Exact Confidence Limits Research Articles

Surface Cleaning with a Microfiber Cloth and Water followed by Ultraviolet-C Light Exposure Achieves Non-Inferior Disinfection of a Pathogenic Staphylococcus aureus Strain versus Use of Germicidal Wipes.

We hypothesized that ultraviolet-C (UV-C) irradiation (Surfacide, Waukesha, WI) following use of microfiber cloths (Sanny Shop LLC, Longmont, CO) soaked in waterwould be noninferior to surface disinfection wipes containing a quaternary ammonium compound and alcohol (PDI Healthcare, Woodcliff Lake, NJ)for the pathogenic Staphylococcus aureus (S. aureus) sequence type 5 (ST5). This was a randomized laboratory study of disinfection approaches for S. aureusST5. A total of 270 polycarbonate slides loaded with ST5 were prepared for the standard surface disinfection group (N=18) and water-soaked microfiber cloths and UV-C treatment group (N=144), along with positive and negative microbiological controls. All 18 samples of S. aureus ST5 bacteria treated with standard chemical wipes showed complete disinfection (colony forming units (CFU) = 0). All 144 treatments with water-soaked microfiber wipes followed by UV-C exposure showed complete disinfection (CFU =0) regardless of soiling, height from the floor, or orientation to the emitters. The upper 95% exact one-sided confidence limit for any CFU >0 was 2.1%. These data affirm our hypothesis that surface wiping with a damp cloth followed by triangular UV-C irradiation delivery is noninferior to surface disinfection for S. aureusST5 using germicidal wipes, even when UV-C is compromised by height from the floor and orientation to the emitters and surface disinfection is targeted. Removing bioburden with chemical-free microfiber cloths followed by triangular UV-C delivery is a noninferior strategy to targeted surface disinfection with chemical disinfecting wipes for the pathogenicS. aureusST5 strain in the laboratory setting.

Magnetic resonance imagingfollowing the demonstration of a normal common bile duct on ultrasound in children with suspected choledocholithiasis: what is the benefit?

The role of MRI in evaluating children with an in situ gallbladder and suspected choledocholithiasis following a negative or inconclusive US is unclear. To determine whether MRI benefits children with suspected choledocholithiasis and a normal common bile duct (CBD) without stones on US. We conducted a retrospective 10-year review of paired US and MRI (within 10days) in children 18years or younger with suspected choledocholithiasis. With MRI as a reference standard, two reviewers independently evaluated the images for CBD diameter, choledocholithiasis, cholelithiasis and pancreatic edema. Serum lipase was recorded. We calculated exact binomial confidence limits for test positive predictive values (PPVs) and negative predictive values (NPVs) using R library epiR. Of 87 patients (46 female, 41 male; mean age 14years, standard deviation [SD] 4.6years; mean interval between US and MRI 1.6days, SD 1.8days), 55% (48/87) had true-negative US, without CBD dilation/stones confirmed on MRI; 5% (4/87) had false-positive US showing CBD dilatation without stones, not confirmed on MRI; 33% (29/87) had true-positive US, with MRI confirming CBD dilatation; and 7% (6/87) had false-negative US, where MRI revealed CBD stones without dilatation (2 patients) and CBD dilatation with or without stones (4 patients). Patients with false-negative US had persistent or worsening symptoms, pancreatitis or SCD. The overall US false-negative rate was 17% (6/35). Normal-caliber CBD on US without stones had an NPV of 89% (48/54, 95% confidence interval: 0.77-0.96). MRI adds little information in children with a sonographically normal CBD except in the setting of pancreatitis or worsening clinical symptoms.Further evaluation is warranted in children with elevated risk of stone disease.

Diagnostic accuracy of the CxPREVENTIVE Colon model for early detection of colorectal cancer.

e15518 Background: Despite different available methods for colorectal cancer (CRC) screening and their proven benefits, morbidity, and mortality of this malignancy are still high, partly due to technical limitations and low compliance with screening. The aim of the present study was to assess the diagnostic accuracy for early detection of CRC using a modeling algorithm based on multiple blood and urine biomarkers. Methods: In this retrospective cohort study, clinical and blood and urine markers-based algorithms with predefined cutoff values were applied to a generally healthy asymptomatic outpatient cohort of adults aged 50 years or older undergoing colonoscopy and histopathology for routine colorectal cancer screening. We used a modeling algorithm based on two different frameworks (Multiple Biomarkers Disease Activity Algorithm MBDAA [Bioprognos], and Artificial Intelligence Recursive Algorithm AIRA [Mintlot] both in Barcelona, Spain). Both algorithms compute information from a wide number of analytes, tumor markers (AFP, CA 19.9, CA 72.4, CA 125, CEA, Cyr61, NGAL, EGFR and 8-OHdG), and additional clinical data (age, weight, height, and BMI). MBDAA includes Barcelona Criteria (four criteria to correctly interpret the cause of the increase in tumor markers, benign or malignant, defined by the Spanish Society of Clinical Biochemistry and Molecular Pathology, Commission of Biological Markers of Cancer). To assess the association between the modelling algorithm and downstream diagnosis we used logistic regression to compute receiver operating characteristic curves (ROC). Exact binomial confidence limits were calculated to test accuracy, sensitivity, and specificity. Results: 221 people (median age 63 yr. [IQR 49-77]; 107 [49%] women and 114 [51%] men) who underwent colonoscopy at the Juan Ramón Jiménez Hospital (Huelva, Spain), were included in this analysis. Based on colonoscopy and histopathologic findings, CRC was diagnosed in 45 (20%) patients, colonic polyposis in 56 (25%), inflammatory bowel disease in 37 (17%), and absence of pathological findings (control group) was seen in 83 (38%). The diagnostic intervention for CRC yielded an area under the curve (AUC) of 1 among the entire specimen set, accuracy 1 (95% CI 0.996,1), Se 1 (0.988, 1) and Sp 1 (0.997, 1). Besides, the algorithm also performed very well in the identification of polyps with an accuracy 1 (95% CI, 0.967 to 1), Se of 1 (0.991, 1) and of Sp 1 (0.996, 1), as well in the diagnosis of inflammatory bowel disease with an accuracy of 1 (0.968 to 1), Se of 1 (0.986, 1) and Sp of 1 (0.997, 1). Conclusions: Using colonoscopy as a gold standard, our data suggest that an innovative newly designed non-invasive blood and urine-based biomarker algorithm CxPREVENTIVE Colon may provide a timely diagnosis of CRC with very high accuracy. Our findings warrant further investigation, and we are planning large-scale (n 10,000), fully powered study to inform clinical practice.

Diagnostic accuracy of the CxPREVENTIVE breast model for early detection of breast cancer.

e13578 Background: Despite different available methods for breast cancer (BC) screening (mainly mammographies for ages between 50 and 65 yr.), and their proven benefits, morbidity, and mortality of this malignancy are still high, partly due to technical limitations and low compliance with screening. The aim of the present study was to assess the diagnostic accuracy for early detection of BC using a modeling algorithm based on multiple blood and urine biomarkers. Methods: In this retrospective cohort study, clinical and blood and urine markers-based algorithms with predefined cutoff values were applied to a generally healthy asymptomatic outpatient cohort of women aged 23 years or older undergoing mammography and histopathology for routine breast cancer screening. We used a modeling algorithm based on two different frameworks (Multiple Biomarkers Disease Activity Algorithm MBDAA [Bioprognos], and Artificial Intelligence Recursive Algorithm AIRA [Mintlot] both in Barcelona, Spain). Both algorithms compute information from a wide number of analytes, tumor markers (CA 15.3, CEA, EGFR, NGAL, NSE and 8-OHdG), and additional clinical data (age, weight, height, and BMI). MBDAA includes Barcelona Criteria (four criteria to correctly interpret the cause of the increase in tumor markers, benign or malignant, defined by the Spanish Society of Clinical Biochemistry and Molecular Pathology, Commission of Biological Markers of Cancer). To assess the association between the modelling algorithm and downstream diagnosis we used logistic regression to compute receiver operating characteristic curves (ROC). Exact binomial confidence limits were calculated to test accuracy, sensitivity, and specificity. Results: 123 women (median age 48 yr. [IQR 40-63]) who underwent mammography at the Juan Ramón Jiménez Hospital (Huelva, Spain), were included in this analysis. Based on mammography and histopathologic findings, BC was diagnosed in 61 (49.5%) women, and absence of pathological findings (control group) was seen in 62 (51.5%). The diagnostic intervention for BC yielded an area under the curve (AUC) of 1 among the entire specimen set, accuracy 1 (95% CI 0.990,1), Se 1 (0.991, 1) and Sp 1 (0.991, 1). Conclusions: Using mammography as a gold standard, our data suggest that an innovative newly designed non-invasive blood and urine-based biomarker algorithm CxPREVENTIVE Breast may provide a timely diagnosis of BC with very high accuracy, especially for those women under 50 and over 65yr., where up to 60% of all BC are concentrated. Our findings warrant further investigation, and we are planning large-scale (n 10,000), fully powered study to inform clinical practice.

Probability Analysis and Prevention of Offshore Oil and Gas Accidents: Fire as a Cause and a Consequence

Failures during the drilling and exploitation of hydrocarbons that result in catastrophic offshore oil and gas accidents are relatively rare but if they occur the consequences can be catastrophic in terms of loss of life and environmental damage. Therefore, to gain insight into their prevention, the largest major offshore oil and gas accidents, those with more than 10 fatalities or with a large environmental impact, are analyzed in this article. Special attention is placed on fire as a cause and a consequence. Relevant technological and legislative changes and updates regarding safety that have followed such accidents and that can prevent potential future similar misfortunes are evaluated. Two main approaches to safety are compared: (1) the American prescriptive vs. (2) the European goal-oriented approach. The main causes of accidents are tested statistically in respect of failure probability, where the exact confidence limits for the estimated probabilities are computed. The results of the statistical test based on exact confidence intervals show that there is no significant difference between the analysed factors, which describe the main causes of offshore oil and gas accidents. Based on the small but carefully chosen group of 24 of the largest accidents, it can be concluded that there is no evidence of a difference between the categories of the main causes of accidents.

Exploring mechanisms of a web-based values-tailored childhood vaccine promotion intervention trial: Effects on parental vaccination values, attitudes, and intentions.

A recent childhood vaccine promotion intervention trial showed no effects on vaccination outcomes relative to usual care. The purpose of this paper was to test assumptions and theory-based relationships underlying hypothesised mechanisms for two vaccine promotion educational websites (one tailored to parental values, beliefs, and intentions; one untailored) compared with usual care. This is a secondary analysis of a three-arm randomized controlled trial. Parental vaccine values, hesitancy, attitudes, and intention to vaccinate surveys were administered at baseline (≤2 months) and at 4-6 and 10-12 months of age. Vaccination was assessed using electronic health records. Analyses included random coefficient models and risk differences with exact confidence limits. Parental vaccine values were mostly stable over time. Vaccine attitudes were generally positive, with no differences among study arms. Both tailored and untailored website arms showed similar increases in intention to vaccinate more than usual care. Positive changes in intentions were associated with lower rates of late vaccination. Although attitudes and intentions predicted vaccination behavior and the intervention increased intention to vaccinate all on time, the web-based education and values-tailored messaging approaches were not effective at increasing vaccination rates. Intentions are necessary but insufficient targets for vaccine promotion interventions.

Exact confidence limits compatible with the result of a sequential trial

Sequential (or adaptive) designs are common in acceptance sampling and pharmaceutical trials. This is because they can achieve the same type 1 and type 2 error rate with fewer subjects on average than fixed sample trials. After the trial is completed and the test result decided, we need full inference on the main parameter Δ. In this paper, we are interested in exact one-sided lower and upper limits.Unlike standard trials, for sequential trials there need not be an explicit test statistic, nor even p-value. This motivates the more general approach of defining an ordering on the sample space and using the construction of Buehler (1957). This is guaranteed to produce exact limits, however, there is no guarantee that the limits will agree with the test. For instance, we might reject Δ≤Δ0 at level α but have a lower 1−α limit being less then Δ0. This paper gives a very simple condition to ensure that this unfortunate feature does not occur. When the condition fails, the ordering is easily modified to ensure compatibility.

Targeted axillary lymph node dissection in breast cancer patients using I-125 microseeds for prostate cancer brachytherapy.

e12601 Background: To date, targeted axillary lymph node dissection is one of the possible methods of de-escalation of surgical aggression on the areas of regional lymph flow in breast cancer patients with confirmed metastases in the axillary lymph nodes prior to the neoadjuvant chemotherapy. There are no specialized microseeds for targeted axillary dissection. The purpose of our study was to determine the possibility of using I-125 microseed for prostate cancer brachytherapy for targeted axillary dissection. Methods: A prospective study of patients with biopsy-confirmed nodal axillary metastases with a I-125 microseed placed in the node was performed. I-125 microseed for prostate cancer brachytherapy was used to mark the axillary lymph node. After neoadjuvant therapy, patients underwent targeted axillary lymph node dissection in combination with SLNB with pathomorphological examination of marked lymph node and total axillary lymph node dissection with pathomorphological examination of over lymph nodes for FNR evaluation. Results: 45 breast cancer patients stage cT1-3N1M0 were enrolled in the study. The frequency of reaching ypN0 was 58%. Residual disease identified in 19 patients. The clipped node revealed metastases in 18 patients, resulting in an FNR of 5.26% (95% CI, to 20.6) for the clipped node. CIs for FNR were calculated using exact (Clopper-Pearson) confidence limits for the binomial proportion. Conclusions: Marking the biopsy-confirmed lymph node using a I-125 microseed prior neoadjuvant chemotherapy and performing targeted axillary lymph node dissection in combination with SLNB is a safe method for diagnosing axillary lymph nodes and allows you to abandon routine ALD for ypN0 patients. Advantages of I-125 microseed for prostate cancer brachytherapy: fixation in the lymph node without migration, the ability to use a standard gamma-probe to locate the microseed during the operation, these microseeds are registered for the treatment of cancer patients.

Exact Confidence Limits for the Parameter of an Exponential Distribution in the Accelerated Life Tests under Type-I Censoring

Exact Confidence Limits for the Parameter of an Exponential Distribution in the Accelerated Life Tests under Type-I Censoring

Exact confidence limits after a group sequential single arm binary trial.

Group sequential single arm designs are common in phase II trials as well as attribute testing and acceptance sampling. After the trial is completed, especially if the recommendation is to proceed to further testing, there is interest in full inference on treatment efficacy. For a binary response, there is the potential to construct exact upper and lower confidence limits, the first published method for which is Jennison and Turnbull (1983). We place their method within the modern theory of exact confidence limits and provide a new general result that ensures that the exact limits are consistent with the test result, an issue that has been largely ignored in the literature. Amongst methods based on the minimal sufficient statistic, we propose two exact methods that out-perform Jennison and Turnbull's method across 10 selected designs. One of these we prefer and recommend for practical and theoretical reasons. We also investigate a method based on inverting Fisher's combination test, as well as a pure tie-breaking variant of it. For the range of designs considered, neither of these methods result in large enough improvements in efficiency to justify violation of the sufficiency principle. For any nonadaptive sequential design, an R-package is provided to select a method and compute the inference from a given realization.

Studying the Lyman α optical depth fluctuations at z ∼ 5.5 using fast semi-numerical methods

We present a computationally efficient and fast semi-numerical technique for simulating the Lyman-$\alpha$ (Ly$\alpha$) absorption optical depth in presence of neutral hydrogen "islands" left over from reionization at redshifts $5 \lesssim z \lesssim 6$. The main inputs to the analysis are (i) a semi-numerical photon-conserving model of ionized regions during reionization (named SCRIPT) along with a prescription for simulating the shadowing by neutral islands and (ii) the fluctuating Gunn-Peterson approximation to model the Ly$\alpha$ absorption. Our model is then used for simulating the large-scale fluctuations in the effective optical depth as observed along sight lines towards high$-z$ quasars. Our model is fully described by five parameters. By setting two of them to default values and varying the other three, we obtain the constraints on reionization history at $5 \lesssim z \lesssim 6$ as allowed by the data. We confirm that reionization is \emph{not} complete before $z \sim 5.6$ at $\gtrsim 2\sigma$ confidence, with the exact confidence limits depending on how the non-detections of the flux in the data are treated. We also confirm that the completion of reionization can be as late as $z \sim 5.2$. With further improvements in the model and with more sight lines at $z \sim 6$, we can take advantage of the computational efficiency of our analysis to obtain more stringent constraints on the ionization fraction at the tail-end of reionization.

Exact Confidence Limits on Some New Measures of Concordance and Discordance in Binary Outcomes.

Using a measure of agreement that does not distinguish the "positive" outcome from the "negative" outcome can be sometimes misleading in assessing resemblance. To alleviate this concern, some new indices, including the "positive" and "negative" conditional synchrony measures (CSM) (or the conditional discordant measures [CDM]), as well as their related measures, have been recently proposed elsewhere. We show that one can easily derive exact confidence limits for these new indices. Using Monte Carlo simulation, we find that the asymptotic interval estimator derived from the score test and these exact interval estimators can all perform well in a variety of situations, while the asymptotic interval estimator based on Wald's statistic can lose accuracy. We use the data taken from a cross-sectional validation study assessing the diagnostic performance of the Whooley questions for major depression disorder (MDD) among older adults to illustrate the use of these interval estimators developed here.

A Review of the Use of Confidence Intervals for Bland-Altman Limits of Agreement in Optometry and Vision Science.

Confidence intervals are still seldom reported for Bland-Altman 95% limits of agreement. When they are reported, 50% of articles use approximate methods and 50% use exact methods. Bland-Altman limits of agreement can be unreliable estimates, especially for small sample sizes. However, authors seldom use confidence intervals for limits of agreement. This article reviews their use in Optometry and Vision Science. A keyword search for "Bland," "Altman," "Bland-Altman," "LoA," and "limits of agreement" was conducted on the Optometry and Vision Science website within a time range from January 2016 to December 2018. Fifty articles were reported or were judged to use Bland-Altman analysis; sample sizes ranged from 3 to 2072. Eight of these article reported confidence limits for limits of agreement, four of which used exact methods and four used Bland and Altman's approximate method. Use of confidence intervals for limits of agreement has increased in Optometry and Vision Science but is far from universal. To assist researchers in calculating exact confidence limits for Bland-Altman limits of agreement, spreadsheets are included for performing the calculations and generating Bland-Altman plots with the confidence intervals included.

Exact confidence limits for proportion difference in clinical trials with bilateral outcome

Bilateral data are frequently occur in medical research. Asymptotic approaches are traditionally used to construct confidence intervals for proportion difference. However, they are often have unsatisfactory performance with regards to coverage, with the actual coverage below the nominal level or being too conservative. For these reasons, we propose developing exact one-sided limits for proportion difference in a parallel study with bilateral data to guarantee the coverage probability when sample size is small to medium. A statistical quantity has to be used for sample space ordering in the exact limit calculation. Four asymptotic limits are utilized as statistical quantities: the Wald limits under the independence or dependence assumptions for variance estimates, the Wald limits with the difference estimate under the dependence assumption, and the bootstrap percentile limits. We compare the performance of these exact limits with regards to average length and the limits of all possible samples. A real example from a randomized clinical trial in otolaryngology is used to illustrate the application of the proposed exact limits.

Exact Confidence Limits on Some New Measures of Concordance and Discordance in Binary Outcomes

Using a measure of agreement that does not distinguish the "positive" outcome from the "negative" outcome can be sometimes misleading in assessing resemblance. To alleviate this concern, some new indices, including the "positive" and "negative" conditional synchrony measures (CSM) (or the conditional discordant measures [CDM]), as well as their related measures, have been recently proposed elsewhere. We show that one can easily derive exact confidence limits for these new indices. Using Monte Carlo simulation, we find that the asymptotic interval estimator derived from the score test and these exact interval estimators can all perform well in a variety of situations, while the asymptotic interval estimator based on Wald's statistic can lose accuracy. We use the data taken from a cross-sectional validation study assessing the diagnostic performance of the Whooley questions for major depression disorder (MDD) among older adults to illustrate the use of these interval estimators developed here.

Exact confidence limit for complex system reliability based on component test data

ABSTRACTReliability analysis for complex system is one of the most concerned problems in industry. On account of high cost of testing we often obtain a small size of sample, even only test data for components. In this article, an exact method for system reliability assessment will be presented generalized from the Buehler confidence limit. We give a suggestion on the choice of statistic order based on an estimate of system reliability which only relies on the true value of even for multiparameter model. In addition, we present an algorithm to solve the function with constraint set up in Buehler method. A three-component application is given to illustrate the algorithm. We also present some simulation studies to compare our proposed method with other widely applied methods.

Early hemodynamic performance of the Trifecta\u2122 surgical bioprosthesis aortic valve in Indian patient population: 12\xa0month outcomes of the EVEREST post-market study

BackgroundIndian patients undergoing surgical aortic valve replacement (SAVR) differ from western populations with respect to aortic annulus size and valve disease morphology. The purpose of this post-market, non-randomized observational study was to evaluate the early hemodynamic performance of the Trifecta™ bioprosthesis (Abbott, previously St. Jude Medical, Minneapolis, US) in an Indian patient population.MethodsFrom January 2014 to September 2015, 100 patients (mean age 64.4 ± 7.1 years, 62% male) undergoing SAVR for valve disease (68% stenosis, 7% insufficiency, 25% mixed pathology) were enrolled across 10 centers in India. Patients implanted with a 19–27 mm Trifecta™ valve were eligible to participate and were prospectively followed for 12-months post-implantation. Echocardiographic hemodynamic performance was evaluated at pre-implant, pre-discharge and at 12-months by an independent core laboratory. Adverse events were adjudicated by the study sponsor. Functional status at 12-months was assessed according to NYHA classification. Continuous data was summarized using descriptive statistics (mean &standard deviation,) and categorical data was summarized using frequencies and percentages.ResultNinety patients (mean age 64.5, 62.2% male) completed the 12-month follow up. Significant improvements in hemodynamic valve performance were reported in 81 patients with available echocardiographic data at 12 months. Compared to baseline at 12-month follow up visit, mean effective orifice area increased from 0.75cm2 to 1.61cm2 (p < 0.0001), mean pressure gradient reduced to 10.42 mmHg from 51.47 mmHg (p < 0.0001), cardiac output increased from 4.46 l/min to 4.85 l/min (P 0.9254). Compared to baseline, functional status improved by ≥1 NYHA class in 75% of patients at 12 months (95% Clopper-Pearson (Exact) confidence limit [64.6%, 83.6%]). No instances of early mortality (< 30 days from index procedure) or structural valve dysfunction were reported.ConclusionIn an Indian patient population, implantation of the Trifecta™ bioprosthesis is shown to be safe and associated with favorable early hemodynamic performance and improved functional status at 12 months.Trial registrationThe clinical study has been registered under Clinical Trial Registry-India (http://www.ctri.nic.in) and registration number is CTRI/2014/02/004434 registered on 25 February 2014 retrospectively registered.

Exact confidence limits for the probability of response in two-stage designs

ABSTRACTIn addition to point estimate for the probability of response in a two-stage design (e.g. Simon's two-stage design for binary endpoints), confidence limits should be computed and reported. The current method of inverting the p-value function to compute the confidence interval does not guarantee coverage probability in a two-stage setting. The existing exact approach to calculate one-sided limits is based on the overall number of responses to order the sample space. This approach could be conservative because many sample points have the same limits. We propose a new exact one-sided interval based on p-value for the sample space ordering. Exact intervals are computed by using binomial distributions directly, instead of a normal approximation. Both exact intervals preserve the nominal confidence level. The proposed exact interval based on the p-value generally performs better than the other exact interval with regard to expected length and simple average length of confidence intervals.

Exact inference for exponential distribution with multiply Type-I censored data

ABSTRACTIn this paper, we focus on exact inference for exponential distribution under multiple Type-I censoring, which is a general form of Type-I censoring and represents that the units are terminated at different times. The maximum likelihood estimate of mean parameter is calculated. Further, the distribution of maximum likelihood estimate is derived and it yields an exact lower confidence limit for the mean parameter. Based on a simulation study, we conclude that the exact limit outperforms the bootstrap limit in terms of the coverage probability and average limit. Finally, a real dataset is analyzed for illustration.

Exact One-Sided Confidence Limit for the Ratio of Two Poisson Rates

ABSTRACTThis article examines exact one-sided confidence limits for the ratio of two independent Poisson rates. The Buehler method is used to obtain exact limits, and this method is used in conjunction with existing approximate limits. The method of variance estimates recovery (MOVER) is a general approach to construct the ratio of two independent Poisson rates from the confidence intervals of each rate which can be obtained from commonly used methods. Four existing approximate limits are considered: the Wilson interval, the MOVER Jeffreys interval, the MOVER Rao score interval, and MOVER Rao score interval on log-scale. The exact limits respect the coverage requirement, and they are as small as possible under certain mild conditions. Our numerical studies indicate that exact upper limits using the MOVER Jeffreys interval, and the MOVER Rao score interval have good performance.