15950 Tildrakizumab efficacy by metabolic syndrome status in psoriasis: Post hoc analysis of 3-year data from the phase 3 reSURFACE 2 study
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Post-hoc analysis
Interleukin-23
Post hoc
Using a hypothetical scenario typifying the experience that authors have when submitting manuscripts that report results of negative clinical trials, the pitfalls of a post hoc analysis are illustrated. We used the same scenario to explain how confidence intervals are used in interpreting results of clinical trials. We showed that confidence intervals better inform readers about the possibility of an inadequate sample size than do post hoc power calculations.
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Abstract This paper illustrates the use of a Scheffé-like multivariate post hoc procedure known as the Roy-Bose or simultaneous confidence interval procedure. This method is contrasted with the use of Bonferroni or planned linear combinations for the one- and two-sample cases. The Roy-Bose procedure also is compared to the more frequently employed univariate F tests for post hoc analysis.
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Scheffé’s test ( Scheffé, 1953 ), which is commonly used to conduct post hoc contrasts among k group means, is unnecessarily conservative because it guards against an infinite number of potential post hoc contrasts when only a small set would ever be of interest to a researcher. This paper identifies a set of post hoc contrasts based on subsets of the treatment groups and simulates critical values from the appropriate multivariate F-distribution to be used in place of those associated with Scheffé’s test. The proposed method and its critical values provide a uniformly more powerful post hoc procedure.
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The purpose of this paper is to present basic characteristics and highlight the differences between post hoc tests, as well as to show their application on concrete data of the research conducted. The said tests are applied on data obtained in the research which found evidence of 240 Serbian hotel ratings, given by their 71,700 guests. Each guest rated: cleanliness, comfort, location, facilities, staff, value for money, and free Wi-Fi in the hotel. A difference in ratings in relation to hotel category was observed and explained using several post hoc tests. The use of those tests is made much easier with the development of numerous statistical software packages. Therefore, clearly differentiating each of the tests allows one to select the most appropriate test in the research process, according to the type of data and research objectives. The paper presents the tests used when one-way analysis of variance, which is a method frequently used in statistical processing of experimental data, finds evidence of the existence of statistically significant differences in values of arithmetic mean in groups of data observed. The task of post hoc tests is to determine which group of data leads to the difference observed. Tests thus presented here are: the Fisher LSD, the Tukey HSD, the Bonferroni , the Newman-Keuls, the Dunnett and the Scheffe test.
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When assessing the effect of a therapy for psoriasis (PsO), it is important to consider speed of response and cumulative response. However, responses among biologics may differ by body regions. This post hoc analysis compares speed of response and cumulative response for ixekizumab (IXE), an interleukin-17A antagonist, and guselkumab (GUS), an interleukin-23p19 inhibitor, in different body regions of patients with moderate-to-severe plaque PsO participating in the IXORA-R study, up to week 24. The IXORA-R design has been previously described. Patients received the respective on-label dosing of IXE or GUS. The median time to first Psoriasis Area and Severity Index (PASI) 50, 75, 90, and 100 response (50%, 75%, 90%, and 100% improvement from baseline, respectively) and the cumulative days with clear skin for PASI 50, 75, 90, and 100 responses were assessed in four body regions: head, trunk, upper extremities, and lower extremities. A total of 1027 patients were enrolled and received IXE (N = 520) or GUS (N = 507). Median time to first PASI 50, 75, 90, and 100 response was shortest in the head region, followed by the remaining body regions in both IXE and GUS cohorts. In each body region, IXE was significantly faster than GUS (p < 0.001) in achieving PASI 50, 75, 90, and 100. Through 24 weeks, the number of days with clear skin for PASI 90 and 100 was greater in the head region, followed by trunk, upper extremities, and lastly lower extremities in both IXE and GUS cohorts. In each body region, through 24 weeks, patients on IXE experienced a significantly higher number of days with clear skin for PASI 50, 75, 90, and 100 than patients on GUS (p < 0.01). As compared to GUS, IXE provided a faster skin clearance and more days with clear skin in all body regions of patients with moderate-to-severe plaque PsO through 24 weeks. https://www.clinicaltrials.gov/ : NCT03573323 (IXORA-R). Psoriasis, a long-term, inflammatory skin disease, impacts patient's lives, and response to treatment varies depending on the body region affected. Here, we assessed the speed of response and cumulative response through 24 weeks in different body regions (head, trunk, upper extremities, and lower extremities) of patients with moderate-to-severe plaque psoriasis treated with currently approved therapies: ixekizumab (IXE), an interleukin-17A antagonist, or guselkumab (GUS), an interleukin-23p19 inhibitor. We calculated the speed of response as the number of weeks to achieve first skin clearance, based on the Psoriasis Area and Severity Index (PASI) tool, and the cumulative response as the number of days with clear skin throughout the 24-week period. We found that the head region achieved skin clearance fastest and had a higher number of days with clear skin compared to the trunk, upper extremities, and lower extremities, in both groups of patients treated with IXE or GUS. Compared to GUS, IXE provided faster skin clearance and a higher number of days with clear skin in all body regions. For example, the head region of patients treated with IXE, as compared to GUS, achieved complete skin clearance twofold faster and experienced 18.7% more days of complete skin clearance. In conclusion, treatment with IXE through 24 weeks provided a faster response and a higher cumulative response than treatment with GUS in all four body regions of patients with moderate-to-severe plaque psoriasis.
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Abstract Review of nursing research literature revealed that post hoc comparisons of mean differences were not consistently reported, although their use was warranted. This paper describes the critical features of post hoc procedures and offers guidelines for selecting one method over another. Particular attention is given to how various procedures control Type 1 error. Selection of post hoc procedures considering the investigator's desire for control of Type 1 and Type 2 error also is presented.
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The online support of IBM SPSS proposes that users alter the syntax when performing post-hoc analyses for interaction effects of ANOVA tests. Other authors also suggest altering the syntax when performing GEE analyses. This being done, the number of possible comparisons (k value) is also altered, therefore influencing the results from statistical tests that k is a component of the formula, such as repeated measures-ANOVA and Bonferroni post-hoc of ANOVA and GEE. This alteration also exacerbates type I error, producing erroneous results and conferring potential misinterpretations of data. Reasoning from this, the purpose of this paper is to report the misuse and improper handling of syntax for ANOVAs and GEE post-hoc analyses in SPSS and to illustrate its consequences on statistical results and data interpretation.
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Bonferroni correction
Gee
Repeated measures design
Statistical Analysis
Analysis of covariance
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