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Strongest Independent Predictor (strongest + independent_predictor)
Selected AbstractsDesign, validation, and use of an evaluation instrument for monitoring systemic reformJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 6 2001Kathryn Scantlebury Over the past decade, state and national policymakers have promoted systemic reform as a way to achieve high-quality science education for all students. However, few instruments are available to measure changes in key dimensions relevant to systemic reform such as teaching practices, student attitudes, or home and peer support. Furthermore, Rasch methods of analysis are needed to permit valid comparison of different cohorts of students during different years of a reform effort. This article describes the design, development, validation, and use of an instrument that measures student attitudes and several environment dimensions (standards-based teaching, home support, and peer support) using a three-step process that incorporated expert opinion, factor analysis, and item response theory. The instrument was validated with over 8,000 science and mathematics students, taught by more than 1,000 teachers in over 200 schools as part of a comprehensive assessment of the effectiveness of Ohio's systemic reform initiative. When the new four-factor, 20-item questionnaire was used to explore the relative influence of the class, home, and peer environment on student achievement and attitudes, findings were remarkably consistent across 3 years and different units and methods of analysis. All three environments accounted for unique variance in student attitudes, but only the environment of the class accounted for unique variance in student achievement. However, the class environment (standards-based teaching practices) was the strongest independent predictor of both achievement and attitude, and appreciable amounts of the total variance in attitudes were common to the three environments. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 646,662, 2001 [source] Survival in surgically treated, nodal positive prostate cancer patients is predicted by histopathological characteristics of the primary tumor and its lymph node metastases ,THE PROSTATE, Issue 4 2009Achim Fleischmann Abstract BACKGROUND Histopathological risk factors for survival stratification of surgically treated nodal positive prostate cancer patients are poorly defined as reflected by only one category for nodal metastases. METHODS We evaluated biochemical recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) in 102 nodal positive, hormone treatment-naïve prostate cancer patients (median age: 65 years, range: 45,75 years; median follow-up 7.7 years, range: 1.0,15.9 years) who underwent radical prostatectomy and standardized extended lymphadenectomy. RESULTS A significant stratification was possible, with the Gleason score of the primary and virtually all nodal parameters favoring patients with better differentiated primaries and metastases, lower nodal tumor burden, and without extranodal extension of metastases. In multivariate analyses, diameter of the largest metastasis (,10 mm vs. >10 mm) was the strongest independent predictor for RFS (P,<,0.001), DSS (P,<,0.001), and OS (P,<,0.001) with a more than quadrupled relative risk of cancer related deaths for patients with larger metastases (Hazard ratio: 4.2, Confidence interval: 2.0,8.9; 5-year RFS/DSS/OS: 18%/57%/54%). The highest 5-year survival rates were seen in patients with micrometastases only (RFS/DSS/OS: 47%/94%/94%). CONCLUSION The TNM classification's current allocation of only one category for nodal metastases in prostate cancers is unsatisfactory since subgroups with significantly different prognoses can be identified. The diameter of the patient's largest metastasis (,10 mm vs. >10 mm) should be used for substaging because of its independent prognostic value. The substage "micrometastasis only" is also useful in nodal positive prostate cancer since it designates the subgroup with the most favorable outcome. Prostate 69:352,362, 2009. © 2008 Wiley-Liss, Inc. [source] The percentage of prostate needle biopsy cores with carcinoma from the more involved side of the biopsy as a predictor of prostate specific antigen recurrence after radical prostatectomy,,CANCER, Issue 11 2003Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database Abstract BACKGROUND The authors previously found that, although the total percentage of prostate needle biopsy cores with carcinoma was a significant predictor of prostate specific antigen (PSA) failure among men undergoing radical prostatectomy (RP), there was a trend toward a lower risk of recurrence in patients with positive bilateral biopsies, suggesting that high-volume, unilateral disease was a worse predictor of outcome than an equivalent number of positive cores distributed over two lobes. In the current study, the authors sought to compare the total percentage of cores with carcinoma directly with the percentage of cores from the more involved or dominant side of the prostate with carcinoma for their ability to predict outcome among men who underwent RP. METHODS A retrospective survey of 535 patients from the Shared Equal Access Regional Cancer Hospital database who underwent RP at 4 different equal-access medical centers between 1988 and 2002 was undertaken. The total percentage of cores positive was compared with the percentage of cores positive from the dominant and nondominant sides for their ability to predict biochemical recurrence after RP. The best predictor then was compared with the standard clinical variables PSA, biopsy Gleason score, and clinical stage in terms of ability to predict time to PSA recurrence after RP using multivariate analysis. RESULTS The adverse pathologic features of positive surgical margins and extracapsular extension were significantly more likely to be ipsilateral to the dominant side on the prostate biopsy. The percentage of cores positive from the dominant side provided slightly better prediction (concordance index [C] = 0.636) for PSA failure than the total percentage of cores positive (C = 0.596) and markedly better than the percentage of cores from the nondominant side (C = 0.509). Cutoff points for percentage of cores positive from the dominant side were identified (< 34%, 34,67%, and > 67%) that provided significant risk stratification for PSA failure (P < 0.001). On multivariate analysis, the percentage of cores positive from the dominant side was the strongest independent predictor of PSA recurrence (P < 0.001). Biopsy Gleason score (P = 0.017) also was a significant, independent predictor of recurrence. There was a trend, which did not reach statistical significance, toward an association between greater PSA values and biochemical failure (P = 0.052). Combining the PSA level, biopsy Gleason score, and percentage of cores positive from the dominant side of the prostate resulted in a model that provided a high degree of prediction for PSA failure (C = 0.671). CONCLUSIONS The percentage of cores positive from the dominant side of the prostate was a slightly better predictor of PSA recurrence than was the total percentage of cores positive. Using the percentage of cores from the dominant side along with the PSA level and the biopsy Gleason score provided significant risk stratification for PSA failure. Cancer 2003. Published 2003 by the American Cancer Society. [source] Original article: Predictors of response to bronchial allergen challenge in 5- to 6-year-old atopic childrenALLERGY, Issue 4 2007T. A. Douglas Background:, The relationship between atopy and bronchial allergy in young children is not completely understood. Objective:, To examine the association between response to bronchial allergen challenge, immune markers of atopy and other clinical characteristics in 5- to 6-year-old children. Methods:, Children with positive skin test (SPT) to aeroallergen, together with a proportion of SPT negative children (as controls), were recruited from a birth cohort of 198 children at high risk of developing atopic disease and underwent allergen challenge. Results:, Thirty-seven children (26 atopic and 11 SPT negative), median age 74.5 months, were challenged: 31 with house dust mite and six with grass allergen. Only atopic children responded to challenge: n = 12/26 (46%). Wheal size [odds ratio (OR) 2.5 (1.2,5.3), P = 0.01], allergen-specific immunoglobulin E (IgE) [OR 3.4 (1.23,9.61), P = 0.02], total IgE [OR 8.6 (1.1,68.7), P = 0.04], current wheeze [OR 12 (1.7,81.7), P = 0.006] and persistent eczema [OR 11.0 (1.7,68.3), P = 0.006] emerged as the strongest independent predictors of response to allergen challenge. Prediction of response to allergen challenge was significantly improved when immune markers of atopy, and in particular wheal size, were combined with clinical characteristics. Conclusion:, The relationship between atopy and bronchial allergy is quantitative at this age. There may be potential to create more powerful indicators of the presence of respiratory allergy in young children when immunological markers of atopy are considered quantitatively and when combined with clinical history of coexistent allergic disease. [source] | ||||||||||