Category: Statistics

J Biosoc Sci. 2023 Nov 20:1-21. doi: 10.1017/S002193202300024X. Online ahead of print.

ABSTRACT

Unsafe abortion refers to induced abortions performed without trained medical assistance. While previous studies have investigated predictors of unsafe abortion in India, none have addressed these factors with accounting sample selection bias. This study aims to evaluate the contributors to unsafe abortion in India by using the latest National Family Health Survey data conducted during 2019-2021, incorporating the adjustment of sample selection bias. The study included women aged 15 to 49 who had terminated their most recent pregnancy within five years prior to the survey (total weighted sample (N) = 4,810). Descriptive and bivariate statistics and the Heckman Probit model were employed. The prevalence of unsafe abortion in India was 31%. Key predictors of unsafe abortion included women’s age, the gender composition of their living children, gestation stage, family planning status, and geographical region. Unsafe abortions were typically performed in the early stages of gestation, often involving self-administered medication. The primary reasons cited were unintended pregnancies and health complications. This study underscores the urgent need for targeted interventions that take into account regional, demographic, and social dynamics influencing abortion practices in India.

PMID:37982282 | DOI:10.1017/S002193202300024X

Psychiatr Hung. 2023;38(3):189-202.

ABSTRACT

BACKGROUND: Digitized databases of scientific publications provide an opportunity to study the development and structure of science as a whole or a discipline. Qualitative methods of bibliometrics help with this, and the multidisciplinary approach, known as the “Science of Science”, provides a thinking framework and methods. There is no example for the analysis of the bibliometric characteristics of Hungarian suicidology publications.

METHOD: In this study, the author analyzes publications related to suicidal behavior published between 1992 and 2021, with the participation of at least one Hungarian author, using statistical, data visualization, and network analysis methods. The analysis used publications in English, Hungarian, and other languages found in the Scopus database.

RESULTS: The present research could identify 426 Hungarian publications in the three decades examined. The number of studies increased 5.8 times between the first and last five-year periods. The growth is not linear; there was a sudden increase in the number of studies around 2004. The doubling time for the number of studies is 9.6 years. The analysis identified five larger and five smaller clusters in the authors’ network of relationships, representing well-known domestic suicidal research groups. In suicidology, Lotka’s law also applies to the Hungarian sample. That is, few authors write the majority of studies, while the vast majority write only a few publications during their careers. A study’s average number of authors increased significantly during the examined period. Multi-author studies received significantly more citations than single-author studies. 74.4% of the announcements are in English, and 21.6% are in Hungarian.

CONCLUSIONS: The methods of bibliometric analysis and the “science of science” can help research groups identify new research directions. All of this can ultimately contribute to a better understanding of suicidal behavior, allowing answering social and scientific problems. The focus of future bibliometric research, in addition to foreign databases, could be the analysis of a broader time interval with the help of Hungarian databases (e.g., MATARKA).

PMID:37982267

Psychiatriki. 2023 Nov 14. doi: 10.22365/jpsych.2023.027. Online ahead of print.

ABSTRACT

Chronic Low Back Pain (CLBP) is a very common health problem that has a great negative impact on the quality of life and the psychological well-being of backache patients. Literature findings have shown that a conventional physiotherapeutic approach is a beneficial choice for CLBP management. The aim of this study was to examine the short-term effects of a conservative physical treatment on depression, anxiety, somatic symptom disorders (SSD), quality of life, pain and disability in Greek individuals suffering from CLBP. Seventy-five CLBP patients were recruited using random systematic sampling. All subjects received ultrasound, low-level laser, massage, transcutaneous electrical nerve stimulation (ΤENS) and alongside an exercise program (sum of 10 sessions, 5 times per week). The intervention was assessed by comparing pre and post outcome measurements based on the Hospital Anxiety and Depression Scale (HADS), Somatic Symptom Scale-8 (SSS-8), EuroQol 5-dimension 5-level (EQ-5D-5L), Roland-Morris Disability Questionnaire (RMDQ) and Pain Numerical Rating Scale (PNRS) instruments. The mean age of the sample was 60.8 years (±14.4) and nearly one out of four (25.3%) was obese. After the end of the treatment, there were improvements in EQ-5D-5L indices and decreases in HADS, SSS-8, RMDQ and PNRS scores, which were found to be statistically significant. Greater effect size was found in PNRS (d=0.75), followed by EQ-5D-5L index value scale (d=0.42), SSS-8 (d=0.38), EQ-5D-5L VAS (d=0.36), RMDQ (d=0.29), HADS-A (d=0.16) and HADS-D (d=0.14). Men and women had similar changes in all under-study scales after the treatment, while besides pain scale, the pre-intervention scores as well as the degree of change in all scores were similar across all Body Mass Index (BMI) levels. In conclusion, convectional physical treatment was found to be an effective option in improving considerably the psychological status and quality of life, while also decreasing functional disability and pain in CLBP patients in the short run.

PMID:37982251 | DOI:10.22365/jpsych.2023.027

Clin Trials. 2023 Nov 20:17407745231211272. doi: 10.1177/17407745231211272. Online ahead of print.

ABSTRACT

BACKGROUND: After an initial recommendation from the World Health Organisation, trials of patients hospitalised with COVID-19 often include an ordinal clinical status outcome, which comprises a series of ordered categorical variables, typically ranging from ‘Alive and discharged from hospital’ to ‘Dead’. These ordinal outcomes are often analysed using a proportional odds model, which provides a common odds ratio as an overall measure of effect, which is generally interpreted as the odds ratio for being in a higher category. The common odds ratio relies on the assumption of proportional odds, which implies an identical odds ratio across all ordinal categories; however, there is generally no statistical or biological basis for which this assumption should hold; and when violated, the common odds ratio may be a biased representation of the odds ratios for particular categories within the ordinal outcome. In this study, we aimed to evaluate to what extent the common odds ratio in published COVID-19 trials differed to simple binary odds ratios for clinically important outcomes.

METHODS: We conducted a systematic review of randomised trials evaluating interventions for patients hospitalised with COVID-19, which used a proportional odds model to analyse an ordinal clinical status outcome, published between January 2020 and May 2021. We assessed agreement between the common odds ratio and the odds ratio from a standard logistic regression model for three clinically important binary outcomes: ‘Alive’, ‘Alive without mechanical ventilation’, and ‘Alive and discharged from hospital’.

RESULTS: Sixteen randomised clinical trials, comprising 38 individual comparisons, were included in this study; of these, only 6 trials (38%) formally assessed the proportional odds assumption. The common odds ratio differed by more than 25% compared to the binary odds ratios in 55% of comparisons for the outcome ‘Alive’, 37% for ‘Alive without mechanical ventilation’, and 24% for ‘Alive and discharged from hospital’. In addition, the common odds ratio systematically underestimated the odds ratio for the outcome ‘Alive’ by -16.8% (95% confidence interval: -28.7% to -2.9%, p = 0.02), though differences for the other outcomes were smaller and not statistically significant (-8.4% for ‘Alive without mechanical ventilation’ and 3.6% for ‘Alive and discharged from hospital’). The common odds ratio was statistically significant for 18% of comparisons, while the binary odds ratio was significant in 5%, 16%, and 3% of comparisons for the outcomes ‘Alive’, ‘Alive without mechanical ventilation’, and ‘Alive and discharged from hospital’, respectively.

CONCLUSION: The common odds ratio from proportional odds models often differs substantially to odds ratios from clinically important binary outcomes, and similar to composite outcomes, a beneficial common OR from a proportional odds model does not necessarily indicate a beneficial effect on the most important categories within the ordinal outcome.

PMID:37982237 | DOI:10.1177/17407745231211272

J Am Psychiatr Nurses Assoc. 2023 Nov-Dec;29(6):447-456. doi: 10.1177/10783903231205495.

ABSTRACT

BACKGROUND: A Mental Health Task Force (MHTF) was developed in a large public college of nursing in the Southeastern United States to address the urgent mental health needs expressed by growing numbers of nursing students related to the coronavirus disease 2019 (COVID-19).

AIMS: The purpose of this study was to report on a needs assessment conducted by the MHTF.

METHODS: The needs assessment study design was a 16-item cross-sectional online survey and four “Town Hall” focus groups with nursing students, faculty, and staff (n = 1-8 participants per group). Survey data were analyzed using descriptive statistics and free-text questions from the survey and focus groups were analyzed using a qualitative descriptive approach.

RESULTS: Undergraduate and graduate students (n = 115) ranging in age from 17 to 50 years completed the survey; 95% female, 94% full-time, 56% employed, 77% White, and 81% in the Bachelor of Science in Nursing program. Eleven students participated in the focus groups. The analysis of the free-text survey questions identified the students’ perceived needs. Mental health care was the most frequently requested, followed by faculty check-ins, stress management, and peer support.

CONCLUSIONS: The administration of the survey provided an opportunity for students to communicate concerns and make requests. To address the ongoing effects of the COVID-19 pandemic on nursing students, multi-modal needs assessments should be conducted periodically to identify priority mental health needs.

PMID:37982227 | DOI:10.1177/10783903231205495

J Am Heart Assoc. 2023 Nov 20:e028760. doi: 10.1161/JAHA.122.028760. Online ahead of print.

ABSTRACT

BACKGROUND: Perioperative myocardial injury is common after major noncardiac surgery and is associated with adverse outcomes. This study investigated the use of ivabradine in patients undergoing urgent surgery for fracture.

METHODS AND RESULTS: This was a prospective, double-blind, placebo-controlled, randomized clinical trial. Participants were enrolled 1:1 into ivabradine or placebo arm, and study drug was commenced before operation and continued for 7 days or until discharge. High-sensitivity troponin I was measured daily using Abbott Alinity analyzer and assay, and heart rate data were obtained using continuous Holter monitoring. A total of 199 patients underwent acute orthopedic surgery, 98 in the ivabradine group and 101 in the placebo group. The mean age was 78.7 years (range, 77.5-79.9 years), with 68% women. The average heart rate was 5 to 11 beats per minute lower in the ivabradine group compared with the placebo group at all time points (P<0.001 for all). There was no statistically significant difference between the ivabradine and placebo groups in the number of patients who had perioperative myocardial injury: 28.6% versus 31.6% (P=0.71). In patients with perioperative myocardial injury, average peak troponin was 168.8 ng/L (±431.2 ng/L) in the ivabradine group and 2094.5 ng/L (±7201.9 ng/L) in the placebo group (P=0.16). There was no statistically significant difference between groups in 30-day mortality, blood pressure, stroke, or major adverse cardiovascular event.

CONCLUSIONS: Starting ivabradine preoperatively in elderly patients requiring acute surgery for fracture did not result in a statistically significant difference in the incidence of perioperative myocardial injury. There was no statistically significant difference in morbidity, mortality, or adverse events between treatment groups.

REGISTRATION: URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12616001634460p.

PMID:37982213 | DOI:10.1161/JAHA.122.028760

J Am Heart Assoc. 2023 Nov 20:e030604. doi: 10.1161/JAHA.123.030604. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare the performance of established cardiovascular risk algorithms in Korean patients with new-onset rheumatoid arthritis.

METHODS AND RESULTS: This retrospective cohort study identified patients newly diagnosed with rheumatoid arthritis without a history of cardiovascular diseases between 2013 and 2019 using the National Health Insurance Service database. The cohort was followed up until 2020 for the development of the first major adverse cardiovascular event. General cardiovascular risk prediction algorithms, such as the systematic coronary risk evaluation model, the Korean risk prediction model for atherosclerotic cardiovascular diseases, the American College of Cardiology/American Heart Association pooled equations, and the Framingham Risk Score, were used. The discrimination and calibration of cardiovascular risk prediction models were evaluated. Hazard ratios were estimated using Cox proportional hazards regression. A total of 611 patients among 24 889 patients experienced a major adverse cardiovascular event during follow-up. The median 10-year atherosclerotic cardiovascular diseases risk score was significantly higher in patients with major adverse cardiovascular events than those without. The C-statistics of risk algorithms ranged between 0.72 and 0.74. Compared with the low-risk group, the actual risk of developing major adverse cardiovascular events increased significantly in the intermediate- and high-risk groups for all algorithms. However, the risk predictions calculated from all algorithms overestimated the observed cardiovascular risk in the middle to high deciles, and only the systematic coronary risk evaluation algorithm showed comparable observed and predicted event rates in the low-intermediate deciles with the highest sensitivity.

CONCLUSIONS: The systematic coronary risk evaluation model algorithm and the general risk prediction models discriminated patients with rheumatoid arthritis appropriately. However, overestimation should be considered when applying the cardiovascular risk prediction model in Korean patients.

PMID:37982210 | DOI:10.1161/JAHA.123.030604

Proc Inst Mech Eng H. 2023 Nov 20:9544119231212269. doi: 10.1177/09544119231212269. Online ahead of print.

ABSTRACT

Electrogastrography (EGG) is a novel diagnostic modality for assessing the gastrointestinal tract (GI) that generates spontaneous electrical activity and monitors gastric motility. The aim of this study was to compare patients with functional dyspepsia (FD) and diabetic gastroparesis (D-GP) with healthy controls (CT) to use established findings on abnormalities of gastric motility based on EGG characteristics. In this study, 50 patients with FD, 50 D-GP patients, and 50 CT subjects were studied to compare EGG with discrete wavelet transform models (DWT) to extract signal characteristics using a variety of different qualitative and quantitative metrics from pre-prandial and postprandial states. As a result, higher statistically significant (p < 0.05*) were found in the DWT models based on power spectral density (PSD) analysis in both states. We also present that the correlations between EGG metrics and the presence of FD, D-GP, and CT symptoms were inconsistent. This paper represents that EGG assessments of FD and D-GP patients differ from healthy controls in terms of abnormalities of gastric motility. Additionally, we demonstrate that diverse datasets showed adequate gastric motility responses to a meal. We anticipate that our method will provide a comprehensive understanding of gastric motility disorders for better treatment and monitoring in both clinical and research settings. In conclusion, we present potential future opportunities for precise gastrointestinal electrophysiological disorders.

PMID:37982194 | DOI:10.1177/09544119231212269

Eur Heart J Cardiovasc Imaging. 2023 Nov 20:jead285. doi: 10.1093/ehjci/jead285. Online ahead of print.

ABSTRACT

Cardiac disease affects the heart non-uniformly. Examples include focal septal or apical hypertrophy with reduced strain in hypertrophic cardiomyopathy (HCM), replacement fibrosis with akinesia in an infarct-related coronary artery territory and pattern of scarring in dilated cardiomyopathy. The detail and versatility of cardiovascular magnetic resonance imaging (CMR) mean it contains a wealth of information imperceptible to the naked eye and not captured by standard global measures. CMR-derived heterogeneity biomarkers could facilitate earlier diagnosis, better risk stratification and more comprehensive prediction of treatment response. Small cohort and case-control studies demonstrate feasibility of proof-of-concept structural and functional heterogeneity measures. Detailed radiomic analyses of different CMR sequences using open source software delineate unique voxel patterns as hallmarks of histopathological changes. Meanwhile measures of dispersion applied to emerging CMR strain sequences describe variable longitudinal, circumferential and radial function across the myocardium. Two of the most promising heterogeneity measures are mean absolute deviation of regional standard deviations (madSD) on native T1 and T2 and the SD of time to maximum regional radial wall motion, termed tissue synchronisation index (TSI) in a 16-segment LV model. Real world limitations include the non-standardisation of CMR imaging protocols across different centres and the testing of large numbers of radiomic features in small inadequately powered patient samples. We therefore propose a 3-step roadmap to benchmark novel heterogeneity biomarkers, including defining normal reference ranges, statistical modelling against diagnosis and outcomes in large epidemiological studies and finally, comprehensive internal and external validation.

PMID:37982176 | DOI:10.1093/ehjci/jead285

J Comput Graph Stat. 2023;32(3):1097-1108. doi: 10.1080/10618600.2022.2146697. Epub 2022 Dec 13.

ABSTRACT

Many problems in classification involve huge numbers of irrelevant features. Variable selection reveals the crucial features, reduces the dimensionality of feature space, and improves model interpretation. In the support vector machine literature, variable selection is achieved by ℓ1 penalties. These convex relaxations seriously bias parameter estimates toward 0 and tend to admit too many irrelevant features. The current paper presents an alternative that replaces penalties by sparse-set constraints. Penalties still appear, but serve a different purpose. The proximal distance principle takes a loss function L(β) and adds the penalty ρ2dist(β,Sk)2 capturing the squared Euclidean distance of the parameter vector β to the sparsity set Sk where at most k components of β are nonzero. If βρ represents the minimum of the objective fρ(β)=L(β)+ρ2dist(β,Sk)2, then βρ tends to the constrained minimum of L(β) over Sk as ρ tends to ∞. We derive two closely related algorithms to carry out this strategy. Our simulated and real examples vividly demonstrate how the algorithms achieve better sparsity without loss of classification power.

PMID:37982129 | PMC:PMC10656054 | DOI:10.1080/10618600.2022.2146697