Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework

Background: The low (LF) vs. high (HF) frequency energy ratio, computed from the spectral decomposition of heart beat intervals, has become a major tool in cardiac autonomic system control and sympatho-vagal balance studies. The (statistical) distributions of response variables designed from ratios...

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Autores principales: Fernández, Elmer Andrés, Souza Neto, E.P., Abry, P., Macchiavelli, R., Balzarini, Mónica, Cuzin, B., Baude, C., Frutoso, J., Gharib, C.
Formato: Artículo PeerReviewed
Lenguaje:Español
Publicado: 2010
Materias:
TA Ingeniería de asistencia técnica (General). Ingeniería Civil (General)
Acceso en línea:http://pa.bibdigital.ucc.edu.ar/4982/1/A_Fernandez.pdf
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Producción Académica Universidad Católica de Córdoba (UCCor) de Universidad Católica de Córdoba
id I38-R144-4982
record_format dspace
spelling I38-R144-49822025-11-04T15:12:34Z http://pa.bibdigital.ucc.edu.ar/4982/ Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework Fernández, Elmer Andrés Souza Neto, E.P. Abry, P. Macchiavelli, R. Balzarini, Mónica Cuzin, B. Baude, C. Frutoso, J. Gharib, C. TA Ingeniería de asistencia técnica (General). Ingeniería Civil (General) Background: The low (LF) vs. high (HF) frequency energy ratio, computed from the spectral decomposition of heart beat intervals, has become a major tool in cardiac autonomic system control and sympatho-vagal balance studies. The (statistical) distributions of response variables designed from ratios of two quantities, such as the LF/HF ratio, are likely to non-normal, hence preventing e.g., from a relevant use of the . t-test. Even using a non-parametric formulation, the solution may be not appropriate as the test statistics do not account for correlation and heteroskedasticity, such as those that can be observed when several measures are taken from the same patient. Objectives: The analyses for such type of data require the application of statistical models which do not assume a priori independence. In this spirit, the present contribution proposes the use of the Generalized Linear Mixed Models (GLMMs) framework to assess differences between groups of measures performed over classes of patients. Methods: Statistical linear mixed models allow the inclusion of at least one random effect, besides the error term, which induces correlation between observations from the same subject. Moreover, by using GLMM, practitioners could assume any probability distribution, within the exponential family, for the data, and naturally model heteroskedasticity. Here, the sympatho-vagal balance expressed as LF/HF ratio of patients suffering neurogenic erectile dysfunction under three different body positions was analyzed in a case-control protocol by means of a GLMM under gamma and Gaussian distributed responses assumptions. Results: The gamma GLMM model was compared with the normal linear mixed model (LMM) approach conducted using raw and log transformed data. Both raw GLMM gamma and log transformed LMM allow better inference for factor effects, including correlations between observations from the same patient under different body position compared to the raw LMM. The gamma GLMM provides a more natural distribution assumption of a response expressed as a ratio. Conclusions: A gamma distribution assumption intrinsically models quadratic relationships between the expected value and the variance of the data avoiding prior data transformation. SAS and R source code are available on request. 2010-12-31 Artículo PeerReviewed application/pdf spa http://pa.bibdigital.ucc.edu.ar/4982/1/A_Fernandez.pdf Fernández, Elmer Andrés ORCID: https://orcid.org/0000-0002-4711-8634 <https://orcid.org/0000-0002-4711-8634>, Souza Neto, E.P., Abry, P., Macchiavelli, R., Balzarini, Mónica ORCID: https://orcid.org/0000-0002-4858-4637 <https://orcid.org/0000-0002-4858-4637>, Cuzin, B., Baude, C., Frutoso, J. and Gharib, C. (2010) Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework. Computer Methods and Programs in Biomedicine, 99 (1). pp. 49-56. ISSN 18727565 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.cmpb.2009.11.001
institution Universidad Católica de Córdoba
institution_str I-38
repository_str R-144
collection Producción Académica Universidad Católica de Córdoba (UCCor)
language Español
orig_language_str_mv spa
topic TA Ingeniería de asistencia técnica (General). Ingeniería Civil (General)
spellingShingle TA Ingeniería de asistencia técnica (General). Ingeniería Civil (General)
Fernández, Elmer Andrés
Souza Neto, E.P.
Abry, P.
Macchiavelli, R.
Balzarini, Mónica
Cuzin, B.
Baude, C.
Frutoso, J.
Gharib, C.
Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
topic_facet TA Ingeniería de asistencia técnica (General). Ingeniería Civil (General)
description Background: The low (LF) vs. high (HF) frequency energy ratio, computed from the spectral decomposition of heart beat intervals, has become a major tool in cardiac autonomic system control and sympatho-vagal balance studies. The (statistical) distributions of response variables designed from ratios of two quantities, such as the LF/HF ratio, are likely to non-normal, hence preventing e.g., from a relevant use of the . t-test. Even using a non-parametric formulation, the solution may be not appropriate as the test statistics do not account for correlation and heteroskedasticity, such as those that can be observed when several measures are taken from the same patient. Objectives: The analyses for such type of data require the application of statistical models which do not assume a priori independence. In this spirit, the present contribution proposes the use of the Generalized Linear Mixed Models (GLMMs) framework to assess differences between groups of measures performed over classes of patients. Methods: Statistical linear mixed models allow the inclusion of at least one random effect, besides the error term, which induces correlation between observations from the same subject. Moreover, by using GLMM, practitioners could assume any probability distribution, within the exponential family, for the data, and naturally model heteroskedasticity. Here, the sympatho-vagal balance expressed as LF/HF ratio of patients suffering neurogenic erectile dysfunction under three different body positions was analyzed in a case-control protocol by means of a GLMM under gamma and Gaussian distributed responses assumptions. Results: The gamma GLMM model was compared with the normal linear mixed model (LMM) approach conducted using raw and log transformed data. Both raw GLMM gamma and log transformed LMM allow better inference for factor effects, including correlations between observations from the same patient under different body position compared to the raw LMM. The gamma GLMM provides a more natural distribution assumption of a response expressed as a ratio. Conclusions: A gamma distribution assumption intrinsically models quadratic relationships between the expected value and the variance of the data avoiding prior data transformation. SAS and R source code are available on request.
format Artículo
PeerReviewed
author Fernández, Elmer Andrés
Souza Neto, E.P.
Abry, P.
Macchiavelli, R.
Balzarini, Mónica
Cuzin, B.
Baude, C.
Frutoso, J.
Gharib, C.
author_facet Fernández, Elmer Andrés
Souza Neto, E.P.
Abry, P.
Macchiavelli, R.
Balzarini, Mónica
Cuzin, B.
Baude, C.
Frutoso, J.
Gharib, C.
author_sort Fernández, Elmer Andrés
title Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
title_short Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
title_full Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
title_fullStr Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
title_full_unstemmed Assessing erectile neurogenic dysfunction from heart rate variability through a Generalized Linear Mixed Model framework
title_sort assessing erectile neurogenic dysfunction from heart rate variability through a generalized linear mixed model framework
publishDate 2010
url http://pa.bibdigital.ucc.edu.ar/4982/1/A_Fernandez.pdf
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