Category: Statistics

Arch Esp Urol. 2022 Jun;75(5):400-404. doi: 10.37554/en-j.arch.esp.urol-20210704-3502-22.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Although erectile dysfunction is frequently seen in hemodialysis patients, little information is documented about the efficacy of phosphodiesterase type 5 (PDE5) inhibitors and almost all the articles evaluate sildenafil. We aimed to evaluate the efficacy of chronic low dose tadalafil in this group of patients.

MATERIALS AND METHODS: The International Index of Erectile Function (IIEF) questionairre was administered to patients under hemodialysis program. A total of 58 patients with ED (International Index of Erectile Function (IIEF) score < 26), each having a stable partner, between 18-60 years, receiving routine outpatient HD matched the inclusion criteria and divided into two equal groups; placebo and tadalafil 5 mg/3 days. Changes of the IIEF score was recorded after one month of treatment.

RESULTS: The mean age of the patients was 50.0±9.93 years. Duration of dialysis was 57.5(12-108) months. Hemoglobin (g/dl) and creatinin clearence (ml/Min) values of placebo and tadalafil groups were not significantly different; 10.9(8.8-14) vs 10.7(8.9-13) and 5.7±1.3 vs 6.0±1.4 respectively. There was a statistically significant increase for all subgroups related erectile dysfunction 9.28±4.17 vs 21.07±5.99 (p=0.037), intercourse satisfaction 8(3-9) vs 10(5-15) (p<0.001), orgasmic function 4(1-10) vs 8(4-10) (p<0.001), sexual desire 4(2-10) vs 7(3-9) (p<0.001) and general satisfaction 5(2-9) vs 6(2-9) (p<0.001) with low dose of tadalafil at the end of four weeks without any major side effects. There was only a significant increase in sexual desire 4(3-9) vs 6(4-10) (p<0.001),in placebo group with an insignificant change in all other IIEF domains. Total IIEF score of the placebo group was insignificantly increased from 21.13±7.73 to 21.99±7.04 (p=0.771) while there was a statistically significant increase in tadalafil group; from 20.87±8.84 to 30.75±7.04 (p<0.001).

CONCLUSIONS: Tadalafil 5 mg once in three days is appear to be efficacious and well tolerated for the treatment of ED in hemodialysis patients.

PMID:35983809 | DOI:10.37554/en-j.arch.esp.urol-20210704-3502-22

Arch Esp Urol. 2022 Jun;75(5):382-399. doi: 10.56434/j.arch.esp.urol.20227505.56.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Post-finasteride syndrome (PFS) is a little known adverse effect of 5α-reductase inhibitor (5-ARI) drugs used in benign prostatic hyperplasia (BPH) and androgenetic alopecia. Five articles on the syndrome have been published in Spain, although no review has been published.The objectives of this article are to review the world literature, including the Spanish literature.

MATERIAL AND METHODS: A retrospective review on post-finasteride syndrome was performed between 2011 and 2020. The search for information in PubMed/Medline was performed using the English terms “post-finasteride, post-finasteride syndrome” and in Google with the Spanish “post-finasteride, síndrome post-finasteride”. The results of the variables studied were analyzed using descriptive statistics.

RESULTS: A total of 64 worldwide articles on post-finasteride syndrome were found, discarding 24 (37.5%) that did not deal with the symptoms of the syndrome, and 40 articles (62.5%) by 37 authors were included for study, corresponding to 29 publications on case series (72.5%) and 11 reviews (27.5%). Of the 40 articles, 37 referred to male post-finasteride syndrome (92.5%) and 3 to female (7.5%), the number of patients studied in the review was 87,887 corresponding to 87,224 men (99.2%) and 663 women (0.7%), with the number of articles on general symptoms being 23 (57.5%), male sexual symptoms 20 (50%) and female sexual symptoms 1 (2.5%). The articles came from 14 specialties, with Dermatology 14 publications (35%), Urology-Andrology 7 (17.5%) and Pharmacology 6 (15%). The countries with the highest number of publications were the USA 15 (37.5%), Italy 7 (17.5%) and Spain 5 (12.5%).

CONCLUSIONS: Finasteride is rarely associated with sexual and systemic adverse effects that constitute the so-called post-finasteride syndrome. There are still few studies on this syndrome in the world. This is the first review of this syndrome in Spain.

PMID:35983808 | DOI:10.56434/j.arch.esp.urol.20227505.56

Acupunct Med. 2022 Aug 19:9645284221108215. doi: 10.1177/09645284221108215. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify a comprehensive list of outcomes and explore the reporting rate of core outcome sets (COS) and related factors in systematic reviews (SRs) of acupuncture for osteoarthritis (OA).

STUDY DESIGN AND SETTING: Databases were searched for the relative SRs. Descriptive statistics were calculated as frequencies and percentages. Binary logistic regression was used to explore the factors affecting the reporting rate of COS.

RESULTS: We included 59 SRs. Outcome measures reported in the SRs were classified into 11 domains and 67 unique outcomes. No SR completely reported COS. In COS released in 2016, 75% of outcomes (6/8) were only reported by ⩽5% SRs. In COS released in 2019, the reporting rate was very low (from 0% to 17%) for 73.3% of outcomes (11/15). SRs published in the most recent 5 years had a significantly greater possibility of reporting COS (odds ratio (OR) = 4.74, 95% confidence interval (CI) = 1.33 to 16.88, p = 0.016).

CONCLUSION: Core outcomes were rarely reported in systematic reviews of acupuncture for OA, with considerable heterogeneity in the use of outcomes. The publication of COS in the COMET (Core Outcome Measures in Effectiveness Trials) database may help promote the reporting of COS. We encourage systematic reviewers to use relevant COS.

PMID:35983785 | DOI:10.1177/09645284221108215

Br J Nutr. 2022 Aug 19:1-22. doi: 10.1017/S0007114522002641. Online ahead of print.

ABSTRACT

Vitamin D (VD) deficiency [serum 25(OH)D concentration of <20 ng/ml], in endemic proportions, demands a supplementation strategy with optimal dosing regimens. A randomised parallel-group, active-controlled trial was conducted among apparently healthy, VD deficient subjects, age 18-60 years who received 600 IU/day (Group A), 1000 IU/day (Group B), 2000 IU/day (Group C) and 60,000 IU/month (Group D) of oral cholecalciferol. The intervention was carried in two phases (I&II) of 12 weeks each, with same dose, separated by a washout phase of 12 weeks. Serum 25(OH)D, iPTH, calcium (Ca), phosphorous (PO4), alkaline phosphatase (ALP), spot urine calcium/creatinine (Ca/Cr) was measured at baseline, 12, 24 and 36 weeks following the intervention and adverse events were recorded at each occurrence and at 12, 24 and 36 weeks. A statistically significant time-group interaction was found in serum 25(OH)D concentration (P<0.05). Serum 25(OH)D concentration increased significantly from baseline to 12 weeks (P<0.05) in all the groups with no change at 24 weeks but further increase at 36 weeks (P<0.05). At the end of study, group C had maximum increment in serum 25(OH)D concentration while as groups C and D (95%, and 90%) had higher proportion of subjects VD sufficient than groups A and B (65% and 78%) (Table 3) (P<0.05). No significant time-dose interactions were observed in serum iPTH, Ca, PO4 and ALP or Urine Ca/Cr ratio. Three subjects (two in group C and one in group D) developed transient hypercalciuria. Supplementation with daily 2000IU or monthly 60,000IU oral cholecalciferol among adults seems optimal and safe.

PMID:35983775 | DOI:10.1017/S0007114522002641

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