Category: Statistics

Spine Deform. 2026 Apr 1. doi: 10.1007/s43390-026-01351-9. Online ahead of print.

ABSTRACT

BACKGROUND: Early (within 30 days) postoperative complications following pediatric scoliosis surgery continue to be of clinical importance; however, reported risk factors demonstrate inconsistency across various studies. We conducted a systematic review and meta-analysis to quantify patient- and procedure-related predictors of 30-day postoperative outcomes complications.

METHODS: A systematic search of PubMed, Embase, Scopus, and Web of Science identified observational studies reporting risk factors for 30-day postoperative complications following scoliosis surgery. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models. Heterogeneity was assessed with the I² statistic.

RESULTS: Ten observational studies comprising 113,082 patients met the inclusion criteria; nine reported adjusted estimates. Osteotomy was significantly associated with increased risk (OR = 1.40; 95% CI 1.25-1.55; I² = 0%), as was pelvic fixation (OR = 1.65; 95% CI 1.07-2.55; I² = 0%), with no observed heterogeneity across studies. In contrast, multiple medical and patient-related risk factors including cardiopulmonary, hematologic and metabolic comorbidities were not significantly associated with postoperative morbidity, although point estimates suggested a directionally elevated risk and were characterized by wide confidence intervals. Male sex and neuromuscular disorders were also not associated with a significant increase in risk.

CONCLUSIONS: Among the evaluated factors, complex surgical techniques involving osteotomy and pelvic fixation were the most consistent predictors of early postoperative complications within the contemporary literature. Preoperative patient comorbidities showed variable, generally non-significant associations, underscoring the need for standardized risk definitions and prospective multicenter studies to better predict outcomes in the early postoperative period.

PMID:41920499 | DOI:10.1007/s43390-026-01351-9

Spine Deform. 2026 Apr 1. doi: 10.1007/s43390-026-01341-x. Online ahead of print.

ABSTRACT

PURPOSE: Reduced trunk muscle quantity or quality, commonly assessed using imaging-based metrics, has been associated with adverse outcomes in spine surgery. However, evidence specific to adult spinal deformity (ASD) surgery remains heterogeneous and methodologically limited. This systematic review aimed to synthesize existing muscle metrics and surgical outcomes in patients undergoing ASD surgery.

METHODS: A systematic search of PubMed and EMBASE was performed to identify studies evaluating imaging-based muscle quantity or quality in adult patients (≥ 18 years) undergoing thoracolumbar corrective surgery. Eligible studies employed radiographic measures of muscle status. Outcomes of interest were postoperative complications, reoperation, readmission, length of stay (LOS), and patient-reported outcome measures (PROMs). Data were extracted based on study design, patient demographics, surgical characteristics, and follow-up. Meta-analysis was conducted using Review Manager 5.4, with odds ratios (ORs) for dichotomous outcomes and mean differences for continuous outcomes.

RESULTS: Fifteen studies met the eligibility criteria in this review. Meta-analysis demonstrated substantial heterogeneity across studies, particularly for proximal junctional kyphosis (PJK) and length of stay (LOS), limiting the interpretability of pooled estimates. No statistically significant differences were observed for reoperation, readmission, wound complications, or patient-reported outcomes. A modest increase in LOS was observed in patients with lower muscle metrics, although this finding was highly heterogeneous and may reflect residual confounding.

CONCLUSION: Current evidence examining imaging-based muscle metrics in ASD surgery is characterized by substantial heterogeneity and predominantly retrospective study designs. While reduced muscle quantity or quality may be associated with postoperative outcomes, existing data do not support definitive conclusions or causal inferences. These findings highlight the need for standardized muscle assessment methods and prospective studies incorporating validated sarcopenia criteria to better clarify the clinical relevance of muscle health in ASD surgery.

PMID:41920498 | DOI:10.1007/s43390-026-01341-x

J Comput Neurosci. 2026 Apr 1. doi: 10.1007/s10827-026-00927-8. Online ahead of print.

NO ABSTRACT

PMID:41920486 | DOI:10.1007/s10827-026-00927-8

Sports Med Open. 2026 Apr 1;12(1):38. doi: 10.1186/s40798-026-01012-1.

ABSTRACT

BACKGROUND: Drop-set training (DROP) is a time-efficient resistance training method for hypertrophy and strength. Its long-term adaptations remain debated, particularly in relation to its acute physiological responses such as metabolic stress and fatigue. This meta-analysis examines both acute and chronic effects of DROP to provide a comprehensive evaluation of its efficacy.

METHODS: A systematic search was conducted across PubMed, Web of Science, SCOPUS, and SPORTDiscus up to January 20, 2026, following PRISMA guidelines. Studies comparing DROP and traditional resistance training (TRAD) on hypertrophy, strength, metabolic stress, fatigue, and perceived exertion were included. Data extraction and risk of bias assessment were performed using the PEDro scale. Meta-analyses were conducted using a random-effects model.

RESULTS: The meta-analysis, based on 12 studies (n = 274 participants), revealed significant increases in ratings of perceived exertion (SMD = 1.62, 95% CI [0.33 to 2.91]) and lactate levels (SMD = 0.67, 95% CI [0.20 to 1.14]) for DROP. A trend in favor of DROP was observed for heart rate, although this did not reach statistical significance (SMD = 0.45, 95% CI [- 0.12 to 1.02]). No significant differences were observed between DROP and TRAD for chronic hypertrophy (SMD = 0.04, 95% CI [- 0.29 to 0.36]), strength (SMD = – 0.04, 95% CI [- 0.34 to 0.26]), or muscle endurance adaptations (SMD = 0.53, 95% CI [- 0.20 to 1.26]).

CONCLUSION: DROP offers a time-efficient alternative to TRAD, yielding comparable long-term gains in muscle hypertrophy and strength. Based on current evidence, DROP acutely induces significantly higher perceived exertion and lactate responses, whereas heart rate shows no consistent differences between methods. Practitioners should consider these elevated perceptual demands and potential recovery needs when integrating DROP into long-term training periodization.

PMID:41920484 | DOI:10.1186/s40798-026-01012-1

Dig Dis Sci. 2026 Apr 1. doi: 10.1007/s10620-026-09880-z. Online ahead of print.

ABSTRACT

PURPOSE: Current biomarkers for inflammatory bowel disease (IBD) often rely on invasive procedures and lack broad availability, limiting their utility in clinical practice. This study aims to investigate the association between handgrip strength (HGS) and crucial treatment endpoints in IBD, such as disease activity, endoscopic severity and nutritional status in patients with IBD.

METHODS: This double-center study enrolled patients with Crohn’s disease (CD) and ulcerative colitis (UC). The disease activity, endoscopic severity, health-related quality of life (HRQoL) and presence of depressive disorder were evaluated using validated scores. HGS was measured through a calibrated isokinetic dynamometer and the nutritional status of the participants was assessed. A statistical software was used to analyze the data.

RESULTS: A total of 144 patients were included in this study. A statistically significant correlation was found between HGS and disease activity (r_s = – 0.182, p = 0.035), HRQoL (r = 0.330, p < 0.001), depression (r = – 0.203, p = 0.03) but not endoscopic severity. In patients with CD, the correlations were more pronounced and HGS also correlated with the number of extraintestinal manifestations (r_s = – 0.218, p < 0.001). Receiver operating characteristics analysis indicated an acceptable diagnostic accuracy of HGS for malnutrition diagnosis (AUC: 0.733, 95% CI 0.643-0.824, p < 0.001).

CONCLUSION: HGS correlates with crucial endpoints in IBD, with an acceptable accuracy for malnutrition diagnosis. These findings support the value of HGS as an indicator of overall health and nutritional status in routine clinical practice. While normalization of HGS values could be considered a meaningful goal, further prospective studies are necessary to validate its prognostic role in IBD.

PMID:41920463 | DOI:10.1007/s10620-026-09880-z

Doc Ophthalmol. 2026 Apr 1. doi: 10.1007/s10633-026-10097-8. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate variability observed in pupil light response with the EyeKinetix pupillometer in healthy non-dark-adapted individuals.

METHODS: We performed objective pupillometry in 440 non-dark-adapted patients with 20/20 corrected visual acuity, normal visual fields, and no ophthalmic disease who presented for routine exam. EyeKinetix was performed as part of the routine exam screening protocol. Metrics reviewed were RAPDx amplitude scores, latency scores, and quantitative metrics of pupil dynamics measured by the EyeKinetix. Sequential retesting was analyzed for repeatability. Statistical analyses included normality testing, confidence intervals, t-tests, and Intraclass Correlation Coefficient (ICC) calculations for repeated measures.

RESULTS: Amplitude and latency scores exhibited significant variability. The mean amplitude score was 0.0249 ± 0.247, with 5% of patients > = 2 standard deviations [> 0.51 log unit (LU)]. Latency scores showed low reliability (ICC = 0.165), whereas amplitude, constriction velocity, and release velocity demonstrated moderate to high reliability (ICC = 0.472-0.966).

CONCLUSION: Objective pupillometry without dark adaptation using the EyeKinetix device displays substantial variability and identifies a number of relative afferent pupil defects (RAPDs) in this cohort of healthy patients. These findings indicate that, in healthy populations, reliance on RAPDx scores alone could generate false positives. Establishing robust normative cutoffs and validating them in disease cohorts will be necessary before reliable use as a screener. Further optimization may be necessary for more clinical confidence in a primary care setting.

PMID:41920452 | DOI:10.1007/s10633-026-10097-8

Qual Life Res. 2026 Apr 1;35(5):116. doi: 10.1007/s11136-026-04233-9.

NO ABSTRACT

PMID:41920451 | DOI:10.1007/s11136-026-04233-9

Med Health Care Philos. 2026 Apr 1. doi: 10.1007/s11019-026-10346-2. Online ahead of print.

ABSTRACT

Artificial intelligence is increasingly integrated into medical decision-making, often framed as a supportive tool that enhances accuracy while leaving final judgment to clinicians. This paper argues that such framing obscures a deeper structural shift: medical action may proceed without any judgment ever occurring. AI systems do not judge; they generate outputs through statistical transduction. Clinicians, under institutional and legal pressures, may relay these outputs without regenerating them as their own reasons. When neither AI nor clinician generates judgment, decisions are enacted without a judging subject. While judgment without a judging subject may be sustainable elsewhere, medicine renders this absence unsustainable. Medical practice is characterized by irreversibility, case-specificity, meaning-demand, and relational accountability-features that presuppose judgment as a human act. Even clinically correct outcomes do not guarantee that patients will recognize a decision as right for them. When judgment disappears, informed consent persists only as a procedural ritual, simulating understanding without grounding it. To make this absence explicit, the paper introduces Metaqualia Theory (MTQ), distinguishing patient experience (Q), technical transduction (T), and judgment as meaning-generating endorsement (M). This leads to a prior ethical question: Is there an M here? This question precedes concerns about explainability and helps clarify the conditions under which consent and responsibility remain meaningful. The analysis suggests that when AI outputs are not regenerated as human judgment, their role in medical practice raises structural limits that cannot be addressed by transparency alone.

PMID:41920434 | DOI:10.1007/s11019-026-10346-2

Ther Innov Regul Sci. 2026 Apr 1. doi: 10.1007/s43441-026-00962-8. Online ahead of print.

NO ABSTRACT

PMID:41920433 | DOI:10.1007/s43441-026-00962-8

Qual Life Res. 2026 Apr 1;35(5):126. doi: 10.1007/s11136-026-04234-8.

NO ABSTRACT

PMID:41920430 | DOI:10.1007/s11136-026-04234-8