Modelling neuromotor ratings with floor-effects
Theo Gasser1, Valentin Rousson
1Department of Biostatistics, Institute for Social and Preventive Medicine, University of Zürich, Sumatrastrasse 30, CH-8006 Zürich, Switzerland.
Insights
This study introduces a new method to create age- and gender-specific reference curves for associated movements (AMs) in children. This approach improves the analysis of motor dysfunction by handling data limitations and enabling individualized assessments.
Area of Science:
- Pediatrics
- Developmental Neuroscience
- Biostatistics
Background:
- Associated movements (AMs) are crucial for diagnosing motor dysfunction in children.
- Existing methods struggle with ordinal data, floor/ceiling effects, and age/gender variations.
- A robust methodology is needed for accurate AMs assessment.
Purpose of the Study:
- To develop age- and gender-dependent reference curves for associated movements (AMs) in typically developing children.
- To address data limitations including ordinal scales, floor/ceiling effects, and discreteness.
- To create a methodology enabling individualized, standardized AMs assessments.
Main Methods:
- Combined ordinal ratings of AM duration and extent into a quasi-continuous 'intensity' measure.
- Employed censored regression with a truncated normal distribution to handle data limitations (left-, right-, interval-censored).
- Utilized Wei and Tanner's data augmentation algorithm with linear mixed-effects modeling.
Main Results:
- Successfully generated age- and gender-dependent reference curves for AM intensity.
- The methodology effectively addressed issues of discreteness, floor-effects, and ceiling-effects.
- Enabled calculation of individual age- and gender-standardized AM values.
Conclusions:
- The proposed methodology provides a more accurate and nuanced assessment of associated movements in children.
- This approach overcomes limitations of previous methods for analyzing ordinal and censored data.
- Facilitates further research into motor development and dysfunction by allowing detailed individual analysis.
Abstract:
Associated movements (AMs) are a classical diagnostic tool to assess differences between normal children and children with some motor dysfunction. This paper presents a methodology to produce age- and gender-dependent reference-curves for AMs of normal children, for various tasks of a test battery. Data available consist of separate ratings of duration and extent of AMs, which are ordinal quantities with few levels. Other problems are severe age- and gender-dependent floor-effects (as well as some ceiling-effects), leaving little information for analysis at older ages. To get a better scale, we combined the two ordinal ratings into one meaningful and quasi-continuous quantity referred to as intensity of AMs. In order to solve problems due to floor-effects, ceiling-effects and discreteness, we assumed left- , right- and interval-censored values, respectively. We considered a censored regression problem and postulated a truncated normal distribution for the non-censored values (after an appropriate transformation of the data). Using Wei and Tanner's poor man's data augmentation algorithm, together with the technique of linear mixed effects modelling, useful reference-curves could be produced. In contrast to the cumulative probabilities approach for ordinal data, our methodology allows the calculation of individual age- and gender-standardized values, which puts us in a position to investigate numerous scientific questions.
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