Category: Statistics

BJU Int. 2026 Jul 2. doi: 10.1111/bju.70378. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the incidence of venous thromboembolism (VTE) after penile cancer surgery using national hospital data and to assess current thromboprophylaxis practices across UK specialist centres.

SUBJECTS/PATIENTS AND METHODS: A retrospective cohort study was conducted using Secondary Uses Service (SUS) data on penile cancer surgeries performed in NHS hospitals in England between 2015 and 2024. A national survey of UK Penile Cancer Network (UK PeCaN) surgeons was undertaken to assess current thromboprophylaxis practice. The primary outcome was symptomatic VTE within 180 days of surgery, identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Cumulative incidence of first postoperative VTE was analysed using patient-level time-to-event methods, with censoring at second surgery, 180 days or administrative end of follow-up. Survey responses were summarised using descriptive statistics.

RESULTS: In this observational population-level study, 4310 patients underwent 5903 penile cancer-related procedures. A total of 143 VTE episodes were recorded over the 9-year period, corresponding to an overall crude incidence of 2.5%. In patient-level time-to-event analysis, the cumulative incidence of first postoperative symptomatic VTE was 0.21% at 30 days, 0.69% at 90 days and 1.08% at 180 days. Descriptive procedure-level analyses suggested higher unadjusted VTE rates following more extensive procedures, including lymph node dissection and total penectomy, although these estimates should be interpreted cautiously because of staged procedures and unmeasured patient-level confounding. Most VTE events occurred after hospital discharge. The survey, comprising 24 responses from 10 specialist centres, revealed substantial variation in thromboprophylaxis practice, with 71% of surgeons not using formal VTE risk assessment tools.

CONCLUSIONS: Venous thromboembolism is an important postoperative complication after penile cancer surgery, particularly after more extensive procedures and staged treatment pathways. Current prophylaxis practices are inconsistent. These findings support the further collection and analysis of disease-specific and the development of procedure-specific guidelines recommending extended thromboprophylaxis in high-risk patients.

PMID:42389899 | DOI:10.1111/bju.70378

Clin Obes. 2026 Aug;16(4):e70096. doi: 10.1111/cob.70096.

ABSTRACT

This service evaluation of a primary care-based specialist weight management service reports data from 1094 patients over 5 years (2014-2019), including weight data at 1-year post-discharge. The results show clinically and statistically significant improvements in weight, diet, physical activity, quality of life, blood pressure and blood glucose control (in people living with type 2 diabetes). Change in weight was statistically significant for all timepoints in all subgroups. At 1-year completers (n = 560) had lost a mean of 8.3 kg (SD 0.3) and 133 patients (23.8%) had lost ≥ 10% of their starting weight. Using baseline observation carried forward analysis on the whole cohort (n = 1094) the mean weight loss at the end of the 1-year programme was 4.5 kg (SD 0.2) and 144 (13.2%) had lost ≥ 10% of their starting weight. A year after discharge completers demonstrated a mean weight loss of 8.3% (SD 10.3 n = 303) and 35.6% (n = 108) of completers had maintained ≥ 10% change in body weight. Analysis showed a mean weight loss of 2.5% (SD 6.8 n = 1094) in the whole cohort using baseline observation carried forward, demonstrating maintenance of weight loss and suggesting that specialist weight management services in primary care may be effective in the longer-term.

PMID:42389898 | DOI:10.1111/cob.70096

Phlebology. 2026 Jul 2:2683555261467340. doi: 10.1177/02683555261467340. Online ahead of print.

ABSTRACT

ObjectivesGenerative artificial intelligence (AI) models capable of producing photorealistic medical images are increasingly proposed for patient education, clinical illustration, and trainee instruction. However, their ability to accurately represent anatomically distinct disease subtypes remains unclear. This study evaluated the diagnostic accuracy of a widely used generative AI model in producing images corresponding to the five anatomical lipedema types defined by the Schmeller classification.MethodsIn this prospective audit, ChatGPT’s image-generation interface was prompted to create 60 images for each lipedema type (Types I-V),yielding 300 images. Prompts were standardized and limited to the subtype label without additional descriptors. Two clinicians independently classified each image into one of the five lipedema types or as indeterminate, blinded to the original prompt; disagreements were resolved by a third clinician. Diagnostic performance was assessed using a confusion matrix and per-type sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV),F1-score,and one-vs-rest receiver operating characteristic area under the curve (ROC AUC). Overall accuracy and Cohen’s κ statistics were also calculated.ResultsAll 300 images were evaluable. The model generated anatomically consistent images for Types I,II, and III (sensitivity = 1.00 for each). Specificity was 1.00 for Types I and II but 0.50 for Type III because all images requested as Types IV and V were classified as Type III. Consequently, the model failed to generate any images consistent with Type IV(arm-predominant) or Type V(calf-isolated) lipedema (sensitivity = 0.00 for both). Overall accuracy was 0.600. Unweighted and quadratic-weighted Cohen’s κ values were 0.500 and 0.667, respectively. Micro- and macro-averaged ROC AUC were both 0.750.ConclusionThe model reproduces severity gradients within lower-extremity lipedema but systematically collapses anatomically distinct subtypes into the dominant Type III phenotype, failing to depict arm-predominant and calf-isolated disease. Current generative AI systems may therefore encode lipedema as a single visual phenotype rather than a distributed anatomical entity, limiting their reliability for medical education and clinical communication.

PMID:42389893 | DOI:10.1177/02683555261467340

Aust Endod J. 2026 Jul 2. doi: 10.1111/aej.70105. Online ahead of print.

ABSTRACT

This study aimed to evaluate the content and quality of YouTube videos on bioceramic-based root canal sealers. A total of 43 videos were assessed using the Journal of the American Medical Association (JAMA), Global Quality Score (GQS) and Modified DISCERN (mDISCERN) measurement tools. Statistical analyses were conducted using the Kruskal-Wallis test, Spearman correlation analysis and multiple linear regression (p < 0.05). Videos uploaded by dentists had significantly higher GQS, mDISCERN, JAMA and Total Content Score (TCS) scores than those from other sources (p < 0.05). Videos with rich content showed higher GQS, mDISCERN and JAMA scores than those with poor content (p < 0.05). Although the number of comments demonstrated an individual association with GQS, the overall regression model was not statistically significant (p > 0.05). In conclusion, most videos on bioceramic-based root canal sealers were of poor to moderate quality and could have limitations in reliability.

PMID:42389892 | DOI:10.1111/aej.70105

Suicide Life Threat Behav. 2026 Aug;56(4):e70124. doi: 10.1111/sltb.70124.

ABSTRACT

INTRODUCTION: Passive suicidal ideation (SI) is a well-established risk factor for suicidal behavior but has received less attention than active SI. Although recent work has leveraged intensive longitudinal data and machine learning (ML) to forecast short-term risk for active SI, passive SI remains understudied as a prediction target.

METHODS: Seventy-eight psychiatrically hospitalized youth (ages 13-17 years) completed baseline assessments and daily ratings of risk and protective factors for 28 days post-discharge. Multiple ML models were trained to predict the presence of next-day passive SI. Models with and without baseline variables were compared to assess the relative predictive value of time-varying versus baseline features.

RESULTS: ML models predicted next-day passive SI with high accuracy (AUC = 0.90). The strongest predictors were within-person 7-day moving averages of passive SI duration and frequency. Including baseline variables had negligible performance impact, even during initial days post-discharge.

CONCLUSIONS: Short-term passive SI remains an underutilized but important target for suicide prevention. Forecasting next-day passive SI using ML is feasible and highly accurate. Within-person, time-varying features outperformed baseline factors, even in early days post-discharge. Additional research on SI facets, such as duration, is needed. Integrating passive SI into personalized intervention frameworks may enhance the precision of suicide prevention efforts.

PMID:42389887 | DOI:10.1111/sltb.70124

Cancer Control. 2026 Jan-Dec;33:10732748261465064. doi: 10.1177/10732748261465064. Epub 2026 Jul 2.

ABSTRACT

IntroductionLow cancer health literacy undermines patients’ ability to interpret complex information and participate in shared decision making, and is associated with worse outcomes. Evidence for effective health literacy interventions in metastatic breast cancer (MBC) remains limited. We evaluated a patient-led, virtual health literacy program designed to strengthen MBC-specific knowledge and self-efficacy.MethodsWe conducted a mixed-methods, pre-post evaluation across two program iterations (Fall 2023; Spring 2024) delivered by a national, patient-led-MBC organization, Project Life. The five-week synchronous course called Spinning Science covered breast cancer subtyping, genetic/genomic testing, clinical trials, circulating tumor DNA, and information literacy, with small-group activities and polling. Program participants were adults living with MBC. De-identified pre/post surveys assessed (1) self-efficacy for engaging in health decisions, and (2) knowledge using items adapted from the Cancer Health Literacy Test aligned to course content. Paired two-sample t-tests examined pre-post changes (α=0.05). Open-ended responses were analyzed thematically.ResultsFifty-four people with MBC were enrolled (cohort 1, n=17; cohort 2, n=37); 46 provided matched pre- and post-surveys (14 and 32, respectively). Agreement with “I don’t know enough to make my own medical decisions” declined from 43% pre to 13% post (p<0.05), indicating improved self-efficacy. Baseline knowledge scores were high, and knowledge item gains were not statistically significant, consistent with ceiling effects. Post-program items showed >80% agreement for increased confidence in self-advocacy, improved health literacy, and sense of community. Qualitative feedback highlighted strengths like digestible content, approachable patient facilitators and flexible scheduling, as well as priorities for refinement such as continued access to materials, and more MBC-specific and numeracy content.ConclusionsA patient-developed, virtual health literacy program for people living with MBC showed meaningful improvements in self-efficacy, with actionable, participant-driven refinements between cohorts. This model offers a practical, scalable pathway for advancing self-efficacy within and beyond MBC.

PMID:42389868 | DOI:10.1177/10732748261465064

Acta Odontol Scand. 2026 Jul 2;85:408-415. doi: 10.2340/aos.v85.46336.

ABSTRACT

OBJECTIVE: The objective of this study was to compare self-reported treatment preferences related to pulpectomy prior to prosthetic treatment, restoration selection for vital teeth, and impression-taking methods between Lithuanian general dentists (GDs) and prosthodontists (Ps).

MATERIAL AND METHODS: A questionnaire-based survey was conducted among 386 dentists in Lithuania, including GDs (62.4%) and Ps (37.6%). Data were analyzed using descriptive statistics and inferential tests (Chi-square and Fisher’s exact test), with a significance level of p < 0.05.

RESULTS: Most indications for pulpectomy were reported similarly by both groups; however, significant differences were observed for extensive coronal structure loss (> 50%) and deep caries, cervical lesions, gingival recession, short clinical crown, insufficient retention, enamel hypoplasia, and external root resorption (p < 0.05). Ps also more frequently reported using indirect restorations, including porcelain-fused-to-metal crowns, lithium disilicate ceramic inlays and onlays, and polymethyl methacrylate crowns. Conventional impressions were more common among GDs, whereas digital or combined workflows were more common among Ps.

CONCLUSIONS: Lithuanian GDs and Ps reported broadly similar preferences regarding preservation of tooth vitality, but differed in selected pulpectomy indications, restorative options, and impression-taking methods. These differences may reflect variation in specialist training, clinical experience, and access to prosthetic workflows.

PMID:42389859 | DOI:10.2340/aos.v85.46336

Haematologica. 2026 Jul 2. doi: 10.3324/haematol.2026.301126. Online ahead of print.

ABSTRACT

Oral decitabine/cedazuridine plus venetoclax offers a fully oral regimen for older or unfit patients with acute myeloid leukemia (AML). We previously reported outcomes from a phase II study; here we present extended follow-up of the frontline cohort. In this single-center phase II study, adults with AML ineligible for intensive induction received oral decitabine/cedazuridine (35 mg/100 mg, days 1-5) plus venetoclax in 28-day cycles. This analysis included newly diagnosed (ND) AML. Endpoints included overall response rate (ORR), overall survival (OS), relapse-free survival (RFS), duration of response (DOR) and safety. Outcomes were compared between de novo and secondary AML. Between March 2021, and January 2026, 68 patients were treated, including 32 de novo and 36 secondary AML; median age was 79 years. The cohort was high risk, with >50% ECOG ≥2, less favorable genomics and 16% prior hypomethylating agents exposure. ORR was 75% in de novo AML and 58% in secondary AML. Among responders, MRD negativity was 58% and 56%. With median follow-up of 32 months, median OS was 12.7 months (95% CI, 9.1-20.3) vs 7.2 months (95% CI, 3.6-29.9) (P = 0.61). Median RFS was 9.2 months vs 11.7 months (P = 0.56). No statistically significant differences were observed in survival, relapse or non-relapse mortality. Oral decitabine/cedazuridine plus venetoclax is an effective oral treatment for older or unfit patients with ND AML. Response rates were higher in de novo AML, while survival outcomes were not statistically significant. These findings highlight the need for improved therapeutic strategies particularly in secondary AML.

PMID:42389833 | DOI:10.3324/haematol.2026.301126

J Ultrasound Med. 2026 Jul 2. doi: 10.1002/jum.70356. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare the efficacy of microvascular flow imaging (MVFI) and ultrasound viscoelasticity imaging (UVI) in assessing renal allograft stability, and to evaluate their potential as noninvasive diagnostic tools for early dysfunction detection and biopsy guidance.

METHODS: A total of 61 renal transplant recipients (37 stable, 24 unstable) were ultimately included. All participants underwent conventional ultrasonography, MVFI, and UVI. Quantitative parameters included entire color pixel percentage (eCPP), cortical color pixel percentage (cCPP), and viscoelastic metrics (elasticity, viscosity, and dispersion). Group differences were assessed using appropriate statistical tests; correlations with estimated glomerular filtration rate (eGFR) and serum creatinine were evaluated; and receiver operating characteristic (ROC) curves were generated to assess diagnostic performance. Intra- and inter-observer consistency was calculated to ensure measurement reliability.

RESULTS: Significant differences in color pixel percentage and multiple cortical viscoelastic parameters (eg, mean elasticity and viscosity) were observed between stable and unstable groups (p < .05). cCPP correlated strongly with eGFR (r = 0.715, p < .001) and serum creatinine (r = -0.731, p < .001), whereas other viscoelastic metrics showed weaker correlations. ROC analysis revealed that cCPP had superior diagnostic accuracy compared to the combined viscoelastic model. Both modalities exhibited excellent reproducibility (ICC >0.87 for all parameters).

CONCLUSION: MVFI provides high diagnostic accuracy for distinguishing stable and unstable renal allografts (cCPP AUC = 0.95), outperforming UVI parameters. UVI provides complementary microstructural information, and combining MVFI and UVI may enhance noninvasive monitoring and optimize biopsy decision-making in renal transplant recipients.

PMID:42389817 | DOI:10.1002/jum.70356

Circ Arrhythm Electrophysiol. 2026 Jul 2:e014420. doi: 10.1161/CIRCEP.125.014420. Online ahead of print.

ABSTRACT

BACKGROUND: Current guidelines recommend regular screening for first-degree relatives of gene-elusive arrhythmogenic right ventricular cardiomyopathy (ARVC) patients using a similar regimen as for genotype-positive/phenotype-negative relatives. However, the multifactorial nature of gene-elusive ARVC may necessitate a different approach. This study aimed to determine the yield of cardiac screening in first-degree relatives of ARVC probands without a validated genetic cause.

METHODS: We included all first-degree relatives of probands who (1) met the 2010 Task Force Criteria, (2) underwent next-generation sequencing that included all genes with at least moderate evidence for ARVC causation per Clinical Genome Resource appraisal (validated ARVC genes), and (3) had no pathogenic/likely pathogenic (P/LP) variants identified in these genes. The primary and secondary end points were definite ARVC by the 2010 Task Force Criteria and ventricular arrhythmia, respectively.

RESULTS: We included 44 relatives (39.0 [22.3-45.8] years; 36% male) from 24 families. In 4 (17%) families, a P/LP variant was identified in a different cardiomyopathy/arrhythmia gene (SCN5A, LMNA, CDH2, FLNC). Overall, 10 (23%) relatives had definite ARVC at baseline evaluation. Of the 20 relatives without definite ARVC who had follow-up available, 8/20 (40%) relatives progressed to definite ARVC during 9.0 (5.8-14.4) years of follow-up. No statistical difference in the yield of baseline screening or serial evaluation between relatives from families with a P/LP variant and relatives from families without a P/LP variant was observed. Of the 27 relatives who had follow-up available, ventricular arrhythmia was observed in 2/27 (7%) relatives and occurred 6.3 and 13.8 years after definite ARVC diagnosis. Both of those relatives were from families without a P/LP variant.

CONCLUSIONS: These findings highlight the importance of managing first-degree relatives of ARVC probands without a validated genetic cause similarly to genotype-positive ARVC relatives. Furthermore, using a broad cardiomyopathy and arrhythmia gene panel in ARVC probands, rather than limiting testing to validated ARVC genes alone, is warranted.

PMID:42389803 | DOI:10.1161/CIRCEP.125.014420