New simple tests for age-at-onset anticipation: application to panic disorder

Recently, testing for anticipation has received renewed interest. It is well known that standard statistical methods are inappropriate for this purpose due to problems of sampling bias. Few statistical tests have been proposed for comparing mean age of onset in affected parents with mean age of onset in affected children. All of them are difficult to compute and lack software to perform the tests. In this report, we formulate the problem in terms of symmetry tests. We propose a simple generalized paired t-test and a Wilcoxon signed rank test to adjust for the bias caused by the right truncation of both the parent's and child's ages at onset. We also extend the generalized paired t-test to a random effects model that enables analysis of correlated data from nuclear families, and could be further extended to larger family structures. We illustrate the approaches with an example of panic disorder.