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      Comparison of frontal QRS-T angle in patients with schizophrenia and healthy volunteers

      , , , ,
      Journal of Psychiatric Research
      Elsevier BV

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          The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia

          The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
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            Is Open Access

            Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis

            As discussed in the previous statistical notes, although many statistical methods have been proposed to test normality of data in various ways, there is no current gold standard method. The eyeball test may be useful for medium to large sized (e.g., n > 50) samples, however may not useful for small samples. The formal normality tests including Shapiro-Wilk test and Kolmogorov-Smirnov test may be used from small to medium sized samples (e.g., n 2.1 Kurtosis is a measure of the peakedness of a distribution. The original kurtosis value is sometimes called kurtosis (proper) and West et al. (1996) proposed a reference of substantial departure from normality as an absolute kurtosis (proper) value > 7.1 For some practical reasons, most statistical packages such as SPSS provide 'excess' kurtosis obtained by subtracting 3 from the kurtosis (proper). The excess kurtosis should be zero for a perfectly normal distribution. Distributions with positive excess kurtosis are called leptokurtic distribution meaning high peak, and distributions with negative excess kurtosis are called platykurtic distribution meaning flat-topped curve. 2) Normality test using skewness and kurtosis A z-test is applied for normality test using skewness and kurtosis. A z-score could be obtained by dividing the skew values or excess kurtosis by their standard errors. As the standard errors get smaller when the sample size increases, z-tests under null hypothesis of normal distribution tend to be easily rejected in large samples with distribution which may not substantially differ from normality, while in small samples null hypothesis of normality tends to be more easily accepted than necessary. Therefore, critical values for rejecting the null hypothesis need to be different according to the sample size as follows: For small samples (n < 50), if absolute z-scores for either skewness or kurtosis are larger than 1.96, which corresponds with a alpha level 0.05, then reject the null hypothesis and conclude the distribution of the sample is non-normal. For medium-sized samples (50 < n < 300), reject the null hypothesis at absolute z-value over 3.29, which corresponds with a alpha level 0.05, and conclude the distribution of the sample is non-normal. For sample sizes greater than 300, depend on the histograms and the absolute values of skewness and kurtosis without considering z-values. Either an absolute skew value larger than 2 or an absolute kurtosis (proper) larger than 7 may be used as reference values for determining substantial non-normality. Referring to Table 1 and Figure 1, we could conclude all the data seem to satisfy the assumption of normality despite that the histogram of the smallest-sized sample doesn't appear as a symmetrical bell shape and the formal normality tests for the largest-sized sample were rejected against the normality null hypothesis. 3) How strict is the assumption of normality? Though the humble t test (assuming equal variances) and analysis of variance (ANOVA) with balanced sample sizes are said to be 'robust' to moderate departure from normality, generally it is not preferable to rely on the feature and to omit data evaluation procedure. A combination of visual inspection, assessment using skewness and kurtosis, and formal normality tests can be used to assess whether assumption of normality is acceptable or not. When we consider the data show substantial departure from normality, we may either transform the data, e.g., transformation by taking logarithms, or select a nonparametric method such that normality assumption is not required.
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              Prolonged QTc interval and risk of sudden cardiac death in a population of older adults.

              This study sought to investigate whether prolongation of the heart rate-corrected QT (QTc) interval is a risk factor for sudden cardiac death in the general population. In developed countries, sudden cardiac death is a major cause of cardiovascular mortality. Prolongation of the QTc interval has been associated with ventricular arrhythmias, but in most population-based studies no consistent association was found between QTc prolongation and total or cardiovascular mortality. Only very few of these studies specifically addressed sudden cardiac death. This study was conducted as part of the Rotterdam Study, a prospective population-based cohort study that comprises 3,105 men and 4,878 women aged 55 years and older. The QTc interval on the electrocardiogram was determined during the baseline visit (1990 to 1993) and the first follow-up examination (1993 to 1995). The association between a prolonged QTc interval and sudden cardiac death was estimated using Cox proportional hazards analysis. During an average follow-up period of 6.7 years (standard deviation, 2.3 years) 125 patients died of sudden cardiac death. An abnormally prolonged QTc interval (>450 ms in men, >470 ms in women) was associated with a three-fold increased risk of sudden cardiac death (hazard ratio, 2.5; 95% confidence interval, 1.3 to 4.7), after adjustment for age, gender, body mass index, hypertension, cholesterol/high-density lipoprotein ratio, diabetes mellitus, myocardial infarction, heart failure, and heart rate. In patients with an age below the median of 68 years, the corresponding relative risk was 8.0 (95% confidence interval 2.1 to 31.3). Abnormal QTc prolongation on the electrocardiogram should be viewed as an independent risk factor for sudden cardiac death.
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                Author and article information

                Contributors
                Journal
                Journal of Psychiatric Research
                Journal of Psychiatric Research
                Elsevier BV
                00223956
                May 2022
                May 2022
                : 149
                : 76-82
                Article
                10.1016/j.jpsychires.2022.02.033
                35255386
                6647a6f4-cbd8-4111-b39b-8960da1ea50d
                © 2022

                https://www.elsevier.com/tdm/userlicense/1.0/

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