Category: Statistics

Syst Rev. 2023 Jan 3;12(1):1. doi: 10.1186/s13643-022-02163-4.

ABSTRACT

BACKGROUND: The importance of systematic reviews in collating and summarising available research output on a particular topic cannot be over-emphasized. However, initial screening of retrieved literature is significantly time and labour intensive. Attempts at automating parts of the systematic review process have been made with varying degree of success partly due to being domain-specific, requiring vendor-specific software or manually labelled training data. Our primary objective was to develop statistical methodology for performing automated title and abstract screening for systematic reviews. Secondary objectives included (1) to retrospectively apply the automated screening methodology to previously manually screened systematic reviews and (2) to characterize the performance of the automated screening methodology scoring algorithm in a simulation study.

METHODS: We implemented a Latent Dirichlet Allocation-based topic model to derive representative topics from the retrieved documents’ title and abstract. The second step involves defining a score threshold for classifying the documents as relevant for full-text review or not. The score is derived based on a set of search keywords (often the database retrieval search terms). Two systematic review studies were retrospectively used to illustrate the methodology.

RESULTS: In one case study (helminth dataset), [Formula: see text] sensitivity compared to manual title and abstract screening was achieved. This is against a false positive rate of [Formula: see text]. For the second case study (Wilson disease dataset), a sensitivity of [Formula: see text] and specificity of [Formula: see text] were achieved.

CONCLUSIONS: Unsupervised title and abstract screening has the potential to reduce the workload involved in conducting systematic review. While sensitivity of the methodology on the tested data is low, approximately [Formula: see text] specificity was achieved. Users ought to keep in mind that potentially low sensitivity might occur. One approach to mitigate this might be to incorporate additional targeted search keywords such as the indexing databases terms into the search term copora. Moreover, automated screening can be used as an additional screener to the manual screeners.

PMID:36597132 | DOI:10.1186/s13643-022-02163-4

BMC Endocr Disord. 2023 Jan 3;23(1):1. doi: 10.1186/s12902-022-01260-8.

ABSTRACT

BACKGROUND: Osteoporosis (OP) and diabetes mellitus (DM) are two major healthcare issues in the world. Numerous population based-studies have reported an increased prevalence of OP among individuals with DM, though, estimates vary significantly.

PURPOSE: The objective of this study is to estimate the prevalence of OP in patients with DM.

METHODS: To identify relevant literature, PubMed, Embase, Medline, CBM and Cochrane Library were searched for studies published from inception till July 2022, The search was conducted, and studies were included without countries and language restrictions. For full-text articles included in the study, the references were also independently searched. Random inverse variance-weighted models were used by Stata version 17.0 to estimate the prevalence of OP in patients with diabetes across studies. The heterogeneity was examined with I² via the χ² test on Cochrane’s Q statistic. Subgroup analysis and meta-regression were used to explore potential sources of heterogeneity. Egger’s test was used to assess publication bias.

RESULTS: A high OP prevalence of 27.67% (95% confidence interval (CI) 21.37-33.98%) was found in a pooled analysis of 21 studies involving 11,603 T2DM patients. Methodological value of the included articles was high, with only three medium-quality studies and no low-quality studies. A significantly high heterogeneity (I² = 98.5%) was observed.

CONCLUSIONS: Worldwide, a high prevalence of OP was found in patients with T2DM. Therefore, strong measures to prevent and treat osteoporosis in diabetic patients are required.

TRIAL REGISTRATION: This study has been registered on PROSPERO, number CRD42021286580 .

PMID:36597121 | DOI:10.1186/s12902-022-01260-8

BMC Nutr. 2023 Jan 3;9(1):5. doi: 10.1186/s40795-022-00665-x.

ABSTRACT

BACKGROUND: Food Insecurity (FI) is a global health concern. For the first time, this study evaluated households’ food insecurity and factors related to it in Golestan province, North of Iran.

METHODS: This cross-sectional study was conducted on 5129 randomly selected households in the Golestan Province in 2016. Sociodemographic characteristics, including age, ethnicity, household size, education level, and occupation status, were collected via interview. The prevalence and severity of food insecurity were identified by the Household Food Insecurity Access Scale (HFIAS), whose scores are between 0 and 27, with larger values indicating more severe food insecurity. The prevalence of food insecurity based on the geographical area was presented using GIS.

RESULTS: Out of 5129 households, 2216 (43.21%) had food security, and 2913 (56.79%) households had food insecurity, with a Mean ± SD HFIAS score of 4.86 ± 5.95. Out of 2913 households with FI, 1526 (52.39%), 956 (32.82%), and 431 (14.79%) had mild, moderate, and severe food insecurity, respectively. Among 14 regions of the province, three regions had the most cases of food insecurity. Food insecurity (moderate or severe) was significantly associated with mothers as the household head (adjusted OR = 1.67, 95% CI: 1.03-2.70) and lower education level of the household head.

CONCLUSION: The prevalence of household food insecurity in the Golestan Province is higher than the national average. Factors such as literacy, employment status, and gender of the household head can be significantly associated with food insecurity.

PMID:36597118 | DOI:10.1186/s40795-022-00665-x

BMC Health Serv Res. 2023 Jan 3;23(1):4. doi: 10.1186/s12913-022-08994-0.

ABSTRACT

BACKGROUND: Telephone triage has been established in many countries as a response to the challenge of non-urgent use of out-of-hours primary care services. However, limited evidence is available regarding the effect of training interventions on clinicians’ telephone consultation skills and patient outcomes.

METHODS: This was a pragmatic randomized controlled educational intervention for telephone triage nurses in 59 Norwegian out-of-hours general practitioners’ (GPs) cooperatives, serving 59% of the Norwegian population. Computer-generated randomization was performed at the level of out-of-hours GP cooperatives, stratified by the population size. Thirty-two out-of-hours GP cooperatives were randomized to intervention. One cooperative did not accept the invitation to participate in the educational programme, leaving 31 cooperatives in the intervention group. The intervention comprised a 90-minute e-learning course and 90-minute group discussion about respiratory tract infections (RTIs), telephone communication skills and local practices. We aimed to assess the effect of the intervention on out-of-hours attendance and describe the distribution of RTIs between out-of-hours GP cooperatives and list-holding GPs. The outcome was the difference in the number of doctor’s consultations per 1000 inhabitants between the intervention and control groups during the winter months before and after the intervention. A negative binomial regression model was used for the statistical analyses. The model was adjusted for the number of nurses who had participated in the e-learning course, the population size and patients’ age groups, with the out-of-hours GP cooperatives defined as clusters.

RESULTS: The regression showed that the intervention did not change the number of consultations for RTIs between the two groups of out-of-hours GP cooperatives (incidence rate ratio 0.99, 95% confidence interval 0.91-1.07). The winter season’s out-of-hours patient population was younger and had a higher proportion of RTIs than the patient population in the list-holding GP offices. Laryngitis, sore throat, and pneumonia were the most common diagnoses during the out-of-hours primary care service.

CONCLUSIONS: The intervention did not influence the out-of-hours attendance. This finding may be due to the intervention’s limited scope and the intention-to-treat design. Changing a population’s out-of-hours attendance is complicated and needs to be targeted at several organizational levels.

PMID:36597106 | DOI:10.1186/s12913-022-08994-0

Contracept Reprod Med. 2023 Jan 3;8(1):1. doi: 10.1186/s40834-022-00196-7.

ABSTRACT

BACKGROUND: Adolescent girls should practice good menstrual hygiene to enhance their health and educational attainment. However, socio-cultural restrictions and limited water, sanitation, and hygiene in school environments continued to make it difficult for in school adolescent females to practice good menstrual hygiene management. So, the main aim of this study was to assess menstrual hygiene management practice and its associated factors among in-school adolescent girls in the secondary schools of Gimbi town, western Ethiopia.

METHODS: A school-based cross-sectional study was conducted among 378 adolescent girls in Gimbi town secondary schools. The study participants were selected by using stratified random sampling techniques. Pretested self-administered Afan Oromo questionnaire with sociodemographic characteristics, information and knowledge about menstruation, and practice of menstrual hygiene management, as well as observational checklist to assess school environment were used to collect the data. Data were cleaned, coded, and entered into Epi-info version 7.2.0.4 and exported to SPSS version 25 for statistical analysis. Multivariable logistic regression analysis was used to identify factors associated with the practice of menstrual hygiene management and P-values less than 0.05 was used to declare statistical significance.

RESULTS: Out of 378 respondents, 163 (43.1%) (38-48) of adolescent girls had good menstrual hygiene management practice. Being urban resident (AOR = 3.48, (95% C.I:1.99-6.08), having mother with secondary level of education (AOR = 2.71, 95%CI: 1.15,6.42), having mother with educational level of college and above (AOR = 3.30, 95%CI1.28,8.50), having discussion about menstruation with parents (AOR = 2.42,95%CI:1.45,4.04), and having knowledge about menstruation (AOR = 2.94, 95% CI: 1.69-5.13) were factors associated with good menstrual hygiene management practice.

CONCLUSION: In this study, good menstrual hygiene management practice is low among in school adolescent girls. Place of residence, maternal educational level, discussion about menstrual issue with parent, and having knowledge about menstruation were factors associated with good menstrual management practice. Stakeholders should give appropriate awareness and health education related to menstrual hygiene for adolescent girls at all levels.

PMID:36597101 | DOI:10.1186/s40834-022-00196-7

BMC Med Educ. 2023 Jan 3;23(1):3. doi: 10.1186/s12909-022-03992-6.

ABSTRACT

BACKGROUND: Compared with traditional tendon repair teaching methods, using a virtual reality (VR) simulator to teach tendon suturing can significantly improve medical students’ exercise time, operation flow and operation knowledge. At present, the purpose of this study is to explore the long-term influence of VR simulator teaching on the practice performance of medical students.

METHOD: This is a one-year long-term follow-up study of a randomized controlled study. A total of 117 participants who completed the initial study were invited to participate in the follow-up study. Participants in the VR group and the control group were required to complete a questionnaire developed by the authors and the teachers in the teaching and research department and to provide their surgical internship scores and Objective Structure Clinical Examination(OSCE) graduation scores.

RESULTS: Of the 117 invitees, 108 completed the follow-up. The answers to the questions about career choice and study habits were more positive in the VR group than in the control group (p < 0.05). The total score for clinical practice in the VR group was better than that in the control group, and the difference was statistically significant (p < 0.05). In the OSCE examination, the scores for physical examination, suturing and knotting and image reading were higher in the VR group than in the control group, and the difference was statistically significant (p < 0.05).

CONCLUSION: The results of the one-year long-term follow-up indicated that compared with medical students experiencing the traditional teaching mode, those experiencing the VR teaching mode had more determined career pursuit and active willingness to learn, better evaluations from teachers in the process of surgical clinical practice, and better scores in physical examination, suturing and knotting and image reading in the OSCE examination. In the study of nonlinear dynamics to cultivate a good learning model for medical students, the VR teaching model is expected to become an effective and stable initial sensitive element.

TRIAL REGISTRATION: Chinese Clinical Trial Registry(25/05/2021, ChiCTR2100046648); http://www.chictr.org.cn/hvshowproject.aspx?id=90180 .

PMID:36597093 | DOI:10.1186/s12909-022-03992-6

BMC Ophthalmol. 2023 Jan 3;23(1):5. doi: 10.1186/s12886-022-02758-4.

ABSTRACT

BACKGROUND: To evaluate corneal topography and densitometry features in patients with polycystic ovary syndrome (PCOS) and compare them with healthy individuals.

METHODS: 53 eyes of 53 female patients diagnosed with PCOS and 53 eyes of 53 age-matched female volunteers were analyzed in the study. In addition to the detailed ophthalmological and gynecological examination, anterior segment analysis was performed using Pentacam. A complete analysis of aberrometric, keratometric, topometric, and, densitometric values between the groups was performed, and the results were outlined.

RESULTS: According to the results, although Kmax-front, Kmean-front, ISV, IVA, IHA, BAD_D and PI-Avg values were slightly higher in PCOS group along with a slight thinning in the thinnest location, there was no statistically significant difference between the groups. Moreover, correlation analysis between PCOS clinical parameters and keratometric/topometric/aberrometric data were found to be almost normal. Yet, when Pentacam tomography maps of all cases are examined in detail, mild ectatic changes were observed in 5 cases in PCOS group. Furthermore, a significant increase in thickness across all densitometry values except anterior (10-12 mm), central (10-12 mm), and total (10-12 mm) was found in PCOS group.

CONCLUSIONS: Our study showed that an intensification of corneal densitometry values ​​and various changes in keratometry data implying ectasia can be observed in patients with PCOS. Prospective studies with larger patient series are needed to reveal any potential relationship between PCOS and corneal abnormalities.

PMID:36597084 | DOI:10.1186/s12886-022-02758-4

BMC Pediatr. 2023 Jan 4;23(1):8. doi: 10.1186/s12887-022-03826-w.

ABSTRACT

BACKGROUND: Celiac disease (CD) is an autoimmune disease caused by gluten intake. Traditionally CD was believed to be a disease of the gut, although a wide range of extra-intestinal manifestations (EIM) was recognized. The exact prevalence of EIM and the associated risk factors have not been well studied.

AIM: We aimed to assess the prevalence of EIM in children with CD and their association with human leukocyte antigen (HLA) typing, and pathological and laboratory indices.

METHOD: We conducted a cross-sectional study on children and adolescents with a definite diagnosis of CD. They were followed in the main Celiac Clinic of Southern Iran.

RESULTS: We included 204 children who were visited between 2012 and 2017. Nearly 85% of them were positive for HLA-DQ2 and 40.6% for HLA-DQ8. The most prevalent intestinal complaints reported were abdominal pain (42.6%) and chronic constipation (19.1%). Failure-to-thrive (32.7%), iron deficiency anemia (25%), short stature (20.5%), and eczema (18.6%) were the most common EIMs. However, failure-to-thrive and short stature were presented at significantly younger ages, whereas those patients with concomitant type 1 diabetes mellitus (DM) were significantly older. We also found significant relationships between autoimmune thyroid disease and HLA-DQ5, and the presence of headaches with HLA-DQ7. The prevalence of HLA types of DQ2, DQ8, DQ6, and DQ7 significantly varied among different Marsh groups. Patients who were positive for HLA-DQ8, were significantly older, taller, and weightier. No significant association was found between HLA types and any of the gastrointestinal symptoms, anti-tTG and compliance to gluten free diet. Moreover, there were no statistically significant differences detected between the presence of each individual EIM, the level of IgA anti-tTG, sex, and Marsh typing.

CONCLUSION: This study highlights the presence of EIM in CD and their associated factors. We show the potential role of HLA typing in some EIMs, which may shed light for future studies.

PMID:36597078 | DOI:10.1186/s12887-022-03826-w

BMC Public Health. 2023 Jan 4;23(1):16. doi: 10.1186/s12889-022-14845-8.

ABSTRACT

BACKGROUND: Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners.

METHOD: Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13-18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points.

RESULT: Health risk behaviours increased consistently for alcohol consumption (25.7-42.7%), smoking cannabis (10.4-22.1%) and (22.3-36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2-1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2-1.4), p < 0.001] and had sex [OR:1.5 (1.4-1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2-1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1-1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53-0.83), p < 0.001]; and sex [OR: 0.5 (0.4-0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis.

CONCLUSION: The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.

PMID:36597075 | DOI:10.1186/s12889-022-14845-8

BMC Public Health. 2023 Jan 3;23(1):7. doi: 10.1186/s12889-022-14914-y.

ABSTRACT

BACKGROUND: Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland.

METHODS: The 2010-2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations.

RESULTS: Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010-2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index).

CONCLUSIONS: Significant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas.

PMID:36597073 | DOI:10.1186/s12889-022-14914-y