Category: Nevin Manimala

Microb Genom. 2026 Apr;12(4). doi: 10.1099/mgen.0.001690.

ABSTRACT

Whole-genome sequencing provides a vast amount of genetic information, but its use in clinical and epidemiological studies often depends on the accurate inference of genomic variants. Comparative genomic studies in Mycobacterium tuberculosis typically involve mapping short reads from a diverse population to the same reference genome. This approach can lead to the incorrect characterization of many genomic regions that are susceptible to mapping bias when the reference is too distantly related to the sample. We analysed the consequences of mapping reads from different lineages of M. tuberculosis to the commonly used reference H37Rv and showed that the mapping bias varied depending on both the lineage and the gene mapped. To resolve these issues, we propose a new hybrid workflow which involves three steps: first, building a de novo assembly from short reads; second, aligning this assembly to a reference genome; and finally, mapping the reads to this aligned assembly. We show that many of the lineage and gene biases were corrected using this approach, which leads to a better characterization of lineages and hypervariable regions in comparative analysis. Our proposed approach will enable researchers to elucidate more genetic variations in M. tuberculosis and other bacterial pathogens.

PMID:41961532 | DOI:10.1099/mgen.0.001690

JAMA Netw Open. 2026 Apr 1;9(4):e264892. doi: 10.1001/jamanetworkopen.2026.4892.

ABSTRACT

IMPORTANCE: Exposure to parental depression is a risk factor for offspring mental illness.

OBJECTIVE: To examine the association between the timing of exposure to parental depression, from pregnancy to young adulthood, and adult offspring mental health.

DESIGN, SETTING, AND PARTICIPANTS: This prospective longitudinal cohort study of adult offspring aged 22 to 27 years in the Avon Longitudinal Study of Parents and Children, a British birth cohort, was conducted from September 1990 to July 2020. Data were analyzed from March 2024 to January 2026.

EXPOSURES: Parental depressive symptoms were assessed repeatedly using the Edinburgh Postnatal Depression Scale (score range, 0 to 30, with higher scores indicating more severe depressive symptoms) beginning in pregnancy through offspring age of 21 years.

MAIN OUTCOMES AND MEASURES: The main outcomes were offspring symptoms of depression at age 27 years, anxiety at age 25 years, psychotic disorders at age 24 years, and alcohol use disorder (AUD) at age 22 years. Covariates included socioeconomic status and maternal-offspring polygenic risk for multiple psychiatric disorders.

RESULTS: A total of 5329 adult offspring (3276 females [61.5%]) provided at least 1 outcome measure, which included 3795 participants providing symptoms of depression (mean [SD] age, 27.8 [0.5] years), 3505 participants providing symptoms of anxiety (mean [SD] age, 25.3 [0.6] years), 3342 participants with assessments for psychotic disorders (mean [SD] age, 24.5 [0.8] years), and 3392 participants reporting on symptoms of AUD (mean [SD] age, 22.9 [0.5] years). Cumulative exposure to parental depression across all time points was associated with increased odds of offspring depression (maternal: AOR, 2.36 [95% CI, 1.91-2.92]; paternal: AOR, 2.13 [95% CI, 1.60-2.83]) and anxiety (maternal: AOR, 2.58 [95% CI, 2.06-3.23]; paternal: AOR, 1.98 [95% CI, 1.49-2.63]). Only maternal depression was associated with increased odds of psychosis symptoms (maternal: AOR, 1.90 [95% CI, 1.27-2.82]; paternal: AOR, 1.63 [95% CI, 0.95-2.80]). There were no statistically significant associations with AUD. Significant associations between maternal depression and adult offspring depression were observed from 32 weeks’ gestation (AOR, 1.08 [95% CI, 1.01-1.15]) to age 18 years (AOR, 1.08 [95% CI, 1.01-1.16]). Maternal depression from the 8-month postnatal period (AOR, 1.06 [95% CI, 1.01-1.11]) onward (aged 21 years: AOR, 1.13 [95% CI, 1.02-1.24]) was associated with offspring anxiety symptoms. Paternal depression was significantly associated with offspring depression from mid-childhood (AOR, 1.08 [95% CI, 1.01-1.15]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]), with similar associations between paternal depression and offspring anxiety from mid-childhood (aged 5 years: AOR, 1.11 [95% CI, 1.03-1.18]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]). Only maternal prenatal depression at 32 weeks’ gestation was associated with offspring psychotic symptoms (AOR, 1.20 [95% CI, 1.03-1.41]).

CONCLUSIONS AND RELEVANCE: In this cohort study, analyses of 2 decades of data found distinct temporal associations between maternal and paternal depression and offspring psychiatric symptoms, and pregnancy was found to be a sensitive period in the association between maternal depression and offspring psychotic experiences. The findings suggest a substantial role of timing for specifying the association between parental depression and psychiatric outcomes in young adults and emphasize the need to support parental mental health from pregnancy onward.

PMID:41961501 | DOI:10.1001/jamanetworkopen.2026.4892

JAMA Netw Open. 2026 Apr 1;9(4):e264901. doi: 10.1001/jamanetworkopen.2026.4901.

ABSTRACT

IMPORTANCE: Taxane-induced peripheral neuropathy (TIPN) affects quality of life and ability to complete cancer treatment and has limited effective interventions for prevention and treatment.

OBJECTIVE: To develop and validate a TIPN risk prediction model.

DESIGN, SETTING, AND PARTICIPANTS: SWOG S1714 was a prospective observational cohort study conducted at sites in the National Cancer Institute National Community Oncology Research Program between March 1, 2019, and November 15, 2021, with 3 years of follow-up. The study included evaluable participants 18 years or older with stage I to III lung, breast, or ovarian, fallopian tube, or primary peritoneal cancer who were starting taxane-based treatment. Statistical analysis was conducted from December 2023 to June 2024.

EXPOSURES: Taxane-based regimens including paclitaxel or docetaxel.

MAIN OUTCOMES AND MEASURES: The primary end point was occurrence of TIPN by 24 weeks. TIPN was assessed using the patient-reported European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20-item scale (CIPN-20) at baseline and weeks 4, 8, 12, and 24. Occurrence of TIPN was defined as an increase of 8 points or more over baseline in the CIPN-20 sensory subscale score. With a 60% random sample of evaluable participants, best-subset selection using logistic regression and k-fold cross-validation identified a best model based on demographic factors, baseline comorbid conditions, and treatment factors. Adverse risk factors were summed, generating a score, split at the median and tested in the remaining 40% of evaluable participants. The target difference was 12% between high-risk vs low-risk groups.

RESULTS: A total of 1336 participants enrolled in S1714. Of 1278 evaluable participants (median age, 55.0 years [range, 23.0-84.0 years]; 1264 women [98.9%]; 1164 with breast cancer [91.1%]), 804 (62.9%) experienced TIPN by week 24. Using the training set of 768 participants, a risk prediction model for TIPN was developed that included 5 adverse risk factors: receipt of paclitaxel; stage II or III disease; planned taxane duration of more than 12 weeks; diabetes, autoimmune disease, moderate kidney disease, or a neurologic condition; and self-identified race and ethnicity (Black, Hispanic, Native American, Pacific Islander, multiple races, or unknown race or ethnicity). In the test set of 510 participants, TIPN was more common in high-risk (235 of 345 [68.1%]) vs low-risk (84 of 165 [50.9%]) groups (absolute difference, 17.2%), exceeding the 12% target.

CONCLUSIONS AND RELEVANCE: In this cohort study of participants with early-stage cancer receiving a taxane regimen, a set of baseline risk factors stratified TIPN risk. A risk prediction model may guide treatment decision-making, symptom monitoring, and enrollment in interventional trials for TIPN prevention and treatment.

PMID:41961500 | DOI:10.1001/jamanetworkopen.2026.4901

JAMA Netw Open. 2026 Apr 1;9(4):e266042. doi: 10.1001/jamanetworkopen.2026.6042.

ABSTRACT

IMPORTANCE: Nirsevimab is highly effective in preventing respiratory syncytial virus (RSV) infection in healthy infants. Evidence among infants at higher risk of severe RSV disease, such as those born preterm or with congenital heart disease (CHD), remains limited to clinical settings.

OBJECTIVE: To evaluate the association of nirsevimab with the prevention of RSV-related hospitalizations among at-risk infants after implementation of a universal immunization strategy in Chile.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study used nationwide health registries of all public and private hospitals in Chile during the 2024 RSV season following the launch of a universal RSV immunization program with nirsevimab. The case group included at-risk infants born preterm (gestational age <36 weeks) or with congenital heart disease (CHD) hospitalized for RSV-related lower respiratory tract infection (LRTI), while the control group included infants not hospitalized for RSV-related LRTI. Each case infant was matched to 4 control infants by age, prematurity or CHD status, and geographic region.

EXPOSURE: A single intramuscular dose of nirsevimab administered to all infants born up to 6 months before April 1, 2024, and those born between April 1 and September 30, 2024.

MAIN OUTCOME AND MEASURES: The main outcome was RSV-related LRTI hospitalization. Associations were assessed for at-risk infants and high-risk infants (born extremely preterm at gestational age <32 weeks or with CHD), with nirsevimab outcomes associated with RSV-related LRTI hospitalization estimated as (1 – adjusted odds ratio) × 100, with 95% CIs.

RESULTS: Of 179 RSV-related LRTI hospitalizations among at-risk infants (including 58 [32.4%] with extreme prematurity, 41 [22.9%] with CHD, and 87 [48.6%] without extreme prematurity and CHD [non-high risk]; categories not mutually exclusive), 177 (median [IQR] age, 210.0 [148.0-266.0] days; 109 male [61.3%]) were successfully matched to 708 control infants (including 55 of 58 [94.8%] with extreme prematurity, 39 of 41 [95.1%] with CHD, and 87 [100%] non-high risk; median [IQR] age, 210.5 [147.8-268.5] days; 393 male [55.5%]). A total of 156 case infants (88.1%) and 689 control infants (97.3%) received nirsevimab. In subgroup analyses, nirsevimab receipt in case vs control infants was 79 of 90 (87.8%) vs 351 of 360 (97.5%) among high-risk infants, 50 of 55 (90.9%) vs 213 of 220 (96.8%) among extremely preterm infants, 33 of 39 (84.6%) vs 153 of 156 (98.1%) among infants with CHD, and 77 of 87 (88.5%) vs 339 of 348 (97.4%) in non-high-risk infants. Nirsevimab was associated with a reduced risk of RSV-related LRTI hospitalization of 84.3% (95% CI, 67.0%-92.5%) among all at-risk infants, 85.1% (95% CI, 60.2%-94.4%) among infants with extreme prematurity and CHD combined, and 96.3% (95% CI, 65.5%-99.6%) among infants with CHD but was not associated with a reduced risk for hospitalization among infants with extreme prematurity alone (65.9%; 95% CI, -10.8% to 89.5%).

CONCLUSIONS AND RELEVANCE: This case-control study of Chile’s nationwide nirsevimab immunization program found that RSV-related LRTI hospitalizations among infants at higher risk of severe disease were substantially reduced. These findings support replacing targeted palivizumab prophylaxis with a broader, universal nirsevimab strategy as part of RSV prevention policy.

PMID:41961498 | DOI:10.1001/jamanetworkopen.2026.6042

JAMA Netw Open. 2026 Apr 1;9(4):e266303. doi: 10.1001/jamanetworkopen.2026.6303.

ABSTRACT

IMPORTANCE: Colorectal cancer (CRC) is the third most common cancer in the US, accounting for 9% of all cancer deaths. People in persistent poverty areas-where at least 20% have lived in poverty for at least 30 years-face higher colorectal cancer mortality than those in other areas.

OBJECTIVE: To investigate which risk factors mediated the association between living in persistent poverty areas and mortality, specifically disease severity and aggressiveness, type of CRC treatment, quality of treatment, access to medical care, and complications.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used linked data from the Central Cancer Registry, Death Certificates, and the All-Payer Claims Database (APCD) from January 2013 to June 2023. The population included patients from urban census tracts in Arkansas who were newly diagnosed with colorectal cancer. Analyses were conducted between May and September 2025.

EXPOSURE: Residence in a persistent poverty census tract.

MAIN OUTCOME AND MEASURES: The main outcome was overall survival. Potential confounders (including demographics and comorbidities) and potential mediators (including disease severity and aggressiveness, type and quality of treatment, health care access, and complications) were also examined.

RESULTS: Among 5028 patients newly diagnosed with CRC in 382 urban census tracts, 2587 (51.5%) were male; 705 (14.0%) were Black, 4142 (82.4%) were White, and 181 (3.6%) were of other race or ethnicity; and 2371 (47.2%) were married, with a mean (SD) age of 64.6 (13.7) years. Among 617 patients living in persistent poverty tracts, 329 (53.3%) died, vs 1927 of 4411 (43.7%) in other tracts (hazard ratio, 1.17; 95% CI, 1.03-1.33). There was significant evidence of mediation by stage at diagnosis (33.7% mediation; 95% CI, 7.4%-89.5%; P = .01), not having surgery (29.3% mediation; 95% CI, 5.5%-87.2%; P = .02), and type of health insurance (13.8% mediation); 95% CI, 2.2%-55.3%; P = .03).

CONCLUSION AND RELEVANCE: In this retrospective cohort study of patients with CRC in urban persistent poverty areas, more advanced stage, not receiving surgery, and type of health insurance were key mediators of their increased risk of mortality. Improved awareness of these mediators may help inform targeted interventions to reduce the risk of mortality in this population.

PMID:41961497 | DOI:10.1001/jamanetworkopen.2026.6303

JAMA Netw Open. 2026 Apr 1;9(4):e268641. doi: 10.1001/jamanetworkopen.2026.8641.

ABSTRACT

IMPORTANCE: Few environmental risk factors for ovarian cancer have been discovered. Women exposed to ionizing radiation from the atomic bomb during World War II experienced an increased risk of ovarian cancer. Today, the largest source of ionizing radiation is radon gas in the home, but whether ionizing radiation is associated with increased risk of ovarian cancer more broadly is unknown.

OBJECTIVE: To evaluate whether higher home radon levels are associated with increased risk of ovarian cancer.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included 127 547 women from the Women’s Health Initiative, including 40 clinical centers across the US, with outcomes followed up for 31 years (1993-2024). Postmenopausal women aged 50 to 79 years were enrolled in an observational study or 1 or more randomized clinical trials. All cases of ovarian cancer were physician adjudicated.

EXPOSURE: Radon measurements from the 1993 US Geological Survey, classified into low (<2 pCi/L), medium (2-4 pCi/L), and high zones (>4 pCi/L), were linked with the geocoded home addresses of participants at baseline (1993-1998).

MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) for ovarian cancer, adjusted for covariates with 95% CIs.

RESULTS: Among the 127 547 women (mean [SD] age, 63.1 [7.2] years) with available radon zone values, 1645 incident ovarian cancers and 1048 ovarian cancer deaths were observed over a mean (SD) follow-up of 17.7 (8.4) years. After adjustment for covariates, the HR for all ovarian cancers for women living in the medium radon zone compared with women living in the low radon zone was not significantly higher (HR, 1.13 [95% CI, 1.00-1.29]). However, the HR was significantly higher for women living in the high radon zone compared with those living in the low radon zone (HR, 1.31 [95% CI, 1.11-1.54]). Similar findings were observed for the most common histologic type, serous ovarian cancer, for which the HR in the medium zone was 1.06 (95% CI, 0.88-1.27) and the HR in the high zone was 1.38 (95% CI, 1.09-1.74). Ovarian cancer mortality also was significantly higher in the high radon zone compared with the low radon zone (HR, 1.31 [95% CI, 1.07-1.60]). Sensitivity analyses using 3 alternate radon measures produced similar results.

CONCLUSIONS AND RELEVANCE: In this large, prospective cohort of postmenopausal women, the risks of ovarian cancer incidence and mortality were significantly higher for women living in homes in the high radon zone. Residential radon is a ubiquitous and modifiable risk factor. This is the first epidemiologic study of radon and ovarian cancer among postmenopausal women to date, and its findings suggest a potential target for mitigating cancer risk.

PMID:41961496 | DOI:10.1001/jamanetworkopen.2026.8641

JAMA Health Forum. 2026 Apr 3;7(4):e260624. doi: 10.1001/jamahealthforum.2026.0624.

ABSTRACT

IMPORTANCE: The population of adults experiencing homelessness in the US is aging, with 20% now 55 years or older. Individuals who are unhoused, but especially those who are older, experience substantial morbidity and mortality and incur the high costs of acute health care.

OBJECTIVE: To assess the health outcomes and cost of providing stable housing to older adults experiencing homelessness in the US.

DESIGN, SETTING, AND PARTICIPANTS: This was an economic evaluation using a model-based cost-effectiveness analysis of adults experiencing homelessness in 2025 in the US. Two simulated cohorts of 1000 adults were used to compare those aged 55 years and older to those aged 18 to 54 years.

INTERVENTION: Provision of stable housing, with no requirement to enter treatment for opioid use disorder.

MAIN OUTCOMES AND MEASURES: Overdoses and deaths during a 5-year period, lifetime per person discounted quality-adjusted life-years (QALYs) and costs, and incremental cost-effectiveness ratios compared to the status quo (no housing provision).

RESULTS: The analysis assessed and compared 2 simulated cohorts of 1000 unhoused adults each: an older cohort of those aged 55 years and older (mean [SD] age, 62.6 [7.5] years; 321 females [32.1%], 679 males [67.9%]) and a younger cohort of those aged 18 to 54 years (mean [SD] age, 39.2 [9.5] years; 319 females [31.9%], 679 males [67.9%]). Among the older cohort, under the status quo, 218 (95% CI, 209-229) deaths occurred over 5 years, with 5.64 (95% CI, 5.11-6.20) lifetime QALYs and $308 598 (95% CI, $299 000-$318 000) in costs per person. With the stable housing intervention, 184 (95% CI, 176-194) deaths occurred over 5 years, with 7.52 (95% CI, 6.82-8.26) lifetime QALYs and $460 673 (95% CI, $438 000-$485 000) in costs per person. The intervention cost $80 700 (95% CI, $67 900-$96 100) per QALY gained. Among the younger cohort, under the status quo, 72 (95% CI, 60-90) deaths occurred over 5 years, with 9.60 (95% CI, 8.65-10.67) lifetime QALYs and $391 976 (95% CI, $367 000-$415 000) in costs per person. With the stable housing intervention, 62 (95% CI, 50-78) deaths occurred over 5 years, with 12.13 (95% CI, 10.94-13.37) lifetime QALYs and $530 492 (95% CI, $496 000-$564 000) in costs per person. The intervention cost $54 800 (95% CI, $44 200-$68 500) per QALY gained. In sensitivity analyses, the housing intervention for older adults experiencing homelessness consistently cost less than $100 000 per QALY gained.

CONCLUSIONS AND RELEVANCE: In this economic evaluation, investing in stable housing for adults of any age who were experiencing homelessness saved lives, improved health outcomes, and was cost-effective. As the homeless population continues to age, meeting the housing and care needs of older adults in vulnerable conditions is an increasingly urgent national priority. These findings strengthen the evidence demonstrating that permanent supportive housing for older adults experiencing homelessness is a health intervention with strong humanitarian, clinical, and economic justification.

PMID:41961493 | DOI:10.1001/jamahealthforum.2026.0624

JAMA Health Forum. 2026 Apr 3;7(4):e260631. doi: 10.1001/jamahealthforum.2026.0631.

ABSTRACT

IMPORTANCE: Although electronic nicotine delivery systems (ENDS) use is decreasing among youth in the US, the frequency of use is increasing among current users, particularly high school students.

OBJECTIVE: To evaluate the effectiveness of local flavored tobacco ban policies and assess whether policies may have unintended outcomes in youth in California.

DESIGN, SETTING, AND PARTICIPANTS: Repeated cross-sectional study using a confounder-adjusted dynamic difference-in-difference (DID) analysis to obtain estimates of the average treatment effect among the treated (ATT) over 6 years. Participants were middle school and high school students in the 2017-2022 California Healthy Kids Survey. Data were analyzed from February 1 to October 1, 2025.

EXPOSURES: Policy exposure (treated group) defined as attending a school in person within a jurisdiction with an active flavored tobacco ban at the time of survey administration.

MAIN OUTCOMES AND MEASURES: The primary outcome was current ENDS use, and the secondary outcome was current cigarette use. To address confounding, additional measures included racial and ethnic diversity, federal poverty level, and educational attainment, which were aggregated to the local policy jurisdiction area.

RESULTS: Among 2 805 708 middle and high school student tobacco users, local flavored tobacco bans were associated with a reduction in current ENDS use of 2.4 percentage points (ATT, -0.024; 95% CI, -0.031 to -0.017) and were not associated with current cigarette use (ATT, 0.002; 95% CI, -0.002 to 0.005). Three years after policy implementation, ENDS use was lower in jurisdictions with flavor ban compared with jurisdictions without by 1.9 percentage points (ATT, -0.019; 95% CI, -0.027 to -0.010). Four years after policy implementation, ENDS use was lower in jurisdictions with flavor ban compared with jurisdictions without by 9.3 percentage points (ATT, -0.093; 95% CI, -0.117 to -0.069).

CONCLUSIONS AND RELEVANCE: In this study, a local flavored tobacco ban policy was associated with reduced ENDS use among youth but not with cigarette use within this population. Future research should also examine trends in other states to evaluate policy adoption and enforcement.

PMID:41961492 | DOI:10.1001/jamahealthforum.2026.0631

Echocardiography. 2026 Apr;43(4):e70447. doi: 10.1111/echo.70447.

ABSTRACT

BACKGROUND: Quantitative assessment of right ventricular (RV) function by transthoracic echocardiogram (TTE) commonly relies on tricuspid annular plane systolic excursion (TAPSE) and lateral tricuspid annulus peak systolic velocity (S’). However, full cardiac cycle data may provide additional information beyond these two systolic measures.

OBJECTIVE: We sought to (1) automate the estimation of systolic parameters (TAPSE and S’) from tissue spectral Doppler imaging (Tissue Doppler Imaging [TDI]) and (2) integrate these tabular systolic parameters and the full-cycle functional signal to estimate RV systolic function.

METHODS: We identified 387 patients who underwent both TTE and cardiac magnetic resonance imaging (CMR) within 24 h. We developed and validated an automated algorithm to extract TAPSE and S’ from raw TDI. We trained two classifier models for RV dysfunction (RVEF < 45%): (1) Tabular model (RVD_TABULAR) using algorithmic measurement of TAPSE/S’ and age/sex, and (2) Integrated model (RVD_INTEGRATED), an attention-based neural network model using the entire digitized TDI waveforms in addition to tabular data.

RESULTS: In the TTE-CMR paired dataset, the proposed algorithm accurately estimated S’ (mean error: -0.05 cm/s) and TAPSE (mean error: -0.97 mm). Tabular model RVD_TABULAR achieved an AUROC of 0.71 and an AUPRC of 0.48 for predicting RVEF <45%, while the integrated model RVD_INTEGRATED achieved significantly better performance (AUROC: 0.768; AUPRC: 0.56). In the external validation cohort with pulmonary hypertension (PH), the integrated model’s prediction was significantly associated with event-free survival (p = 0.036).

CONCLUSIONS: We developed a fully automated pipeline that integrates digitized TDI waveforms with both parametric and non-parametric features to classify RVEF <45%. This approach can effectively risk-stratify patients with PH.

PMID:41961465 | DOI:10.1111/echo.70447

Updates Surg. 2026 Apr 10. doi: 10.1007/s13304-026-02616-8. Online ahead of print.

ABSTRACT

Pancreaticoduodenectomy (PD) is associated with a long and complex recovery. Enhanced recovery programmes have improved short-term clinical outcomes, but there is a growing interest in patient-reported outcomes as an indicator for postoperative recovery. Health-related quality of life (HRQoL) and patient-reported postoperative recovery provide a wider perspective on the effects of surgery. However, the relationship between the two measures remains unexplored. Therefore, the aim of this study was to explore the relationship between HRQoL and patient-reported recovery in patients undergoing PD. This prospective, single-centre study included 77 participants who all underwent PD in the context of an enhanced recovery programme. Instruments used were the EQ-5D-3L and the SwQoL-24. Data was collected preoperatively and at 1,3,6,9, and 12 months postoperatively. Longitudinal trends were analysed using a mixed-effect repeated measures model. Predictive associations were explored via linear regression. The EQ-5D-3L improved, and the SwQoL-24 total score declined throughout the first year. The EQ-5D-3L Index and the VAS explained the SwQoR-24 value at six months and 12 months; R² 0.52/0.47 and 0.52/0.56, respectively. Preoperative EQ-5D-3L values predicted between (R²) 0.09-0.17 for 6 and 12-month SwQoR-24 values. Other tested factors were statistically non-significant. This study demonstrates a significant improvement in postoperative recovery as well as HRQoL during the first year after PD, with a strong association between the two measures. The findings also suggest that the EQ-5D-3L index and the EQ VAS have a significant but limited predictive value for postoperative recovery. Other demographical and care-related factors did not predict levels of recovery quality.

PMID:41961460 | DOI:10.1007/s13304-026-02616-8