Combining Item Purification and Multiple Comparison Adjustment Methods in Detection of Differential Item Functioning.

Many of the differential item functioning (DIF) detection methods rely on a principle of testing for DIF item by item, while considering the rest of the items or at least some of them being DIF-free. Computational algorithms of these DIF detection methods involve the selection of DIF-free items in an iterative procedure called item purification. Another aspect is the need to correct for multiple comparisons, which can be done with a number of existing multiple comparison adjustment methods. In this article, we demonstrate that implementation of these two controlling procedures together may have an impact on which items are detected as DIF items. We propose an iterative algorithm combining item purification and adjustment for multiple comparisons. Pleasant properties of the newly proposed algorithm are shown with a simulation study. The method is demonstrated on a real data example.

Rectal cancer treatment in a teaching hospital.

BACKGROUND: Rectal adenocarcinomas surgery morbidity and mortality might be impaired by neoadjuvant therapy. We performed this retropsective study to be compared with the PROCARE study running afterwards. METHODS: We performed a retrospective study of 95 patients operated on for rectal adenocarcinoma in a single institution during the period of 2007-2009. We used logistic regression to estimate the relationship between possible predictive parameters of anastomotic leakage (AL). RESULTS: The laparoscopic approach is favored in 63.1% of the cases with a conversion rate of 11.6%, mainly in man (6 out of 7). For low rectal cancer though, laparotomy was the first choice (92.3%). From a carcinological point of view, laparoscopy allowed a complete tumor resection according to the PME (n = 27) and TME (n = 26) standards. Multivariate analysis revealed that women, lower BMI, lower rectum tumor, laparoscopic surgery, neoadjuvant treatment and anal suture were associated with higher risk of AL. The mean hospital stay was 15.4 days (3-46 days) with an in-hospital mortality rate of 3.1%. Adjuvant chemotherapy was completed in 42.1% of the patients. Despite these treatments, we registered a recurrence rate of 26.6%. Of these, 72% were distally localized and 12% exclusively locally. Among the patients operated on by laparoscopy, there was one local recurrence and one local with distant metastases (3.7%). The one- and three-year survival rates were 91.5% and 80.4%, respectively. CONCLUSIONS: Our study showed a higher rate of AL than expected (18%). In our series recorded in PROCARE-Home, our leak rate has dropped to 10%. It may be indicating a positive effect of PROCARE.

Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps.

OBJECTIVES: The efficacy of stapedotomies performed on patients with small air-bone gaps (<25 dB) was compared with the efficacy of the operation in patients who had otosclerosis with high air-bone gaps (≥25 dB). METHODS: This retrospective study evaluates the short-term postoperative air and bone conduction thresholds and air-bone gaps after 182 CO2 laser stapedotomies. RESULTS: A significantly smaller air-bone gap and lower air conduction thresholds after surgery were observed in the group of patients who underwent surgery with preoperative air-bone gaps of less than 25 dB. Bone conduction thresholds improve in the group with small air-bone gaps after surgery. CONCLUSIONS: The results after stapedotomies are good even if the preoperative air-bone gap is small and the overall risk of hearing deterioration due to stapes surgery remains low.

Snijders's correction of Infit and Outfit indexes with estimated ability level: an analysis with the Rasch model.

The Infit mean square W and the Outfit mean square U are commonly used person fit indexes under Rasch measurement. However, they suffer from two major weaknesses. First, their asymptotic distribution is usually derived by assuming that the true ability levels are known. Second, such distributions are even not clearly stated for indexes U and W. Both issues can seriously affect the selection of an appropriate cut-score for person fit identification. Snijders (2001) proposed a general approach to correct some person fit indexes when specific ability estimators are used. The purpose of this paper is to adapt this approach to U and W indexes. First, a brief sketch of the methodology and its application to U and W is proposed. Then, the corrected indexes are compared to their classical versions through a simulation study. The suggested correction yields controlled Type I errors against both conservatism and inflation, while the power to detect specific misfitting response patterns gets significantly increased.

On the Developmental Trajectories of Relational Concepts Among Children and Adolescents With Intellectual Disability of Undifferentiated Etiology.

The aim of this study was to examine the developmental trajectories of comprehension of relational concepts among 557 participants with intellectual disability (ID) of undifferentiated etiology (M age  =  12.20 years, SD  =  3.18) and 557 typically developing (TD) participants (M age  =  4.57 years, SD  =  0.80). Logistic regression analyses, with nonverbal cognitive level entered first in the equations, showed only negligible differences with regard to the discriminative power of each of the 72 concepts used as outcome variables, and moderate differences in difficulty for only three items. A moderate mixed effect (i.e., combining a group difference in difficulty and discriminative power) was observed for a fourth item. It is concluded that the developmental trajectories of relational concepts are similar for participants with or without ID. The implications and limitations of the study are discussed.

A general framework and an R package for the detection of dichotomous differential item functioning.

Differential item functioning (DIF) is an important issue of interest in psychometrics and educational measurement. Several methods have been proposed in recent decades for identifying items that function differently between two or more groups of examinees. Starting from a framework for classifying DIF detection methods and from a comparative overview of the most traditional methods, an R package for nine methods, called difR, is presented. The commands and options are briefly described, and the package is illustrated through the analysis of a data set on verbal aggression.

Efficient Standard Errors in Item Response Theory Models for Short Tests.

In dichotomous item response theory (IRT) framework, the asymptotic standard error (ASE) is the most common statistic to evaluate the precision of various ability estimators. Easy-to-use ASE formulas are readily available; however, the accuracy of some of these formulas was recently questioned and new ASE formulas were derived from a general asymptotic theory framework. Furthermore, exact standard errors were suggested to better evaluate the precision of ability estimators, especially with short tests for which the asymptotic framework is invalid. Unfortunately, the accuracy of exact standard errors was assessed so far only in a very limiting setting. The purpose of this article is to perform a global comparison of exact versus (classical and new formulations of) asymptotic standard errors, for a wide range of usual IRT ability estimators, IRT models, and with short tests. Results indicate that exact standard errors globally outperform the ASE versions in terms of reduced bias and root mean square error, while the new ASE formulas are also globally less biased than their classical counterparts. Further discussion about the usefulness and practical computation of exact standard errors are outlined.

Does the Development of Syntax Comprehension Show a Premature Asymptote Among Persons With Down Syndrome? A Cross-Sectional Analysis.

Uncertainty persists regarding the post-childhood trajectory of syntactic acquisition of persons with Down syndrome (DS). In some studies, asymptote is reached in the early teens, whereas others find syntax continuing to develop at least into early adulthood. This study addressed the issue using a cross-sectional approach. Receptive syntax and vocabulary were tested in 62 children, adolescents and young adults with DS matched on chronological age and cognitive level with 62 participants with intellectual disability (ID) of undifferentiated etiology. On both tests there were significant effects of chronological age and diagnosis, but the chronological age × diagnosis interactions were nonsignificant. We concluded that comprehension of vocabulary and syntax does not asymptote prematurely in individuals with DS relative to those with other forms of ID.

Basic visual perceptual processes in children with typical development and cerebral palsy: The processing of surface, length, orientation, and position.

The present study aims to assess how the processing of basic visual perceptual (VP) components (length, surface, orientation, and position) develops in typically developing (TD) children (n = 215, 4-14 years old) and adults (n = 20, 20-25 years old), and in children with cerebral palsy (CP) (n = 86, 5-14 years old) using the first four subtests of the Battery for the Evaluation of Visual Perceptual and Spatial processing in children. Experiment 1 showed that these four basic VP processes follow distinct developmental trajectories in typical development. Experiment 2 revealed that children with CP present global and persistent deficits for the processing of basic VP components when compared with TD children matched on chronological age and nonverbal reasoning abilities.

Alteration of right ventricular-pulmonary vascular coupling in a porcine model of progressive pressure overloading.

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n=6) or sham-operated controls (n=6). Right ventricular pressure-volume (PV) loops were recorded using a conductance catheter. Right ventricular contractility was estimated by the slope of the end-systolic PV relationship (Ees). After load was referred to as pulmonary arterial elastance (Ea) and assessed using a four-element Windkessel model. Right ventricular-arterial coupling (Ees/Ea) and efficiency of energy transfer (from PV area to external mechanical work [stroke work]) were assessed at baseline and every 30 min for 4 h. Ea increased progressively after embolization, from 0.26+/-0.04 to 2.2+/-0.7 mmHg mL(-1) (P<0.05). Ees increased from 1.01+/-0.07 to 2.35+/-0.27 mmHg mL(-1) (P<0.05) after the first two injections but failed to increase any further. As a result, Ees/Ea initially decreased to values associated with optimal SW, but the last injection was responsible for Ees/Ea values less than 1, decreased stroke volume, and RV dilation. Stroke work/PV area consistently decreased with each injection from 79%+/-3% to 39%+/-11% (P<0.05). In response to gradual increases in afterload, RV contractility reserve was recruited to a point of optimal coupling but submaximal efficiency. Further afterload increases led to RV-vascular uncoupling and failure.

Evaluation of BM-573, a novel TXA2 synthase inhibitor and receptor antagonist, in a porcine model of myocardial ischemia-reperfusion.

AIMS: To investigate whether BM-573 (N-tert-butyl-N'-[2-(4'-methylphenylamino)-5-nitro-benzenesulfonyl]urea), an original combined thromboxane A2 synthase inhibitor and receptor antagonist, prevents reperfusion injury in acutely ischemic pigs. METHODS: Twelve animals were randomly divided in two groups: a control group (n = 6) intravenously infused with vehicle, and a BM-573-treated group (n = 6) infused with BM-573 (10 mg kg(-1) h(-1)). In both groups, the left anterior descending (LAD) coronary artery was occluded for 60 min and reperfused for 240 min. Either vehicle or BM-573 was infused 30 min before LAD occlusion and throughout the experiment. Platelet aggregation induced by arachidonic acid ex vivo measured was prevented by BM-573. RESULTS: In both groups, LAD occlusion decreased cardiac output, ejection fraction, slope of stroke work--end-diastolic volume relationship, and induced end-systolic pressure-volume relationship (ESPVR) rightward shift, while left ventricular afterload increased. Ventriculo-arterial coupling and mechanical efficiency decreased. In both groups, reperfusion further decreased cardiac output and ejection fraction, while ESPVR displayed a further rightward shift. Ventriculo-arterial coupling and mechanical efficiency remained impaired. Area at risk, evidenced with Evans blue, was 33.2+/-3.4% of the LV mass (LVM) in both groups, and mean infarct size, revealed by triphenyltetrazolium chloride (TTC), was 27.3+/-2.6% of the LVM in the BM-573-treated group (NS). Histological examination and immunohistochemical identification of desmin revealed necrosis in the anteroseptal region similar in both groups, while myocardial ATP dosages and electron microscopy also showed that BM-573 had no cardioprotective effect. CONCLUSIONS: These data suggest that BM-573 failed to prevent reperfusion injury in acutely ischemic pigs.

Efficient Standard Error Formulas of Ability Estimators with Dichotomous Item Response Models.

This paper focuses on the computation of asymptotic standard errors (ASE) of ability estimators with dichotomous item response models. A general framework is considered, and ability estimators are defined from a very restricted set of assumptions and formulas. This approach encompasses most standard methods such as maximum likelihood, weighted likelihood, maximum a posteriori, and robust estimators. A general formula for the ASE is derived from the theory of M-estimation. Well-known results are found back as particular cases for the maximum and robust estimators, while new ASE proposals for the weighted likelihood and maximum a posteriori estimators are presented. These new formulas are compared to traditional ones by means of a simulation study under Rasch modeling.

On the Finiteness of the Weighted Likelihood Estimator of Ability.

The purpose of this note is to focus on the finiteness of the weighted likelihood estimator (WLE) of ability in the context of dichotomous and polytomous item response theory (IRT) models. It is established that the WLE always returns finite ability estimates. This general result is valid for dichotomous (one-, two-, three- and four-parameter logistic) IRT models, the class of polytomous difference models and divide-by-total models, independently of the number of items, the item parameters and the response patterns. Further implications of this result are outlined.

An Item Analysis of the French Version of the Test for Reception of Grammar Among Children and Adolescents With Down Syndrome or Intellectual Disability of Undifferentiated Etiology.

Purpose: An item analysis of Bishop's (1983) Test for Reception of Grammar (TROG) in its French version (F-TROG; Lecocq, 1996) was conducted to determine whether the difficulty of items is similar for participants with or without intellectual disability (ID). Method: In Study 1, responses to the 92 F-TROG items by 55 participants with Down syndrome (DS), 55 with ID of undifferentiated etiology (UND), and 55 typical children (TYP) matched on their F-TROG total score were compared using the transformed item difficulties method, a statistical approach designed to detect differential item functioning (DIF) between groups. In Study 2, an additional comparison involving 526 TYP participants and 526 participants with UND was conducted to increase the statistical power of the analysis. Results: The difficulty of items was highly similar whatever the sample size or clinical status of participants. Fewer than 3.5% of the items were flagged as showing DIF. Conclusions: Tests such as the TROG can be used with confidence in clinical practice as well as in research studies comparing participants with or without ID. Methods designed for investigating potential internal test bias-such as done here-should be more regularly employed in the developmental disability field to affirm the absence of DIF.

Characterization of an original model of myocardial infarction provoked by coronary artery thrombosis induced by ferric chloride in pig.

BACKGROUND: Great advances have been made in the prevention of thrombotic disorders by developments of new pharmacological and surgical treatments. Animal models of arterial thrombosis have largely contributed to the discovery and to the validation of original treatments. The purpose of the present work was to develop and validate an original model of acute myocardial infarction provoked in pig by thrombosis of the left anterior descending (LAD) coronary artery induced by topical application of ferric chloride solution. METHODS AND RESULTS: Myocardial infarction, resulting from an occlusive and adherent mixed thrombus formed in the LAD coronary artery, was examined at macroscopic level using dual staining technique (Evans blue dye; triphenyltetrazolium chloride) and at microscopic level using conventional histological analyses and immunohistochemical detection of desmin. Biochemical markers (troponin T and ATP), platelet reactivity and standard hemodynamic parameters (such as stroke volume, ejection fraction, stroke work and cardiac output) have also been evaluated. From these analyses, it was demonstrated that each pig developed a transmural area of irreversible damage mainly located in the anteroseptal region of the left ventricle. The more progressive development of coronary artery occlusion, as compared to an abrupt ligation, was accompanied by a correspondingly progressive impairment in hemodynamics. CONCLUSION: We conclude that this original porcine model of myocardial infarction is quite close to clinical pathophysiological conditions, such as thrombus formation occurring after atherosclerotic plaque rupture. This certainly constitutes a further argument in favour of this model to assess pharmaceutical or mechanical support of an acutely ischemic heart.

Effects of BM-573, a thromboxane A2 modulator on systemic hemodynamics perturbations induced by U-46619 in the pig.

The aim of our study was to evaluate the effects of thromboxane A2 (TXA2) agonist, U-46619, on systemic circulatory parameters in the pigs before and after administration of a novel TXA2 receptor antagonist and synthase inhibitor (BM-573). Twelve anesthetized pigs were randomly assigned in two groups: in Ago group (n=6), the animals received six consecutive injections of U-46619 at 30 min interval, while in Anta group (n=6) they received an increasing dosage regimen of BM-573 10 min before each U-46619 injection. The effects of each dose of BM-573 on ex vivo platelet aggregation induced by arachidonic acid, collagen or ADP were also evaluated. Vascular properties such as characteristic impedance, peripheral resistance, compliance, arterial elastance were estimated using a windkessel model. Intravenous injections of 0.500 mg/ml of BM-573 and higher doses resulted in a complete inhibition of platelet aggregation induced by arachidonic acid. In the same conditions, BM-573 completely blocked the increase of arterial elastance, and stabilized both mean aortic blood pressure and mean systemic blood flow. In conclusion, BM-573 could therefore be a promising therapeutic approach in pathophysiological states where TXA2 plays a main role in the increase of vascular resistance like in pathologies such as systemic hypertension.

Effects of endotoxic shock on right ventricular systolic function and mechanical efficiency.

OBJECTIVE: To investigate the effects of endotoxin infusion on right ventricular (RV) systolic function and mechanical efficiency. METHODS: Six anesthetized pigs (Endo group) received a 0.5 mg/kg endotoxin infusion over 30 min and were compared with six other anesthetized pigs (Control group) receiving placebo for 5 h. RV pressure-volume (PV) loops were obtained by the conductance catheter technique and pulmonary artery flow and pressure were measured with high-fidelity transducers. RESULTS: RV adaptation to increased afterload during the early phase of endotoxin-induced pulmonary hypertension (T30) was obtained by both homeometric and hetereometric regulations: the slope of the end-systolic PV relationship of the right ventricle increased from 1.4+/-0.2 mmHg/ml to 2.9+/-0.4 mmHg/ml (P<0.05) and RV end-diastolic volume increased from 56+/-6 ml to 64+/-11 ml (P<0.05). Consequently, right ventricular-vascular coupling was maintained at a maximum efficiency. Ninety minutes later (T120), facing the same increased afterload, the right ventricle failed to maintain its contractility to such an elevated level and, as a consequence, right ventricular-vascular uncoupling occurred. PV loop area, which is known to be highly correlated with oxygen myocardial consumption, increased from 1154+/-127 mmHg/ml (T0) to 1798+/-122 mmHg/ml (T180) (P<0.05) while RV mechanical efficiency decreased from 63+/-2% (T0) to 45+/-5% (T270) (P<0.05). CONCLUSIONS: In the very early phase of endotoxinic shock, right ventricular-vascular coupling is preserved by an increase in RV contractility. Later, myocardial oxygen consumption and energetic cost of RV contractility are increased, as evidenced by the decrease in RV efficiency, and right ventricular-vascular uncoupling occurs. Therefore, therapies aiming at restoring right ventricular-vascular coupling in endotoxic shock should attempt to increase RV contractility and to decrease RV afterload but also to preserve RV mechanical efficiency.

A note on weighted likelihood and Jeffreys modal estimation of proficiency levels in polytomous item response models.

Warm (in Psychometrika, 54, 427-450, 1989) established the equivalence between the so-called Jeffreys modal and the weighted likelihood estimators of proficiency level with some dichotomous item response models. The purpose of this note is to extend this result to polytomous item response models. First, a general condition is derived to ensure the perfect equivalence between these two estimators. Second, it is shown that this condition is fulfilled by two broad classes of polytomous models including, among others, the partial credit, rating scale, graded response, and nominal response models.

Layman versus Professional Musician: Who Makes the Better Judge?

The increasing number of casting shows and talent contests in the media over the past years suggests a public interest in rating the quality of vocal performances. In many of these formats, laymen alongside music experts act as judges. Whereas experts' judgments are considered objective and reliable when it comes to evaluating singing voice, little is known about laymen's ability to evaluate peers. On the one hand, layman listeners-who by definition did not have any formal training or regular musical practice-are known to have internalized the musical rules on which singing accuracy is based. On the other hand, layman listeners' judgment of their own vocal skills is highly inaccurate. Also, when compared with that of music experts, their level of competence in pitch perception has proven limited. The present study investigates laypersons' ability to objectively evaluate melodies performed by untrained singers. For this purpose, laymen listeners were asked to judge sung melodies. The results were compared with those of music experts who had performed the same task in a previous study. Interestingly, the findings show a high objectivity and reliability in layman listeners. Whereas both the laymen's and experts' definition of pitch accuracy overlap, differences regarding the musical criteria employed in the rating task were evident. The findings suggest that the effect of expertise is circumscribed and limited and supports the view that laypersons make trustworthy judges when evaluating the pitch accuracy of untrained singers.

On the asymptotic standard error of a class of robust estimators of ability in dichotomous item response models.

In item response theory, the classical estimators of ability are highly sensitive to response disturbances and can return strongly biased estimates of the true underlying ability level. Robust methods were introduced to lessen the impact of such aberrant responses on the estimation process. The computation of asymptotic (i.e., large-sample) standard errors (ASE) for these robust estimators, however, has not yet been fully considered. This paper focuses on a broad class of robust ability estimators, defined by an appropriate selection of the weight function and the residual measure, for which the ASE is derived from the theory of estimating equations. The maximum likelihood (ML) and the robust estimators, together with their estimated ASEs, are then compared in a simulation study by generating random guessing disturbances. It is concluded that both the estimators and their ASE perform similarly in the absence of random guessing, while the robust estimator and its estimated ASE are less biased and outperform their ML counterparts in the presence of random guessing with large impact on the item response process.