Category: Statistics

Prev Chronic Dis. 2024 Nov 14;21:E90. doi: 10.5888/pcd21.240229.

ABSTRACT

We analyzed 2021 and 2022 National Health Interview Survey data to describe the prevalence of past 12-month telemedicine use among US adults with no prediabetes or diabetes diagnosis, diagnosed prediabetes, and diagnosed diabetes. In 2021 and 2022, telemedicine use prevalence was 34.1% and 28.2% among adults without diagnosed diabetes or prediabetes, 47.6% and 37.6% among adults with prediabetes, and 52.8% and 39.4% among adults with diabetes, respectively. Differences in telemedicine use were identified by region, urbanicity, insurance status, and education among adults with prediabetes or diabetes. Findings suggest that telemedicine use can be improved among select populations with prediabetes or diabetes.

PMID:39541587 | DOI:10.5888/pcd21.240229

JMIR Public Health Surveill. 2024 Nov 14;10:e57168. doi: 10.2196/57168.

ABSTRACT

BACKGROUND: Cataract is a leading cause of vision impairment. Obesity-related risk factors, including insulin resistance, increase the risk of cataract. The fatty liver index (FLI) is a biomarker for noninvasive fat layer prediction of nonalcoholic fatty liver disease. The FLI has been used to evaluate the metabolic contribution in other organs besides the eye. However, no study exists on the FLI and eye disease.

OBJECTIVE: This retrospective cohort study for the association between the FLI and incidence of cataract surgery in individuals older than 50 years was designed to show that a higher FLI is associated with an increased incidence of cataract surgery in individuals aged 50 years and older.

METHODS: This study was retrospectively designed based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) cohort (median follow-up of 9.8 years). Participants were assigned to 1 of 3 groups based on the FLI: low (FLI<30), intermediate (FLI 30-59), or high (FLI≥60). Kaplan-Meier survival analysis was performed on the cumulative incidence of all-cataract and senile-cataract surgery. Multivariable Cox proportional hazards regression models were used to study the association between the FLI group and cataract surgery after adjusting for potential confounders.

RESULTS: Of the 138,347 included participants, the incidence of cataract surgery was 12.49% (4779/38,274), 13.95% (6680/47,875), and 14.16% (7496/52,930) in the low, intermediate, and high FLI groups, respectively. After adjusting for all confounding factors, hazard ratios (HRs; 95% CIs) in the high FLI group for all-cataract surgery were 1.111 (1.028-1.199) and 1.184 (1.101-1.274) in men and women, respectively, when compared with the low FLI group. HRs (95% CIs) in the high FLI group for senile-cataract surgery were 1.106 (1.022-1.197) and 1.147 (1.065-1.237) in men and women, respectively, when compared with the low FLI group. The project was conducted between August 2023 and February 2024 without donations from external bodies.

CONCLUSIONS: Individuals with a higher FLI had a higher risk of all-cataract surgery. This association was maintained even after limiting the analyses to senile-cataract surgery.

PMID:39541585 | DOI:10.2196/57168

JMIR Form Res. 2024 Nov 14;8:e57244. doi: 10.2196/57244.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) are increasingly using the internet to meet casual sexual partners. Those who do are at higher risk of sexually transmitted diseases. However, little is known about the rates and associations of frequent HIV testing and self-testing among such MSM.

OBJECTIVE: We aimed to examine HIV serostatus communication and perceptions regarding the HIV infection risk of internet-based partners, along with their associations with frequent HIV testing and self-testing.

METHODS: A cross-sectional study was conducted between May 2018 and April 2019 in Zhejiang Province, China. The study participants were assigned male at birth, were aged 18 years or older, had had casual sex with another male found through the internet in the last 6 months, and were HIV-negative. Information was obtained on HIV-testing behavior, along with demographic characteristics, HIV-related knowledge, internet-based behaviors, sexual behaviors with male partners, HIV serostatus communication, and perceptions regarding the HIV infection risk of internet-based partners. Uni- and multivariate logistic regression models were used to measure the associations of HIV testing and self-testing.

RESULTS: The study recruited 281 individuals who had sought casual sexual partners through the internet during the previous 6 months. Of the participants, 61.9% (174/281) reported frequent HIV testing (twice or more frequently) and 50.9% (119/234; 47 with missing values) reported frequent HIV self-testing. MSM who always or usually communicated about the HIV serostatus of internet-based partners in the previous 6 months had 3.12 (95% CI 1.76-5.52) and 2.45 (95% CI 1.42-4.22) times higher odds of being frequently tested or self-tested for HIV, respectively, compared with those who communicated about this issue minimally or not at all.

CONCLUSIONS: There remains a need to improve the frequency of HIV testing and self-testing among internet-based MSM. HIV serostatus communication should be improved within the context of social networking applications to promote frequent HIV testing among internet-based MSM, especially for those who communicated about this issue minimally or not at all.

PMID:39541583 | DOI:10.2196/57244

J Med Internet Res. 2024 Nov 14;26:e55400. doi: 10.2196/55400.

ABSTRACT

BACKGROUND: Telemedicine is expanding rapidly, with public direct-to-consumer (DTC) telemedicine representing 70% of the market. A key priority is establishing clear quality distinctions between the public and private sectors. No studies have directly compared the quality of DTC telemedicine in the public and private sectors using objective evaluation methods.

OBJECTIVE: Using a standardized patient (SP) approach, this study aimed to compare the quality of DTC telemedicine provided by China’s public and private sectors.

METHODS: We recruited 10 SPs presenting fixed cases (urticaria and childhood diarrhea), with 594 interactions between them and physicians. The SPs evaluated various aspects of the quality of care, effectiveness, safety, patient-centeredness (PCC), efficiency, and timeliness using the Institute of Medicine (IOM) quality framework. Ordinary least-squares (OLS) regression models with fixed effects were used for continuous variables, while logistic regression models with fixed effects were used for categorical variables.

RESULTS: Significant quality differences were observed between public and private DTC telemedicine. Physicians from private platforms were significantly more likely to adhere to clinical checklists (adjusted β 15.22, P<.001); provide an accurate diagnosis (adjusted odds ratio [OR] 3.85, P<.001), an appropriate prescription (adjusted OR 3.87, P<.001), and lifestyle modification advice (adjusted OR 6.82, P<.001); ensure more PCC (adjusted β 3.34, P<.001); and spend more time with SPs (adjusted β 839.70, P<.001), with more responses (adjusted β 1.33, P=.001) and more words (adjusted β 50.93, P=.009). However, SPs on private platforms waited longer for the first response (adjusted β 505.87, P=.001) and each response (adjusted β 168.33, P=.04) and paid more for the average visit (adjusted β 40.03, P<.001).

CONCLUSIONS: There is significant quality inequality in different DTC telemedicine platforms. Private physicians might provide a higher quality of service regarding effectiveness and safety, PCC, and response times and words. However, private platforms have longer wait times for their first response, as well as higher costs. Refining online reviews, establishing standardized norms and pricing, enhancing the performance evaluation mechanism for public DTC telemedicine, and imposing stricter limitations on the first response time for private physicians should be considered practical approaches to optimizing the management of DTC telemedicine.

PMID:39541582 | DOI:10.2196/55400

JMIR Res Protoc. 2024 Nov 14;13:e56649. doi: 10.2196/56649.

ABSTRACT

BACKGROUND: Mucopolysaccharidosis type IVA (MPS IVA), also known as Morquio A syndrome, is a rare lysosomal storage disease characterized by autosomal recessive inheritance of mutations in the N-acetylgalactosamine-6-sulfatase (GALNS) gene. This leads to a deficiency of the GALNS enzyme, causing the accumulation of glycosaminoglycans in tissues. Morquio A syndrome primarily affects the skeletal system and joints but can also impact various organs, resulting in symptoms such as hearing and vision loss, respiratory issues, spinal cord compression, heart diseases, and hepatomegaly. The genotype-phenotype relationship is diverse, with studies highlighting variants associated with classic, nonclassic, or intermediate phenotypes. Understanding these genetic factors is crucial for predicting disease prognosis and tailoring effective treatment strategies for individuals with Morquio A syndrome.

OBJECTIVE: The aim of this meta-analysis is to comprehend the relationship between the severity of the phenotype and the genotype of patients with MPS IVA, considering factors such as the type of variant and its location in the different domains of the protein.

METHODS: This meta-analysis will include articles featuring participants of all genders and age groups who have a molecular diagnosis of MPS IVA and a description of the phenotype. Literature published in English, Spanish, and Portuguese will be considered. Exclusion criteria will encompass studies lacking full-text availability and those involving patients with an MPS IVA diagnosis but without phenotype information. The databases to be searched include PubMed, MEDLINE, ScienceDirect, and Scopus. The screening of literature, paper selection, and data extraction will involve 2 independent reviewers, who will conduct the process blindly. In the event of disagreements between the 2 reviewers at any stage, resolution will be sought through discussion or with the involvement of an additional reviewer. The final selection of manuscripts will be based on consensus. The results of the review will be presented using descriptive statistics, and the information will be organized in either diagrammatic or tabular formats, following the guidelines provided by the Joanna Briggs Institute. Genotype-phenotype relationships will be analyzed using IBM SPSS Statistics, using chi-square tests, Fisher exact tests, and regression analysis to interpret the data.

RESULTS: A literature search conducted in January 2024 produced 760 results. The review is expected to be completed by the end of 2024.

CONCLUSIONS: This meta-analysis will gather and analyze information on the phenotype-genotype relationship in patients diagnosed with MPS IVA. The data collection and resulting analyses will make a substantial contribution to understanding the underlying mechanism of the disease, enabling the prediction of the syndrome’s progression and severity.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56649.

PMID:39541578 | DOI:10.2196/56649

Microsc Microanal. 2024 Nov 14:ozae112. doi: 10.1093/mam/ozae112. Online ahead of print.

ABSTRACT

The production of plutonium-238 through irradiation of neptunium-237 (237Np) target materials for the use in radioisotope thermoelectric generators is paramount for continued deep space exploration. This work employs scanning electron microscopy to analyze 237Np materials coupled with a well-developed image analysis framework (Morphological Analysis for Material Attribution, or MAMA) to determine the degree of micron-scale homogeneity in the materials. This work demonstrated how the quantification of particle characteristics can validate production materials and affirm the qualitative similarities observed in micrographs. The 237Np oxide particle analysis determined that the materials from five production runs were quantitatively homogenous (significant at α = 0.05) in particle area, circularity, equivalent circular diameter, and ellipse aspect ratio, with two of the sampling dates having statistically significant different means for one of the four characteristics. These metrics not only confirm general homogeneity of the material but also expand the application of MAMA workflows to 237Np materials, demonstrating the utility of MAMA analysis for a wider breadth of nuclear materials than previously reported. In the open literature, this study is the first time that these microanalytical techniques were applied to 237Np materials to this degree.

PMID:39541565 | DOI:10.1093/mam/ozae112

JCO Glob Oncol. 2024 Nov;10:e2400059. doi: 10.1200/GO.24.00059. Epub 2024 Nov 14.

ABSTRACT

PURPOSE: Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer, with approximately 225,419 new cases with over 125,000 deaths annually in India. This trial compared the efficacy and safety of biosimilar cetuximab versus innovator cetuximab (IC) in combination with platinum-based chemotherapy in patients with recurrent locoregional or metastatic SCCHN.

METHODS: This phase III trial is a multicenter, randomized, double-blind and parallel group study performed in Indian patients with recurrent locoregional or metastatic SCCHN. Patients were randomly assigned in 2:1 ratio to receive biosimilar cetuximab and IC in combination with cisplatin and fluorouracil via intravenous infusions. The primary end points were disease control rate (DCR) and overall response rate (ORR) as per response evaluation criteria in solid tumors version 1.1. The secondary end points included pharmacokinetics (PK), immunogenicity, safety, and tolerability.

RESULTS: Of 180 patients enrolled, 120 patients received biosimilar cetuximab and 60 patients received IC treatment. No significant statistical difference was observed in the primary outcomes between two groups. Treatment difference in DCR and ORR response was found to be -5.21 (90% CI, -8.94 to -1.48) and -4.79 (90% CI, -19.42 to 9.84), respectively, indicating noninferiority to reference product. The incidence of treatment-emergent adverse events (AEs; biosimilar cetuximab: 89.2% v IC: 91.7%; P = .8364) and serious AEs (biosimilar cetuximab: 23.3% v IC: 13.3%; P = .0603) and PK parameters were comparable between treatment groups. The immunogenicity findings showed higher incidence of anticetuximab antibodies in the biosimilar cetuximab group compared with the IC group at the end of Study.

CONCLUSION: The findings of this study demonstrated noninferiority along with comparable PK, safety, and immunogenicity of biosimilar cetuximab and IC in patients with recurrent or metastatic SCCHN.

PMID:39541562 | DOI:10.1200/GO.24.00059

JCO Glob Oncol. 2024 Nov;10:e2400281. doi: 10.1200/GO-24-00281. Epub 2024 Nov 14.

ABSTRACT

PURPOSE: Health-related quality of life (HRQoL) is now an important goal of therapy for patients with chronic myeloid leukemia (CML). However, there is paucity of data for patients living in low-income countries (LICs) and on factors associated with their HRQoL profile. The primary objective was to compare the HRQoL of patients with CML living in an LIC (Ethiopia) with that of patients living in a high-income country (HIC).

METHODS: Adult patients with CML treated with tyrosine kinase inhibitors in Ethiopia were considered eligible for this study. To assess their HRQoL and symptom burden, eligible patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the EORTC Quality of Life Questionnaire Chronic Myeloid Leukemia 24 (QLQ-CML24). A matched case-control analysis was applied to compare the HRQoL profile of the herein-recruited Ethiopian cohort with a sample of patients with CML from an HIC (Italy).

RESULTS: Overall, 395 Ethiopian patients were enrolled between February 2021 and June 2021. Except for dyspnea and satisfaction with care, the Ethiopian patients reported lower HRQoL and functioning and higher symptom burden compared with patients with CML living in an HIC. A remarkable proportion of Ethiopian patients (n = 353, 89.4%) reported financial toxicity (FT). Compared with patients without FT, those with FT reported a higher prevalence of clinically important problems and symptoms across all the QLQ-C30 scales. For example, the prevalence of clinically important impairment of social functioning was almost sixfold higher for patients with FT compared with those without FT (41.8%, 7.1%, respectively).

CONCLUSION: Our results indicate that the HRQoL profile of patients with CML living in Ethiopia may be worse across several important functional and symptom domains than that of their peers living in an HIC. In addition, FT is highly prevalent among these patients and it is associated with poorer HRQoL outcomes.

PMID:39541560 | DOI:10.1200/GO-24-00281

JCO Glob Oncol. 2024 Nov;10:e2400031. doi: 10.1200/GO.24.00031. Epub 2024 Nov 14.

ABSTRACT

PURPOSE: Stronger Together is a peer mentoring model that seeks to address the severe lack of mental health and psychosocial support for patients with cancer in many low- and middle-income countries (LMICs). This article presents the results of the Stronger Together pilot study among patients with breast and gynecologic cancer in Viet Nam (VN).

METHODS: Eligible participants comprised women age 25 years or older with a diagnosis of breast or gynecologic cancers and receiving treatment at four participating hospitals. Participants were asked whether they wanted to proceed with usual care or be matched with a trained and supervised peer mentor (a cancer survivor). Surveys were administered at baseline (0) and 2, 4, and 6 months and assessed depression, anxiety, stress, mental health and physical health components of quality of life (QOL), self-efficacy, and social support. We computed and compared 2-, 4-, and 6-month changes in scores from baseline and conducted difference-in-difference analyses to estimate the intervention effect at 6 months.

RESULTS: The sample size included N = 186 participants. Mentees (n = 91) exhibited improvements in depression, anxiety, stress, and mental health QOL across all time points, whereas usual care participants (n = 95) experienced these improvements at later periods (4 and 6 months). Compared with usual care participants, mentees reported greater improvements in depression at 2 and 4 months, mental health QOL at all time points, and self-efficacy and social support at 4 and 6 months. Greater improvements in stress were also seen in the breast cancer subsample.

CONCLUSION: Stronger Together is a promising model to improve mental health and psychosocial outcomes among patients with breast and gynecologic cancer in VN and can help fill gaps in cancer peer support interventions in many LMICs.

PMID:39541553 | DOI:10.1200/GO.24.00031

J Psychopathol Clin Sci. 2024 Nov 14. doi: 10.1037/abn0000960. Online ahead of print.

ABSTRACT

Substance use relapse is difficult to define, and previous work has used one-size-fits-all ad hoc definitions. Researchers have called for a dynamic and personalized understanding of relapse as a concept and model, necessitating novel statistical tools. We aimed to develop and validate a novel statistical model of latent relapse processes: the double-well potential model (DWPM). This model describes posttreatment substance use in terms of a dynamical system with stable equilibria of abstinence and relapse, person-specific dominant equilibria (tilt), the ease of changing between equilibria (steepness), and an overall relapse risk (RR). Using timeline follow-back data from N = 139 adults with a substance use disorder transitioning back to the community after residential treatment, we examined individual differences and the criterion-related validity of DWPM parameters to determine the clinical utility of the double-well model. While nonuse was the predominant stable state across participants, we found significant between-subjects variability steepness and RR. These individual differences were predictable via demographics, baseline psychopathology, treatment history, and treatment condition. Steepness and RR also predicted long-term outcomes, including life satisfaction and criminal behavior, above and beyond traditional metrics of relapse (proportion of days used and time to first use). Thus, the DWPM is a strong theoretical and statistical representation of the underlying relapse processes. Moreover, the parameters show criterion-related validity and may be useful in precision medicine. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39541537 | DOI:10.1037/abn0000960