Category: Statistics

Curr Med Res Opin. 2026 Jun 11:1-11. doi: 10.1080/03007995.2026.2683436. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment-resistant depression (TRD) imposes a substantial economic burden on South Korea, yet limited cost data exist for the TRD stage. This study estimated the 28-day societal costs of TRD across distinct health states.

METHODS: A mixed micro-macro-costing approach was used to estimate direct medical, non-medical, and indirect costs from a societal perspective across four health states (major depressive episodes [MDE], treatment response, remission, and recovery). Healthcare resource utilization was assessed through expert consultation with eight board-certified psychiatrists. The unit costs were derived from national fee schedules, published literature, and national statistics. Indirect costs included productivity losses due to absenteeism, presenteeism, and suicide-related mortality.

RESULTS: Over a 28-day cycle, the per-patient direct medical cost in the MDE state ($803.2) was 15.2 times higher than that in the recovery state ($52.8). From a societal perspective, the 28-day economic burden during the MDE state ($2,388.4) was 25.7 times greater than that of the recovery state ($93.1). In the MDE state, indirect costs constituted the largest component of this 28-day societal burden ($1,074.6; 45% of total costs), followed by direct medical costs ($803.2; 34%).

CONCLUSIONS: TRD imposes a substantial economic burden on South Korea, with costs peaking during acute episodes. These findings underscore the critical importance of clinical interventions that reduce episode duration and accelerate recovery to minimize healthcare utilization and societal costs.

PMID:42275136 | DOI:10.1080/03007995.2026.2683436

Curr Med Res Opin. 2026 Jun 11:1-10. doi: 10.1080/03007995.2026.2682588. Online ahead of print.

ABSTRACT

OBJECTIVE: to investigate whether drug resistance is differentially reported for integrase strand-transfer inhibitors (INSTIs) in a global pharmacovigilance database.

METHODS: A disproportionality analysis was conducted to assess resistance to the five available INSTIs using VigiBase, the WHO global database of individual case safety reports (ICSRs). ICSRs were identified through Medical Dictionary for Regulatory Activities – MedDRA preferred terms (PTs) drug resistance, drug resistance mutation, genotype drug resistance test/test positive, multiple-drug resistance and pathogen resistance between October 2007 and September 2024. Descriptive analyses were employed to characterize individual cases according to sociodemographic and reporting-related variables. Disproportionality signals for at least one resistance-related MedDRA PTs compared with all other drugs in the database were expressed as reporting odds ratios (ROR) and information component (IC), with 95% confidence intervals (CI).

RESULTS: 35,406,826 deduplicated ICSRs were identified; 22,825 comprised reports of drug resistance and 1,084 involved exposure to INSTIs. Cases of HIV resistance were predominantly males. Most reports were regarded as serious and originated from Europe and the Americas. Disproportionality signals for drug resistance were observed for all first-generation (ROR= 52.5; CI 95% = 47.6-57.9; IC = 5.56; 95% CI = 5.4-5.7 – raltegravir) and second-generation INSTIs (ROR = 55.9; CI 95% = 50.8-61.5; IC = 5.65; 95% CI = 5.5-5.8 – dolutegravir).

CONCLUSIONS: HIV drug resistance to all INSTIs as well significant disproportionate safety signals were identified. These findings should be interpreted with caution given the inherent limitations of spontaneous reporting. Resistance monitoring in clinical settings is relevant.

PMID:42275135 | DOI:10.1080/03007995.2026.2682588

Integr Comp Biol. 2026 Jun 11:icag083. doi: 10.1093/icb/icag083. Online ahead of print.

ABSTRACT

Long-lived marine mammals such as bowhead whales (Balaena mysticetus) provide rare opportunities to examine physiological responses to past environmental and anthropogenic pressures. Using baleen plates from six adult females, we constructed up to 18 years of longitudinal profiles per individual for eight analytes: corticosterone, cortisol, dehydroepiandrosterone and its sulfated form (DHEA(S)), progesterone, testosterone, triiodothyronine (T3), and stable isotope ratios of carbon (δ13C) and nitrogen (δ15N). These records spanned three distinct periods (regimes): the 1850s-1870s, marked by commercial whaling and a warm Pacific Decadal Oscillation (PDO) phase; the 1940s-1960s, a cold PDO phase with Arctic stability and multiple La Niña events; and the 1970s-1980s, which included a major PDO regime shift and strong El Niño events. We identified 1-8 putative pregnancies per individual based on progesterone profiles, with variation in gestation length (13-21 months), interpregnancy interval (8 months to >4 years), and apparent pregnancy loss or calf loss. Pregnancy was associated with elevated corticosterone, DHEA(S), and testosterone. Certain hormones varied significantly with regime: DHEA(S) and testosterone were higher in the 1850s-1870s relative to at least one later regime, whereas T3 was significantly lower in the 1970s-1980s compared to earlier periods. δ¹³C was a significant negative predictor of T3, suggesting a potential link between foraging habitat and metabolic output. These findings highlight baleen as a retrospective biomonitoring tool and reveal potential reproductive plasticity and physiological responses of female bowheads to environmental change.

PMID:42275131 | DOI:10.1093/icb/icag083

Nephrol Dial Transplant. 2026 Jun 11:gfag130. doi: 10.1093/ndt/gfag130. Online ahead of print.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Iohexol and 99mTc-DTPA are commonly used exogenous filtration markers for determining measured glomerular filtration rate (mGFR). Traditional intravenous sampling is time-consuming and often inconvenient in clinical practice, whereas dried blood spot (DBS) sampling is a promising alternative. This study used population pharmacokinetic modeling (popPK) and traditional performance statistics to investigate whether intravenous and DBS sampling can be used interchangeably for measuring GFR in older medical patients with low appetite.

METHODS: Older patients aged ≥65 years with poor appetite, defined as a Simplified Nutritional Appetite Questionnaire (SNAQ) score ≤14, received intravenous administration of iohexol and 99mTc-DTPA, followed by sampling over 4-8 hours intravenously (for both tracers) and by DBS (for iohexol). Gentamicin 5 mg/kg was used as a model drug and administered intravenously to all patients, followed by plasma sampling over 22 hours. Employing a previously developed gentamicin popPK model, model fit improvement for each mGFR method was evaluated by reduction in objective function value (OFV) and inter-individual variability (IIV) when including mGFR as a covariate on clearance. Performance of each method relative to intravenous iohexol sampling was also evaluated by bias (median difference) and P15 (percentage of values within 15%).

RESULTS: 51 older patients (51% male, aged 67-96) were included. All three mGFR methods improved model fit when implemented as covariates on gentamicin clearance in popPK models (-ΔOFV = 115.6-137.6). The improvements were greater when mGFR was expressed in mL/min, rather than mL/min/1.73 m2. Compared to intravenous sampling of iohexol, DBS sampling of iohexol performed better (bias [95% CI] = 2 [0-3] mL/min, P15 = 98% [94.1%-100%]) than intravenous sampling of 99mTc-DTPA (bias = 4 [3-5] mL/min, P15 = 78.4% [66.7%-88.2%]).

CONCLUSIONS: Compared to intravenous sampling of iohexol or 99mTc-DTPA, DBS sampling of iohexol yielded similar improvements to model fit when incorporated as a covariate on gentamicin clearance in a popPK model.

PMID:42275113 | DOI:10.1093/ndt/gfag130

J Burn Care Res. 2026 Jun 11:irag092. doi: 10.1093/jbcr/irag092. Online ahead of print.

ABSTRACT

Albumin is essential for maintaining oncotic pressure and vascular integrity. In burn injuries, increased capillary permeability leads to hypoalbuminaemia, which is a recognised marker of poor outcomes in critical illness. However, its prognostic value in acute burn care remains underexplored. This study evaluated the prognostic value of admission serum albumin in predicting mortality, acute kidney injury (AKI), hospital and intensive care unit (ICU) length of stay, ventilatory requirements, sepsis, and pulmonary infection in burn patients. A systematic search of PubMed, Scopus, Cochrane Library, Web of Science, MEDLINE, and Embase was conducted. Of 5,587 studies screened, 19 were included in the systematic review and 9 in the meta-analysis. Statistical analysis was performed using RStudio, with pooled outcomes reported as odds ratios (OR), standardised mean differences (SMD), and hierarchical summary receiver operating characteristic (HSROC) curves. Heterogeneity was assessed using Cochran’s Q, I2, and Tau.2 Hypoalbuminaemia on admission was significantly associated with increased mortality during admission (OR 9.51; 95%CI 3.04-29.78; I2 49.3%). Admission hypoalbuminaemia was also associated with an increased risk of AKI (OR 2.83; 95%CI 2.49-3.22; I2 0%). Evidence for other outcomes was limited and heterogeneous. Admission serum albumin appears to be a valuable prognostic marker in burn patients, particularly for mortality and AKI. Further research is required to support its integration into burn-specific risk models, characterise albumin trends within the first 24 hours post-injury, and establish optimal cut-off values.

PMID:42275083 | DOI:10.1093/jbcr/irag092

Health Psychol. 2026 Jun 11. doi: 10.1037/hea0001612. Online ahead of print.

ABSTRACT

OBJECTIVE: Family-based behavioral treatment (FBT) is an evidence-based treatment that has shown statistically significant short- and long-term outcomes for children. However, statistical and clinical significance are different ways to study the impact of a treatment, and recent data have indicated the degree of body mass index z-score (zBMI) change that prevents the development of cardiometabolic disease.

METHOD: We conducted a mega-analysis using an individual participant database extracted from 16 randomized controlled studies (N = 1,098) on FBT for 6-12-year-old children with overweight or obesity and a participating parent with overweight and obesity that had at least 1-year follow-up. These data were used to evaluate clinical effectiveness based on -0.25 zBMI change and what percentage of children showed reversal of obesity at 6-, 12-, 24-, 60-, and 120-month follow-up. Analyses also examined whether age and sex were predictors of zBMI change.

RESULTS: Across the combined databases, 70%, 61%, 52%, 54%, and 68% met the -0.25 zBMI criteria, and 29%, 27%, 23%, 46%, and 48% reversed their obesity status at 6, 12, 24, 60, and 120 months, respectively. Age was a reliable predictor of change, with younger children showing greater change up to the 24-month follow-up.

CONCLUSIONS: These results suggest FBT is associated with clinical effectiveness, with long-term effects stable or improving over time. These data support the utility of FBT, and providing data on the clinical effectiveness of pediatric obesity treatment complements traditional reporting of statistical significance of FBT to support the clinical utility of FBT. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42275030 | DOI:10.1037/hea0001612

Traffic Inj Prev. 2026 Jun 11:1-7. doi: 10.1080/15389588.2026.2673090. Online ahead of print.

ABSTRACT

OBJECTIVE: Autonomous Emergency Braking (AEB) fitted to vehicles has proven road safety benefits in terms of preventing collisions with other vehicles. AEB with pedestrian detection (PAEB) extends this capability to protect vulnerable road users: the current paper evaluates these safety benefits in comparison with AEB without pedestrian detection and vehicles without any AEB.

METHODS: We analyzed data from Australian and New Zealand crashes involving injury over the period 2016-2023. The target crash types for PAEB analyzed either involved a vulnerable road user or the vehicle was rear-ended by another vehicle. Vehicles listed in Redbook (which provides vehicle specification information to assist Australian vehicle purchasers) with the feature “Control – Pedestrian Avoidance with Braking” were classed as having PAEB; for other vehicles, “Collision Mitigation – Forward (High speed)” and “Collision Mitigation – Forward (Low speed)” identified other forms of AEB. Using an induced exposure approach, crash rates associated with the safety technology fitted were estimated.

RESULTS: Controlling for jurisdiction, speed limit area, vehicle market group, driver age group and sex, weather, day/night and year of crash, there was a 17% reduction (95% CI 5% to 27%) in the rate of pedestrian or cyclist collisions associated with vehicles equipped with PAEB relative to vehicles without any AEB system; for vehicles equipped with AEB without pedestrian detection, there was no reduction in the rate of pedestrian or cyclist collisions. For collisions with motorcycles, the associated benefits were smaller: compared to vehicles with no AEB system, there was a statistically significant 11% reduction associated with PAEB (95% CI 0% to 21%) and a non-significant 8% reduction (95% CI an increase of 4% to a decrease of 19%) associated with other AEB system fitment. There were insufficient cyclists in the data to estimate benefits specifically for cyclists but there was no evidence that the associated benefit was any less than for pedestrians. The safety benefits for vulnerable road users associated with AEB with pedestrian detection were estimated to be higher at nighttime, contrary to some findings in other studies.

CONCLUSIONS: The safety benefits associated with PAEB for vulnerable road users are significantly greater than AEB without pedestrian detection, and this analysis of real-world crash outcomes shows these benefits extend to the protection of motorcyclists.

PMID:42275024 | DOI:10.1080/15389588.2026.2673090

Psychol Methods. 2026 Jun 11. doi: 10.1037/met0000843. Online ahead of print.

ABSTRACT

Hierarchical models for ordinal responses, in which responses are modeled successively by partitioning groups of categories into finer subgroups are proposed. These partitions reflect conceptually meaningful distinctions among categories. Such models are particularly well suited for Likert items, which typically differentiate between disagreement, agreement, and, in some cases, a neutral category. The hierarchical framework offers a parsimonious representation of predictor effects and often provides a better fit than traditional ordinal models. It also enables the investigation of dispersion effects, that is, systematic tendencies of respondents to prefer either extreme categories or middle categories, independently of the substantive content. In addition to specialized fitting tools for ordinal models, we provide a more general procedure that can be used to fit any hierarchically structured model. The practical use of these methods is demonstrated through illustrative examples. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42275018 | DOI:10.1037/met0000843

Anal Chem. 2026 Jun 11. doi: 10.1021/acs.analchem.5c06841. Online ahead of print.

ABSTRACT

Metabolomics studies employing liquid chromatography-mass spectrometry are affected by signal drift and batch effects, introducing technical variance that impedes biological knowledge discovery. Quality control (QC) sample-based normalization strategies are widely implemented but remain vulnerable to outliers, thereby reducing normalization performance. We introduce rLOESS, rGAM, and tGAM, three robust normalization methods that improve resistance to outliers by downweighting or accommodating them. Leveraging additive models, the rGAM and tGAM methods allow flexible nonlinear modeling, differential sample weighting, and data-driven QC representativeness evaluation. Implementations of these methods are gathered in the Metanorm R package, integrating robust normalization with visualization for performance verification while supporting efficient parallel processing. In in silico and/or experimental data sets, the robust methods, relative to several popular existing strategies, improved replicate concordance and reduced drift and batch effects. The robust methods, with improved recovery of the underlying signal demonstrated in simulation, produced distinct differential abundance results, highlighting the impact of normalization on downstream statistical inference. Overall, tGAM-based normalization suggested the best performance across scenarios and is proposed as the default choice. Metanorm is versatile, supporting normalization in metabolomics studies across scales and experimental setups. Metanorm is freely available at https://github.com/UGent-LIMET/Metanorm.

PMID:42275003 | DOI:10.1021/acs.analchem.5c06841

J Gambl Stud. 2026 Jun 11. doi: 10.1007/s10899-026-10517-z. Online ahead of print.

ABSTRACT

Adolescent gambling has become increasingly prevalent with the rise of online platforms and the normalization of gambling behaviors. This study aimed to estimate the past-year prevalence of gambling among high school students in Viana do Castelo, Portugal, to investigate sex-related differences in gambling behavior, and to identify factors associated with gambling. A cross-sectional study was conducted in 2024 with 1064 students from the three existing high schools. Participants completed an anonymous online questionnaire covering sociodemographic data, gambling in the past 12 months and its characterization, substance use, and environmental influences. The primary dependent variable was past-year gambling, coded dichotomously as yes/no. Chi-square tests and logistic regression were used to assess associations between past-year gambling and the other variables. The weighted past-year prevalence of gambling was 35.0%, higher among males. Statistically significant sex differences emerged in gambling type, companions, expenditure, frequency, and mode of access. Compared with females, males were more likely to engage in sports betting and poker, gamble alone or with friends, spend more money, gamble more frequently, and gamble online only or both online and land-based. Multivariable analysis showed that being male, attending public schools, early tobacco initiation, frequent consumption of spirit drinks, and knowing others who gamble were independently associated with gambling in the past 12 months. Gambling is widespread among adolescents in this sample, with distinct sex-related patterns and strong social influences. Early prevention strategies should address both individual behaviors and broader social contexts. Longitudinal studies are needed to understand causal pathways and inform targeted interventions.

PMID:42274980 | DOI:10.1007/s10899-026-10517-z