Category: Statistics

J Glaucoma. 2026 May 1;35(5):317-325. doi: 10.1097/IJG.0000000000002696. Epub 2026 Apr 21.

ABSTRACT

PRCIS: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) has gained considerable acceptance as a preferred cyclodestructive intervention for refractory glaucoma, offering significantly enhanced safety profiles through precisely controlled pulse energy delivery while maintaining equivalent therapeutic outcomes compared with traditional modalities.

OBJECTIVE: To compare the efficacy and safety profiles of MP-TSCPC versus continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in patients with refractory glaucoma.

MATERIALS AND METHODS: This prospective, randomized, single-blind study included 52 patients (52 eyes) with refractory glaucoma assigned to either MP-TSCPC or CW-TSCPC. Patients were followed for 18 months. Secondary outcomes included absolute IOP values, medication reduction, preservation of visual acuity, visual function parameters, quality of life, and complication rates. Success was defined as IOP between 6-21 mm Hg without medications (complete success), with medications (qualified success), or either (cumulative success). Patients were followed for 18 months.

RESULTS: At 18 months, 47 eyes completed follow-up (24 in MP-TSCPC and 23 in CW-TSCPC). The MP-TSCPC group (n=24) achieved a 34.43% IOP reduction from baseline, compared with 42.86% in the CW-TSCPC group (n=23), P=0.052. Complete success rates were 25.00% (6/24) for MP-TSCPC and 21.74% (5/23) for CW-TSCPC (P=0.999), while qualified success rates were 29.16% (7/24) and 39.13% (9/23), respectively (P=0.550). The cumulative success rates were 54.17% for MP-TSCPC and 60.87% for CW-TSCPC (P=0.706). The CW-TSCPC group experienced significantly higher rates of postoperative pain (56.52% vs. 20.83%, P=0.012) and prolonged inflammation (34.78% vs. 8.33%, P=0.039). Visual function parameters remained stable in both groups throughout the study period. Quality of life improved significantly in the MP-TSCPC group but not in the CW-TSCPC group, although between-group differences were not statistically significant.

CONCLUSION: MP-TSCPC demonstrated comparable efficacy to CW-TSCPC in IOP reduction and success rates for refractory glaucoma management, while offering a significantly improved safety profile with less postoperative pain and inflammation. These findings suggest that MP-TSCPC may be considered as a preferred initial cyclodestructive option when balancing efficacy and safety, though larger studies are needed to confirm these findings.

PMID:42044484 | DOI:10.1097/IJG.0000000000002696

Neurol Neuroimmunol Neuroinflamm. 2026 Jul;13(4):e200586. doi: 10.1212/NXI.0000000000200586. Epub 2026 Apr 27.

ABSTRACT

BACKGROUND AND OBJECTIVES: Inebilizumab and rituximab (RTX) are anti-CD19 and anti-CD20 B cell-depleting antibodies, respectively. They are both used in the treatment of neuromyelitis optica spectrum disorders (NMOSD). However, limited data on both drugs exist regarding real-world clinical applications. This study aimed to assess the efficacy and safety of inebilizumab vs low-dose RTX in NMOSD patients through a retrospective-prospective multicenter analysis.

METHODS: This study collected data on aquaporin-4 immunoglobulin G seropositive NMOSD patients from 6 cities in China among those receiving either inebilizumab or low-dose RTX (500 mg), with a 1-year follow-up. Analyses assessed outcomes using inverse probability of treatment weighting and doubly robust models.

RESULTS: We included a total of 229 patients, comprising 119 treated with inebilizumab and 110 with low-dose RTX. The cohort was predominantly female (217/229, 94.76%). The median follow-up duration was 12.0 months (range: 4.0-12.0) in the inebilizumab group and 12.0 months (range: 7.0-12.0) in the low-dose RTX group. Relapses occurred in 8/119 (6.72%) inebilizumab recipients vs 24/110 (21.82%) low-dose RTX recipients (hazard ratio [HR] 3.77, 95% confidence interval [CI] 1.56-9.14; p = 0.003). Adjusted annualized relapse rates were significantly lower in the inebilizumab group (0.06) than in the low-dose RTX group (0.24), corresponding to an incidence rate ratio (IRR) of 3.65 (95% CI 1.59-8.39; p = 0.003). Adverse events (AEs) occurred in 35 patients (29.42%) with inebilizumab, including 2 serious adverse events (SAEs; 1.68%), vs 44 patients (40.00%) with low-dose RTX (4 SAEs [3.64%]). Both AE and SAE rates showed no statistical difference between groups. The rate of patients with at least 1 infection in inebilizumab group was lower than that in the low-dose RTX group (p = 0.003).

DISCUSSION: In this short-term study, inebilizumab demonstrated greater efficacy in reducing relapse risk, along with significantly lower rates of key adverse events, compared with low-dose RTX in patients with NMOSD. These findings support the use of inebilizumab as an effective and well-tolerated therapeutic option in a broader NMOSD population.

CLASSIFICATION OF EVIDENCE: This short-term study with a 12-month observation period provides Class III evidence that in patients with NMOSD, inebilizumab is more effective than low-dose RTX in reducing relapses.

PMID:42044464 | DOI:10.1212/NXI.0000000000200586

JCO Clin Cancer Inform. 2026 Apr;10(2):e2500172. doi: 10.1200/CCI-25-00172. Epub 2026 Apr 27.

ABSTRACT

PURPOSE: Curating high-quality clinical and genomic data sets from patients with cancer to predict hospital readmission using machine learning (ML) models.

METHODS: We extracted data from electronic health records for patients with cancer in the University of California, San Diego Health System, to curate clinicogenomic data sets for lung, breast, and colon cancers. We constructed ML models to predict the risk of hospital readmission 30, 60, and 90 days postdischarge. Standard ML models (logistic regression, random forest [RF], gradient boosting [GB], neural network) and multitask neural network models were developed to simultaneously predict all three readmission outcomes.

RESULTS: Our results revealed that rehospitalization is most frequent in colon cancer within 30 days. For the 30-day hospitalization prediction, GB achieved the highest area under the precision recall curve (PR-AUC) for lung (0.415) and breast (0.470) cancers and RF achieved the overall highest PR-AUC for colon cancer (0.621). Explainability analysis revealed that health care metrics (such as the number of previous admissions and average length of stay), risk scores composed of diagnosis codes, and treatments are significant features in predicting readmission within cancer types. It also identified EGFR mutations as a potential predictor of readmission in colon cancer.

CONCLUSION: The study highlights the potential of integrating clinical and genomic data for predicting adverse outcomes in patients with cancer. The standard ML approaches were able to successfully capture patterns in readmission and outperformed the more complex models. Limitations include the relatively small data set from a single institution. Ultimately, this study highlights the value of curating and maintaining clinicogenomic information at an institution level to streamline data set curation and model development.

PMID:42044461 | DOI:10.1200/CCI-25-00172

Turk Arch Pediatr. 2026 Mar 5;61(3):206-213. doi: 10.65717/TurkArchPediatr.2026.25004.

ABSTRACT

OBJECTIVE: To describe demographic, clinical, and laboratory characteristics of patients with juvenile localized scleroderma (JLS), determine the presence of extracutaneous involvement (ECI) and other comorbidities, and assess treatment response.

MATERIALS AND METHODS: Retrospective single-center cohort study of JLS patients followed between 2015 and 2025 who met Padua classification criteria and had ≥6 months of regular follow-up. Clinical, laboratory, and treatment data were systematically collected, and ECI was analyzed using comparative statistics.

RESULTS: Among 87 patients, 77% were female. Mean ages at symptom onset, diagnosis, and last visit were 7.1, 9.0, and 14.4 years, respectively, with a median diagnostic delay of 1.2 years. The most frequent subtype was linear scleroderma (36.7%), followed by circumscribed (31.0%), generalized (20.6%), mixed-type (6.8%), and pansclerotic morphea (4.6%). The lower extremities were the most commonly affected, accounting for 54 of 136 sites (39.7%). The ECI occurred in 47.1% of patients, mainly musculoskeletal, and was linked to generalized/pansclerotic subtypes, limb involvement, higher erythrocyte sedimentation rate, higher disease activity scores, and poorer response to conventional disease-modifying antirheumatic drugs (cDMARDs). Overall, 85 patients received at least 1 cDMARD, with 85.9% responding. Methotrexate regimens had high response rates; 14.1% were non-responsive to at least 2 cDMARDs, and 5.7% had active disease at last visit.

CONCLUSION: The JLS carries substantial cutaneous and extracutaneous morbidity, particularly in generalized and pansclerotic subtypes with limb involvement. These findings underscore the importance of early recognition, systematic assessment of ECI, and close longitudinal monitoring in specialized centers and support the need for prospective studies to refine risk stratification and optimize treatment strategies for refractory JLS.

PMID:42044443 | DOI:10.65717/TurkArchPediatr.2026.25004

Turk Arch Pediatr. 2025 Oct 3;61(2):170-172. doi: 10.5152/TurkArchPediatr.2025.25006.

NO ABSTRACT

PMID:42044435 | DOI:10.5152/TurkArchPediatr.2025.25006

Turk Arch Pediatr. 2025 Dec 29;61(2):152-161. doi: 10.5152/TurkArchPediatr.2025.25261.

ABSTRACT

OBJECTIVE: This study explores whether GSTM1, GSTT1, and TP53 rs1042522 polymorphisms, key regulators of detoxification and oxidative stress responses, influence obesity risk and related metabolic profiles in children.

MATERIALS AND METHODS: Blood samples from 60 obese children and 60 healthy controls were analyzed. GSTM1 and GSTT1 deletions were assessed via polymerase chain reaction melting curve analysis, and TP53 rs1042522 was genotyped by direct DNA sequencing. Deviations from Hardy-Weinberg expectations and genotype frequencies in controls were evaluated, and the association of genetic variants with obesity, clinical complications, and metabolic parameters was examined.

RESULTS: In obese children, GSTM1 and GSTT1 genotype frequencies deviated from Hardy-Weinberg expectations and differed from controls, whereas TP53 rs1042522 conformed to expected distributions yet was statistically underpowered. The GSTM1 null genotype increased obesity risk 3.28-fold (95% CI: 1.36-7.93, P < .05). The GSTT1 null genotype conferred a 4.76-fold higher risk (95% CI: 2.08-10.88, P < .001). TP53 rs1042522 showed no association (OR = 1.12, 95% CI: 0.44-2.87). The GSTM1 null carriers had elevated cholesterol, low-density lipoprotein (LDL), and gamma-glutamyl transferase, while TP53 Arg/Arg and Pro/Pro carriers exhibited higher LDL and alanine aminotransferase, respectively. No significant links were observed with insulin resistance or hepatic steatosis.

CONCLUSION: The GSTM1 and GSTT1 null genotypes are significant genetic risk factors for childhood obesity, likely through reduced detoxification capacity and subsequent oxidative stress-related metabolic disruption. These findings highlight the importance of considering detoxification pathways when assessing genetic predisposition to obesity in children.

PMID:42044432 | DOI:10.5152/TurkArchPediatr.2025.25261

Turk Arch Pediatr. 2025 Dec 22;61(2):139-146. doi: 10.5152/TurkArchPediatr.2025.25342.

ABSTRACT

OBJECTIVE: To describe oral health status and its relationship with glycemic control in children with type 1 diabetes mellitus (T1DM) using standardized indices.

MATERIALS AND METHODS: A comparative cross-sectional study was conducted with 30 children aged 6-14 years with T1DM and 30 healthy controls. Oral examinations recorded DMFS/dfs (Decayed, Missing, Filled Surfaces), PUFA/pufa (Pulpal involvement, Ulceration, Fistula, Abscess), Plaque Index (PI), Gingival Index (GI), and Simplified Oral Hygiene Index (OHI-S). Glycated hemoglobin (HbA1c) levels were categorized as ≤7% or >7%. Non-parametric tests, Spearman’s correlation analyses were performed. The level of statistical significance was set at P < .05.

RESULTS: The T1DM group had significantly lower DMFS/dfs and PUFA/pufa scores than controls (P < .001 and P = .004, respectively), and no significant differences were found in PI, GI, and OHI-S values. In the T1DM group, correlation analyses between HbA1c levels and oral health indices (DMFS/dfs, PUFA/pufa, PI, GI, and OHI-S) revealed no statistically significant associations (P > .05). No statistically significant correlations were found between HbA1c and any of the oral health indices (P > .05).

CONCLUSION: Children with T1DM showed lower caries experience, possibly due to regular medical follow-up, nutritional counseling, and improved oral hygiene. Routine oral health monitoring should be integrated into pediatric diabetes care.

PMID:42044430 | DOI:10.5152/TurkArchPediatr.2025.25342

Am J Manag Care. 2026 Apr;32(4):230-236. doi: 10.37765/ajmc.2026.89919.

ABSTRACT

OBJECTIVES: Significant variation in coding intensity exists across patients and institutions, with important implications for reimbursement and risk-adjusted quality metrics. The degree to which coding intensity for hospitalized patients may be a function of primary payer is not well understood. We sought to measure differences in coding intensity between commercially insured and Medicare, Medicaid and Medicare, and self-pay and Medicare inpatient encounters for the same cohort of patients.

STUDY DESIGN: Regression discontinuity, leveraging the fact that patients typically enroll in Medicare at age 65 years.

METHODS: A multivariable linear regression was estimated to evaluate the relationship between the outcomes of interest and primary payer, controlling for age, age by payer interaction term, and inpatient visit count. Our analysis included Florida inpatients with at least 1 commercially insured, Medicaid, or self-pay inpatient hospitalization before age 65 years and at least 1 inpatient Medicare hospitalization at 65 years and older, with patients serving as their own controls. The outcome of interest was the number of hospital discharge diagnoses. Outcomes were measured separately for each group (commercial insurance to Medicare, Medicaid to Medicare, and self-pay to Medicare).

RESULTS: Medicare inpatient encounters were associated with 0.8 (95% CI, 0.4-1.2), 1.0 (95% CI, 0.5-1.5), and 2.0 (95% CI, 1.2-2.8) more discharge diagnoses than commercially insured, Medicaid, and self-pay inpatient encounters, respectively.

CONCLUSIONS: Our findings suggest that Medicare inpatient encounters are associated with higher coding intensity than commercially insured, Medicaid, or self-pay inpatient encounters for those same individuals prior to age 65 years. This has important implications for the impact that insurance status may have on risk-adjusted quality measures.

PMID:42044421 | DOI:10.37765/ajmc.2026.89919

Am J Manag Care. 2026 Apr;32(4):212-217. doi: 10.37765/ajmc.2026.89917.

ABSTRACT

OBJECTIVES: This study aimed to quantify the economic impact of missed billing opportunities for tobacco cessation counseling at an academic medical center to identify what may be a systematic defect in the administration of tobacco cessation services and to highlight opportunities to improve patient outcomes and revenue. Patient surveys show that evidence-based tobacco cessation interventions are provided at low rates despite guidelines supporting the use of these services at every eligible encounter.

STUDY DESIGN: Retrospective cohort study.

METHODS: The study analyzed deidentified patient health data from electronic health records at an academic medical center, focusing on primary care encounters from January 1, 2020, to December 31, 2023, involving patients 18 years and older with a history of current tobacco use. Billing data for tobacco cessation counseling ( Current Procedural Terminology codes 99406 or 99407) were examined to estimate revenue loss from unbilled eligible encounters.

RESULTS: Of 1,068,875 primary care visits, 16.8% (179,304) involved tobacco users. However, only 1.0% of these encounters were billed for cessation services, representing an estimated potential revenue loss of $3.2 million over 4 years.

CONCLUSIONS: These findings identify a significant discrepancy between the billing of tobacco cessation services and the opportunities to do so. Better provision and billing of tobacco cessation counseling can improve patient health outcomes, advance value-based care goals, and enhance financial sustainability.

PMID:42044419 | DOI:10.37765/ajmc.2026.89917

Am J Manag Care. 2026 Apr 1;32(4):e133-e137. doi: 10.37765/ajmc.2026.89926.

ABSTRACT

OBJECTIVE: To examine trends in Dual-Eligible Special Needs Plan (D-SNP) offerings and enrollment before and after permanent authorization in 2018.

STUDY DESIGN: Retrospective descriptive analysis.

METHODS: We analyzed publicly available monthly SNP Comprehensive Reports, comparing preauthorization (2010-2018) and postauthorization (2019-2025) periods. We calculated annual totals of D-SNPs and enrollees along with mean annual growth rates for both periods.

RESULTS: The mean annual growth rate of unique D-SNP offerings increased from 10.0% preauthorization to 16.2% post authorization. Enrollment of dually eligible beneficiaries increased from a mean annual growth rate of 0.3% preauthorization to 12.8% post authorization. D-SNP enrollment has steadily increased, more than doubling over the past 5 years. By January 2025, there were 986 D-SNPs with 6,030,665 dual enrollees, representing approximately 44% of total dual enrollees.

CONCLUSIONS: The significant acceleration in both D-SNP offerings and enrollment reflects notable changes in the D-SNP market following permanent authorization. As states transitioned plans into D-SNPs through 2025, these specialized Medicare Advantage plans are positioned to play an increasingly vital role in addressing the complex needs of Medicare-Medicaid dual enrollees.

PMID:42044401 | DOI:10.37765/ajmc.2026.89926