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Sign Test for Matched Pairs

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The sign test for matched pairs offers a robust method for comparing two paired samples, often for the effects of an intervention in one of them. This method is very useful in situations where the underlying distribution of the data is unknown. The test compares two related samples—often pre- and post-treatment measurements on the same subjects—to determine if there are significant differences in their median values.
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A z score (or standardized value) is measured in units of the standard deviation. It tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
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A z score (or standardized value) is measured in units of the standard deviation. It indicates how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a zero z score. It is important to note that the mean of the z scores is zero, and the standard deviation is one.
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z scores are the standardized values obtained after converting a normal distribution into a standard normal distribution. A z score is measured in units of the standard deviation. The z score tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a z score of...
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Leadless pacemaker versus transvenous single-chamber pacemaker therapy: A propensity score-matched analysis.

Fleur V Y Tjong1, Reinoud E Knops1, Erik O Udo2

  • 1AMC Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Heart Rhythm
|May 1, 2018
PubMed
Summary

Leadless pacemakers show lower complication rates than transvenous pacemakers in single-chamber pacing. However, this advantage disappears when including advisory-related complications.

Keywords:
ArrhythmiaLeadless pacemakerLeadless pacingPacemakersPacing

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Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Trials

Background:

  • Leadless pacemakers (PMs) were developed to reduce complications associated with traditional transvenous leads and pockets.
  • Initial studies suggest promise for leadless PMs, but limited data and short follow-up hinder direct comparisons with transvenous PMs.

Purpose of the Study:

  • To conduct a balanced comparison of leadless and transvenous single-chamber pacemaker therapies.
  • Utilize a propensity score-matched analysis to mitigate bias between patient groups.

Main Methods:

  • Propensity score matching was used to compare leadless PM patients from experienced centers with VVI-R transvenous PM patients from a registry.
  • The primary outcome was device-related complications requiring intervention at mid-term follow-up.
  • Analyses were performed both including and excluding PM advisory-related complications.

Main Results:

  • A total of 440 patients (220 leadless, 220 transvenous) were matched.
  • Excluding advisory complications, leadless PMs had a significantly lower complication rate (0.9% vs. 4.7%) at 800 days (P = .02).
  • Including advisory complications, the difference in complication rates was not significant (10.9% vs. 4.7%, P = .063).

Conclusions:

  • Leadless single-chamber pacing demonstrates favorable complication rates compared to transvenous pacing at mid-term follow-up in matched cohorts.
  • The observed benefit of leadless pacing is diminished when PM advisory-related complications are considered in the analysis.