OBJECTIVE: To compare three statistical strategies for classifying positive treatment response based on a dimensional measure (Yale Global Tic Severity Scale [YGTSS]) and a categorical measure (Clinical Global Impression-Improvement [CGI-I] scale). METHOD: Subjects (N=232; 69.4% male; ages 9-69years) with Tourette syndrome or chronic tic disorder participated in one of two 10-week, randomized controlled trials comparing behavioral treatment to supportive therapy. The YGTSS and CGI-I were rated by clinicians blind to treatment assignment. We examined the percent reduction in the YGTSS-Total Tic Score (TTS) against Much Improved or Very Much Improved on the CGI-I, computed a signal detection analysis (SDA) and built a mixture model to classify dimensional response based on the change in the YGTSS-TTS. RESULTS: A 25% decrease on the YGTSS-TTS predicted positive response on the CGI-I during the trial. The SDA showed that a 25% reduction in the YGTSS-TTS provided optimal sensitivity (87%) and specificity (84%) for predicting positive response. Using a mixture model without consideration of the CGI-I, the dimensional response was defined by 23% (or greater) reduction on the YGTSS-TTS. The odds ratio (OR) of positive response (OR=5.68, 95% CI=[2.99, 10.78]) on the CGI-I for behavioral intervention was greater than the dimensional response (OR=2.86, 95% CI=[1.65, 4.99]). CONCLUSION: A 25% reduction on the YGTSS-TTS is highly predictive of positive response by all three analytic methods. For trained raters, however, tic severity alone does not drive the classification of positive response. Clinicaltrials.gov identifiers: NCT00218777; NCT00231985.
RCT Entities:
OBJECTIVE: To compare three statistical strategies for classifying positive treatment response based on a dimensional measure (Yale Global Tic Severity Scale [YGTSS]) and a categorical measure (Clinical Global Impression-Improvement [CGI-I] scale). METHOD: Subjects (N=232; 69.4% male; ages 9-69years) with Tourette syndrome or chronic tic disorder participated in one of two 10-week, randomized controlled trials comparing behavioral treatment to supportive therapy. The YGTSS and CGI-I were rated by clinicians blind to treatment assignment. We examined the percent reduction in the YGTSS-Total Tic Score (TTS) against Much Improved or Very Much Improved on the CGI-I, computed a signal detection analysis (SDA) and built a mixture model to classify dimensional response based on the change in the YGTSS-TTS. RESULTS: A 25% decrease on the YGTSS-TTS predicted positive response on the CGI-I during the trial. The SDA showed that a 25% reduction in the YGTSS-TTS provided optimal sensitivity (87%) and specificity (84%) for predicting positive response. Using a mixture model without consideration of the CGI-I, the dimensional response was defined by 23% (or greater) reduction on the YGTSS-TTS. The odds ratio (OR) of positive response (OR=5.68, 95% CI=[2.99, 10.78]) on the CGI-I for behavioral intervention was greater than the dimensional response (OR=2.86, 95% CI=[1.65, 4.99]). CONCLUSION: A 25% reduction on the YGTSS-TTS is highly predictive of positive response by all three analytic methods. For trained raters, however, tic severity alone does not drive the classification of positive response. Clinicaltrials.gov identifiers: NCT00218777; NCT00231985.
Authors: Eric A Storch; Tanya K Murphy; Gary R Geffken; Muhammad Sajid; Pam Allen; Jonathan W Roberti; Wayne K Goodman Journal: Psychol Assess Date: 2005-12
Authors: Joseph R Calabrese; Paul E Keck; Wayne Macfadden; Margaret Minkwitz; Terence A Ketter; Richard H Weisler; Andrew J Cutler; Robin McCoy; Ellis Wilson; Jamie Mullen Journal: Am J Psychiatry Date: 2005-07 Impact factor: 18.112
Authors: Sanjiv Kumra; Harvey Kranzler; Ginny Gerbino-Rosen; Hana M Kester; Courtney De Thomas; Vivian Kafantaris; Christoph U Correll; John M Kane Journal: Biol Psychiatry Date: 2007-07-25 Impact factor: 13.382
Authors: J F Leckman; M A Riddle; M T Hardin; S I Ort; K L Swartz; J Stevenson; D J Cohen Journal: J Am Acad Child Adolesc Psychiatry Date: 1989-07 Impact factor: 8.829
Authors: Sabine Wilhelm; Alan L Peterson; John Piacentini; Douglas W Woods; Thilo Deckersbach; Denis G Sukhodolsky; Susanna Chang; Haibei Liu; James Dziura; John T Walkup; Lawrence Scahill Journal: Arch Gen Psychiatry Date: 2012-08
Authors: Denis G Sukhodolsky; Lawrence Scahill; Heping Zhang; Bradley S Peterson; Robert A King; Paul J Lombroso; Lily Katsovich; Diane Findley; James F Leckman Journal: J Am Acad Child Adolesc Psychiatry Date: 2003-01 Impact factor: 8.829
Authors: Susanna W Chang; Joseph F McGuire; John T Walkup; Douglas W Woods; Lawrence Scahill; Sabine Wilhelm; Alan L Peterson; James Dziura; John Piacentini Journal: Psychiatry Res Date: 2018-01-02 Impact factor: 3.222
Authors: Emily J Ricketts; Joseph F McGuire; Susanna Chang; Deepika Bose; Madeline M Rasch; Douglas W Woods; Matthew W Specht; John T Walkup; Lawrence Scahill; Sabine Wilhelm; Alan L Peterson; John Piacentini Journal: Behav Ther Date: 2017-05-25
Authors: Davide Martino; Tamara M Pringsheim; Andrea E Cavanna; Carlo Colosimo; Andreas Hartmann; James F Leckman; Sheng Luo; Alexander Munchau; Christopher G Goetz; Glenn T Stebbins; Pablo Martinez-Martin Journal: Mov Disord Date: 2017-01-10 Impact factor: 10.338
Authors: Carly J Johnco; Alessandro S De Nadai; Adam B Lewin; Jill Ehrenreich-May; Jeffrey J Wood; Eric A Storch Journal: J Autism Dev Disord Date: 2015-10
Authors: David C Houghton; Matthew R Capriotti; Alessandro S De Nadai; Scott N Compton; Michael P Twohig; Angela M Neal-Barnett; Stephen M Saunders; Martin E Franklin; Douglas W Woods Journal: J Anxiety Disord Date: 2015-09-24
Authors: Angeli Landeros-Weisenberger; Antonio Mantovani; Maria G Motlagh; Pedro Gomes de Alvarenga; Liliya Katsovich; James F Leckman; Sarah H Lisanby Journal: Brain Stimul Date: 2014-12-03 Impact factor: 8.955