier B.V. All rights reserved.

A new class of survival regression models with heavy-tailed errors: robustness and diagnostics

Birnbaum-Saunders models have largely been applied in material fatigue studies and reliability analyses to relate the total time until failure with some type of cumulative damage. In many problems related to the medical field, such as chronic cardiac diseases and different types of cancer, a cumulative damage caused by several risk factors might cause some degradation that leads to a fatigue process. In these cases, BS models can be suitable for describing the propagation lifetime. However, since the cumulative damage is assumed to be normally distributed in the BS distribution, the parameter estimates from this model can be sensitive to outlying observations. In order to attenuate this influence, we present in this paper BS models, in which a Student-t distribution is assumed to explain the cumulative damage. In particular, we show that the maximum likelihood estimates of the Student-t log-BS models attribute smaller weights to outlying observations, which produce robust parameter estimates. Also, some inferential results are presented. In addition, based on local influence and deviance component and martingale-type residuals, a diagnostics analysis is derived. Finally, a motivating example from the medical field is analyzed using log-BS regression models. Since the parameter estimates appear to be very sensitive to outlying and influential observations, the Student-t log-BS regression model should attenuate such influences. The model checking methodologies developed in this paper are used to compare the fitted models.

Beta-binomial/Poisson regression models for repeated bivariate counts

We analyze data obtained from a study designed to evaluate training effects on the performance of certain motor activities of Parkinson`s disease patients. Maximum likelihood methods were used to fit beta-binomial/Poisson regression models tailored to evaluate the effects of training on the numbers of attempted and successful specified manual movements in 1 min periods, controlling for disease stage and use of the preferred hand. We extend models previously considered by other authors in univariate settings to account for the repeated measures nature of the data. The results suggest that the expected number of attempts and successes increase with training, except for patients with advanced stages of the disease using the non-preferred hand. Copyright (c) 2008 John Wiley & Sons, Ltd.

Influence diagnostics in beta regression

We consider the issue of assessing influence of observations in the class of beta regression models, which is useful for modelling random variables that assume values in the standard unit interval and are affected by independent variables. We propose a Cook-like distance and also measures of local influence under different perturbation schemes. Applications using real data are presented. (c) 2008 Elsevier B.V.. All rights reserved.

Improved maximum-likelihood estimation in a regression model with general parametrization

We analyse the finite-sample behaviour of two second-order bias-corrected alternatives to the maximum-likelihood estimator of the parameters in a multivariate normal regression model with general parametrization proposed by Patriota and Lemonte [A. G. Patriota and A. J. Lemonte, Bias correction in a multivariate regression model with genereal parameterization, Stat. Prob. Lett. 79 (2009), pp. 1655-1662]. The two finite-sample corrections we consider are the conventional second-order bias-corrected estimator and the bootstrap bias correction. We present the numerical results comparing the performance of these estimators. Our results reveal that analytical bias correction outperforms numerical bias corrections obtained from bootstrapping schemes.

Covariance matrix formula for Birnbaum-Saunders regression models

The Birnbaum-Saunders regression model is commonly used in reliability studies. We derive a simple matrix formula for second-order covariances of maximum-likelihood estimators in this class of models. The formula is quite suitable for computer implementation, since it involves only simple operations on matrices and vectors. Some simulation results show that the second-order covariances can be quite pronounced in small to moderate sample sizes. We also present empirical applications.

Influence diagnostics in Birnbaum-Saunders nonlinear regression models

We consider the issue of assessing influence of observations in the class of Birnbaum-Saunders nonlinear regression models, which is useful in lifetime data analysis. Our results generalize those in Galea et al. [8] which are confined to Birnbaum-Saunders linear regression models. Some influence methods, such as the local influence, total local influence of an individual and generalized leverage are discussed. Additionally, the normal curvatures for studying local influence are derived under some perturbation schemes. We also give an application to a real fatigue data set.

Asymptotic skewness in Birnbaum-Saunders nonlinear regression models

The family of distributions proposed by Birnbaum and Saunders (1969) can be used to model lifetime data and it is widely applicable to model failure times of fatiguing materials. We give a simple matrix formula of order n(-1/2), where n is the sample size, for the skewness of the distributions of the maximum likelihood estimates of the parameters in Birnbaum-Saunders nonlinear regression models, recently introduced by Lemonte and Cordeiro (2009). The formula is quite suitable for computer implementation, since it involves only simple operations on matrices and vectors, in order to obtain closed-form skewness in a wide range of nonlinear regression models. Empirical and real applications are analyzed and discussed. (C) 2010 Elsevier B.V. All rights reserved.

Some restriction tests in a new class of regression models for proportions

The main purpose of this work is to study the behaviour of Skovgaard`s [Skovgaard, I.M., 2001. Likelihood asymptotics. Scandinavian journal of Statistics 28, 3-32] adjusted likelihood ratio statistic in testing simple hypothesis in a new class of regression models proposed here. The proposed class of regression models considers Dirichlet distributed observations, and the parameters that index the Dirichlet distributions are related to covariates and unknown regression coefficients. This class is useful for modelling data consisting of multivariate positive observations summing to one and generalizes the beta regression model described in Vasconcellos and Cribari-Neto [Vasconcellos, K.L.P., Cribari-Neto, F., 2005. Improved maximum likelihood estimation in a new class of beta regression models. Brazilian journal of Probability and Statistics 19,13-31]. We show that, for our model, Skovgaard`s adjusted likelihood ratio statistics have a simple compact form that can be easily implemented in standard statistical software. The adjusted statistic is approximately chi-squared distributed with a high degree of accuracy. Some numerical simulations show that the modified test is more reliable in finite samples than the usual likelihood ratio procedure. An empirical application is also presented and discussed. (C) 2009 Elsevier B.V. All rights reserved.

Birnbaum-Saunders nonlinear regression models

We introduce, for the first time, a new class of Birnbaum-Saunders nonlinear regression models potentially useful in lifetime data analysis. The class generalizes the regression model described by Rieck and Nedelman [Rieck, J.R., Nedelman, J.R., 1991. A log-linear model for the Birnbaum-Saunders distribution. Technometrics 33, 51-60]. We discuss maximum-likelihood estimation for the parameters of the model, and derive closed-form expressions for the second-order biases of these estimates. Our formulae are easily computed as ordinary linear regressions and are then used to define bias corrected maximum-likelihood estimates. Some simulation results show that the bias correction scheme yields nearly unbiased estimates without increasing the mean squared errors. Two empirical applications are analysed and discussed. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.

Bias correction in a multivariate normal regression model with general parameterization

This paper derives the second-order biases Of maximum likelihood estimates from a multivariate normal model where the mean vector and the covariance matrix have parameters in common. We show that the second order bias can always be obtained by means of ordinary weighted least-squares regressions. We conduct simulation studies which indicate that the bias correction scheme yields nearly unbiased estimators. (C) 2009 Elsevier B.V. All rights reserved.

Livskvalitet och fatigue vid Multipel Skleros : en systematisk litteraturstudie

Syftet med denna systematiska litteraturstudie var att beskriva hur livskvaliteten påverkas hos personer med Multipel Skleros (MS) och vad som kan göras för att öka livskvaliteten. I syftet ingick även att beskriva hur personer med MS upplever fatigue som är ett av huvudsymtomen av sjukdomen samt vad som kan göras för att lindra följderna av fatigue. Artiklarna har sökts i databaserna Elin@Dalarna och Cinahl, tillgängliga via Högskolan Dalarnas proxyserver och granskats med hjälp av en granskningsmall för att säkerställa att de var av en god kvalitet. Sökord som användes var: “multiple sclerosis”, “quality of life”, “nursing” och “fatigue”. Av de artiklar som användes i resultatet var 10 kvantitativa, fyra kvalitativa i en användes båda ansatserna. Resultatet visade att personer med MS generellt sett har en sämre livskvalitet än den övriga befolkningen. Mycket av patienternas livskraft går åt till att bara klara av det dagliga livet. Många personer med MS upplever en stor frustration relaterad till att vilja men inte kunna. Ofta har den försämrade livskvaliteten sin orsak i det sociala livet. Fatigue har ofta en stor påverkan på livet för personer med MS. Det finns en mängd varierande icke farmakologiska behandlingsmetoder som med fördel kan användas för att öka livskvaliteten och minska följderna av fatigue. Exempel på dessa är kylväst, träning och yoga.

Att leva med Multipel Skleros : Patienters upplevelser och omvårdnadsbehov

Syfte: Syftet med denna studie var att sammanställa patienters upplevelser av att leva med Multipel Skleros (MS) samt att undersöka vilka omvårdnadsbehov patienter med MS har. Metod: Uppsatsen har genomförts som en systematisk litteraturstudie. Inklusionskriterier var att artiklarna skulle vara vetenskapligt granskade och inte äldre än fem år. Sammanlagt har 17 stycken artiklar använts till resultatet, av dessa var nio stycken kvantitativa studier och åtta stycken kvalitativa studier. Resultat: Trötthet och depression var de mest besvärliga och immobiliserande symptomen för personer med MS. Sjukdomen inverkade negativt på sexlivet. Symptom som inkontinens och urinträngningar upplevdes som ett stort problem, men själv-kateterisering ledde till färre urinvägsproblem. Smärta fanns hos hälften av MS-patienterna, av dem upplevde 70,5 % neurogen smärta. Balanssvårigheter var det största problemet gällande rörligheten, och ovissheten om hur symptomen varierar från dag till dag upplevdes frustrerande. En stor del upplevde att andra människor har svårt att förstå deras situation och ta den på allvar. Kvaliteten på information och kommunikation mellan patienterna och vårdpersonalen hade stor betydelse. Delaktighet i planeringen av sin vård var av stor vikt för patienterna med MS.

Sjuksköterskans omvårdnadsåtgärder vid Multipel Skleros : En systematisk litteraturstudie

Föreliggande systematiska litteraturstudies syfte var att inhämta information om och evidensgradera sjuksköterskans omvårdnadsåtgärder hos patienter med MS. Artiklar söktes ur databasen Electronic Libary Information Navigator (ELIN) via biblioteket på Högskolan Dalarna. Sökorden ”multiple sclerosis” och ”quality of life” användes. Artiklarna kvalitetsgranskades efter granskningsmallar med 28 bedömningskriterier därefter evidensgraderades artiklarna med hjälp av en tillämpad granskningsskala (Batshevani, 2008). Av dessa var 17 artiklar användbara i resultatet för vidare granskning. I resultaten framkom fyra evidensbaserade omvårdnadsåtgärder vid MS: information och undervisning om urinvägsproblem, information om träning och dess betydelse, koordinering av samarbete och insatser i omvårdnadsarbetet med andra yrkeskategorier inom hälso- och sjukvården samt information och undervisning om trötthet. Av dessa omvårdnadsåtgärder hade information och undervisning om urinvägsproblem samt information om träning och dess betydelse inte tidigare tagits nämnvärd hänsyn till. Resultatet i föreliggande studie kan hjälpa sjuksköterskor att öka förståelsen och se unika behov hos MS patienter och att ha med sig dessa kunskaper i utförandet, utvecklandet och stödjandet av omvårdnaden hos dessa patienter för att öka eller bevara livskvaliteten. Resultatet i föreliggande studie diskuterades utifrån Virginia Hendersons omvårdnadsteoretiska modell där sjuksköterskans specifika funktion och mål för omvårdnaden är att främja hälsa, välbefinnande och tillfrisknande vilket kan leda till en ökad livskvalitet hos patienter med MS.