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Evaluating a Variable as a Proxy for another Measure: Assessing the Step Test Exercise Prescription as a Proxy for the Maximal, High- intensity Peak Oxygen Consumption in Older Adults Jonathan D. Mahnken, Ph.D., PStat ® Associate Professor of Biostatistics The University of Kansas Medical Center Director, Data Management and Statistics Core The University of Kansas Alzheimer’s Disease Center © 2013 Jonathan D. Mahnken. All Rights Reserved.1
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In Collaboration with… Xueyi Chen, Ph.D. Alexandra R. Brown, M.S. Eric D. Vidoni, Ph.D. Sandra A. Billinger, Ph.D. © 2013 Jonathan D. Mahnken. All Rights Reserved.2
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Acknowledgement The University of Kansas Alzheimer’s Disease Center (P30 AG035982) for support of the Data Management and Statistics Core Aim 2: Provide Statistical Expertise for ADC Projects Aim 2a: Support Study Design, Oversight, and Data Analyses Aim 2b: Participate in the Preparation of Study Presentations and Publications Aim 2c: Develop Novel Statistical Methodology to Ensure Proper Interpretation of ADC Data © 2013 Jonathan D. Mahnken. All Rights Reserved.3
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Motivating Example KU ADC thematic focus on modifiable lifestyle risk factors and AD prevention Maximal, high-intensity peak oxygen consumption (VO 2 peak) an important measure of fitness Interested in whether a lower-impact, sub-maximal Step Test Exercise Prescription, or STEP, could serve as valid proxy Less equipment required: staircase and stopwatch Likely to facilitate better subject recruitment for AD research Validity of STEP as a proxy for VO 2 peak in older adult population unclear © 2013 Jonathan D. Mahnken. All Rights Reserved.4
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Statistical Definition © 2013 Jonathan D. Mahnken. All Rights Reserved.5 (Kotz and Johnson eds., 1986, p 323)
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Valid Proxy © 2013 Jonathan D. Mahnken. All Rights Reserved.6
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Valid Proxy (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.7
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Valid Proxy (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.8
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An Extreme Example Aside © 2013 Jonathan D. Mahnken. All Rights Reserved.10
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Test of Unbiased Proxy © 2013 Jonathan D. Mahnken. All Rights Reserved.11
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Linear Transformation © 2013 Jonathan D. Mahnken. All Rights Reserved.12
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Linear Transformation (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.13
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Linear Transformation (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.14
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© 2013 Jonathan D. Mahnken. All Rights Reserved.15
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Comments on Comparing the Power Functions © 2013 Jonathan D. Mahnken. All Rights Reserved.18
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Compare Power Curves © 2013 Jonathan D. Mahnken. All Rights Reserved.19
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© 2013 Jonathan D. Mahnken. All Rights Reserved.20
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© 2013 Jonathan D. Mahnken. All Rights Reserved.21 Power = type I error when unbiased
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© 2013 Jonathan D. Mahnken. All Rights Reserved.35
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Motivating Example © 2013 Jonathan D. Mahnken. All Rights Reserved.36
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Motivating Example (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.37
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Motivating Example (cont.) © 2013 Jonathan D. Mahnken. All Rights Reserved.38
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Summary and Limitations © 2013 Jonathan D. Mahnken. All Rights Reserved.39
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Future Directions © 2013 Jonathan D. Mahnken. All Rights Reserved.40
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References Kotz S, Johnson NL eds., Encyclopedia of Statistical Sciences, Vol. 7. John Wiley & Sons: New York, 1986. Vidoni ED, Mattlage A, Mahnken J, Burns JM, McDonough J, Billinger SA: “Validity of the Step Test for Exercise Prescription Does Not Extend to a Larger Age Range.” Journal of Aging and Physical Activity. (Accepted in 2012.) © 2013 Jonathan D. Mahnken. All Rights Reserved.41
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I S H E D © 2013 Jonathan D. Mahnken. All Rights Reserved.42 Questions?
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