Category: Statistics

JMIR Form Res. 2026 Mar 12;10:e84130. doi: 10.2196/84130.

ABSTRACT

BACKGROUND: Visual patient avatars are an innovative patient monitoring technology that can be used to translate numerical and waveform data into intuitive, avatar-based representations of patient conditions. Previous research indicates that this technology improves health care providers’ situational awareness compared to conventional monitoring methods. As patient-worn continuous vital sign monitoring continues to evolve, we introduce the Visual Patient Wearable device to provide avatar-based visualization tailored to this application.

OBJECTIVE: This study aimed to evaluate whether a wearable-based animated patient avatar can improve patients’ perception and recall of simulated vital sign deviations compared to conventional monitoring methods, and to assess the usability and acceptance of this avatar-based visualization.

METHODS: This computer-based study included 67 patients from 3 academic hospitals in Central Europe. Participants were randomly assigned to a Visual Patient Wearable group or a conventional monitoring group and viewed a standardized instructional video for their allocated method. They then completed 4 randomized clinical scenarios, each displayed for 6 seconds to simulate glance-based assessment. Accuracy in recalling vital sign deviations was measured, and Visual Patient Wearable participants additionally gave user feedback on Likert scales.

RESULTS: The Visual Patient Wearable system was associated with higher detection accuracy of vital sign deviations compared with standard monitoring layouts, increasing from a median correctness of 46% (IQR 33%-63%) with conventional monitoring to a median of 67% (IQR 49%-79%) with the Visual Patient Wearable system (P<.001). This corresponded to a risk ratio of 1.34 (95% CI 1.23%-1.47%). The magnitude of this association varied across signals, with the largest relative improvement observed for heart rhythm (137% improvement, 95% CI 85%-209%), followed by oxygen saturation (SpO₂; 64% improvement, 95% CI 30%-108%) and temperature (30% improvement, 95% CI 5%-60%). No statistically significant reductions in risk were observed for heart rate, respiratory rate, or blood pressure. User experience ratings based on Likert scale assessments indicated high levels of satisfaction across all 6 vital sign categories (median score 4, IQR 4-5 on a 5-point scale).

CONCLUSIONS: This computer-based study suggests that Visual Patient Wearable visualizations enhance patients’ ability to detect and recall simulated vital sign deviations. Participants found the system intuitive, easy to learn, and reassuring. The Visual Patient Wearable system provides an at-a-glance interface that may support patients’ understanding of their vital signs and could facilitate communication of relevant information to clinical staff, thereby potentially contributing to informed patient engagement. The next step is to develop a software prototype for wearable devices and test it in a clinical study.

PMID:41818743 | DOI:10.2196/84130

Jpn J Clin Oncol. 2026 Mar 12:hyag039. doi: 10.1093/jjco/hyag039. Online ahead of print.

ABSTRACT

INTRODUCTION: Comprehensive genomic profiling (CGP) has expanded treatment options for metastatic castration-resistant prostate cancer (mCRPC); however, real-world data on its clinical utility in Japanese patients remain limited. To address this gap, we conducted a multicenter real-world analysis to evaluate the implementation and clinical relevance of CGP in Japanese patients with mCRPC.

METHODS: We retrospectively analyzed 128 patients with mCRPC who underwent CGP at four Japanese institutions using FoundationOne® CDx, FoundationOne® Liquid CDx, or OncoGuide™ NCC Oncopanel. We assessed the prevalence of druggable genomic signatures, including BRCA pathogenic variants (PVs), microsatellite instability-high (MSI-high), and tumor mutational burden-high (TMB-high), and described subsequent use of genomically matched therapies.

RESULTS: The median age at CGP testing was 73 years, and patients had received a median of three prior systemic treatment lines. BRCA PVs were identified in 18 patients (14%), MSI-high in 4 (3%), and TMB-high in 11 (9%); all MSI-high cases were also TMB-high. Overall, 26 patients (20%) harbored either BRCA PVs or TMB-high status. Among these, 14 patients (54%) received matched targeted therapies, including poly(ADP-ribose) polymerase inhibitors or pembrolizumab. BRCA PVs were detected in 17% of tissue-based (F1 CDx) assays and 9% of liquid-based assays, without a statistically significant difference.

CONCLUSIONS: CGP identified BRCA PVs, MSI-high, or TMB-high in 20% of patients with metastatic CRPC, supporting its value in guiding precision oncology. However, only some patients received matched therapy, supporting earlier CGP testing. Routine integration of CGP may facilitate precision oncology-guided treatment decision-making in this population.

PMID:41818716 | DOI:10.1093/jjco/hyag039

Bioinformatics. 2026 Mar 12:btag065. doi: 10.1093/bioinformatics/btag065. Online ahead of print.

ABSTRACT

MOTIVATION: Comparing mathematical models offers a means to evaluate competing scientific theories. However, exact methods of model calibration are not applicable to many probabilistic models which simulate high-dimensional spatio-temporal data. Approximate Bayesian Computation is a widely-used method for parameter inference and model selection in such scenarios, and it may be combined with Topological Data Analysis to study models which simulate data with fine spatial structure.

RESULTS: We develop a flexible pipeline for parameter inference and model selection in spatio-temporal models. Our pipeline identifies topological summary statistics which quantify spatio-temporal data and uses them to approximate parameter and model posterior distributions. We validate our pipeline on models of tumour-induced angiogenesis, inferring four parameters in three established models and identifying the correct model in synthetic test-cases.

AVAILABILITY AND IMPLEMENTATION: Simulation code for all models, data analyses, parameter inference and model selection is available online at https://github.com/rmcdomaths/tms/ and archived at https://doi.org/10.5281/zenodo.17392787.

SUPPLEMENTARY INFORMATION: Supplementary Information will be available online.

PMID:41818692 | DOI:10.1093/bioinformatics/btag065

Neurology. 2026 Apr 14;106(7):e214704. doi: 10.1212/WNL.0000000000214704. Epub 2026 Mar 12.

ABSTRACT

BACKGROUND AND OBJECTIVES: There are limited population-based data on the incidence and risk factors for childhood stroke, including associations with recent infection and vaccination. Therefore, we aimed to determine (1) the incidence of childhood ischemic and hemorrhagic stroke and (2) associations between a recent infection or vaccination and the risk of childhood stroke.

METHODS: A population-based case-control study was undertaken using linked administrative data from 2017 to 2023 in Victoria, Australia. All residents, aged 28 days to <18 years, were included. Infections in the 60 days immediately before admission were ascertained using state-wide notifiable infections and hospital admissions data sets. Vaccinations in the 42 days immediately before admission were ascertained using the Australian Immunisation Register. Strokes were identified in state-wide hospital admissions and death registry databases. Each case of childhood stroke was matched with up to 5 nonstroke controls on age (1-year bands), sex, socioeconomic position, comorbidities, and year. Conditional logistic regression was used to examine associations between infection and vaccination with childhood stroke.

RESULTS: Over the 7 years, 571 childhood strokes (60% ischemic; median age 8.2 years; 44% female patients) occurred among 9,881,934 person-years (5.8 events [95% CI 5.3-6.3] per 100,000 person-years). Two in 5 patients had evidence of an infection in the preceding 60 days, with lower respiratory infections (n = 74), sepsis (n = 67), upper respiratory tract infections (n = 63), meningitis/encephalitis (n = 40), gastrointestinal tract infections (n = 28), and urinary tract infections (n = 22) being the most common. Children with stroke (vs matched controls) were more likely to have had a recent infection (cases 41.9% vs controls 18.6%; adjusted odds ratio [aOR] 2.54, 95% CI 1.97-3.27). The magnitude of this association was greater for ischemic stroke (aOR 3.39, 95% CI 2.45-4.69) than hemorrhagic stroke (aOR 1.90, 95% CI 1.24-2.90). No significant association was detected between recent vaccination and childhood stroke (cases 4.2% vs controls 2.5%; aOR 1.69, 95% CI 0.92-3.09).

DISCUSSION: We provide contemporary data on new cases of childhood stroke in Australia, using population-wide linked data. Having a recent infection doubled the risk of childhood stroke. We found no significant evidence of an association between vaccination and childhood stroke.

PMID:41818652 | DOI:10.1212/WNL.0000000000214704

JCO Precis Oncol. 2026 Mar;10(3):e2500635. doi: 10.1200/PO-25-00635. Epub 2026 Mar 12.

ABSTRACT

PURPOSE: MYCN amplification (MYCN-A) is an important prognostic marker in neuroblastoma. However, the impact of MYCN-A in patients with metastasized high-risk neuroblastoma during the course of disease remains unclear. The aim of this study was to investigate response and relapse patterns of stage IV patients with and without amplification of MYCN.

MATERIALS AND METHODS: Amplification of the MYCN oncogene was assessed by fluorescence in situ hybridization, whole exome sequencing, or single nucleotide polymorphism analysis. Complete remission (according to the revised International Neuroblastoma Response Criteria) and survival outcomes were estimated.

RESULTS: Among the 164 patients older than 12 months with metastatic high-risk neuroblastoma, 50 (30%) had MYCN-A. MYCN-A was a significant prognostic marker for overall survival (P = .04). Patients with MYCN-amplified tumors reached complete remission faster compared with those without MYCN amplification (HR, 1.8 [95% CI, 1.2 to 2.8]; P < .01). MYCN-A was associated with recurrence when evaluated from diagnosis and after induction treatment (HR, 1.6 [95% CI, 1.0 to 2.4]; and HR, 1.8 [95% CI, 1.1 to 2.8], respectively), as well as to the cumulative incidence of recurrence (P = .04 and P = .03, respectively). SIOPEN scores detected on meta-[¹²³I]iodobenzylguanidine (MIBG) scintigraphy were significantly lower in patients with MYCN-amplified tumors than in patients with MYCN nonamplified tumors at diagnosis and after induction treatment (P < .01 and P = .01, respectively). From end of induction, MYCN-A stratified by SIOPEN score was associated with the cumulative incidence of recurrence (P < .01).

CONCLUSION: Despite achieving complete remission faster, patients with MYCN-A have a higher probability of recurrence compared with those without MYCN-A.

PMID:41818646 | DOI:10.1200/PO-25-00635

JCO Precis Oncol. 2026 Mar;10(3):e2500725. doi: 10.1200/PO-25-00725. Epub 2026 Mar 12.

ABSTRACT

PURPOSE: A multicancer early detection (MCED) test was developed and validated in the case-control Circulating Cell-free Genome Atlas (CCGA) study (ClinicalTrials.gov identifier: NCT02889978). Previous analysis of the second (cross-validation) CCGA substudy identified prognostic value of cancer signal detection by the MCED test with 3-year follow-up. Here, we evaluated the prognostic value of a cancer signal detected (CSD) result in the third (validation) CCGA substudy (CCGA3) using an updated statistical methodology with 5-year follow-up.

METHODS: CCGA3 participants with confirmed cancer were followed for up to 5 years; overall survival was stratified by MCED test result (CSD or no CSD [NCSD]). Observed survival was compared with the expected survival of a reference population calculated from Surveillance, Epidemiology, and End Results data matched to clinical characteristics (age, sex, cancer type, and stage) in each signal detection group.

RESULTS: Of 2,513 participants with stageable, invasive cancer, 792 (31.5%) died and 1,683 (67.0%) were confirmed alive at follow-up, with 38 (1.5%) lost to follow-up. CSD rates were higher in participants who died during follow-up compared with those alive (85% v 34%). Overall observed survival versus expected survival was similar for CSD (43% observed v 40% expected) and NCSD (88% observed v 81% expected) groups. For NCSD, hazard ratios (HRs) were more favorable (<1) relative to the matched reference population at all stages (P < .0001); for CSD, HRs were <1 at stages III to IV (P < .0001) and ≅1 at stages I to II (P > .4).

CONCLUSION: CSD cancers had long-term survival similar to expectations, even in early stages, indicating that CSD early-stage cancers are unlikely to be more micrometastatic and lethal than cancers detected by conventional means. The MCED test was likely to find clinically significant cancers without contributing to overdiagnosis.

PMID:41818645 | DOI:10.1200/PO-25-00725

PLoS Med. 2026 Mar 12;23(3):e1004923. doi: 10.1371/journal.pmed.1004923. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: In the United States, already-prevalent power outages are increasing in frequency and duration with climate change. Studies from New York State show that power outages may increase hospitalizations for cardiovascular disease (CVD) and respiratory disease in vulnerable populations such as older adults, but exposure data limitations have constrained nationwide studies of power outages and health. Here, we tested if power outages were associated with emergency CVD and respiratory disease-related hospitalizations among older adults in the United States.

METHODS AND FINDINGS: We developed a national dataset of power outage exposure and identified county-days with ≥1% of customers exposed to 8+ hour power outages in 2018. We leveraged data on 23 million Medicare Fee-For-Service beneficiaries aged 65+ to estimate daily county-level rates of emergency CVD- and respiratory-related hospitalizations. We applied a case-crossover design with a conditional Poisson model to estimate the lagged association (up to 1 week) between daily county-level power outage exposure and cause-specific hospitalization rates. Models controlled for daily temperature, precipitation, and wind speed.

RESULTS: Power outages were associated with increased emergency CVD and respiratory hospitalizations. The association between power outage and CVD hospitalizations was strongest the day after power outage exposure (rate ratio [RR]=1.02, 95% CI: 1.01, 1.03), while the association between outage and respiratory disease was strongest the day of power outage exposure (RR = 1.03, 95% CI: 1.01, 1.04). We estimated this association using county-level power outage data; future studies could use higher spatial resolution data.

CONCLUSIONS: Power outages may increase the risk of CVD and respiratory hospitalizations among US older adults. Improving electricity reliability could support community health and protect older adults from CVD and respiratory disease exacerbations.

PMID:41818642 | DOI:10.1371/journal.pmed.1004923

Indian J Ophthalmol. 2026 Mar 12. doi: 10.4103/IJO.IJO_1856_25. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the use of red and green lasers in studying retinoblastoma seeds in pathological samples.

METHODS: This study was a retrospective, laboratory-based experimental study, conducted at a tertiary care eye center of northeast India. Medical records were retrospectively analyzed in a 7-year period from 2016 to 2023 to identify enucleated retinoblastoma (RB) eyeballs having tumor seedings. All pathological specimens that were studied using red and green laser pointers (Class III Laser product) were included. Lasers of wavelength 532 nm (green) and 630 nm (red) were used under the objective of compound microscopes to study different RB seeds. The activities of seeds were studied by the use of lasers. The seeds were documented under the objective of the compound microscope. For statistical analysis, IBM SPSS 26 was utilized. The descriptive statistics of the quantitative variables was reported through the metric mean. The categorical variables were described using count and percentages. Independence of categorical variable was carried out using Chi-square test and P values.

RESULTS: Thirty-eight specimens with RB seedings at different locations were included in the study. RB seeds in anterior segment (n = 2 cases), over ciliary process (n = 2 cases), vitreous seeds (n = 18 cases), retinal seeds (n = 2 cases), retinal pigment epithelium seeds (n = 3 cases), subretinal seeds (n = 5 cases), combined vitreous and subretinal seeds (n = 6 cases), and calcified seeds (n = 2 cases) were noted. With red and green lasers, varied changes were observed in the RB seeds, particularly the presence and absence of electron dense clouding within the seeds. Active seeds could be differentiated from inactive seeds using the laser technique.

CONCLUSION: Use of laser in the present study was first of its kind, carried out to visualize RB seeds at different sites in raw or wet specimens of the enucleated eyeballs. By this technique, active seeds could be differentiated from the inactive seeds based on electron dense clouds within the seeds’ configurations.

PMID:41817580 | DOI:10.4103/IJO.IJO_1856_25

Indian J Ophthalmol. 2026 Mar 12. doi: 10.4103/IJO.IJO_1572_25. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the functional outcomes and complications of pars plana vitrectomy with scleral flaps covered with a two-point sutured scleral-fixated intraocular lens (SFIOL).

METHODS: A retrospective, single-center, single-surgeon case study, including 97 cases. About 25 G pars plana vitrectomy with a two-point sutured scleral-fixated IOL was used as a surgical modality.

RESULTS: This study included 97 patients and eyes with scleral IOL fixation, with a mean follow-up of 6 months. The indications for SFIOL were divided into cases of surgical aphakia (63, 64.94%), hyper-mature cataract not suitable for routine procedure (5,5.15%), traumatic cataracts not suitable for routine procedures (18,18.5%), and other categories (11,64.94%). In this study, the median ± standard deviation of best-corrected visual acuity (BCVA) values in logarithm of the minimum angle of resolution (LogMAR) pre, post 1 month, 3 months, 6 months showed statistically significant improvement in VA with P value <0.001. The most common complications as number of cases seen in our study were cystoid macular edema (four cases), Descemet membrane folds (three cases), epiretinal membrane (five cases), exposed suture knots (one case), iatrogenic retinal break (two cases), iatrogenic retinal touch (two cases), IOL edge glare (one case), IOL tilt (one case), secondary glaucoma (three cases), post-op uveitis (one case), retinal detachment (one case), no complications 73 cases out of total cases.

CONCLUSION: The mean BCVA improved from preoperative to postoperative 1 day, 1 month, 3 months, and 6 months (P < 0.001) using this technique. This technique, which is more time-consuming, offers advantages over other available options, including improved stability, reduced risk of complications, and enhanced visual outcome.

PMID:41817571 | DOI:10.4103/IJO.IJO_1572_25

Indian J Ophthalmol. 2026 Mar 12. doi: 10.4103/IJO.IJO_2659_25. Online ahead of print.

ABSTRACT

Type 2 diabetes mellitus (T2DM) and obesity are commonly treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, there have been growing concerns over the possibility that these medications may result in ocular adverse events, such as nonarteritic anterior ischemic optic neuropathy (NAION). Standard clinical care can overlook these potentially fatal adverse effects. The purpose of this review was to compile the most recent data on ocular side effects associated with GLP-1 RA therapy, assess their clinical relevance, and highlight necessary preventative and monitoring measures. A thorough search of the literature was conducted using Medline/PubMed/PMC, Google Scholar, Scopus, Web of Science, and ScienceDirect. Relevant literature, including observational studies, randomized trials, case reports, and pharmacovigilance data, was selected for its discussion of GLP-1 RAs and associated eye-related adverse events. Semaglutide, a GLP-1 RA, has been associated in a number of studies and safety assessments with an increased risk of NAION and the progression of diabetic retinopathy, especially in patients with underlying eye disorders. Findings, however, were mixed because no statistically significant link was found in a number of cohort studies and meta-analyses. The necessity for additional research was supported by data from adverse event reporting systems that showed disproportionality signals. Clinicians should be mindful of the potential ocular hazards associated with GLP-1 RAs, even though these medications remain useful in treating T2DM and obesity. Closer ophthalmologic monitoring may be beneficial for patients with known diabetic eye problems. Further prospective research with well-defined ocular outcomes is required to elucidate these correlations and guarantee the secure administration of GLP-1 RAs.

PMID:41817564 | DOI:10.4103/IJO.IJO_2659_25