Category: Statistics

Clin Chem. 2021 Aug 6:hvab115. doi: 10.1093/clinchem/hvab115. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-based real-time quality control (PBRTQC) has gained increasing attention in the field of clinical laboratory management in recent years. Despite the many upsides that PBRTQC brings to the laboratory management system, it has been questioned for its performance and practical applicability for some analytes. This study introduces an extended method, regression-adjusted real-time quality control (RARTQC), to improve the performance of real-time quality control protocols.

METHODS: In contrast to the PBRTQC, RARTQC has an additional regression adjustment step before using a common statistical process control algorithm, such as the moving average, to decide whether an analytical error exists. We used all patient test results of 4 analytes in 2019 from Zhongshan Hospital, Fudan University, to compare the performance of the 2 frameworks. Three types of analytical error were added in the study to compare the performance of PBRTQC and RARTQC protocols: constant, random, and proportional errors. The false alarm rate and error detection charts were used to assess the protocols.

RESULTS: The study showed that RARTQC outperformed PBRTQC. RARTQC, compared with the PBRTQC, improved the trimmed average number of patients affected before detection (tANPed) at total allowable error by about 50% for both constant and proportional errors.

CONCLUSIONS: The regression step in the RARTQC framework removes autocorrelation in the test results, allows researchers to add additional variables, and improves data transformation. RARTQC is a powerful framework for real-time quality control research.

PMID:34355737 | DOI:10.1093/clinchem/hvab115

Int J Neuropsychopharmacol. 2021 Aug 6:pyab054. doi: 10.1093/ijnp/pyab054. Online ahead of print.

ABSTRACT

BACKGROUND: High placebo response in ADHD can reduce medication-placebo differences, jeopardizing the development of new medicines. This research aims to 1) determine placebo response in ADHD, 2) compare the accuracy of meta-regression and MetaForest in predicting placebo response, and 3) determine the covariates associated with placebo response.

METHODS: A systematic review with meta-analysis (SRMA) of RPCCTs investigating pharmacological interventions for ADHD was performed. Placebo response was defined as the change from baseline in ADHD symptom severity assessed according to the 18-item, clinician-rated, DSM-based rating scale. The effect of study design-, intervention- and patient-related covariates in predicting placebo response was studied by means of meta-regression and MetaForest.

RESULTS: Ninety-four studies including 6,614 patients randomized to placebo were analysed. Overall, placebo response was -8.9 points, representing a 23.1% reduction in the severity of ADHD symptoms. Cross-validated accuracy metrics for meta-regression were R 2 = 0.0012 and RMSE = 3.3219 for meta-regression and 0.0382 and 3.2599 for MetaForest. Placebo response amongst ADHD patients increased by 63% between 2001 and 2020 and was larger in the US than in other regions of the world.

CONCLUSIONS: Strong placebo response was found in ADHD patients. Both meta-regression and MetaForest showed poor performance in predicting placebo response. ADHD symptom improvement with placebo has markedly increased over the last two decades and is grater in the US than the rest of the world.

PMID:34355753 | DOI:10.1093/ijnp/pyab054

Cranio. 2021 Aug 6:1-12. doi: 10.1080/08869634.2021.1964052. Online ahead of print.

ABSTRACT

Objective: To discover the extent of the connection between occlusal plane asymmetry and the rest tone of the four muscle groups of the orofacial region with temporomandibular joint pathology.Methods: Eighty-seven subjects were divided into two groups. The following methods were applied: clinical examination, roentgenological examination, and electromyography. Data were evaluated and statistically analyzed.Results: The variability of occlusal plane inclination in relation to the porion plane was 0-4.6º.The tonus of masseter muscle was higher in the experimental group: 1.45 mV more than in the control group: 1.23 mV (p < 0.05).Conclusion: Asymmetry of the occlusal plane inclination was found for nearly all subjects in both groups. It can be compensated for by adaptation mechanisms and does not cause temporomandibular joint disorders. Undertaken research shows the existence of a proven correlation between TMJ disorders and the resting tonus of the masseter muscle.

PMID:34355675 | DOI:10.1080/08869634.2021.1964052

Curr Pharm Des. 2021 May 21. doi: 10.2174/1381612827666210521132737. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to assess the relationship between different dialysis modalities and depression in end-stage renal disease (ESRD) patients.

METHODS: We searched through the PsycINFO, PubMed, Cochrane Library, EMBASE and CNKI for all related studies from 1 January 1990 till 30 June 2019 without restriction on language. We selected papers that compared the depression levels among patients undergoing hemodialysis and peritoneal dialysis. Two authors independently selected studies, evaluated the quality of included studies, and extracted data according to Newcastle-Ottawa Scale (NOS). A discussion with a third author checked any disagreement to minimize the publication bias. PRISMA guidelines were used as the standards of reporting (PRISMA registration ID is 239172).

RESULTS: There was not enough evidence to prove the relationship between different dialysis modalities and depression (OR: 2.37, 95%CI: 0.88-6.40). We also found no statistical significance between the mean difference of depression level and dialysis modalities (Std mean difference=0.69, 95%CI: -2.09–3.46).

CONCLUSION: The available limited, deficient quality evidence assessed by ROBINS-I does not support an association between depression and dialysis modalities among ESRD patients. Further studies that provide data for different sex and age groups are needed to clarify whether a subgroup of dialysis modalities has a different risk of depression.

PMID:34355679 | DOI:10.2174/1381612827666210521132737

J Interprof Care. 2021 Aug 6:1-8. doi: 10.1080/13561820.2021.1951188. Online ahead of print.

ABSTRACT

This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach’s alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.

PMID:34355655 | DOI:10.1080/13561820.2021.1951188

Acta Oncol. 2021 Aug 6:1-5. doi: 10.1080/0284186X.2021.1959057. Online ahead of print.

NO ABSTRACT

PMID:34355650 | DOI:10.1080/0284186X.2021.1959057

Subst Use Misuse. 2021 Aug 6:1-9. doi: 10.1080/10826084.2021.1958866. Online ahead of print.

ABSTRACT

Physicians trained in opioid use disorder (OUD) harm reduction can mitigate opioid overdose deaths by prescribing naloxone and educating patients about its use. Unfortunately, many physicians possess OUD stigma. Training during medical school presents an opportunity to reduce OUD stigma and improve opioid overdose reversal knowledge. This study assessed the efficacy of Opioid Overdose Awareness and Reversal Training (OOART) and evaluated the equivalency of the online and in-person OOART. Methods: Voluntary training was delivered to first-year medical (M1) students at one medical school. In 2018 and 2019, 29 and 68 M1 students, respectively, received in-person OOART training and completed pre- and post-training surveys. In 2020, 62 students participated in online OOART training, of which 53 completed both pre- and post-training surveys. Results: All three opioid overdose Knowledge questions showed significant improvements between pre- and post-training survey responses. For Attitude questions, six of eleven questions in 2019 and 2020 and four of eleven questions in 2018 had statistically significant improvements between pre- and post-training survey responses. There were no statistical differences between in-person and online post-training survey results for two out of the three Knowledge questions and all 11 Attitude questions. Conclusions: This study demonstrates that our OOART was effective in increasing opioid overdose reversal knowledge and reducing OUD stigma. There was no meaningful difference in outcomes between the training modalities. These results support the future expansion of online and in-person OOART to a larger population of medical students.

PMID:34355637 | DOI:10.1080/10826084.2021.1958866

Leuk Lymphoma. 2021 Aug 6:1-10. doi: 10.1080/10428194.2021.1961237. Online ahead of print.

ABSTRACT

We performed a retrospective analysis of 1415 acute lymphoblastic leukemia children diagnosed between January 2000 and December 2016 at Children Welfare Teaching Hospital, Baghdad, Iraq. Patients were divided into three cohorts according to treatment period (2000-2005; 2006-2011; 2012-2016). Treatments were based on modified-UKALL protocols; a steroid-pre-phase was introduced from September 2008. The overall complete remission was 86%, increased from 80% to 91% in the last period. Early deaths occurred in 10%, decreasing to 6%, overtime. Relapses were 23%; toxic deaths and abandonment 8% and 13%, respectively. At a median follow-up of 65.3 months, with abandonment considered as an event, the 5-year overall survival (OS) and event-free survival were 62.2% and 46.3%, statistically influenced by treatment period (5-year OS 62.6%, 59.1%, 66.3%; p=.057, respectively). Though pediatric ALL survival in Iraq is still below that observed in high income countries, survival rates progressively improved. Toxic deaths remain an important cause of failure.

PMID:34355644 | DOI:10.1080/10428194.2021.1961237

SAR QSAR Environ Res. 2021 Aug;32(8):655-687. doi: 10.1080/1062936X.2021.1955414.

ABSTRACT

Gelatinases [gelatinase A – matrix metalloproteinase-2 (MMP-2), gelatinase B – matrix metalloproteinase-9 (MMP-9)] play key roles in many disease conditions including cancer. Despite some research work on gelatinases inhibitors both jointly and individually had been reported, challenges still exist in achieving potency as well as selectivity. Here in part I of a series of work, we have reported the structural requirement of some arylsulfonamides. In particular, regression-based 2D-QSARs, topomer CoMFA (comparative molecular field analysis) and Bayesian classification models were constructed to refine structural features for attaining better gelatinase inhibitory activity. The 2D-QSAR models exhibited good statistical significance. The descriptors nsssN, SHBint6, SHBint7, PubchemFP629 were directly correlated with the MMP-2 binding affinities whereas nsssN, SHBint10 and AATS2i were directly proportional to MMP-9 binding affinities. The topomer CoMFA results indicated that the steric and electrostatic fields play key roles in gelatinase inhibition. The established Naïve Bayes prediction models were evaluated by fivefold cross validation and an external test set. Furthermore, important molecular descriptors related to MMP-2 and MMP-9 binding affinities and some active/inactive fragments were identified. Thus, these observations may be helpful for further work of aryl sulphonamide based gelatinase inhibitors in future.

PMID:34355614 | DOI:10.1080/1062936X.2021.1955414

Hemoglobin. 2021 Aug 6:1-8. doi: 10.1080/03630269.2021.1954943. Online ahead of print.

ABSTRACT

Sickle cell disease is a genetic disease with a predisposition to infections caused by encapsulated organisms, especially Streptococcus pneumoniae. Pneumococcal vaccines and prophylactic penicillin have reduced the rate of this infection and mortality in sickle cell disease. However, implementation of these interventions is limited in Africa. The objectives of the study were to assess health care providers’ behaviors with the implementation of pneumococcal vaccination and penicillin prophylaxis and to identify barriers to their use. A 25-item online questionnaire was administered through SickleinAfrica: a network of researchers, and healthcare providers, in Ghana, Nigeria, and Tanzania, working to improve health outcomes of sickle cell disease in Africa. Data was collected and managed using the Research Electronic Data Capture (REDCap), tools and data analysis was done using STATA version 13 and R statistical software. Eighty-two medical practitioners responded to the questionnaire. Only 54.0 and 48.7% of respondents indicated the availability of published guidelines on sickle cell disease management and pneumococcal vaccine use, respectively, at their facilities. The majority (54.0%) perceived that the vaccines are effective but over 20.0% were uncertain of their usefulness. All respondents from Ghana and Tanzania affirmed the availability of guidelines for penicillin prophylaxis in contrast to 44.1% in Nigeria. Eighty-five percent of respondents affirmed the need for penicillin prophylaxis but 15.0% had a contrary opinion for reasons including the rarity of isolation of Streptococcus pneumoniae in African studies, and therefore, the uncertainty of its benefit. Lack of published guidelines on the management of sickle cell disease and doubts about the necessity of prophylactic measures are potential barriers to the implementation of effective interventions.

PMID:34355623 | DOI:10.1080/03630269.2021.1954943