Document Detail


Multinomial logistic functions in markov chain models of sleep architecture: internal and external validation and covariate analysis.
MedLine Citation:
PMID:  21691915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mixed-effect Markov chain models have been recently proposed to characterize the time course of transition probabilities between sleep stages in insomniac patients. The most recent one, based on multinomial logistic functions, was used as a base to develop a final model combining the strengths of the existing ones. This final model was validated on placebo data applying also new diagnostic methods and then used for the inclusion of potential age, gender, and BMI effects. Internal validation was performed through simplified posterior predictive check (sPPC), visual predictive check (VPC) for categorical data, and new visual methods based on stochastic simulation and estimation and called visual estimation check (VEC). External validation mainly relied on the evaluation of the objective function value and sPPC. Covariate effects were identified through stepwise covariate modeling within NONMEM VI. New model features were introduced in the model, providing significant sPPC improvements. Outcomes from VPC, VEC, and external validation were generally very good. Age, gender, and BMI were found to be statistically significant covariates, but their inclusion did not improve substantially the model's predictive performance. In summary, an improved model for sleep internal architecture has been developed and suitably validated in insomniac patients treated with placebo. Thereafter, covariate effects have been included into the final model.
Authors:
Roberto Bizzotto; Stefano Zamuner; Enrica Mezzalana; Giuseppe De Nicolao; Roberto Gomeni; Andrew C Hooker; Mats O Karlsson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-21
Journal Detail:
Title:  The AAPS journal     Volume:  13     ISSN:  1550-7416     ISO Abbreviation:  AAPS J     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-07-27     Completed Date:  2011-12-09     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  101223209     Medline TA:  AAPS J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-63     Citation Subset:  IM    
Affiliation:
Department of Information Engineering, University of Padova, Padua, Italy. roberto.bizzotto@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Humans
Logistic Models
Markov Chains
Models, Biological*
Multicenter Studies as Topic
Multivariate Analysis
Polysomnography
Predictive Value of Tests
Randomized Controlled Trials as Topic
Reproducibility of Results
Sleep Initiation and Maintenance Disorders / diagnosis,  drug therapy,  physiopathology*
Sleep Stages / drug effects,  physiology*
Time Factors
Comments/Corrections

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