Category: Statistics

Arthroscopy. 2026 Jun 28. doi: 10.1002/arj.70359. Online ahead of print.

ABSTRACT

PURPOSE: To compare clinical outcomes following hip arthroscopy for femoroacetabular impingement syndrome using either limited interportal (IP) or T-capsulotomy (TC) technique, with routine capsular closure.

METHODS: This retrospective cohort study included patients ≤50 years old who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between May 2021 and January 2024 with a minimum of 12-month follow-up. Patients were treated with either IP or TC, and all underwent standardized capsular repair. Patient-reported outcomes (PROs) were collected preoperatively and at final follow-up. Cohort-specific minimum clinically important difference thresholds were calculated for each PROs and compared between groups. Improvements in scores were compared with established thresholds for the patient acceptable symptomatic state (PASS). Statistical significance was set at P < .05.

RESULTS: A total of 116 patients met the inclusion criteria (54 IP, 62 TC; mean age 34.5 ± 8.8 years; 55% female). Mean follow-up was 15.5 ± 5.4 months. Both groups showed significant improvements in all PROs. Although mean improvements were not statistically different, the interportal group showed consistently higher average postoperative scores. Cohort-specific minimum clinically important difference thresholds were achieved at similar rates in both groups, whereas exploratory analyses using previously published PASS thresholds showed higher PASS achievement in the interportal group for International Hip Outcomes Tool (76% vs 54%) and Patient Reported Outcome Measurement Information System Physical Function (58% vs 46%). No revisions or Clavien-Dindo grade ≥2 complications occurred in either group.

CONCLUSIONS: Both IP and TC techniques led to significant improvements in PROs following hip arthroscopy with capsular repair, with similar rates of cohort-specific minimum clinically important difference achievement and no differences in revision surgery or major complications. Exploratory analyses showed higher PASS rates for International Hip Outcomes Tool and Patient Reported Outcome Measurement Information System Physical Function in the IP group, suggesting that a more limited capsulotomy may confer functional advantages.

LEVEL OF EVIDENCE: Level III, retrospective comparative case series.

PMID:42365525 | DOI:10.1002/arj.70359

Int J Dermatol. 2026 Jun 28. doi: 10.1111/ijd.70548. Online ahead of print.

ABSTRACT

BACKGROUND: Keloids are an abnormal fibroproliferative disorder that often causes pruritus, pain, and hyperpigmentation, thereby significantly impacting quality of life. Vascular endothelial growth factor (VEGF) is upregulated in scars and, therefore, can be a potential target for their treatment.

OBJECTIVES: Our aim was to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TAC) versus intralesional bevacizumab injection in the treatment of post-traumatic keloids.

METHODS: This randomized clinical trial was conducted on 28 adult patients with post-traumatic keloids. Patients were randomized into two groups; one group received intralesional triamcinolone acetonide, and the other received intralesional bevacizumab. Injections were done monthly. Patients received a total of three sessions. Therapeutic efficacy was defined in terms of the modified Vancouver Scar Scale (mVSS), erythema index by spectrophotometry, histopathological evaluation, and biochemical assessment of VEGF, collagen type I, and collagen type III levels.

RESULTS: A statistically significant difference in mVSS was observed between the triamcinolone acetonide and bevacizumab groups, favoring the TAC group. The TAC group showed a significant decrease in VEGF level and an increase in collagen type III after treatment. The bevacizumab group showed significant improvement in the spacing between collagen fibers after treatment. The patient satisfaction score and the physician global assessment revealed superior outcomes regarding intralesional triamcinolone acetonide.

CONCLUSION: Despite the superior results observed with triamcinolone, bevacizumab warrants further investigation to determine whether it can be used for early and vascular keloids or as an adjuvant to optimize results.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT07014280.

PMID:42365524 | DOI:10.1111/ijd.70548

Aust J Prim Health. 2026 Aug 17;32(4):PY25238. doi: 10.1071/PY25238.

ABSTRACT

BACKGROUND: Well-implemented vaccination programs can reduce infectious disease burden in an equitable and cost-effective manner. This rapid review used a strengths-based approach to identify enablers and barriers to vaccination for Aboriginal and Torres Strait Islander children aged 0-5 years, and identify the characteristics of effective programs to improve vaccination coverage and timeliness.

METHODS: Databases and grey literature sources were searched for articles published between 2013 and 2025. Following screening, an inductive coding process informed by Braun and Clarke’s reflexive thematic analysis was utilised to consolidate qualitative data.

RESULTS: Twelve studies discussing enablers, barriers and characteristics of successful programs to increase vaccination rates were included. These studies were heterogenous in design and population.

CONCLUSIONS: Despite variability between settings and communities, service access barriers, such as lack of adequate transport and opening hours, were commonly cited throughout the included studies, as well as lack of cultural safety. This review emphasises the value of community ownership and local responsiveness of programs aimed at increasing vaccination timeliness and coverage, and the importance of strengthening the Aboriginal and Torres Strait Islander health workforce.

PMID:42365523 | DOI:10.1071/PY25238

Am J Hematol. 2026 Jun 28. doi: 10.1002/ajh.70430. Online ahead of print.

NO ABSTRACT

PMID:42365517 | DOI:10.1002/ajh.70430

Scand J Surg. 2026 Jun 28:14574969261458557. doi: 10.1177/14574969261458557. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: A large variation in surgery rates can be indicative of its overuse. In Finland, surgeries for carpal tunnel syndrome (CTS) and ulnar nerve disorder (UN) are common, but regional differences in their incidence rates remain unexplored. This study examined how the incidence rates of these surgeries vary across hospital districts in Finland to evaluate regional consistency.

METHODS: We compared regional age- and sex-adjusted incidence rates per 100,000 person-years based on data from Finland’s Care Register for Health Care for CTS and UN surgeries from 2010 to 2021, calculated relative to population size as reported by Statistics Finland. The study included 21 hospital districts in Finland.

RESULTS: During the 4-year period from 2018 to 2021, the difference between the lowest (99.6 cases per 100,000 person-years (95% confidence interval (CI) 80.7-122)) and the highest (351 cases per 100,000 person-years (95% CI 336-367)) adjusted incidence rates for CTS surgery was 3.5-fold, with a median adjusted incidence rate of 213 cases per 100,000 person-years. Over the same period, the difference between the lowest (1.04 cases per 100,000 person-year (95% CI 0.03-5.78)) and the highest (81.9 cases per 100,000 person-years (95% CI 73.2-91.5)) adjusted incidence rates for UN surgery was up to 79-fold, with a median adjusted incidence rate of 17.8 cases per 100,000 person-years.

CONCLUSIONS: Surgery for CTS shows up to a 3.5-fold variation across Finland’s hospital districts. Although less common in absolute numbers, surgical treatment rates for UN vary up to 79-fold among these regions. Such significant variations are unlikely to be attributed solely to differences in population morbidity. Instead, the findings indicate that the criteria for performing these surgeries vary considerably across the Finland’s hospital districts, suggesting a potential overuse in certain areas.

PMID:42365503 | DOI:10.1177/14574969261458557

J Nurs Manag. 2026;2026(1):e8184283. doi: 10.1155/jonm/8184283.

ABSTRACT

Digital services allow patients to efficiently access healthcare. These services work more effectively than traditional paper-based systems by delivering better patient outcomes, helping address global health challenges, and promoting the universal adoption of health technology. This study examined the impact of digital healthcare adoption and service quality on patient satisfaction in Pakistan’s public healthcare sector and the moderating effect of telehealth services on this relationship. This study adopted the technology acceptance model to understand technology sophistication and how electronic medical records, digital patient systems, and technology impact healthcare through efficiency and communication. Simultaneously, the study examined the role of doctor services, nurse services, pharmacy services, and laboratory services in the patient experience. Random sampling techniques were employed, and questionnaires were distributed to 573 respondents across five central districts of Punjab, Pakistan. The hypotheses were tested using IBM SPSS Statistics, Amos, and structural equation modeling. These findings show that digital healthcare adoption and service quality significantly improve patient satisfaction, whereas telehealth services reinforce these relationships by overcoming geographical and logistical hurdles. The conclusions of this study offer pragmatic guidance to policymakers and healthcare administrators for devising digital healthcare strategies to improve patient outcomes.

PMID:42365466 | DOI:10.1155/jonm/8184283

J Nurs Manag. 2026;2026(1):e3021423. doi: 10.1155/jonm/3021423.

ABSTRACT

INTRODUCTION: Postgraduate education is critical for advancing nursing competence, yet enrolment has declined as nurses struggle to balance clinical, academic and personal responsibilities. Workplace learning offers a flexible, context-driven alternative, allowing nurses to integrate academic development into their clinical practice and potentially mitigating work-life conflicts. However, adoption of structured workplace learning remains limited across healthcare organisations.

AIM: This study aimed to explore how workplace learning can be integrated into healthcare settings to inform curriculum design, resource allocation and organisational support in postgraduate nursing education.

DESIGN AND METHODS: An explanatory sequential mixed-methods study comprising a single-cohort quantitative pre-post knowledge assessment and repeated competence assessments, followed by qualitative focus groups to explain implementation enablers and barriers. Twenty-three postgraduate nurses enrolled in a 13-week workplace learning course participated; 22 completed the study. Quantitative data were analysed with nonparametric statistics, while qualitative data underwent thematic analysis.

RESULTS: We observed a slight improvement in median knowledge scores and increasing competence scores across four time points. As this was a single-group evaluation without a control group, quantitative findings cannot be interpreted as causal effects. Qualitative analysis generated three themes: (1) learning and assessment, (2) integration of workplace learning in the organisation and (3) organisational impact on workplace learning.

CONCLUSION: Workplace learning was feasible and valued when supported by peer learning structures, appropriately timed assessments and organisational enablers such as protected time, adequate infrastructure and leadership support.

PMID:42365465 | DOI:10.1155/jonm/3021423

J Nurs Manag. 2026;2026(1):e4803748. doi: 10.1155/jonm/4803748.

ABSTRACT

INTRODUCTION: This review aimed to identify existing workplace violence (WPV) reporting forms worldwide, examine their domains and determine the essential information required to develop a more comprehensive and effective WPV reporting form.

MATERIALS AND METHODS: A systematic search of PubMed, Web of Science and Google Scholar from 1990 to 2025 was conducted. Data extracted included study characteristics, populations, reporting form names, number of items and reporting approaches. Descriptive analysis and hierarchical cluster analysis were performed to determine the number of items and domains included in each WPV reporting form.

RESULTS: A total of 22 WPV reporting forms were included. Across these forms, 148 reporting items were identified and grouped into 13 domains: sociodemographic data of the victim, job characteristics of the victim, characteristics of the notifier, characteristics of the incident, characteristics of the injury, measures taken during the violence, consequences of the violence, postviolence treatment, aftermath of the violence, reporting of the violence, perception of victim postviolence, characteristics of the assailant and characteristics of the witness. Hierarchical cluster analysis classified the 22 WPV reporting forms into three clusters based on comprehensiveness: rapid forms (three items), brief forms (mean 13.75 items) and detailed forms (mean 27.77 items).

CONCLUSIONS: Substantial variation exists in the content of WPV reporting forms. Future WPV reporting forms should, at minimum, include seven most commonly reported domains, particularly job characteristics of the victim, characteristics of the incident, characteristics of the injury, measures taken during the violence, characteristics of assailant, characteristics of the witness and reporting of the violence.

IMPLICATIONS FOR NURSING MANAGEMENT: The findings highlight substantial variability in the content, structure and domains of existing WPV reporting forms used in healthcare institutions, indicating the need for standardised, evidence-based reporting tools that capture essential information relevant to nursing practice. Standardisation would improve comparability of WPV data across institutions and countries, facilitating more accurate benchmarking and global surveillance, particularly as nurses constitute the largest proportion of frontline healthcare workers. Additionally, nursing leaders, hospital administrators and health authorities can utilise these findings to strengthen institutional WPV policies by implementing clear and accessible reporting procedures and integrating domains related to prevention programmes, incident management and postincident support to guide policy development, staff training and resource allocation.

PMID:42365458 | DOI:10.1155/jonm/4803748

Breast J. 2026;2026(1):e4333748. doi: 10.1155/tbj/4333748.

ABSTRACT

INTRO: Divergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real-world patients with MBC in Washington State.

METHODS: Data were retrospectively analyzed using a linked cancer registry and insurance claims platform for patients with recurrent or de novo MBC diagnosed between 2008 and 2019.

RESULTS: We identified 1101 patients with MBC (median age: 66), 715 recurrent and 386 de novo. Most patients were White (89%), all were insured (Commercial [47%], Medicaid [4%], Medicare [35%], or multiple [13%]), and 15% lived in areas of high deprivation (Area Deprivation Index [ADI]: 8-10). Of the patients with recurrent MBC, less than half received a biopsy (49.5%) or biomarker reassessment (48.7%) to confirm the diagnosis of MBC. Patients treated at high- and medium-volume centers had higher rates of biopsy than low-volume clinics (51.9%, 54.3%, and 40.7%, respectively, p = 0.03). ET alone was more common in patients who did not undergo biopsy (62.3% vs. 37.7%, p < 0.001) or biomarker reassessment (62.7% vs. 37.3%, p < 0.001). Among the 677 patients with estrogen receptor (ER)+/HER2- MBC (de novo and recurrent), most received ET alone (69%), followed by CT (22%) and CDKi + ET (9%). Importantly, 40% of patients were treated before CDK4/6i approval. Most patients who received CDKi + ET were < 65 years old (65.2%, p < 0.02). Patients with commercial insurance were more likely to receive CDKi + ET compared to those with Medicare/Medicaid. (60.9% vs. 26.1%, p = 0.10).

CONCLUSION: Our findings highlight key gaps in MBC management and serve as a launch point for patient-centered and quality-promoting initiatives.

PMID:42365454 | DOI:10.1155/tbj/4333748

Expert Opin Biol Ther. 2026 Jun 28. doi: 10.1080/14712598.2026.2694688. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess prescription patterns and describe the long-term real-life effectiveness of different TNF inhibitors (TNFi) in juvenile idiopathic arthritis related uveitis (JIA-U).

METHODS: Patients with JIA-U treated with TNFi were retrospectively enrolled.

RESULTS: 96 JIA-U patients (77% female) with an age at diagnosis of 2.44 [interquartile range (IQR) 1.56-3.81] and a median follow-up of 19 years were included. Adalimumab was the most frequently prescribed TNFi (61%), followed by etanercept (19%), infliximab (15%) and golimumab (5%). Overall, adalimumab showed the lowest complications rate (51%; p < 0.001) and median number of uveitis relapse (1; IQR 0-2; p = 0.012). Conversely etanercept showed the highest median number of uveitis relapses (4; IQR 1-5). The cumulative incidences curves for ‘uveitis relapse’ were similar among TNFi. Conversely, when ‘treatment change’ was considered as the event, a significantly higher risk for patients treated with infliximab compared with those receiving adalimumab emerged (HR 3.06, 95% CI 1.41-6.63; p < 0.01).

CONCLUSIONS: All TNFi appear to be effective for long-term management of JIA-U. We observed some differences in number of uveitis relapses and ocular complication rates favoring adalimumab over infliximab and etanercept, findings to be further confirmed in prospective studies.

PMID:42365450 | DOI:10.1080/14712598.2026.2694688