Category: Statistics

Euro Surveill. 2022 Aug;27(33). doi: 10.2807/1560-7917.ES.2022.27.33.2200070.

ABSTRACT

BackgroundAnalyses of diagnostic performance of SARS-CoV-2 antigen rapid diagnostic tests (AG-RDTs) based on long-term data, population subgroups and many AG-RDT types are scarce.AimWe aimed to analyse sensitivity and specificity of AG-RDTs for subgroups based on age, incidence, sample type, reason for test, symptoms, vaccination status and the AG-RDT’s presence on approved lists.MethodsWe included AG-RDT results registered in Czechia’s Information System for Infectious Diseases between August and November 2021. Subpopulations were analysed based on 346,000 test results for which a confirmatory PCR test was recorded ≤ 3 days after the AG-RDT; 38 AG-RDTs with more than 100 PCR-positive and 300 PCR-negative samples were individually evaluated.ResultsAverage sensitivity and specificity were 72.4% and 96.7%, respectively. We recorded lower sensitivity for age groups 0-12 (65.5%) and 13-18 years (65.3%). The sensitivity level rose with increasing SARS-CoV-2 incidence from 66.0% to 76.7%. Nasopharyngeal samples had the highest sensitivity and saliva the lowest. Sensitivity for preventive reasons was 63.6% vs 86.1% when testing for suspected infection. Sensitivity was 84.8% when one or more symptoms were reported compared with 57.1% for no symptoms. Vaccination was associated with a 4.2% higher sensitivity. Significantly higher sensitivity levels pertained to AG-RDTs on the World Health Organization Emergency Use List (WHO EUL), European Union Common List and the list of the United Kingdom’s Department of Health and Social Care.ConclusionAG-RDTs from approved lists should be considered, especially in situations associated with lower viral load. Results are limited to SARS-CoV-2 delta variant.

PMID:35983773 | DOI:10.2807/1560-7917.ES.2022.27.33.2200070

Elife. 2022 Aug 19;11:e72518. doi: 10.7554/eLife.72518.

ABSTRACT

Complex systems are challenging to understand, especially when they defy manipulative experiments for practical or ethical reasons. Several fields have developed parallel approaches to infer causal relations from observational time series. Yet, these methods are easy to misunderstand and often controversial. Here, we provide an accessible and critical review of three statistical causal discovery approaches (pairwise correlation, Granger causality, and state space reconstruction), using examples inspired by ecological processes. For each approach, we ask what it tests for, what causal statement it might imply, and when it could lead us astray. We devise new ways of visualizing key concepts, describe some novel pathologies of existing methods, and point out how so-called ‘model-free’ causality tests are not assumption-free. We hope that our synthesis will facilitate thoughtful application of methods, promote communication across different fields, and encourage explicit statements of assumptions. A video walkthrough is available (Video 1 or https://youtu.be/AIV0ttQrjK8).

PMID:35983746 | DOI:10.7554/eLife.72518

Public Health Nutr. 2022 Aug 19:1-34. doi: 10.1017/S1368980022001720. Online ahead of print.

ABSTRACT

OBJECTIVE: This study seeks to empirically investigate how the changing eating habits affect health habits within three countries with entirely different cultures and diets to understand to what extent the pandemic may be responsible for these changes.

DESIGN: Specifically, a questionnaire was conducted in China, Portugal, and Turkey in early 2021. A series of statistical analyses were performed to identify how changes in individuals’ eating habits have influenced their diets, considering the pandemic context and the varying cultural contexts where this research was performed.

SETTING: A structured questionnaire form was developed and uploaded to an online platform with unique links for automatic distribution to respondents in each country. Data for the main survey were gathered between 3 January and 1 February 2021.

PARTICIPANTS: Using snowball sampling, the authors leveraged their social networks by asking friends and colleagues to distribute the survey to potentially interested individuals. This distribution was stratified accordingly to the distribution of the population. The authors ultimately collected 319 useable surveys from China, 351 from Portugal, and 449 from Turkey.

RESULTS: The pandemic inspired healthier food habits, mostly because people have additional time to cook, shop differently for food, and spend more money on groceries.

CONCLUSIONS: The study suggests that aside from cultural values and dietary habits, the available time and the fear of the pandemic most explained the new eating habits. Several implications are provided for researchers and overall society in these three countries.

PMID:35983728 | DOI:10.1017/S1368980022001720

Int J Health Plann Manage. 2022 Aug 19. doi: 10.1002/hpm.3549. Online ahead of print.

ABSTRACT

OBJECTIVES: This study is designed to analyse current allocation equity of medical resources in China for a better distribution of medical resources.

METHODS: Descriptive statistical methods were used to analyse the overall allocation of Traditional Chinese medicine (TCM) resources between 2012 and 2018. Lorentz curve and Gini coefficient were used to quantitatively analyse the fairness of the allocation from the population and geography two dimensions.

RESULTS: This study revealed an increase of TCM resources for the 6-year period, but the fair allocation of these resources was subjected to the methods used. The Gini coefficients were <0.3 based on population distribution but >0.5 basing on the geography allocation.

CONCLUSION: Population based analysis for the equity of the TCM resource allocation is superior, more attention for health resource planning is needed to focus on geographical fairness in the future, especially for the less populated rural regions.

PMID:35983688 | DOI:10.1002/hpm.3549

Public Health Nutr. 2022 Aug 19:1-23. doi: 10.1017/S1368980022001744. Online ahead of print.

ABSTRACT

OBJECTIVE: This study sought to explain results of the Water Up!@Home randomized controlled trial where low-income parents were randomized to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in SSB and increases in water intake post-intervention.

DESIGN: Qualitative explanatory in-depth interviews analyzed thematically and deductively.

SETTING: Washington DC metropolitan area, US.

PARTICIPANTS: Low-income Latino parents of infants/toddlers who had participated in the Water UP! @Home randomized controlled trial.

RESULTS: The filter stimulated water consumption in both groups by: 1) increasing parents’ perception of water safety, 2) acting as a cue to action to drink water, 3) improving the flavor of water (which was linked to perceptions of safety), and 4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills, and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake.

CONCLUSIONS: A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption.

PMID:35983682 | DOI:10.1017/S1368980022001744

Turk Kardiyol Dern Ars. 2022 Aug 19. doi: 10.5543/tkda.2022.22430. Online ahead of print.

ABSTRACT

OBJECTIVE: Discontinuation of metformin treatment is a frequently used approach in clinical practice in diabetic ST-segment elevation myocardial infarction patients using metformin in order to reduce the risk of contrast-induced acute kidney injury. There is insufficient evidence in the literature to support this approach. The aim of this study is to determine whether the risk of contrast-induced acute kidney injury is different in diabetic ST-segment elevation myocardial infarction patients using metformin compared to those not taking metformin.

METHODS: The population of the study consisted of patients who applied to our centers that are covered by this study with the diagnosis of ST-segment elevation myocardial infarction and underwent primary percutaneous intervention between 2014 and 2019. Three forty-three diabetic patients that met the study inclusion criteria were divided into 2 groups as who have been receiving metformin and who have not. Patients’ creatinine values at admission and peak creatinine values were compared in order to determine whether they have developed contrastinduced acute kidney injury. The 2 groups were compared using conditional logistic regression analysis conducted with the inverse probability weighting method.

RESULTS: Non-weighted classic multivariable logistic regression analysis revealed that metformin use was not associated with acute kidney injury. Weighted conditional multivariable logistic regression revealed that the increase in the risk of acute kidney injury was associated with baseline creatinine levels [odds ratio: 1.49 (1.06-2.10; 95% CI) P=.02] and that the increase in the risk of contrast-induced acute kidney injury was not associated with metformin usage [odds ratio: 0.92 (0.57-1.50, 95% CI) P=.74].

CONCLUSION: No statistically significant difference was found between the metformin and nonmetformin users among the diabetic ST-segment elevation myocardial infarction patients who underwent primary percutaneous intervention in the risk of contrast-induced acute kidney injury.

PMID:35983653 | DOI:10.5543/tkda.2022.22430

Int J Health Plann Manage. 2022 Aug 18. doi: 10.1002/hpm.3558. Online ahead of print.

ABSTRACT

The role of maternal empowerment (ME) to improve child nutrition in patriarchal societies of developing countries remains ambiguous. This study provides empirical evidence about the impact of ME and some other factors selected under United Nations International Children’s Emergency Fund theoretical framework, on dietary diversity of children (under 5 years age) in Pakistan. Partial proportional odds model is estimated to obtain varying estimates of the parameters by using data of Pakistan Demographic and Health Survey 2017-18. Significant positive role of empowered mothers to improve child dietary diversity (CDD) is explored (OR = 1.135; Confidence Interval [CI] = 1.001-1.288). Moreover, positive association of maternal higher education on CDD (OR = 1.329; 95% CI = 1.085-1.628) supports the productive and allocative efficiency hypotheses of health economics. Maternal agricultural employment, paternal education, and paternal employment were not significantly associated with CDD. This requires further exploration. Positive association of household socioeconomic status with CDD (OR = 1.768; 95% CI = 1.314-2.380) and significance of some demographic variables call for social welfare programs. Positive association of mother’s age and CDD demands for amendment in Child Marriage Restraint Act. The observed adverse association of family size with CDD induces effective family planning to control high birth rate in Pakistan. It may be concluded that ME and creation of awareness about nutrition security through maternal education are the important factors to overcome child malnutrition in Pakistan. Since, socioeconomic and cultural environment in South Asian countries is homogeneous, the analysis in this study might be relevant to the South Asian region. Moreover, the study provides evidence informing the debate on the role of ME to improve child nutrition in patriarchal societies.

PMID:35983643 | DOI:10.1002/hpm.3558

Biometrics. 2022 Aug 18. doi: 10.1111/biom.13743. Online ahead of print.

ABSTRACT

Tensor regression analysis is finding vast emerging applications in a variety of clinical settings, including neuroimaging, genomics and dental medicine. The motivation for this paper is a study of periodontal disease (PD) with an order 3 tensor response: multiple biomarkers measured at pre-specified tooth sites within each tooth, for each participant. A careful investigation would reveal considerable skewness in the responses, in addition to response missingness. To mitigate the shortcomings of existing analysis tools, we propose a new Bayesian tensor response regression method that facilitates interpretation of covariate effects on both marginal and joint distributions of highly skewed tensor responses, and accommodates missing-at-random responses under a closure property of our tensor model. Furthermore, we present a prudent evaluation of the overall covariate effects while identifying their possible variations on only a sparse subset of the tensor components. Our method promises MCMC tools that are readily implementable. We illustrate substantial advantages of our proposal over existing methods via simulation studies and application to a real dataset derived from a clinical study of PD. The R package BSTN available in GitHub implements our model. This article is protected by copyright. All rights reserved.

PMID:35983634 | DOI:10.1111/biom.13743

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Aug;30(4):1272-1276. doi: 10.19746/j.cnki.issn.1009-2137.2022.04.048.

ABSTRACT

OBJECTIVE: To explore the value of the diagnostic-driven therapy with voriconazole in patients with hematological disorders complicated by invasive fungal disease (IFD).

METHODS: A total of 111 patients with hematological disorders complicated by IFD, treated with voriconazole in the hematology department of the General Hospital of South Theatre Command from July 2019 to July 2020, were retrospectively analyzed to compare the differences between the empirical therapy and the diagnostic-driven therapy on the treatment time of voriconazole, hospitalization days and antifungal efficacy. SPSS 23.0 was used for statistical analysis of data.

RESULTS: Compared with the diagnostic-driven therapy group, the empirical therapy group had more IFD high-risk patients, including a higher proportion of agranulocytosis patients (95.2% vs 69.5%, P=0.003). However, there were no significant differences on the treatment time of voriconazole, hospitalization days and antifungal efficacy of voriconazole between the two groups.

CONCLUSION: Using diagnostic-driven therapy in relatively IFD low-risk patients can obtain similar therapeutic outcomes and prognosis as empirical therapy in high-risk patients. Either of two strategies can be used in clinical practice according to the individual conditions of patients.

PMID:35981397 | DOI:10.19746/j.cnki.issn.1009-2137.2022.04.048

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Aug;30(4):1255-1261. doi: 10.19746/j.cnki.issn.1009-2137.2022.04.045.

ABSTRACT

OBJECTIVE: To study the effect of interleukin-6 (IL-6) gene deletion on radiation-induced hematopoietic injury in mice and relative mechanism.

METHODS: Before and after whole body ⁶⁰Co γ-ray irradiation, it was analyzed and compared that the difference of peripheral hemogram, bone marrow hematopoietic stem and progenitor cells conts in IL-6 gene knockout (IL-6^-/-) and wild-type (IL-6^+/+) mice and serum IL-6 and G-CSF expression levels in above- mentioned mouse were detected. Moreover, 30 days survival rate of IL-6^-/- and IL-6^+/+ mice after 8.0 Gy γ-ray irradiation were analyzed.

RESULTS: IL-6 levels in serum of IL-6^+/+ and IL-6^-/- mice were respectively (98.95±3.85) pg/ml and (18.36±5.61) pg/ml, which showed a significant statistical differences (P<0.001). There were no significant differences of peripheral blood cell counts and G-CSF level in serum between IL-6^+/+ and IL-6^-/- mice before irradiation (P>0.05). However, the number of leukocytes, neutrophils, lymphocytes, monocytes, platelets in peripheral blood and G-CSF level in serum of IL-6^-/- mice were significantly decreased at 6 h after 8.0 Gy γ-ray irradiation compared with that of IL-6^+/+ mice. On days 30 after 8.0 Gy γ-ray irradiation, the survival rate of IL-6^+/+ and IL-6^-/- mice was 62.5% and 12.5%, and the mean survival time of dead mice was 16.0±1.0 and 10.6±5.3 days, respectively. On days 14 after 6.5 Gy γ-ray irradiation, bone marrow nucleated cells in IL-6^+/+ and IL-6^-/- mice were respectively (10.0±1.2)×10⁶ and (8.3±2.2)×10⁶ per femur. Compared with IL-6^+/+ mice, the proportion of Lin^–Sca-1^–c-kit⁺ (LK) in bone marrow of IL-6^-/- mice had no significant change (P>0.05), but the proportion of Lin^–Sca-1⁺c-kit⁺ (LSK) was significantly decreased (P<0.05).

CONCLUSION: IL-6 plays an obvious role in regulating hematopoietic radiation injury, and IL-6 deficiency can inhibit the radiation-induced increase of endogenous G-CSF level in serum, aggravates the damage of mouse hematopoietic stem cells（HSC） and the reduction of mature blood cells in peripheral blood caused by ionizing irradiation, resulting in the shortening of the survival time and significant decrease of the survival rate of mice exposed to lethal dose radiation.

PMID:35981394 | DOI:10.19746/j.cnki.issn.1009-2137.2022.04.045