Category: Statistics

Otolaryngol Head Neck Surg. 2024 Nov 26. doi: 10.1002/ohn.1063. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of 2 drug combinations on tinnitus severity and associated stress, depression, sleep, and anxiety.

STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial conducted between 2019 and 2023 for an 8-week duration.

SETTING: Single institution tertiary care center.

METHODS: The study recruited adult patients with moderate to severe tinnitus for 6 months or more. In total, 81 patients were assessed for eligibility, 78 were enrolled and randomized, and 67 were included in the per-protocol analysis. Patients were randomized into 3 groups (1:1:1). Group NT received nortriptyline-topiramate, group VP received verapamil-paroxetine, and group P received placebo.

RESULTS: A total of 19 patients in group NT, 22 in group VP, and 26 patients in group P were included in the per-protocol analysis. In group NT, the Tinnitus Functional Index (TFI) score decreased from 58.4 ± 13.9 (baseline) to 46.3 ± 17.5 (end-of-trial) (P < .001). Similarly, in group VP, the TFI score decreased from 54.6 ± 17.5 to 42.2 ± 16.1 (P = .004). However, group P did not demonstrate any significant decrease in the TFI score from 51.2 ± 18.6 to 45.2 ± 20.1 (P = .086). The between-arm analysis did not yield any statistical significance decrease in the TFI score (analysis of variance, P = .265).

CONCLUSION: Both combinations of drugs were promising in improving tinnitus severity. However, larger-scale trials with longer follow-up periods are warranted to validate our findings between groups.

PMID:39588680 | DOI:10.1002/ohn.1063

Otolaryngol Head Neck Surg. 2024 Nov 26. doi: 10.1002/ohn.1065. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to assess the efficacy and complication rates of interarytenoid injection augmentation (IAIA) for the treatment of dysphagia in patients 1 year of age and under and to determine if concurrent feeding therapy (FT) affects outcome.

STUDY DESIGN: Retrospective case series.

SETTING: Tertiary pediatric hospital.

METHODS: Retrospective review of patients 13 months of age and younger with dysphagia treated by IAIA over a 4-year period. The efficacy of IAIA was determined by comparing perioperative videofluoroscopic swallow studies (VFSS) and Dysphagia Outcome and Severity Scale (DOSS) scores. Complication rates and utilization of concomitant FT were determined by evaluating postoperative admission and follow-up records.

RESULTS: Sixty-five patients met inclusion criteria (median age 8 months, interquartile range [IQR]: 7-11). Sixty-seven percent of patients improved on postoperative VFSS scores (median improvement in aspiration of 2 thickness levels, IQR 0-3, P < .0001), and 56% improved in DOSS scores (median increase of 1, IQR: 0-1.5, P < .0001). Ninety-two percent of patients were discharged home on the day of surgery. The 30-day relevant readmission rate was 5%. No patients had intraoperative complications or severe complications at follow-up. No statistical difference in aspiration or DOSS was noted in the concomitant FT cohort due to a lack of sample size.

CONCLUSION: This study demonstrates that IAIA in children under 13 months old shows comparable rates of success and complications to older patients reported in the literature. No patients had long-term complications and most were discharged home on the day of surgery. More studies are needed to determine the effect of concomitant FT on IAIA.

PMID:39588667 | DOI:10.1002/ohn.1065

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Nov 26. doi: 10.3881/j.issn.1000-503X.16068. Online ahead of print.

ABSTRACT

Objective To explore the application value of multi-model adaptive statistical iterative reconstruction-Veo (ASiR-V) in ultra-low dose chest CT examination of children in the plateau area. Methods The children who underwent chest CT examination in Xizang Autonomous Region People’s Hospital were enrolled in this study and assigned into two groups according to the scanning conditions.Group A underwent scanning at a tube voltage of 100 kV and ASiR-V 50% reconstruction,and group B underwent scanning at a tube voltage of 80 kV and ASiR-V 0 (Group B1) and ASiR-V 50% (Group B2) reconstruction.The image quality of each group was evaluated objectively and subjectively.The radiation dose and image quality were compared between groups. Results Groups A and B showed the volume CT dose indexes of (2.33±0.62) mGy and (0.86±0.01) mGy and the dose length products of (65.01±25.12) mGy·cm and (23.55±3.38) mGy·cm,respectively,which presented differences between groups (both P<0.001).The image noise in the bilateral upper and middle lung areas in group B2 was lower than that in group B1 but higher than that in group A (all P<0.001).There was no significant difference in image quality score of the lung window among groups (all P>0.05).Groups A,B1,and B2 had no significant differences in ascending aorta (P=0.538) or liver CT value (P=0.175) in the mediastinal window.The signal-to-noise ratios and contrast-to-noise ratios of ascending aorta and liver in group B2 were higher than those in group B1 (all P<0.001) and lower than those in group A (all P<0.05).The image quality score of the mediastinal window followed a descending order of group A>group B2>group B1 (all P<0.001). Conclusion ASiR-V combined with low tube voltage can effectively reduce the radiation dose and guarantee the image quality of chest CT of children in the plateau area.

PMID:39588659 | DOI:10.3881/j.issn.1000-503X.16068

G Ital Cardiol (Rome). 2024 Dec;25(12):875-884. doi: 10.1714/4372.43699.

ABSTRACT

In heart failure management, hospitalization is the main cause of medical costs and is associated with an increased risk of adverse events. This review reports evidence on hospitalization as the ideal setting for disease-modifying therapy implementation, with a particular focus on gliflozins in patients with stabilized acute heart failure. The authors analyze data from the EMPULSE trial, the largest clinical study that evaluated a gliflozin in acute heart failure in patients with both reduced and preserved systolic function. The win ratio approach for statistical analysis is also discussed. The EMPULSE trial showed that empagliflozin improved clinical outcomes in patients hospitalized for acute heart failure. Subsequent analyses have also highlighted favorable effects in terms of decongestion. Since clinical benefits due to gliflozin use occur early (after a few weeks) and in order to increase heart failure polypharmacy tolerability, the initiation of gliflozin treatment should be a priority over other treatment titration. Even in complex clinical settings, as in the elderly and in patients with kidney disease, evidence supports safety and good tolerability of gliflozins, which may facilitate initiation/titration of other treatments.

PMID:39588624 | DOI:10.1714/4372.43699

Evolution. 2024 Nov 26:qpae170. doi: 10.1093/evolut/qpae170. Online ahead of print.

ABSTRACT

Reciprocal selection between extended and somatic phenotypes is an active area of investigation. Recent research on the influence of web building on somatic evolution in spiders has produced conflicting results, with some finding no effect of web use on somatic evolution and others showing significant effects. These studies differed in focus, with the former surveying general anatomical traits and the latter concentrating on somatic systems with significant functional roles in prey capture. Here we propose and test the hypothesis that prey immobilization by webs is broadly synergistic with cheliceral biting force and that web builders have lower cheliceral forces compared to free hunters. Our analysis focused on the intercheliceral (IC) sclerite and muscles, a newly characterized system that is synapomorphic and ubiquitously distributed in spiders. Using µCT scans, we quantify IC sclerite shape and model IC muscle function. Statistical analyses show that inferred size-corrected isometric muscle force is lower in web-builders than in free-hunters. No such association was found for IC sclerite shape. In the investigation of reciprocal selective effects between extended and somatic phenotypes, our results highlight the importance that these traits be functionally linked and adaptive.

PMID:39588588 | DOI:10.1093/evolut/qpae170

Stat Methods Med Res. 2024 Nov 26:9622802241298706. doi: 10.1177/09622802241298706. Online ahead of print.

ABSTRACT

The difference between two proportions is the most important parameter in comparing two treatments based on independent two binomials and has garnered widespread application across various fields, particularly in clinical trials. There exists significant interest in devising optimal confidence intervals for the difference. Approximate intervals relying on asymptotic normality may lack reliability, thus calling for enhancements in exact confidence interval construction to bolster reliability and precision. In this paper, we present a novel approach that leverages the most probable test statistic and employs the $h$-function method to construct an optimal exact interval for the difference. We juxtapose the proposed interval against other exact intervals established through methodologies such as the Agresti-Min exact unconditional method, the Wang method, the fiducial method, and the hybrid score method. Our comparative analysis, employing the infimum coverage probability and total interval length as evaluation metrics, underscores the uniformly superior performance of the proposed interval. Additionally, we elucidate the application of these exact intervals using two real datasets.

PMID:39588571 | DOI:10.1177/09622802241298706

Front Genet. 2024 Nov 11;15:1362139. doi: 10.3389/fgene.2024.1362139. eCollection 2024.

ABSTRACT

BACKGROUND: Liver disease is among the top ten causes of death globally. With studies suggesting a link between gut microbiota (GM) and liver disease.

METHOD: We selected summary statistics data from the largest available whole-genome association study (n = 13,266) of GM by the MiBioGen consortium as the exposure, and obtained liver disease-related data from IEU Open GWAS and The NHGRI-EBI GWAS Catalog. A two-sample Mendelian Randomization (MR) analysis employing various methods, to establish the causal relationship between GM and five liver diseases. Meanwhile, single-cell RNA sequencing data were used to examine Prevotella-related genes expression under healthy and disease liver.

RESULTS: The IVW analysis indicate a causal relationship between GM and liver diseases, with Prevotella exhibiting a protective effect in all five liver diseases: Alcoholic liver disease (OR:0.81,95% confidence interval:0.66-1.00,P _IVW = 0.0494); Cirrhosis (OR: 0.85,95% confidence interval: 0.73-0.99,P _IVW = 0.0397); Hepatic failure, not elsewhere classified (OR:0.60,95% confidence interval:0.37-0.95,P _IVW = 0.0305); Benign neoplasm:Liver (OR:0.39,95% confidence interval:0.2-0.75,P _IVW = 0.0046); Malignant neoplasm of liver, primary (OR:0.41, 95% confidence interval:0.18-0.93,P _IVW = 0.0334). The single-cell results suggest differential expression of Prevotella-related genes between liver disease patients and healthy individuals.

CONCLUSION: Our MR results show a causal relationship between the GM and liver disease. Prevotella displays a notable protective effect. This finding may enhance the precision of GM-based therapies and offer new insights for clinical research.

PMID:39588518 | PMC:PMC11586359 | DOI:10.3389/fgene.2024.1362139

Campbell Syst Rev. 2024 Nov 25;20(4):e70006. doi: 10.1002/cl2.70006. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Health guideline developers engage with interested people and groups to ensure that guidelines and their recommendations are relevant and useful to those who will be affected by them. These ‘interest-holders’ include patients, payers/purchasers of health services, payers of health research, peer review editors, product makers, programme managers, policymakers, providers, principal investigators, and the public. The Guidelines International Network (GIN) and McMaster University Guideline Development Checklist describes 146 steps of the guideline process organized into 18 topics. While one topic focuses on engagement, it does not describe how to engage with interest-holders. In addition, interest-holder input could be sought throughout the guideline development process. This scoping review is part of a series of four related reviews. The three other reviews address barriers and facilitators to engagement in guideline development, managing conflicts of interest in guideline development, and assessing the impact of interest-holder engagement on guideline development. The four reviews will inform the development of guidance for multi-interest-holder engagement in guideline development; the GIN-McMaster Guideline Development Checklist Extension for Engagement.

OBJECTIVES: The objective of this scoping review is to identify, describe, and summarise existing guidance and methods for multi-interest-holder engagement throughout the health guideline development process.

SEARCH METHODS: We conducted one comprehensive search for studies of engagement in guidelines to meet the inclusion criteria of one or more of the four systematic reviews in this series. We searched MEDLINE (OVID), CINAHL (EBSCO), EMBASE (OVID), PsycInfo (OVID) and SCOPUS databases up to September 2022. We did not include limits for date, study design, or language. We searched websites of agencies and organizations that engage interest-holder groups, such as the Agency for Healthcare Research and Quality (AHRQ), CIHR Strategy for Patient-Oriented Research (SPOR), National Institute for Health and Care Research (NIHR) Be Part of Research, Guidelines International Network (G-I-N), the National Institute for Health and Care Excellence, and the PatientCentred Outcomes Research Institute (PCORI). We handsearched the websites of guideline producing agencies. We solicited additional grey literature from the members of the MuSE Consortium.

SELECTION CRITERIA: Studies were included in this review if they reported on engagement of any of our identified groups, patients, payers/funders of research, payers/purchasers of health services, policymakers, programme managers, providers, principal investigators/researchers, peer review editors, product makers in the development of a health guideline. Titles and abstracts of identified citations were screened independently, in duplicate. The full text of potentially relevant papers were screened for eligibility into one or more of the four reviews in the series. Screening was done independently, by two reviewers. The team held weekly meetings with all reviewers involved in screening to discuss and resolve conflicts.

DATA COLLECTION AND ANALYSIS: Two reviewers extracted relevant data into a pilot-tested data extraction form using Excel. We used the GIN-McMaster guideline development checklist as a framework for extracting the available guidance for each of our identified interest-holder groups throughout the development process. We presented descriptive statistics of the number of papers reporting guidance for each groups across the steps of the guideline process. We synthesized the relevant text using a qualitative meta-summary approach.

MAIN RESULTS: We included 16 papers (from 17 reports). These papers were from Australia, Denmark, the Netherlands, the UK, and the USA, and eight papers were international (countries not specified). The papers provided guidance for at least one of our interest-holder groups for at least one stage of guideline development. We mapped this guidance to the GIN-McMaster Guideline Development Checklist to identify the available guidance for each of our interest-holder groups across all stages of the guideline development process. Guidance was available for patient engagement in 15 of the 16 papers. At least two papers provided guidance for each of the 18 topics of the GIN-McMaster Guideline Development Checklist. For healthcare providers, 9 papers provided guidance for their engagement across 10 of the 18 guideline development topics. Guidance for engaging with the public was provided for 14 of the 18 topics and reported in 4 of our included papers. For payers/purchasers of health services, policymakers, product makers, programme managers, and principal investigators, 2-3 papers provided guidance for these groups across 4-7 topics of the GIN-McMaster checklist. We did not identify any specific guidance for payers of health research or for editors of peer-reviewed journals.

AUTHORS’ CONCLUSIONS: Guidance for interst-holder engagement in guidelines is available but has focused primarily on patients. We will utilize the guidance identified in this scoping review to inform the GIN-McMaster Guideline Development Checklist Extension for engagement. Combined with the information obtained from the other systematic reviews in this series, we will address the gaps in guidance for the other identified interest-holder groups.

PMID:39588485 | PMC:PMC11586780 | DOI:10.1002/cl2.70006

Eur Oral Res. 2024 Sep 5;58(3):133-138. doi: 10.26650/eor.20231302012.

ABSTRACT

PURPOSE: The objective of this study was to assess the impact of preheating on the microhardness and flexural strength of bulk-fill resin composites.

MATERIALS AND METHODS: In this in vitro study, forty-two specimens were prepared of each composite, X-tra fil and Opus Bulk Fill, resulting in 84 disk-shaped specimens for microhardness testing and 84 bar-shaped specimens for flexural strength analysis. The specimens were divided into four groups as follows: Group 1: X-tra fil composite with preheating (at 68°C for 15 minutes), group 2: X-tra fil composite without preheating (at room temperature), group 3: Opus Bulk Fill composite with the same preheating method, group 4: Opus Bulk Fill composite without preheating. Microhardness was assessed using the Vickers test with a diamond indenter, and flexural strength was measured using a 3-point flexural test. Statistical comparisons were performed on the calculated results.

RESULTS: In the preheated groups, both X-tra fil and Opus Bulk Fill composites exhibited significantly higher mean flexural strength compared to the non-preheated groups (p<0.001). However, there was no significant difference in the mean microhardness between the two groups for either type of composite (p=0.719). Additionally, the mean flexural strength and microhardness of X-tra fil composite, in both preheated and non-preheated conditions, were higher than those of the Opus Bulk Fill composite (p<0.001).

CONCLUSION: Preheating bulk-fill composites to 68°C has no detrimental effect on their microhardness and increases the flexural strength of these materials. Furthermore, the degree of microhardness and flexural strength in bulk-fill composites varies between brands and is influenced by their chemical compositions.

PMID:39588475 | PMC:PMC11586042 | DOI:10.26650/eor.20231302012

Eur Oral Res. 2024 Sep 5;58(3):108-119. doi: 10.26650/eor.20241312721.

ABSTRACT

PURPOSE: Valid and reliable scales which have been developed for assessing individuals’ attitudes toward oral health and are based on multiple theoretical views are limited in number in the literature. Hence, there is a need for more scale development studies for further evaluation of the psychometric properties of the oral and dental health attitudes of students. The aim of this study was to develop a scale for measuring college undergraduates’ attitudes toward oral and dental health.

MATERIALS AND METHODS: A sample of 770 college undergraduates (241 male, 529 female) enrolled in various academic programs of three universities in Turkey participated in this study. We collected data from two separate samples. The data obtained from sample 1 (n = 470) were used for Exploratory Factor Analysis (EFA) and the data from sample 2 (n = 300) were utilized for undertaking Confirmatory Factor Analysis (CFA). To test the construct validity, EFA, CFA, convergent validity, and measurement invariance were used, respectively.

RESULTS: In the first stage, EFA was conducted on a 48-item scale. EFA results showed that the final version of the Oral Health Attitude Scale (OHA-S) had a six-factor structure: sensitivity, importance, avoidance of harmful elements, tendency towards products and activities, awareness, and social impact. To confirm this structure, CFA was used. CFA results showed good model fit indexes. The final version of the scale consisted of 41 items with six factors. Moreover, Cronbach’s alpha and Spearman-Brown Split-Half coefficients showed a good level of reliability. Moreover, t-scores were statistically significant for 27% of the lower and upper groups.

CONCLUSION: The developed scale was found to be a potential tool for measuring and evaluating university students’ attitudes toward oral and dental health.

PMID:39588474 | PMC:PMC11586041 | DOI:10.26650/eor.20241312721