Category: Statistics

Transl Vis Sci Technol. 2023 Aug 1;12(8):8. doi: 10.1167/tvst.12.8.8.

ABSTRACT

PURPOSE: The genetic architecture of corneal dysfunction remains poorly understood. Epidemiological and clinical evidence suggests a relationship between corneal structural features and anthropometric measures. We used global and local genetic similarity analysis to identify genomic features that may underlie structural corneal dysfunction.

METHODS: We assembled genome-wide association study summary statistics for corneal features (central corneal thickness, corneal hysteresis [CH], corneal resistance factor [CRF], and the 3 mm index of keratometry) and anthropometric traits (body mass index, weight, and height) in Europeans. We calculated global genetic correlations (rg) between traits using linkage disequilibrium (LD) score regression and local genetic covariance using ρ-HESS, which partitions the genome and performs regression with LD regions. Finally, we identified genes located within regions of significant genetic covariance and analyzed patterns of tissue expression and pathway enrichment.

RESULTS: Global LD score regression revealed significant negative correlations between height and both CH (rg = -0.12; P = 2.0 × 10-7) and CRF (rg = -0.11; P = 6.9 × 10-7). Local analysis revealed 68 genomic regions exhibiting significant local genetic covariance between CRF and height, containing 2874 unique genes. Pathway analysis of genes in regions with significant local rg revealed enrichment among signaling pathways with known keratoconus associations, including cadherin and Wnt signaling, as well as enrichment of genes modulated by copper and zinc ions.

CONCLUSIONS: Corneal biophysical parameters and height share a common genomic architecture, which may facilitate identification of disease-associated genes and therapies for corneal ectasias.

TRANSLATIONAL RELEVANCE: Local genetic covariance analysis enables the identification of associated genes and therapeutic targets for corneal ectatic disease.

PMID:37561511 | DOI:10.1167/tvst.12.8.8

Psychol Methods. 2023 Aug 10. doi: 10.1037/met0000591. Online ahead of print.

ABSTRACT

Decades of published methodological research have shown the chi-square test of model fit performs inconsistently and unreliably as a determinant of structural equation model (SEM) fit. Likewise, SEM indices of model fit, such as comparative fit index (CFI) and root-mean-square error of approximation (RMSEA) also perform inconsistently and unreliably. Despite rather unreliable ways to statistically assess model fit, researchers commonly rely on these methods for lack of a suitable inferential alternative. Marcoulides and Yuan (2017) have proposed the first inferential test of SEM fit in many years: an equivalence test adaptation of the RMSEA and CFI indices (i.e., RMSEA_t and CFI_t). However, the ability of this equivalence testing approach to accurately judge acceptable and unacceptable model fit has not been empirically tested. This fully crossed Monte Carlo simulation evaluated the accuracy of equivalence testing combining many of the same independent variable (IV) conditions used in previous fit index simulation studies, including sample size (N = 100-1,000), model specification (correctly specified or misspecified), model type (confirmatory factor analysis [CFA], path analysis, or SEM), number of variables analyzed (low or high), data distribution (normal or skewed), and missing data (none, 10%, or 25%). Results show equivalence testing performs rather inconsistently and unreliably across IV conditions, with acceptable or unacceptable RMSEA_t and CFIt model fit index values often being contingent on complex interactions among conditions. Proportional z-tests and logistic regression analyses indicated that equivalence tests of model fit are problematic under multiple conditions, especially those where models are mildly misspecified. Recommendations for researchers are offered, but with the provision that they be used with caution until more research and development is available. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37561492 | DOI:10.1037/met0000591

Psychol Methods. 2023 Aug 10. doi: 10.1037/met0000551. Online ahead of print.

ABSTRACT

With the rising popularity of intensive longitudinal research, the modeling techniques for such data are increasingly focused on individual differences. Here we present mixture multilevel vector-autoregressive modeling, which extends multilevel vector-autoregressive modeling by including a mixture, to identify individuals with similar traits and dynamic processes. This exploratory model identifies mixture components, where each component refers to individuals with similarities in means (expressing traits), autoregressions, and cross-regressions (expressing dynamics), while allowing for some interindividual differences in these attributes. Key issues in modeling are discussed, where the issue of centering predictors is examined in a small simulation study. The proposed model is validated in a simulation study and used to analyze the affective data from the COGITO study. These data consist of samples for two different age groups of over 100 individuals each who were measured for about 100 days. We demonstrate the advantage of exploratory identifying mixture components by analyzing these heterogeneous samples jointly. The model identifies three distinct components, and we provide an interpretation for each component motivated by developmental psychology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37561488 | DOI:10.1037/met0000551

Am J Orthopsychiatry. 2023 Aug 10. doi: 10.1037/ort0000693. Online ahead of print.

ABSTRACT

Research has shown links between homelessness and criminal legal involvement in military veterans. The present study aimed to determine the magnitude and directionality of this association by investigating the incidence of, and factors associated with, homelessness preceding criminal arrest among veterans. Data on incarcerated veterans (N = 1,602) were analyzed from the 2016 Survey of Prison Inmates conducted by the U.S. Bureau of Justice Statistics. In this survey, 27% of incarcerated veterans reported homelessness 12 months before criminal arrest. In multivariable logistic regression analyses, higher odds of experiencing homelessness preceding criminal arrest were associated with younger age, non-White race, substance use disorder (with or without serious mental illness [SMI]), history of previous arrests, parental history of incarceration, and history of homelessness before age 18. These factors were found to be the same for nonveterans, as were rates of homelessness before arrest. However, incarcerated veterans were more likely to have mental disorders, including SMI, posttraumatic stress disorder (PTSD), and personality disorders. In contrast, incarcerated nonveterans were more likely to have a criminal history, including past arrests, parental incarceration, and juvenile detention. Although policymakers may be aware that some veterans they serve are at risk of criminal legal involvement, these national data reveal the magnitude and directionality of this problem: more than one in four incarcerated veterans experienced homelessness before criminal arrest. Identifying characteristics of veterans who experienced homelessness before criminal arrest directly informs service providers of demographic, historical, and clinical factors to evaluate and address to prevent criminal legal involvement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37561476 | DOI:10.1037/ort0000693

JAMA Netw Open. 2023 Aug 1;6(8):e2328159. doi: 10.1001/jamanetworkopen.2023.28159.

ABSTRACT

IMPORTANCE: There are known risks of using opioids for extended periods. However, less is known about the long-term trajectories of opioid use following initiation.

OBJECTIVE: To identify 5-year trajectories of prescription opioid use, and to examine the characteristics of each trajectory group.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study conducted in New South Wales, Australia, linked national pharmaceutical claims data to 10 national and state data sets to determine sociodemographic characteristics, clinical characteristics, drug use, and health services use. The cohort included adult residents (aged ≥18 years) of New South Wales who initiated a prescription opioid between July 1, 2003, and December 31, 2018. Statistical analyses were conducted from February to September 2022.

EXPOSURE: Dispensing of a prescription opioid, with no evidence of opioid dispensing in the preceding 365 days, identified from pharmaceutical claims data.

MAIN OUTCOMES AND MEASURES: The main outcome was the trajectories of monthly opioid use over 60 months from opioid initiation. Group-based trajectory modeling was used to classify these trajectories. Linked health care data sets were used to examine characteristics of individuals in different trajectory groups.

RESULTS: Among 3 474 490 individuals who initiated a prescription opioid (1 831 230 females [52.7%]; mean [SD] age, 49.7 [19.3] years), 5 trajectories of long-term opioid use were identified: very low use (75.4%), low use (16.6%), moderate decreasing to low use (2.6%), low increasing to moderate use (2.6%), and sustained use (2.8%). Compared with individuals in the very low use trajectory group, those in the sustained use trajectory group were older (age ≥65 years: 22.0% vs 58.4%); had more comorbidities, including cancer (4.1% vs 22.2%); had increased health services contact, including hospital admissions (36.9% vs 51.6%); had higher use of psychotropic (16.4% vs 42.4%) and other analgesic drugs (22.9% vs 47.3%) prior to opioid initiation, and were initiated on stronger opioids (20.0% vs 50.2%).

CONCLUSIONS AND RELEVANCE: Results of this cohort study suggest that most individuals commencing treatment with prescription opioids had relatively low and time-limited exposure to opioids over a 5-year period. The small proportion of individuals with sustained or increasing use was older with more comorbidities and use of psychotropic and other analgesic drugs, likely reflecting a higher prevalence of pain and treatment needs in these individuals.

PMID:37561463 | DOI:10.1001/jamanetworkopen.2023.28159

JAMA Netw Open. 2023 Aug 1;6(8):e2328343. doi: 10.1001/jamanetworkopen.2023.28343.

ABSTRACT

IMPORTANCE: In 2018, Medicare removed total knee arthroplasty from the list of inpatient-only procedures, resulting in a new pool of patients eligible for outpatient total knee arthroplasty. How this change was associated with the characteristics of patients undergoing outpatient knee arthroplasty at hospital-owned surgery centers (HOSCs) vs freestanding ambulatory surgery centers (FASCs) is unknown.

OBJECTIVES: To describe the characteristics of patients undergoing outpatient, elective total and partial knee arthroplasty in 2017 and 2018 and to compare the cohorts receiving treatment at FASCs and HOSCs.

DESIGN, SETTING, AND PARTICIPANTS: This observational retrospective cohort study included 5657 patients having elective, outpatient partial and total knee arthroplasty in the Florida and Wisconsin State Ambulatory Surgery Databases in 2017 and 2018. Prior admissions were identified in the State Inpatient Database. Statistical analysis was performed from March to June 2022.

MAIN OUTCOMES AND MEASURES: Characteristics of patients undergoing surgery at a FASC vs a HOSC in 2017 and 2018 were compared.

RESULTS: A total of 5657 patients (mean [SD] age, 64.2 [9.9] years; 2907 women [51.4%]) were included in the study. Outpatient knee arthroplasties increased from 1910 in 2017 to 3747 in 2018 and were associated with an increase in total knee arthroplasties (474 in 2017 vs 2065 in 2018). The influx of patients undergoing outpatient knee arthroplasty was associated with an amplification of differences between the patients treated at FASCs and the patients treated at HOSCs. Patients with private payer insurance seen at FASCs increased from 63.4% in 2017 (550 of 867) to 72.7% in 2018 (1272 of 1749) (P < .001), while the percentage of patients with private payer insurance seen at HOSCs increased, but to a lesser extent (41.6% [427 of 1027] in 2017 vs 46.4% [625 of 1346] in 2018; P < .001). In 2017, the percentages of White patients seen at FASCs and HOSCs were similar (85.0% [737 of 867] vs 88.2% [906 of 1027], respectively); in 2018, the percentage of White patients seen at FASCs had increased and was significantly different from the percentage of White patients seen at HOSCs (90.6% [1585 of 1749] vs 87.9% [1183 of 1346]; P = .01). Both types of facilities saw an increase from 2017 to 2018 in the percentage of patients from communities of low social vulnerability, but this increase was greater for FASCs (FASCs: 6.7% [58 of 867] in 2017 vs 33.9% [593 of 1749] in 2018; HOSCs: 7.6% [78 of 1027] in 2017 vs 21.2% [285 of 1346] in 2018). Finally, while FASCs and HOSCs had cared for a similar portion of patients with prior admissions in 2017 (7.8% [68 of 867] vs 9.4% [97 of 1027], respectively; P = .25), in 2018, FASCs cared for fewer patients with prior admissions than HOSCs (4.0% [70 of 1749] vs 8.1% [109 of 1346]; P < .001).

CONCLUSIONS: This study suggests that the increase in the number of patients undergoing outpatient knee arthroplasty in 2018 corresponded to FASCs treating a greater share of patients who were White, covered by private payer insurance, and healthier. These findings raise a concern that as more operations transition to the outpatient setting, variability in access to FASCs may increase, leaving hospital-owned centers to bear a greater share of the burden of caring for more vulnerable patients with more severe illness.

PMID:37561458 | DOI:10.1001/jamanetworkopen.2023.28343

Br J Radiol. 2023 Aug 10:20230143. doi: 10.1259/bjr.20230143. Online ahead of print.

ABSTRACT

OBJECTIVE: To validate selection criteria for sublobar resection in patients with lung cancer with respect to recurrence, and to investigate predictors for recurrence in patients for whom the criteria are not suitable.

METHODS: Patients who underwent sublobar resection for lung cancer between July 2010 and December 2018 were retrospectively included. The criteria for curative sublobar resection were consolidation-to-tumor ratio ≤0.50 and size ≤3.0 cm in tumors with a ground-glass opacity (GGO) component (GGO group), and size of ≤2.0 cm and volume doubling time ≥400 days in solid tumors (solid group). Cox regression was used to identify predictors for time-to-recurrence (TTR) in tumors outside of these criteria (non-curative group).

RESULTS: Out of 530 patients, 353 were classified into the GGO group and 177 into the solid group. In the GGO group, the 2-year recurrence rates in curative and non-curative groups were 2.1 and 7.7%, respectively (p = 0.054). In the solid group, the 2-year recurrence rates in curative and non-curative groups were 0.0 and 28.6%, respectively (p = 0.03). Predictors of 2-year TTR after non-curative sublobar resection were pathological nodal metastasis (hazard ratio [HR], 6.63; p = 0.02) and lymphovascular invasion (LVI; HR, 3.28; p = 0.03) in the GGO group, and LVI (HR, 4.37; p < 0.001) and fibrosis (HR, 3.18; p = 0.006) in the solid group.

CONCLUSION: The current patient selection criteria for sublobar resection are satisfactory. LVI was a predictor for recurrence after non-curative resection.

ADVANCES IN KNOWLEDGE: This result supports selection criteria of patients for sublobar resection. LVI may help predict recurrence after non-curative sublobar resection.

PMID:37561432 | DOI:10.1259/bjr.20230143

Sch Psychol. 2023 Aug 10. doi: 10.1037/spq0000573. Online ahead of print.

ABSTRACT

This study explored the relationship between 391 third-grade students’ writing productivity and the amount of intervention dosage received over a 6-week period. In addition, the association between gender and the amount of intervention dosage received was examined. Results indicated that intervention dosage had a statistically significant relationship with students’ writing productivity at the conclusion of intervention implementation. In addition, there was not a statistically significant difference in the amount of intervention dose received between female and male students. Notably, less intervention dosage may be indicative of higher rates of school absenteeism, which is associated with adverse academic outcomes. Implications and future research directions are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37561428 | DOI:10.1037/spq0000573

J Travel Med. 2023 Aug 10:taad107. doi: 10.1093/jtm/taad107. Online ahead of print.

ABSTRACT

BACKGROUND: Giardiasis is a common gastrointestinal illness in travellers. Data on the actual giardiasis risk of travellers to different travel destinations is scarce. We aim to estimate the risk of giardiasis in travellers from Germany by destination country and region.

METHODS: We analysed travel-related giardiasis cases, their countries and regions of exposure and the age and sex distribution of cases reported in 2014-2019 in Germany. We defined a travel-related giardiasis case as a laboratory-confirmed (i.e. positive microscopy, antigen test or nucleic acid test) symptomatic individual with outbound travel abroad within 3-25 days before symptom onset. Based on the number of reported cases per exposure country and UNWTO travel data for Germany, we calculated the number of travel-related giardiasis cases per 100 000 travellers and compared the incidence in 2014-2016 and 2017-2019 to identify potential trends.

RESULTS: In 2014-2019, 21 172 giardiasis cases were reported in Germany, corresponding to an overall incidence of 4.3 per 100 000 population. Of all cases, 6879 (32%) were travel-related with a median age of 34 (interquartile range (IQR): 25-50), 51% were male. Southern Asia was the most frequently reported exposure region and had the highest incidence in travellers (64.1 per 100 000 returning travellers) in 2017-2019, followed by Latin America (19.2) and Sub-Saharan Africa (12.9). We observed statistically significant decreasing trends for Southern Asia and Sub-Saharan Africa. Latin America was the only region with a statistically significant increasing trend.

CONCLUSIONS: Almost one-third of recent giardiasis cases in Germany were travel-related. Giardiasis incidence in travellers differs greatly depending on the destination region. Decreasing trends in many regions might be due to improvements in food hygiene or travel conditions. Our results may inform medical consultation pre and post patient’s travel.

PMID:37561417 | DOI:10.1093/jtm/taad107

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2023 Aug 10:1-15. doi: 10.1080/19440049.2023.2240437. Online ahead of print.

ABSTRACT

In this study, direct analysis in real time high resolution mass spectrometry (DART-HRMS) was used to investigate the accurate characterisation of feed additive formulations containing coccidiostats or carotenoids. The study demonstrates the efficacy of DART-HRMS in identifying the active substances in these formulations and distinguishing between feed additives with the same active substance. The protocol for this method involves two simple steps that are extracting samples with organic solvents and measuring the extracts with DART-HRMS. The study also employs various statistical tools, including a factorial design approach, to optimise the DART-HRMS settings, and multivariate statistics, to establish classification models for feed additive formulations using nominal mass spectra. Our study demonstrates the potential of DART-HRMS in ensuring the correct identification of feed additives containing various coccidiostats or carotenoids and proposes this tool as an additional means for compliance checks with EU regulations.

PMID:37561415 | DOI:10.1080/19440049.2023.2240437