Category: Statistics

JMIR Form Res. 2025 Mar 28;9:e69001. doi: 10.2196/69001.

ABSTRACT

BACKGROUND: Subsequent to the COVID-19 pandemic in 2020, a different approach to health care utilization was required to improve safety and efficiency. In the postpandemic era, virtual care and remote assessment of musculoskeletal conditions has become more common, and examining the accuracy of these remote encounters remains vital. In 2023, an innovative, video-based tool-the Virtual Performance Measure (VPM)-was introduced to assess the functional difficulties of patients with osteoarthritis of the knee joint. Further validation of this tool is warranted to expand its application longitudinally and in more diverse populations.

OBJECTIVE: This study examined the longitudinal validity of the VPM, a digitally based outcome tool, in patients with osteoarthritis of the hip and knee joints who had undergone arthroplasty.

METHODS: Patients completed a web-based survey after watching 40 videos that demonstrated 10 functional tasks with increasing difficulty, prior to and at approximately 3-5 months following surgery. The Lower Extremity Functional Scale (LEFS) was used as the reference measure. Longitudinal convergent and known-groups validity as well as sensitivity to change were assessed.

RESULTS: The data of 120 patients (n=80, 67% female; mean age 67, SD 9 years; n=58, 48% with hip osteoarthritis and n=62, 52% with knee osteoarthritis) were examined. There was a statistically significant improvement in both LEFS (t₁₁₉=16.04, P<.001) and VPM total scores (t₁₁₉=13.92, P<.001) over time. The correlation between the postoperative LEFS and VPM scores was higher (r=0.66; P<.001) than the correlation between the change scores of these measures (r=0.51; P<.001). The area under the curve value for the VPM’s ability to differentiate between urgent and nonurgent candidates for surgery was 0.71 (95% CI 0.57-0.84). Sensitivity to change as measured by the standardized response mean was 1.27 (95% CI 1.09-1.45), indicating good ability to detect change over time.

CONCLUSIONS: The VPM demonstrated sufficient longitudinal convergent and known-groups validity as well as sensitivity to change in patients with hip and knee osteoarthritis following arthroplasty. This tool has a potential to improve the delivery of care by increasing access, reducing the frequency of in-person visits, and improving the overall efficiency of the health care system following a major surgery.

PMID:40153784 | DOI:10.2196/69001

J Med Internet Res. 2025 Mar 28;27:e55072. doi: 10.2196/55072.

ABSTRACT

BACKGROUND: People with severe mental illness (SMI) face profound health inequalities, which may be exacerbated by increased rates of digital exclusion, especially as health services move to online provision. The activities that people carry out online can affect how they feel about the internet and may determine whether a person has a positive or negative experience when using the internet. This, in turn, could affect their mental health. To support people with SMI in using digital technology and the internet safely, it is important to understand the internet and digital technology use of those with SMI and their perceived positive or negative impact on their mental health.

OBJECTIVE: This study aimed to explore the internet and digital technology use of those with SMI, with particular focus on any association between greater use of the internet and poorer self-reported mental health.

METHODS: We carried out a qualitative interview study with 16 people with SMI. The sample was drawn from a wider investigation of the impact of the pandemic and its restrictions on the health and well-being of 367 people with SMI. We purposively sampled from the wider study based on age, gender, frequency of internet use, and self-reported mental health. The data were analyzed by 2 researchers using framework analysis.

RESULTS: Participant experiences fell into 3 broad categories: those who had a positive or neutral internet-based experience, those who had negative or difficult experiences, and low users or those with poor digital literacy. Those who had positive or neutral experiences could be broken down into 2 subcategories: first, those with positive or neutral experiences of the internet who were similar in terms of the activities participated in, feelings reported, and their concerns about the internet, and second, conscious users who were mindful of their interaction with the internet world. Participants with difficult experiences fell into 2 categories: those with worries and fears related to using the internet and those who had difficulty limiting their internet use.

CONCLUSIONS: People with SMI, similarly the general population, are expected to conduct more of their activities of daily living online in the postpandemic world. This research shows that most internet users with SMI have positive or neutral experiences. However, our typology reveals subgroups of the population with SMI for whom there is a relationship between internet use and difficult feelings. These subgroups can be identified by asking questions about online activities; time spent online; feelings, difficulties, or issues experienced; and use of gambling, dating, adult content, and conspiracy theory websites. Our findings point to further work in collaboration with people with lived experience to modify and test this typology.

PMID:40153777 | DOI:10.2196/55072

JMIR Mhealth Uhealth. 2025 Mar 28;13:e56666. doi: 10.2196/56666.

ABSTRACT

BACKGROUND: Mobile health (mHealth) apps provide innovative solutions for improving treatment adherence, facilitating lifestyle modifications, and optimizing blood pressure control in patients with hypertension. Despite their potential benefits, the adoption and recommendation of mHealth apps by physicians in Germany remain limited. This reluctance may be due to a lack of understanding of the factors influencing physicians’ willingness to incorporate these digital tools into routine clinical practice. Understanding these factors is crucial for fostering greater integration of mHealth apps in hypertension care.

OBJECTIVE: The aim of this study was to explore the relationship between physicians’ information needs and acceptance factors, and how these elements can support the effective integration of mHealth apps into daily medical routines.

METHODS: We conducted a qualitative study involving 24 semistructured telephone interviews with physicians, including 14 cardiologists and 10 general practitioners, who are involved in the treatment of hypertensive patients. Participants were selected through purposive sampling to ensure a diverse range of perspectives. Thematic analysis was conducted using MAXQDA software (Verbi GmbH) to identify key themes and subthemes related to the acceptance and use of mHealth apps.

RESULTS: The analysis revealed significant variability in physicians’ information needs regarding mHealth apps, particularly concerning their functionalities, clinical benefits, and potential impact on patient outcomes. These informational gaps play a critical role in determining whether physicians are willing to recommend mHealth apps to their patients. Key determinants influencing acceptance were identified, including the availability of robust knowledge about the apps, high-quality and reliable data, generational shifts within the medical profession, solid evidence supporting the effectiveness of the mHealth apps, and clearly defined areas of application and responsibilities within the physician-patient relationship. The study found that acceptance of mHealth apps could be significantly increased through targeted educational initiatives, enhanced data quality, and better integration of these tools into existing clinical workflows. Furthermore, younger physicians, more familiar with digital technologies, demonstrated greater openness to using mHealth apps, suggesting that generational changes may drive future increases in adoption.

CONCLUSIONS: The successful integration of mHealth apps into hypertension management requires a multifaceted approach that addresses both the informational and practical concerns of physicians. By disseminating comprehensive knowledge about the variety, functionality, and proven efficacy of hypertension-related mHealth apps, health care providers can be better equipped to use these tools effectively. This approach necessitates the implementation of various knowledge transfer strategies, such as targeted training programs, peer learning opportunities, and active engagement with digital health technologies. As physicians become more informed and confident in the use of mHealth apps, their acceptance and recommendation of these tools are likely to increase, leading to more widespread adoption. Overcoming current barriers related to information deficits and data quality is essential for ensuring that mHealth apps are optimally used in routine hypertension care, ultimately improving patient outcomes and enhancing the overall quality of care.

TRIAL REGISTRATION: German Clinical Trials Register DRKS00029761; https://drks.de/search/de/trial/DRKS00029761.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3389/fcvm.2022.1089968.

PMID:40153776 | DOI:10.2196/56666

Medicine (Baltimore). 2025 Mar 28;104(13):e41969. doi: 10.1097/MD.0000000000041969.

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic recurrent IBD, whose cause involves the interaction between genetic and environmental factors. Although there is a recognized link between immune response and IBD, the causal relationship between circulating immune cell counts and IBD remains controversial. This study aimed to elucidate the causal relationship between genetically predicted circulating immune cell counts and IBD. We conducted a bidirectional 2-sample Mendelian randomization (MR) study using aggregated statistics from genome-wide association studies. The causal relationship between 5 circulating leukocytes cells (monocytes, lymphocytes, eosinophils, basophils and neutrophils) counts and IBD, including ulcerative colitis (UC) and Crohn disease (CD) was analyzed. Horizontal pleiotropy test and heterogeneity test were used to ensure the stability of the results. Our findings indicated that monocytes, lymphocytes, eosinophils, and basophils count were not significantly associated with IBD, however, elevated circulating neutrophils count was significantly associated with higher risk of IBD [odds ratio (OR) = 1.0017; 95% confidence interval (CI) = 1.0004-1.003; P = .009] and UC [OR = 2.465; 95% CI = 1.236-4.916; P = .01]. In addition, we also found that IBD [OR: 12.07; 95% CI = 1.909-76.316; P = .008] and CD [OR = 1.014; 95% CI = 1.004-1.023; P = .005] were significantly associated with higher circulating neutrophils count in reverse MR. This MR study provides genetic evidence for the causal relationship between the genetically predicted increase in circulating neutrophils count and the risk of IBD (UC and CD). This finding stresses the need for further exploring physiological functions of neutrophils in order to develop effective strategies against IBD.

PMID:40153772 | DOI:10.1097/MD.0000000000041969

Medicine (Baltimore). 2025 Mar 28;104(13):e41948. doi: 10.1097/MD.0000000000041948.

ABSTRACT

After hospitalization caused by COVID-19, a high prevalence of physical deterioration has been observed, hence the importance of having tests to evaluate the functional status of patients and to be able to perform a partition and subsequent referral to the physiotherapy service. This cross-sectional observational study describes the physical status according to the short physical performance battery (SPPB) of patients admitted to the hospital setting for COVID-19 and to identify variables potentially related to this outcome. Thirty-six patients admitted to the hospital setting for COVID-19 in the first wave living in the community. Patients were evaluated with the SPPB, strength test, the International Physical Activity Questionnaire, the 1-minute sit-to stand, spirometry, the Barthel index, the Hospital Anxiety and Depression Scale, and other patient-related data were collected. We performed bivariate and regression analyses. A linear regression was fitted, having SPPB as a dependent variable to ascertain the impact of intensive care unit (ICU) admission on physical performance. Five variables were related to SPPB. There was a significant relationship between admission to the ICU and having a heart disease (P = .015), the level of physical activity (P = .049), number of years smoking (P = .029) and days of hospitalization (P = .005). A total of 22.22% of analyzed patients suffered frailty. SPPB is related to altered respiratory pattern, quadriceps strength, 1-minute sit-to-stand and FEV1, Barthel score, days of hospitalization and FEV/FVC ratio. Lack of association between ICU stay, age or sex with SPPB results differs from the results of other studies.

PMID:40153771 | DOI:10.1097/MD.0000000000041948

Medicine (Baltimore). 2025 Mar 28;104(13):e41941. doi: 10.1097/MD.0000000000041941.

ABSTRACT

Vaccination against human papilloma virus (HPV) play a major role in preventing infection with HPV among heterosexual couples. The aim of this study was to assess public knowledge and attitude towards HPV vaccine in Saudi Arabia. This is an online cross-sectional survey study that was conducted between May and June 2023. This study utilized the convenience sampling technique to recruit the study participants. The study participants were invited to participate in this study through social media platforms (X, Facebook, and WhatsApp). Multiple logistic regression was performed to assess the factors associated with better knowledge level and the findings were presented as odds ratios (OR) with 95% confidence intervals (CI) and corresponding p-values. A total of 819 participants were included in the analysis. A total of 355 participants (43.3%) had a good knowledge score and 464 participants (56.7%) had poor knowledge. The total mean of knowledge score was (3.22 ± 2.44). As the table shown, single participants reported a significant higher knowledge score mean (3.59 ± 2.52) compared to married (2.84 ± 2.32) (P = .0001). Participants aged between 18 to 29 years reported a significant higher knowledge score mean (3.57 ± 2.52) compared to participants aged between 40 and 49 years (2.60 ± 2.21) (P = .0001). Participants who lived in Eastern area had significantly higher odds of knowledge compared to other areas (OR = 2.19, 95% CI = 1.45 – 3.33, P = .001). Participants who worked in medical field had significantly higher odds of having good knowledge compared to other jobs (OR = 3.65, 95% CI = 2.39-5.57, P = .0001). Participants who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge (OR = 2.05, 95% CI = 1.02-4.12, P = .04). This study identified that a considerable proportion of the study participants demonstrated poor level of knowledge of HPV vaccine. Participants who lived in Eastern area, those who worked in medical field, and those who had 2 sexual partners have you had in the past 2 years had a significant higher odd of having good knowledge. Future studies should be directed towards developing educational campaign to improve public awareness of HPV.

PMID:40153766 | DOI:10.1097/MD.0000000000041941

Medicine (Baltimore). 2025 Mar 28;104(13):e41950. doi: 10.1097/MD.0000000000041950.

ABSTRACT

Mandibular fractures are one of the most common maxillofacial bone fractures that can occur during many activities in daily life. The aim of this study was to provide data for practitioners and researchers about the variables and outcomes associated with mandibular fractures by examining the relationships between gender, age groups, trauma causes, side, type, and anatomic location of mandibular fractures and concomitant injuries. The demographic and clinical data of the patients were obtained from the hospital information management system of a university hospital. The hospital records for the 10-year period between 2014 and 2023 were examined retrospectively. The mandible fractures were classified according to type, side, and location and compared against gender, age group, and trauma cause. Evaluation was made of 142 patients with traumatic mandibular fracture, comprising 76.8% males and 23.2% females. Of these cases with mandible fracture, 82.4% were aged < 35 years, and 45.1% of the fractures occurred in road traffic accidents. The majority of mandibular fractures were caused by road traffic accidents in males and adults over the age of 18, whereas home, environmental, and leisure accidents were the major cause of mandibular fractures in females and persons under the age of 18. Compound fractures were determined in 59.2% of the cases, single fractures in 80.3%, and parasymphysis and symphysis fractures in 46.2%. The compound and parasymphysis/symphysis region fractures were more common in males, patients aged < 35 years, and those who had undergone any type of trauma. We consider the information obtained through this study could make significant contributions to the data bank for multicenter prospective in-depth epidemiological research in clinical and forensic sciences in the future.

PMID:40153762 | DOI:10.1097/MD.0000000000041950

Medicine (Baltimore). 2025 Mar 28;104(13):e41989. doi: 10.1097/MD.0000000000041989.

ABSTRACT

Chronic kidney disease (CKD) is a growing health concern worldwide. It is crucial to prevent CKD to mitigate its impact and enhance health results. Recognizing and managing the risk factors of chronic kidney disease at an early stage can aid in stopping its advancement. A cross-sectional study was carried out at a hospital from March 1 to April 30, 2023, involving 422 hypertensive patients. The participants were chosen using systematic random sampling. Data on socio-demographic and clinical factors, as well as knowledge and practices, were gathered through interviews, medical record reviews using structured questionnaires. Descriptive statistics were used to determine the frequency and percentage of variables. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 23 (Chicago). Variables with P-values < .25 were considered for multivariable analysis, and those with P-values < .05 were deemed to be factors associated with knowledge and practices. The study found that 42.2% (178) of hypertensive patients had good knowledge about chronic kidney disease, and 43.6% (184) had good practices. Living in urban areas (with an adjusted odds ratio [AOR] of 3.94 at a 95% confidence interval [CI] of 2.42-6.42) and having a family history of kidney disease (AOR 5.59 at a 95% CI of 3.21-9.75) were factors associated with good knowledge. Being a government employee (AOR 7.29, at 95% CI 1.79-29.58) and maintaining a normal body mass index (AOR 8.03, at 95% CI 3.54-18.19) were linked to good practices. Less than half of the study participants had good knowledge and practices toward prevention of chronic kidney disease. Identifying factors that affect knowledge and practices towards the prevention of chronic kidney disease can offer healthcare providers, governmental and nongovernmental organizations (NGOs), and policymakers’ valuable insights for developing strategic interventions and education programs to promote better management of hypertension and CKD.

PMID:40153756 | DOI:10.1097/MD.0000000000041989

Medicine (Baltimore). 2025 Mar 28;104(13):e41970. doi: 10.1097/MD.0000000000041970.

ABSTRACT

This study aims to evaluate the prevalence and factors associated with high blood pressure in secondary school adolescents in the Bamenda municipality, the North West region of Cameroon. A community-based cross-sectional study was conducted over 5 months, involving 720 adolescents aged 10 to 19 years from 13 secondary schools, using a multi-stage sampling approach. Blood pressure was measured using both oscillometric and mercury sphygmomanometer devices. Weight, height, and body mass index (BMI) were also assessed. Participants with high blood pressure values at the first visit underwent repeat screening for over 3 weeks and hypertension defined according to American Academy of Pediatrics guidelines. Logistic regression analyzed factors associated with hypertension, considering P < .05 as statistically significant at 95% Confidence Interval. The prevalence of hypertension was 5% (4% for stage I and 1% for stage II) and that of elevated Blood Pressure was 4.3%. There was an increase in blood pressure with an increase in age. Systolic blood pressure and diastolic blood pressure were significantly positively correlated with BMI. There was a significant association between enrolled in private school (aOR = 0.32; P = .006) and obesity (aOR = 2.94; P = .017) with hypertension in these participants. This study provides valuable insights into the alarming prevalence of hypertension among secondary school adolescents in Bamenda, Cameroon. The identification of key risk factor, obesity, calls for comprehensive strategies to promote healthy lifestyle, regular screening and timely management of high blood pressure in this vulnerable population.

PMID:40153752 | DOI:10.1097/MD.0000000000041970

Medicine (Baltimore). 2025 Mar 28;104(13):e41974. doi: 10.1097/MD.0000000000041974.

ABSTRACT

This study explored connections between women’s reproductive factors and acute ST-segment elevation myocardial infarction (STEMI). A retrospective case-control study was conducted between 2016 and 2017. The study included 110 women diagnosed with STEMI and 110 control participants. Data on reproductive factors were collected through structured questionnaires and analyzed using statistical methods. Findings showed that increased STEMI risk was associated with longer lactation period, a higher number of parities, gravidity, and abortions. No significant relationships were observed for menopausal status, menopausal age, menarche age, reproductive duration, or oral contraceptive use. This study revealed that higher gravidity, parity, history of abortion, and longer breastfeeding duration were linked to an increased risk of STEMI. However, no significant differences were found between the case and control groups regarding menopausal status, age at menopause, age at menarche, reproductive duration, or oral contraceptive use.

PMID:40153750 | DOI:10.1097/MD.0000000000041974