Category: Statistics

JMIR Res Protoc. 2022 Jul 21;11(7):e37729. doi: 10.2196/37729.

ABSTRACT

BACKGROUND: Digital technologies could contribute to health promotion and disease prevention. It is unclear if and how such digital technologies address the health needs of older people in nonclinical settings (ie, daily life).

OBJECTIVE: This study aims to identify digital technologies for health promotion and disease prevention that target the needs of older people in nonclinical settings by performing a scoping review of the published literature. The scoping review is guided by the framework of Arksey and O’Malley.

METHODS: Our scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The information sources are bibliographic databases (MEDLINE, PsycINFO, CINAHL, and SCOPUS) and bibliographies of any included systematic reviews. Manual searches for additional studies will be performed in Google Scholar and most relevant journals. The electronic search strategy was developed in collaboration with a librarian who performed the search for studies on digital technologies for health promotion and disease prevention targeting the needs of older people. Study selection and data coding will be performed independently by 2 authors. Consensus will be reached by discussion. Eligibility is based on the PCC (Population, Concept, and Context) criteria as follows: (1) older people (population); (2) any digital (health) technology, such as websites, smartphone apps, or wearables (concept); and (3) health promotion and disease prevention in nonclinical (daily life, home, or community) settings (context). Primary studies with any design or reviews with a systematic methodology published in peer-reviewed academic journals will be included. Data items will address study designs, PCC criteria, benefits or barriers related to digital technology use by older people, and evidence gaps. Data will be synthesized using descriptive statistics or narratively described by identifying common themes. Quality appraisal will be performed for any included systematic reviews, using a validated instrument for this study type (A Measurement Tool to Assess Systematic Reviews, version 2 [AMSTAR2]).

RESULTS: Following preliminary literature searches to test and calibrate the search syntax, the electronic literature search was performed in March 2022 and manual searches were completed in June 2022. Study selection based on titles and abstracts was completed in July 2022, and the full-text screen was initiated in July 2022.

CONCLUSIONS: Our scoping review will identify the types of digital technologies, health targets in the context of health promotion and disease prevention, and health benefits or barriers associated with the use of such technologies for older people in nonclinical settings. This knowledge could guide further research on how digital technologies can support healthy aging.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/37729.

PMID:35862187 | DOI:10.2196/37729

JMIR Diabetes. 2022 Jul 21;7(3):e34699. doi: 10.2196/34699.

ABSTRACT

BACKGROUND: Diabetes is a chronic condition that necessitates regular monitoring and self-management of the patient’s blood glucose levels. People with type 1 diabetes (T1D) can live a productive life if they receive proper diabetes care. Nonetheless, a loose glycemic control might increase the risk of developing hypoglycemia. This incident can occur because of a variety of causes, such as taking additional doses of insulin, skipping meals, or overexercising. Mainly, the symptoms of hypoglycemia range from mild dysphoria to more severe conditions, if not detected in a timely manner.

OBJECTIVE: In this review, we aimed to report on innovative detection techniques and tactics for identifying and preventing hypoglycemic episodes, focusing on T1D.

METHODS: A systematic literature search following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed focusing on the PubMed, GoogleScholar, IEEEXplore, and ACM Digital Library to find articles on technologies related to hypoglycemia detection in patients with T1D.

RESULTS: The presented approaches have been used or devised to enhance blood glucose monitoring and boost its efficacy in forecasting future glucose levels, which could aid the prediction of future episodes of hypoglycemia. We detected 19 predictive models for hypoglycemia, specifically on T1D, using a wide range of algorithmic methodologies, spanning from statistics (1.9/19, 10%) to machine learning (9.88/19, 52%) and deep learning (7.22/19, 38%). The algorithms used most were the Kalman filtering and classification models (support vector machine, k-nearest neighbors, and random forests). The performance of the predictive models was found to be satisfactory overall, reaching accuracies between 70% and 99%, which proves that such technologies are capable of facilitating the prediction of T1D hypoglycemia.

CONCLUSIONS: It is evident that continuous glucose monitoring can improve glucose control in diabetes; however, predictive models for hypo- and hyperglycemia using only mainstream noninvasive sensors such as wristbands and smartwatches are foreseen to be the next step for mobile health in T1D. Prospective studies are required to demonstrate the value of such models in real-life mobile health interventions.

PMID:35862181 | DOI:10.2196/34699

J Am Heart Assoc. 2022 Jul 20:e025519. doi: 10.1161/JAHA.122.025519. Online ahead of print.

ABSTRACT

Background A high prevalence of preclinical heart failure (HF) (Stages A and B) has previously been shown. The aim of this study was to explore factors associated with the incidence of preclinical HF in a community population. Methods and Results Retrospective review of 393 healthy community individuals aged ≥45 years from the Olmsted County Heart Function Study that returned for 2 visits, 4 years apart. At visit 2, individuals that remained normal were compared with those that developed preclinical HF. By the second visit, 191 (49%) developed preclinical HF (12.1 cases per 100 person-years of follow-up); 65 (34%) Stage A and 126 (66%) Stage B. Those that developed preclinical HF (n=191) were older (P=0.004), had a higher body mass index (P<0.001), and increased left ventricular mass index (P=0.006). When evaluated separately, increased body mass index was seen with development of Stage A (P<0.001) or Stage B (P=0.009). Echocardiographic markers of diastolic function were statistically different in those that developed Stage A [higher E/e’ (P<0.001), lower e’ (P<0.001)] and Stage B [higher left atrial volume index (P<0.001), higher E/e’ (P<0.001), lower e’ (P<0.001)]. NT-proBNP (N-terminal pro-B-type natriuretic peptide) was higher at visit 2 in those that developed Stage A or B (P<0.001 for both). Hypertension (57%), obesity (34%), and hyperlipidemia (25%) were common in the development of Stage A. Of patients who developed Stage B, 71% (n=84) had moderate or severe diastolic dysfunction. Conclusions There is a high incidence of preclinical HF in a community population. Development of Stage A was driven by hypertension and obesity, while preclinical diastolic dysfunction was seen commonly in those that developed Stage B.

PMID:35862175 | DOI:10.1161/JAHA.122.025519

Sci Med Footb. 2022 Aug;6(3):372-380. doi: 10.1080/24733938.2021.1944660. Epub 2021 Jun 27.

ABSTRACT

INTRODUCTION: Performance assessment in professional soccer often focusses on notational assessment like assists or pass accuracy. However, rather than statistics, performance is more about making the best possible tactical decision, in the context of aplayer’s positional role and the available options at the time. With the current paper, we aim to construct an improved model for the assessment of pass risk and reward across different positional roles, and validate that model by studying differences in decision-making between players with different positional roles.

METHODS: To achieve our aim, we collected position tracking data from an entire season of Dutch Eredivisie matches, containing 286.151 passes of 336 players. From that data, we derived several features on risk and reward, both for the pass that has been played, as well as for the pass options that were available at the time of passing.

RESULTS: Our findings indicate that we could adequately model risk and reward, outperforming previously published models, and that there were large differences in decision-making between players with different positional roles.

DISCUSSION: Our model can be used to assess player performance based on what could have happened, rather than solely based on what did happen in amatch.

PMID:35862167 | DOI:10.1080/24733938.2021.1944660

Sci Med Footb. 2022 Aug;6(3):389-397. doi: 10.1080/24733938.2021.1978106. Epub 2021 Sep 14.

ABSTRACT

In football research, ‘small’ trials with low statistical power are common. On the elite level, the inherently low number of participants obviously conflicts with the relevance of even tiny effects. However, general characteristics of football also contribute (e.g. multifactorially influenced and/or complex outcomes). Importantly, small sample sizes are problematic regardless of the study outcome with issues ranging from inconclusive results and low precision to unrepeatable ‘discoveries’ and overestimation of effect sizes. Therefore, meeting the calculated, target sample size is the first priority. If a suboptimal sample size must be accepted, a range of tools can improve insights. To begin with, some general aspects of data collection and analysis become more important and should be optimally implemented (e.g. reliability of measures). Building on this foundation, specific amendments are available on the levels of data collection (e.g. aggregated single-subject designs) and data analysis (e.g. Bayesian methods). The present commentary aims to give an overview of selected, practical tools for dealing with small sample sizes in football research and provide recommendations for their application in scenarios typical for the field. Importantly, versatility and adaptability are mirrored by the need for utmost transparency including a predetermined (ideally preregistered) study plan. Collaboration or counselling with an expert statistician is strongly encouraged.

PMID:35862155 | DOI:10.1080/24733938.2021.1978106

JMIR Form Res. 2022 Jul 21;6(7):e35197. doi: 10.2196/35197.

ABSTRACT

BACKGROUND: Adolescents’ consumption of healthy foods is suboptimal in low- and middle-income countries. Adolescents’ fondness for games and social media and the increasing access to smartphones make apps suitable for collecting dietary data and influencing their food choices. Little is known about how adolescents use phones to track and shape their food choices.

OBJECTIVE: This study aimed to examine the acceptability, usability, and likability of a mobile phone app prototype developed to collect dietary data using artificial intelligence-based image recognition of foods, provide feedback, and motivate users to make healthier food choices. The findings were used to improve the design of the app.

METHODS: A total of 4 focus group discussions (n=32 girls, aged 15-17 years) were conducted in Vietnam. Qualitative data were collected and analyzed by grouping ideas into common themes based on content analysis and ground theory.

RESULTS: Adolescents accepted most of the individual- and team-based dietary goals presented in the app prototype to help them make healthier food choices. They deemed the overall app wireframes, interface, and graphic design as acceptable, likable, and usable but suggested the following modifications: tailored feedback based on users’ medical history, anthropometric characteristics, and fitness goals; new language on dietary goals; provision of information about each of the food group dietary goals; wider camera frame to fit the whole family food tray, as meals are shared in Vietnam; possibility of digitally separating food consumption on shared meals; and more appealing graphic design, including unique badge designs for each food group. Participants also liked the app’s feedback on food choices in the form of badges, notifications, and statistics. A new version of the app was designed incorporating adolescent’s feedback to improve its acceptability, usability, and likability.

CONCLUSIONS: A phone app prototype designed to track food choice and help adolescent girls from low- and middle-income countries make healthier food choices was found to be acceptable, likable, and usable. Further research is needed to examine the feasibility of using this technology at scale.

PMID:35862147 | DOI:10.2196/35197

Hypertension. 2022 Jul 18:101161HYPERTENSIONAHA12219568. doi: 10.1161/HYPERTENSIONAHA.122.19568. Online ahead of print.

ABSTRACT

BACKGROUND: Poorly controlled hypertension is a great challenge to global public health. Incentive approaches, based on behavioral and economic concepts, may improve patients’ adherence to treatment.

METHODS: We conducted a 2-arm randomized controlled trial to test whether financial incentives can help patients with poorly controlled hypertension in China reduce their blood pressure (BP). Participants were randomized 1:1 to the control and intervention groups. All participants received WeChat-based standard education and support for hypertension management. The intervention group received financial incentives, including process- and outcome-based incentives.

RESULTS: No statistically significant differences in BP reduction and hypertension control rates were found between the two groups from baseline to 12-month follow-up. Mean systolic BP decreased from 158.7 to 149.8 mm Hg in the intervention group and 159.7 to 149.5 mm Hg in the control group (P=0.639). Mean diastolic BP decreased from 93.7 to 86.6 mm Hg in the intervention group and 93.9 to 86.3 mm Hg in the control group (P=0.667). Hypertension control rates in the intervention and control groups were 20.8% and 15.8%, respectively (P=0.318). Medication adherence was 84.2% in the intervention group and 86.2% in the control group (P=0.705).

CONCLUSIONS: Financial incentives were effective in the short term for BP control, but a sustained effect of incentive-based BP control was not identified beyond 3 months of intervention. Future studies that focus on identifying the appropriate amount and structure of financial incentives for BP control are warranted.

REGISTRATION: URL: xxx; Unique identifier: ISRCTN13467677.

PMID:35862120 | DOI:10.1161/HYPERTENSIONAHA.122.19568

Am Psychol. 2022 Jul 21. doi: 10.1037/amp0001033. Online ahead of print.

ABSTRACT

Memorializes Jim Sidanius (née James Brown [1945-2021]), one of the the foremost social and political psychologists of his generation. His theory of social dominance redefined the scientific study of intergroup relations, advancing novel hypotheses regarding the causes and consequences of intergroup conflict and inequality by integrating insights across the social and biological sciences. Jim’s theoretical insights were matched only by his empirical prowess; he was a master at analyzing large data sets with advanced statistical methods, methods that he taught to hundreds of doctoral students over the years in his notoriously challenging but rewarding graduate statistics courses at the University of California, Los Angeles (UCLA), and Harvard. Beyond his teaching of statistics and advanced topics in social psychology and African American studies, Jim mentored dozens of aspiring intergroup relations scholars over a 44-year career. As one of few Black social psychologists, he served as a role model for young Black scholars in particular. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PMID:35862108 | DOI:10.1037/amp0001033

Plast Reconstr Surg. 2022 Jul 22. doi: 10.1097/PRS.0000000000009537. Online ahead of print.

ABSTRACT

BACKGROUND: Implant-based breast reconstruction has evolved, with a recent resurgence of prepectoral techniques. Comparative reconstructive outcomes and complications have not been fully elucidated among the total submuscular (TSM), dual-plane (DP), and prepectoral planes of implant placement.

METHODS: All immediate implant-based breast reconstructions from March 2017 through August 2019 were retrospectively reviewed. Cases were divided into TSM, DP, and prepectoral cohorts. Demographics, operative techniques, and reconstructive outcomes and complications were compared among groups.

RESULTS: 826 cases (510 patients) were identified and divided into TSM (n=392), DP (n=358), and prepectoral (n=76) cohorts. Average follow-up for all patients was 27 months. The prepectoral cohort had a higher average BMI and rate of prior reduction/mastopexy. Overall complications were lowest in the TSM group, though this difference was not statistically significant. Major infection occurred more frequently in the DP group compared to the TSM cohort. The prepectoral cohort had a significantly increased incidence of wound dehiscence than the TSM group, while both the dual-plane and prepectoral groups had higher rates of seroma formation and explantation compared to TSM.

CONCLUSIONS: Overall reconstructive complication rates were comparable among the cohorts. Compared to those undergoing TSM reconstruction, the DP cohort was more likely to develop a major infection or require explantation, while the prepectoral group had significantly higher rates of isolated dehiscence, seroma formation, and explantation. This suggest that the absence of overlying vascularized muscle may lead to an inherent inability to tolerate wound healing complications, though further research is needed to clarify these observations.

PMID:35862095 | DOI:10.1097/PRS.0000000000009537

Plast Reconstr Surg. 2022 Jul 22. doi: 10.1097/PRS.0000000000009532. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple studies have analyzed the impact of co-morbidities on breast reduction surgery with mixed results. The purpose of this investigation was to perform a statistical analysis of all complications by a single surgeon, using a single technique for breast reduction.

METHODS: Records of patients undergoing breast reduction from 1984 to 2019 with an inferior pedicle were reviewed. Co-morbidities analyzed included hypertension, diabetes, nicotine use, weight of breast tissue resected, pedicle length and basal metabolic index. The literature on the effects of comorbidities on outcomes for breast reconstruction were also reviewed.

RESULTS: Although increasing BMI significantly increased the rate of fat necrosis, it did not impact those patients requiring reoperation for this complication. BMI greater than 35, weight of tissue resection greater than 1000gm, and nipple to inframammary fold distance greater than 20cm all increased the odds ratio of having a breast with some fat necrosis. Increasing BMI increased the risk of wound healing problems (both major and minor), but not for patients requiring reoperation. BMI greater than 35, breast tissue resection greater than 1000gm, and nipple to fold distance greater than 20 only minimally increased the odds ratio for a major wound complication.

CONCLUSIONS: Patients with increased BMI are at greater risk for fat necrosis and wound healing complications. However, these usually can be managed conservatively in patients undergoing inferior pedicle breast reduction. Patients do not require free nipple grafting. The use of nicotine, presence of diabetes or hypertension does not impact outcome.

PMID:35862089 | DOI:10.1097/PRS.0000000000009532