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A R Yung - One of the best experts on this subject based on the ideXlab platform.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention.
Schizophrenia research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 (N=416), followed for a mean of 7.5years (the 'PACE 400' cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 (p=0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias). Copyright © 2016 Elsevier B.V. All rights reserved.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention
Schizophrenia Research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:Abstract Background The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. Aims In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. Method The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 ( N = 416), followed for a mean of 7.5 years (the ‘PACE 400’ cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Results Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 ( p = 0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. Discussion These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias).
Borshyang Sheu - One of the best experts on this subject based on the ideXlab platform.
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Lead Time Bias may contribute to the shorter life expectancy in post colonoscopy colorectal cancer
Digestive Diseases and Sciences, 2019Co-Authors: Weiyiing Chen, Hsiu Chi Cheng, Wei Chun Cheng, Jungder Wang, Borshyang SheuAbstract:BACKGROUND The long-term outcomes of post-colonoscopy colorectal cancer have varied in previous studies. Our nationwide cohort analysis estimated expected years of life lost to adjust for Lead Time Bias. AIM We recalculated the long-term outcomes for post-colonoscopy and detected colorectal cancer. METHODS Patients with colorectal cancer registered in the Taiwan Cancer Registry between 2002 and 2009 were enrolled. The detected group included 22,169 cases of colorectal cancer confirmed within 6 months after a colonoscopy. The post-colonoscopy group included 1653 cancer patients who received a colonoscopy 6-60 months before diagnosis. Patients were followed up until 2011. We simulated age-, sex-, and calendar year-matched referents from life tables in the Taiwan National Vital Statistics using a Monte Carlo method. The life expectancy and expected years of life lost of the cancer patients were obtained from extrapolation of the logit transformation of the survival ratio between the cancer cohorts and the referent groups. RESULTS Post-colonoscopy colorectal cancer had shorter life expectancies than detected cancer (stages 2-4: 13.6 vs. 16.1 years; 8.7 vs. 12.6 years; 2.1 vs. 4.1 years, p < 0.001). The loss-of-life expectancy did not show this trend after adjusting for Lead Time Bias. Post-colonoscopy colorectal cancer was found at an older age, more often proximal, and was associated with previous endoscopic polypectomy procedures (p < 0.001). CONCLUSIONS Post-colonoscopy colorectal cancer Leads to a shorter life expectancy, which appears partially explained by the presence of Lead Time Bias. Quality assurance for colonoscopy and close surveillance for high risk groups would reduce post-colonoscopy colorectal cancer.
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Lead Time Bias May Contribute to the Shorter Life Expectancy in Post-colonoscopy Colorectal Cancer
Digestive diseases and sciences, 2019Co-Authors: Weiyiing Chen, Hsiu Chi Cheng, Wei Chun Cheng, Jungder Wang, Borshyang SheuAbstract:BACKGROUND The long-term outcomes of post-colonoscopy colorectal cancer have varied in previous studies. Our nationwide cohort analysis estimated expected years of life lost to adjust for Lead Time Bias. AIM We recalculated the long-term outcomes for post-colonoscopy and detected colorectal cancer. METHODS Patients with colorectal cancer registered in the Taiwan Cancer Registry between 2002 and 2009 were enrolled. The detected group included 22,169 cases of colorectal cancer confirmed within 6 months after a colonoscopy. The post-colonoscopy group included 1653 cancer patients who received a colonoscopy 6-60 months before diagnosis. Patients were followed up until 2011. We simulated age-, sex-, and calendar year-matched referents from life tables in the Taiwan National Vital Statistics using a Monte Carlo method. The life expectancy and expected years of life lost of the cancer patients were obtained from extrapolation of the logit transformation of the survival ratio between the cancer cohorts and the referent groups. RESULTS Post-colonoscopy colorectal cancer had shorter life expectancies than detected cancer (stages 2-4: 13.6 vs. 16.1 years; 8.7 vs. 12.6 years; 2.1 vs. 4.1 years, p
B Nelson - One of the best experts on this subject based on the ideXlab platform.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention.
Schizophrenia research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 (N=416), followed for a mean of 7.5years (the 'PACE 400' cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 (p=0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias). Copyright © 2016 Elsevier B.V. All rights reserved.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention
Schizophrenia Research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:Abstract Background The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. Aims In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. Method The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 ( N = 416), followed for a mean of 7.5 years (the ‘PACE 400’ cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Results Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 ( p = 0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. Discussion These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias).
P D Mcgorry - One of the best experts on this subject based on the ideXlab platform.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention.
Schizophrenia research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 (N=416), followed for a mean of 7.5years (the 'PACE 400' cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 (p=0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias). Copyright © 2016 Elsevier B.V. All rights reserved.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention
Schizophrenia Research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:Abstract Background The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. Aims In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. Method The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 ( N = 416), followed for a mean of 7.5 years (the ‘PACE 400’ cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Results Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 ( p = 0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. Discussion These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias).
S J Wood - One of the best experts on this subject based on the ideXlab platform.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention.
Schizophrenia research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 (N=416), followed for a mean of 7.5years (the 'PACE 400' cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 (p=0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias). Copyright © 2016 Elsevier B.V. All rights reserved.
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Further examination of the reducing transition rate in ultra high risk for psychosis samples: The possible role of earlier intervention
Schizophrenia Research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:Abstract Background The rate of transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a Lead-Time Bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. Aims In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., Lead-Time Bias and earlier intervention. Method The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 ( N = 416), followed for a mean of 7.5 years (the ‘PACE 400’ cohort). Duration of symptoms was analysed by four baseline year Time periods. Analysis of transition rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Results Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 ( p = 0.10). The group with a short duration of symptoms showed lower transition rates and did not catch up in transition rate compared to the long duration of symptoms group. Discussion These data suggest that, while earlier intervention or Lead-Time Bias do not fully account for the declining transition rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (Lead-Time Bias).