Exact likelihood ratio and score confidence intervals for the binomial proportion.

Many methods are available for computing a confidence interval for the binomial parameter, and these methods differ in their operating characteristics. It has been suggested in the literature that the use of the exact likelihood ratio (LR) confidence interval for the binomial proportion should be considered. This paper provides an evaluation of the operating characteristics of the two-sided exact LR and exact score confidence intervals for the binomial proportion and compares these results to those for three other methods that also strictly maintain nominal coverage: Clopper-Pearson, Blaker, and Casella. In addition, the operating characteristics of the two-sided exact LR method and exact score method are compared with those of the corresponding asymptotic methods to investigate the adequacy of the asymptotic approximation.

Longitudinal association of vasomotor symptoms and psychosocial outcomes among postmenopausal women in the United States: a population-based study.

OBJECTIVE: Vasomotor and psychosocial symptoms persist as common manifestations of menopause; their explicit association is unclear. We investigated this association among postmenopausal women over a 2-year period. METHODS: The Menopause Epidemiology Study is a cross-sectional population-based study of women 40 to 65 years old in the United States. We followed participants who were postmenopausal at baseline and at 2-year follow-up (n = 1,506) in the analyses. The vasomotor and psychosocial domains of the Menopause-Specific Quality of Life Questionnaire were used to assess exposure and outcome. Change in symptoms was defined as the difference in the Menopause-Specific Quality of Life Questionnaire domain score from baseline to follow-up 2 years later. Demographic information, behavioral activities, reproductive history, and medication use were evaluated for effect modification and confounding. Covariate-adjusted linear regression was used to assess the relationship between the change in vasomotor symptoms and change in psychosocial symptoms. RESULTS: One quarter (n = 375) of the women reported an increase in vasomotor symptoms over the 2-year study period. Twenty-two percent of the women reported an increase in both vasomotor and psychosocial symptoms. Current smoking status was found to be an effect modifier: a one-unit increase in the vasomotor domain was associated with a 0.21-unit (95% CI, 0.12-0.29) increase in the psychosocial domain among smokers; this was stronger (0.29, 95% CI, 0.20-0.39) among past or never smokers. CONCLUSIONS: This study provides further evidence of an association between vasomotor symptoms and psychosocial symptoms using a validated instrument in a population-based study. There is a small increase in psychosocial symptoms with increasing vasomotor symptoms. Clinicians may want to note this association when treating postmenopausal women with either condition.