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Moderator, Mediators et al: Toward Understanding Heterogeneity

Dr. Helena Kraemer, PhD

Dr. Helena Kraemer is an internationally renowned biostatistician and the primary biostatistics of the SAGE center. Dr.Kraemer became a fellow of the American Statistical Association in 1987. She is a member of the American College of Neuropsychopharmacology (1994) and the National Academy of Medicine (2003) She was awarded the Franklin Ebaugh Prize from Stanford University and the Harvard Prize in Psychiatric Biostatistics and Epidemiology (2001). In 2014, she was awarded an honorary degree from Wesleyan University. She served in NIH study section for many years and was a member of NIMH/NIH counsel. She serves as the primary biostatics expert for the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

Watch the recorded webinar below to learn directly from Dr. Helena Kraemer on the topic of Moderator, Mediators et al: Toward Understanding Heterogeneity

List of References

“Coming to Terms with the Terms of Risk”

Jacobi C, Hayward C, deZwaan M, Kraemer HC, Agras WS. Coming to Terms with Risk Factors for Eating Disorders:  Application of Risk Terminology and Suggestions for a General Taxonomy. Psychological Bulletin. 2004;130(1):19-65.

Kraemer HC, Kazdin AE, Offord DR, Kessler RC, Jensen PS, Kupfer DJ. Coming to Terms with the Terms of Risk. Archives of General Psychiatry. 1997;54:337-343.

Interpretable Effect Sizes: How Strong is Strong Enough? 

Kraemer HC. Correlation coefficients in medical research:  from product moment correlation to the odds ratio. Statistical Methods in Medical Research. 2007;15(6):525-545.

Newcombe RG. A deficiency of the odds ratio as a measure of effect size. Statistics in Medicine. 2006;25:4235-4240.

Kraemer HC. Reconsidering the Odds Ratio as a Measure of 2X2 Association in a Population. Statistics in Medicine. 2004;23(2):257-270.

Kraemer HC, Kazdin AE, Offord DR, Kessler RC, Jensen PS, Kupfer DJ. Measuring the potency of a risk factor for clinical or policy significance. Psychological Methods. 1999;4(3):257-271.

Sackett DL. Down with odds ratios! Evidence-Based Medicine. 1996;1:164-166.

Cohen J. Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychological Bulletin. 1968;70:213-229.

How Risk Factors Work Together with respect to an Outcome

Baron RM, Kenny DA. The Moderator-Mediator variable distinction in social psychological research:  Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51:1173-1182.

Kraemer HC, Stice E, Kazdin A, Kupfer D. How do risk factors work together to produce an outcome?  Mediators, Moderators, Independent, Overlapping and Proxy Risk Factors. The American Journal of Psychiatry. 2001;158:848-856.

MacKinnon DP. Introduction to Statistical Mediation Analysis New York: Psychology Press;  Taylor & Francis Group; 2008.

Kraemer HC. Discovering, Comparing and Combining Moderators of Treatment on Outcome after Randomized Clinical Trials:  A Parametric Approach. In Press.

Kraemer HC. Messages for Clinicians:  Moderators and Mediators of Treatment Outcome in Randomized Clinical Trials. American Journal of Psychiatry. 2016;173(7):672-679.

Kraemer HC. Discovering, comparing, and combining moderators of treatment on outcome after randomized clinicala trials:  a parametric approach. Statistics in Medicine. 2013;EPub ahead of print

Kraemer HC, Kiernan M, Essex MJ, Kupfer DJ. How and Why Criteria Defining Moderators and Mediators Differ Between the Baron & Kenny and MacArthur Approaches. Health Psychology. 2008;27(2):S101-S108.

Kraemer HC. Toward non-parametric and clinically meaningful moderators and mediators. Statistics in Medicine. 2008;27:1679-1692.

Kraemer HC, Frank E, Kupfer DJ. Moderators of Treatment Outcomes:  Clinical, Research, and Policy Importance. Journal of the American Medical Association. 2006;296(10):1-4.

Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and Moderators of Treatment Effects in Randomized Clinical Trials. Archives of General Psychiatry. 2002;59:877-883.

Kraemer HC, Stice E, Kazdin A, Kupfer D. How do risk factors work together to produce an outcome?  Mediators, Moderators, Independent, Overlapping and Proxy Risk Factors. The American Journal of Psychiatry. 2001;158:848-856.

A moderates B on O

Caspi A, Sugden K, Moffitt TE, al e. Influence of life stress on depression:  moderation by a polymorphism in the 5-HTT gene. Science. 2003;301:386-389

Other Terms

Last JM. A Dictionary of Epidemiology. New York: Oxford University Press; 1995.

Model for children of “low-involved” fathers during the infancy period (HGS)

Boyce WT, Essex MJ, Alkon A, Goldsmith HH, Kraemer HC, Kupfer DJ. Early Father Involvement Moderates Biobehavioral Susceptibility to Mental Health Problems in Middle Childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 2006;45(12):1510-1520.

Essex MJ, Kraemer HC, Armstong JM, et al. Exploring Risk Factors for the Emergence of Children’s Mental Health Problems. Archives of General Psychiatry. 2006;63:1246-1256.

Infant Health & Development Program (IHDP)-HTS/HGS

Gross RT, Spiker D, Haynes CW. Helping Low Birth Weight, Premature Babies. Stanford, CA1997.

IHDP. Infant Health and Development Program: Enhancing the Outcomes of Low Birth Weight, Premature Infants:  A Multisite Randomized Trial. Journal of the American Medical Association. 1990;263:3035-3042.

Comorbid Anxiety as a Moderator of MTA effects (HTS)

The_MTA_Cooperative_Group. Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder. 1999;56:1088-1096.

MTA (HGS) Outcome:  Excellent Response (ER) Method:  Recursive Partitioning

Owens EB, Hinshaw SP, Kraemer HC, Arnold LE, Abikoff HB, Cantwell DP, Conners CK, Elliot G, Greenhill LL, Hechtman L, Hoza B, Jensen PS, March JS, Newcorn JH, Pelham WE, Richters JE, Schiller EP, Severe JB, Swanson JM, Vereen D, Vitiello B, Wells KC, Wigal T. What treatment for whom for ADHD:  Moderators of treatment response in the MTA.  Journal of Consulting and Clinical Psychology, 71:3, 540-552, 2003.

Optimal Moderator (HGS) of IPT versus SSRI for Major Depression

Wallace ML, Frank E, Kraemer HC. A Novel Approach for Developing and Interpreting Treatment Moderator Profiles in Randomized Clinical Trials.  JAMA Psychiatry. 2013;70(11):1241-1247.

Kraemer HC, Frank E, Kupfer DJ. How to assess the clinical impact of treatments on patients, rather than the statistical impact of treatments on measures.

  Int J Methods Psychiatr Res. 2011; 20(2):63-72.

Kraemer HC. Discovering, comparing, and combining moderators of treatment on outcome after randomized clinical trials:  a parametric approach. . Statistics in Medicine 2013;32(11):1964-1973.

Frank E, Cassano GB, Rucci P, et al. Predictors and Moderators of time to Remission of Major Depression with Interpersonal Psychotherapy and SSRI Pharmacotherapy. Psychological Medicine. 2011;41(1):151-162.

Graphical Display of results in the Goldin et al study

Goldin PR, Ziv M, Jazaieri H, et al. Cognitive Reappraisal Self-Efficacy Mediates the Effects of Individual Cognitive-Behavioral Therapy for Social Anxiety Disorder. Journal of Consulting and Clinical Psychology. 2012;80(6):1034-1040.

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