Publications by authors named "Tong-Yu Lu"

Objective: Sepsis related injury has gradually become the main cause of death in non-cardiac patients in intensive care units, but the underlying pathological and physiological mechanisms remain unclear. The Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) definition emphasized organ dysfunction caused by infection. Neutrophil extracellular traps (NETs) can cause inflammation and have key roles in sepsis organ failure; however, the role of NETs-related genes in sepsis is unknown.

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Non-inferiority (NI) trials are implemented when there is a practical demand to search for alternatives to standard therapies, such as to reduce side effects. An experimental treatment is considered non-inferior to the standard treatment when it exhibits clinically non-significant loss of efficacy. Ordinal categorical responses are frequently observed in clinical trials.

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Ordinal responses are common in clinical studies. Although the proportional odds model is a popular option for analyzing ordered-categorical data, it cannot control the type I error rate when the proportional odds assumption fails to hold. The latent Weibull model was recently shown to be a superior candidate for modeling ordinal data, with remarkably better performance than the latent normal model when the data are highly skewed.

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To evaluate the patterns of failure and survival trends of patients with stage I nasopharyngeal carcinoma (NPC) treated with radiotherapy alone over the last 20 years. A retrospective cohort study was conducted on 720 patients with stage I NPC who were treated with curative two-dimensional radiotherapy (2DRT), three-dimensional conformal radiotherapy (3DRT), or intensity-modulated radiotherapy (IMRT) between January 1990 and December 2012. The patients were categorized into four calendar periods (1990-1996, 1997-2002, 2003-2007, and 2008-2012) and four age subgroups (18-39, 40-49, 50-59, and >60).

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Purpose: Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors.

Materials And Methods: By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above.

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Article Synopsis
  • - The proportional odds model is commonly used in clinical studies for comparing treatments when responses are in ordered categories, but it fails to maintain accuracy when its key assumption is violated, leading to improper type I error rates.
  • - A newer approach using the latent normal model has shown better performance, but it is limited to treatments with similar distribution shapes, making it inadequate when the treatments differ significantly in skewness.
  • - A proposed solution involves using the latent Weibull distribution, which effectively manages type I error rates regardless of skewness in treatment responses and offers improved testing power, with practical applications demonstrated through clinical examples.
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Different latent variable models have been used to analyze ordinal categorical data which can be conceptualized as manifestations of an unobserved continuous variable. In this paper, we propose a unified framework based on a general latent variable model for the comparison of treatments with ordinal responses. The latent variable model is built upon the location-scale family and is rich enough to include many important existing models for analyzing ordinal categorical variables, including the proportional odds model, the ordered probit-type model, and the proportional hazards model.

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Article Synopsis
  • Clinical trials often compare different treatments to see which is more effective, particularly using ordered categorical responses.
  • This study focuses on enhancing the Wilcoxon-Mann-Whitney test for comparing more than two treatments, but notes limitations when the proportional odds assumption isn't valid.
  • The authors propose a new strategy using a latent normal model, demonstrating its effectiveness in controlling type I error rates and increased power through simulation studies.
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Article Synopsis
  • * When the proportional odds assumption is violated, it can lead to an inflated probability of incorrectly rejecting the null hypothesis, even when treatments have the same efficacy.
  • * The article introduces new statistical methods for comparing multiple treatments to a control without relying on the proportional odds assumption, using a latent normal distribution approach, and illustrates these methods with clinical trial data.
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