Category: Statistics

Radiol Oncol. 2022 Feb 11;56(1):37-45. doi: 10.2478/raon-2022-0005.

ABSTRACT

BACKGROUND: We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method.

PATIENTS AND METHODS: Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%).

RESULTS: Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical significant differences in overall diagnostic performance for the preoperative assessment of MI. The concordance coefficient between both TVUS methods, MRI and histopathology was statistically significant (p < 0.001). Gordon’s method calculating MI reached a positive predictive value (PPV) of 83%, negative predictive value (NPV) of 83%, 77% sensitivity, 88% specificity, and 83% overall accuracy. Karlsson’s method reached PPV of 82%, NPV of 79%, 69% sensitivity, 88% specificity, and 80% overall accuracy. Accordingly, MRI calculating MI reached PPV of 83%, NPV of 97%, 97% sensitivity, 85% specificity, and 90% overall accuracy.

CONCLUSIONS: We found that objective TVUS assessment of myometrial invasion was performed with a diagnostic accuracy comparable to that of MRI in women with endometrial cancer.

PMID:35148470 | DOI:10.2478/raon-2022-0005

Nutr Clin Pract. 2022 Feb 11. doi: 10.1002/ncp.10832. Online ahead of print.

ABSTRACT

The administration of intravenous vitamin C (IV-VC) in treating patients with coronavirus disease 2019 (COVID-19) is still highly controversial. There have been no previous studies on the effect of IV-VC on the severity and mortality of COVID-19. Hence, we conducted a systematic review and meta-analysis to compare the disease severity and mortality in patients with COVID-19 who promptly received IV-VC treatment vs those who did not. We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data, up to June 23, 2021. We identified a total of seven related articles, which were included in this study. This meta-analysis showed that IV-VC treatment did not affect disease severity compared with placebo treatment or usual care (odds ratio [OR], 0.70; 95% CI, 0.45 to 1.07; P = 0.10). In addition, no statistically significant difference in mortality was observed between patients who received IV-VC treatment and those who did not (OR, 0.64; 95% CI, 0.41 to 1.00; P = 0.05). Moreover, the adjusted meta-analysis revealed that the use of IV-VC did not influence disease severity (OR, 0.67; 95% CI, 0.34 to 1.31; P = 0.242) or mortality (OR, 1.02; 95% CI, 0.75 to 1.40; P = 0.877) in comparison with a control group. The results of this meta-analysis demonstrated that short-term IV-VC treatment did not reduce the risk of severity and mortality in patients with COVID-19.

PMID:35148440 | DOI:10.1002/ncp.10832

Rev Neurol. 2022 Feb 16;74(4):125-134. doi: 10.33588/rn.7404.2021196.

ABSTRACT

INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus is currently an evidence-based therapeutic option for motor symptoms in patients with Parkinson’s disease (PD), although other non-motor symptoms can be affected by stimulation.

AIM: Our objective is to evaluate the global changes in the connectivity of the large-scale structural network in PD patients that have obtained a benefit from subthalamic DBS.

SUBJECTS AND METHODS: Retrospective study of 31 subjects: 7 PD patients with subthalamic DBS (group A), 12 age and gender-matched non-operated PD (B) and 12 healthy controls (C). All subjects had undergone a 1.5 T brain MRI with DTI. DICOM images were processed with the FSL5.0 software and TBSS tool.

RESULTS: The study group comprised 23 men and 8 women. No statistically significant differences in age, gender, scores on the HandY scale and mean follow-up between group A and B were found, and in age and gender between groups A and C. Statistical analysis revealed differences in the fractional anisotropy of the different groups in certain areas: bilateral corticospinal tract, anterior thalamic radiations, bilateral fronto-occipital fascicle, both superior longitudinal fascicles, and left inferior longitudinal fascicle.

CONCLUSIONS: In our series, PD patients treated with bilateral subthalamic DBS showed a significantly higher fractional anisotropy in widespread areas of the cerebral white matter; suggesting that neuromodulation produces connectivity changes in different neural networks.

PMID:35148421 | DOI:10.33588/rn.7404.2021196

J Oral Rehabil. 2022 Feb 11. doi: 10.1111/joor.13311. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a specially designed mobile application developed to provide patients with a sense of anxiety control during the various stages of endodontic treatment. The patients’ anxiety was assessed by measuring their salivary cortisol levels.

METHODS: A total of 46 patients requiring endodontic treatment were recruited. The patients were randomly assigned to two groups. The experimental group used the special communication application, while the control group did not. Salivary samples were collected from all patients preoperatively, postanesthesia, and postoperatively. The samples were analyzed with an enzyme-linked immunosorbent assay to measure the cortisol levels.

RESULTS: A significant difference in cortisol levels was observed between the experimental and the control group (Mann-Whitney U test, P < .05). This difference was significant in the experimental group in each step (P < .01). No difference was found in the control group steps (P > .05).

CONCLUSIONS: Perceived control of anxiety using the specially designed software was effective in reducing salivary cortisol levels.

PMID:35148428 | DOI:10.1111/joor.13311

Pain Med. 2022 Feb 11:pnac021. doi: 10.1093/pm/pnac021. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence indicates that combining behavioral treatments with pharmacological treatments for migraine prevention improves efficacy, however little is known about the outcomes of combining neuromodulation and behavioral interventions for acute treatment of migraine. Remote Electrical Neuromodulation (REN) is an FDA-cleared non-pharmacological migraine treatment. The current study evaluated the clinical benefits of augmenting REN treatment with a specially tailored behavioral therapy comprised of Guided Intervention of Education and Relaxation (GIER), for the acute treatment of migraine.

METHODS: In this two-arm observational study, real-world data were collected from patients across the United States who were using the REN device. Eighty-five migraine patients aged ≥18, who treated their attacks with REN in parallel with the GIER intervention were individually matched on age and sex with 85 patients who used REN alone. The groups were compared on the proportion of migraine attacks in which they achieved pain relief, pain freedom, improvement of function, and return to normal function, at 2 hours post-treatment.

FINDINGS: Data from 170 users were analyzed (85 per group). Compared to the REN-only group, the REN+GIER group displayed statistically significant higher proportion of patients achieving consistent pain relief (p = 0.008), consistent improvement in function (p = 0.014), and consistent return to normal function (p = 0.005); all at 2 hours post treatment.

CONCLUSIONS: The results suggest that combining the GIER behavioral intervention with REN treatment can improve the therapeutic efficacy beyond that of REN alone, in terms of both pain level and improvement of disability.

PMID:35148414 | DOI:10.1093/pm/pnac021

Eur J Orthod. 2022 Feb 11:cjac001. doi: 10.1093/ejo/cjac001. Online ahead of print.

ABSTRACT

AIM: To assess the extent of publication bias assessment in systematic reviews (SRs) across the orthodontic literature over the last 12 years and to identify the appropriateness of assessment and association with publication characteristics, including year of publication, journal, searching practices within unpublished literature or attempts to contact primary study authors and others.

MATERIALS AND METHODS: We searched six journals and the Cochrane Database of Systematic Reviews for relevant articles, since January 2010, until November 2021. We recorded practices interrelated with publication bias assessment, at the SR and meta-analysis level. These pertained to reporting strategies for searching within unpublished literature, attempts to communicate with authors of primary studies and formal assessment of publication bias either graphically or statistically. Potential associations between publication bias assessment practices with variables such as journal, year, methodologist involvement, and others were sought at the meta-analysis level.

RESULTS: A sum of 289 SRs were ultimately included, with 139 of those incorporating at least one available mathematical synthesis. Efforts to search within unpublished literature were reported in 191 out of 289 Reviews (66.1%), while efforts to communicate with primary study authors were recorded for 150 of 289 of those (51.9%). An appropriate strategy plan to address issues of publication bias, conditional on the number of studies available and the methodology plan reported, was followed in 78 of the 139 meta-analyses (56.1%). Formal publication bias assessment was actually reported in 35 of 139 meta-analyses (25.2%), while only half of those (19/35; 54.3%) followed an appropriately established methodology. Ten of the latter 19 studies detected the presence of publication bias (52.6%). Predictor variables of appropriate publication bias assessment did not reveal any significant effects.

CONCLUSIONS: Appropriate methodology and rigorous practices for appraisal of publication bias are underreported in SRs within the orthodontic literature since 2010 and up-to-date, while other established methodologies including search strategies for unpublished data or communication with authors appear currently suboptimal.

PMID:35148373 | DOI:10.1093/ejo/cjac001

Clin Infect Dis. 2022 Feb 11;74(3):467-471. doi: 10.1093/cid/ciab441.

ABSTRACT

BACKGROUND: Pregnancy has been reported to be a risk factor for severe COVID-19. We evaluated the impact of pregnancy on severe COVID-19 and mortality in an electronic medical record (EMR) database that enabled exclusion of labor and delivery (L&D) encounters.

METHODS: In this retrospective cohort study, EMRs from 82 healthcare facilities in the Cerner COVID-19 Datamart were analyzed. The study comprised 38 106 individuals aged 18-45 years old with COVID-19 who had emergency department, urgent care, or inpatient encounters from December 2019 to September 2020. Subgroups were balanced through propensity score weights for age, race, smoking status, and number of comorbidities. The primary outcome was COVID-19-related mortality; secondary outcomes were markers of severe COVID-19: intubations, mechanical ventilation, use of vasopressors, diagnosis of sepsis, and diagnosis of acute respiratory distress syndrome.

RESULTS: In comparing pregnant and nonpregnant women, no statistical differences were found for markers of severe COVID-19, after adjusting for age, smoking, race, and comorbidities. The adjusted odds of an inpatient encounter were higher for pregnant vs nonpregnant women (adjusted odds ratio [aOR], 13.2; 95% confidence interval [CI], 11.6-15.3; P < .001), but notably lower after excluding L&D encounters (aOR, 2.3; 95% CI, 1.89-2.88; P < .001). In comparison to women without L&D encounters, hospitalization was significantly more likely for men.

CONCLUSIONS: We did not find an increased risk of severe COVID-19 or mortality in pregnancy. Hospitalization does not necessarily indicate severe COVID-19 in pregnancy, as half of pregnant patients with COVID-19 were admitted for L&D encounters in this study.

PMID:35148386 | DOI:10.1093/cid/ciab441

PLoS One. 2022 Feb 11;17(2):e0263810. doi: 10.1371/journal.pone.0263810. eCollection 2022.

ABSTRACT

BACKGROUND: Trajectory analyses are being increasingly used in efforts to increase understanding about the heterogeneity in the development of different longitudinal outcomes such as sickness absence, use of medication, income, or other time varying outcomes. However, several methodological and interpretational challenges are related to using trajectory analyses. This methodological study aimed to compare results using two different types of software to identify trajectories and to discuss methodological aspects related to them and the interpretation of the results.

METHODS: Group-based trajectory models (GBTM) and latent class growth models (LCGM) were fitted, using SAS and Mplus, respectively. The data for the examples were derived from a representative sample of Spanish workers in Catalonia, covered by the social security system (n = 166,192). Repeatedly measured sickness absence spells per trimester (n = 96,453) were from the Catalan Institute of Medical Evaluations. The analyses were stratified by sex and two birth cohorts (1949-1969 and 1970-1990).

RESULTS: Neither of the software were superior to the other. Four groups were the optimal number of groups in both software, however, we detected differences in the starting values and shapes of the trajectories between the two software used, which allow for different conclusions when they are applied. We cover questions related to model fit, selecting the optimal number of trajectory groups, investigating covariates, how to interpret the results, and what are the key pitfalls and strengths of using these person-oriented methods.

CONCLUSIONS: Future studies could address further methodological aspects around these statistical techniques, to facilitate epidemiological and other research dealing with longitudinal study designs.

PMID:35148351 | DOI:10.1371/journal.pone.0263810

Aesthet Surg J. 2022 Feb 11:sjac029. doi: 10.1093/asj/sjac029. Online ahead of print.

ABSTRACT

BACKGROUND: Major branching patterns of the facial nerve have been extensively studied, as damage to branches of the nerve is associated with complications ranging from weakness to paralysis. However, communicating branches of the facial nerve have received far less attention, despite being hypothesized as a means of motor recovery following facial nerve injury.

OBJECTIVES: The aim of this study was to characterize the frequency of communicating branches (CommB) of the facial nerve to provide clarity on their anatomy and clinical correlations.

METHODS: Bilateral facial dissections were completed on cadaveric donors (n=20) to characterize the frequency and location of CommB across terminal branches of the facial nerve. Statistical analyses were used to analyze differences between the location of communications by side, and whether the CommB were more likely to occur on the left or right side (p<0.05).

RESULTS: Communicating branches were identified among all terminal branches of the facial nerve, and their frequencies reported. The highest frequencies of CommB were identified between the buccal-to-marginal mandibular and zygomatic-to-buccal branches, at 67.5% (27 comm/40 hemifaces). The second highest frequency of CommB was identified between the temporal-to- zygomatic branches in 62.5% (25/40) of donors. The marginal mandibular-to-cervical branches had CommB at a frequency of 55% (22/40). There was no significant difference in the location or sidedness of CommB.

CONCLUSIONS: Our characterization more accurately defines generalizable areas in which CommB are located. These locations of branches, described in relation to nearby landmarks, is fundamental for clinical and surgical settings to improve procedural awareness.

PMID:35148367 | DOI:10.1093/asj/sjac029

PLoS One. 2022 Feb 11;17(2):e0263939. doi: 10.1371/journal.pone.0263939. eCollection 2022.

ABSTRACT

Reconstruction of network is to infer the relationship among nodes using observation data, which is helpful to reveal properties and functions of complex systems. In view of the low reconstruction accuracy based on small data and the subjectivity of threshold to infer adjacency matrix, the paper proposes two models: the quadratic compressive sensing (QCS) and integer compressive sensing (ICS). Then a combined method (CCS) is given based on QCS and ICS, which can be used on binary-state and multi-state dynamics. It is found that CCS is usually a superior method comparing with compressive sensing, LASSO on several networks with different structures and scales. And it can infer larger node correctly than the other two methods. The paper is conducive to reveal the hidden relationship with small data so that to understand, predicate and control a vast intricate system.

PMID:35148349 | DOI:10.1371/journal.pone.0263939