Categories
Nevin Manimala Statistics

External Validation of the PRECISE-DAPT Cancer Score in Patients With Acute Myocardial Infarction

Catheter Cardiovasc Interv. 2025 Jul 22. doi: 10.1002/ccd.70040. Online ahead of print.

ABSTRACT

AIMS: We aimed to externally validate the PRECISE-DAPT cancer score which showed better accuracy in predicting bleeding events in patients with cancer than the original PRECISE-DAPT score.

METHODS: We used data from the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome) project. We compared the performance and clinical usefulness of the original score and the cancer score by calculating the C-statistic, the net reclassification index (NRI), and decision curve analysis.

RESULTS: A total of 13,932 patients were included, of which 864 patients had a diagnosis of cancer at the time of presentation with an AMI. According to the original PRECISE DAPT score, 63.3% of patients with cancer were classified as HBR, whereas 94.9% of patients with cancer were classified as HBR according to the cancer score. Cox-regression models showed that patients classified as HBR by the updated cancer score have higher odds of bleeding (HR 2.6, 95% CI 2.1-3.1) events than patients classified as HBR by the original score (HR 2.2, 95% CI 1.8-2.7). The cancer score showed higher discrimination ability (C-statistic 0.66) than the original score (C-statistic 0.64). The overall NRI of the cancer score was 2.7%. The decision curves analysis showed that the cancer score use is roughly identical to the original score in patients without cancer but superior to the original score in patients with cancer.

CONCLUSION: The PRECISE-DAPT cancer score is a valid and useful tool for the prediction of bleeding risk in patients with cancer and presenting with AMI.

PMID:40693319 | DOI:10.1002/ccd.70040

Categories
Nevin Manimala Statistics

RETRACTION: Direct Aspiration Versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18319. Online ahead of print.

ABSTRACT

B. Haydardedeoglu, F. Gjemalaj, P.C. Aytac, and E.B. Killicdag, “Direct Aspiration Versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial,” BJOG: An International Journal of Obstetrics & Gynaecology 124, no. 8 (2017): 1190-1196, https://doi.org/10.1111/1471-0528.14629. The above article, published online on 09 March 2017 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the randomized control trial and the successful implementation of randomization. The third party was unable to recalculate the statistical results presented in Table 1, raising concerns that the statistical reports were also flawed. The authors provided their raw dataset to the journal so it could be evaluated by an independent expert. This expert confirmed that many of the statistical results were not reproducible using the reported methods. They also found several inconsistencies and errors within the article, including the duplication of two participants in the dataset. As a result, the data and conclusions are considered unreliable and the article must be retracted.

PMID:40693313 | DOI:10.1111/1471-0528.18319

Categories
Nevin Manimala Statistics

RETRACTION: Evaluation of Postpartum Blood Loss After Misoprostol-Induced Labour

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18318. Online ahead of print.

ABSTRACT

M. El-Sedeek, E.E. Awad, S.M. Elsebaey, “Evaluation of Postpartum Blood Loss After Misoprostol-Induced Labour,” BJOG: An International Journal of Obstetrics and Gynaecology, 116, 3 (2009): 431-435, https://doi.org/10.1111/j.1471-0528.2008.02054.x. The above article, published online on 21 January 2009 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the statistical data reported in the article. The third party noted the p-values reported in Table 1 were not compatible with the article’s summary data, and the distribution data featured in the scatterplots of Figures 3 and 4 was unusual. An independent expert evaluated the summary data reported in the article and confirmed that many of the statistical results were not reproducible using reported methods. The expert noted that there were several instances of data anomalies within the article, including the distribution of postpartum bleeding within Group 1, where the scores reported feature a pattern that is unusual. The authors did not respond when asked for their original data and clarification. As a result, the data and conclusions are considered unreliable, and the article must be retracted.

PMID:40693309 | DOI:10.1111/1471-0528.18318

Categories
Nevin Manimala Statistics

RETRACTION: Plasma Orexin-A Levels in Postmenopausal Women: Possible Interaction With Estrogen And Correlation With Cardiovascular Risk Status

BJOG. 2025 Jul 22. doi: 10.1111/1471-0528.18317. Online ahead of print.

ABSTRACT

M. El-Sedeek, A.A. Korish, and M.M. Deef, “Plasma Orexin-A Levels in Postmenopausal Women: Possible Interaction With Estrogen And Correlation With Cardiovascular Risk Status,” BJOG: An International Journal of Obstetrics and Gynaecology 117, no. 4 (2010): 488-492, https://doi.org/10.1111/j.1471-0528.2009.02474.x. The above article, published online on 08 February 2010 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the reported calculations and statistical results. The third party was unable to recalculate the mean BMI using the reported weight and height metrics and also noted that the F values in Tables 1 and 2 were unusually large and the p-values reported in these tables do not appear compatible with the reported summary data. An independent expert evaluated the summary data reported in the article and confirmed the incompatibility of the statistical results and found that both the reported and recalculated F values are implausibly large. The authors did not respond when asked for their original data and clarification. As a result, the data and conclusions are considered unreliable, and the article must be retracted.

PMID:40693303 | DOI:10.1111/1471-0528.18317

Categories
Nevin Manimala Statistics

Micropulse Cyclophotocoagulation versus Ultrasound Cycloplasty in a Tertiary Eye Care Center in Riyadh, Saudi Arabia

Clin Ophthalmol. 2025 Jul 17;19:2373-2381. doi: 10.2147/OPTH.S519777. eCollection 2025.

ABSTRACT

PURPOSE: To compare the efficacy, safety and outcomes of micropulse cyclophotocoagulation (MP-CPC) to ultrasound cycloplasty (UCP) in patients referred to a tertiary eye care center in Riyadh, Saudi Arabia.

PATIENTS AND METHODS: A retrospective study evaluated data from patients who had undergone MP-CPC or UCP from January 2017 to October 2023. Patients who lost to follow up and patients with incomplete medical reports were excluded from the study. Data was collected for day 1, 2nd week, 1 month and 3, 6, and 12 months postoperatively. At each visit, data was collected on intraocular pressure (IOP), corrected distance visual acuity (CDVA), medications and possible complications. Data was compared between groups. P<0.05 was considered statistically significant.

RESULTS: Out of 139 eyes, 65 underwent UCP, and 74 underwent MP-CPC. IOP in the UCP group decreased from 29.67±9.82 mmHg preoperatively to 21.00±6.78 mmHg at one year postoperatively and in the MP-CPC group, IOP decreased from 28.44±9.46 mmHg to 20.41±8.77 mmHg respectively. In the UCP group, at the 1-year follow-up, vision remained unchanged from the preoperative levels in 6 eyes (27.3%), while 2 eyes (9.1%) lost 1 line of vision, and 8 eyes (36.4%) experienced a loss of ≥2 lines. In the MP-CPC group, at the 1-year follow-up, vision remained unchanged in 24 eyes (43.6%), 2 eyes (3.6%) lost 1 line, and 20 eyes (36.4%) had a loss of ≥2 lines. The number of antiglaucoma medications at 1 year postoperatively did not differ between groups. The qualified success rate at 1 year was similar between groups.

CONCLUSION: Both UCP and MP-CPC are safe and effective for reducing IOP in refractory glaucoma, with similar reductions observed between the two techniques. Visual outcomes and qualified success rates were comparable between UCP and MP-CPC.

PMID:40693283 | PMC:PMC12278948 | DOI:10.2147/OPTH.S519777

Categories
Nevin Manimala Statistics

Penalized distributed lag interaction model: Air pollution, birth weight, and neighborhood vulnerability

Environmetrics. 2024 Jun;35(4):e2843. doi: 10.1002/env.2843. Epub 2024 Feb 1.

ABSTRACT

Maternal exposure to air pollution during pregnancy has a substantial public health impact. Epidemiological evidence supports an association between maternal exposure to air pollution and low birth weight. A popular method to estimate this association while identifying windows of susceptibility is a distributed lag model (DLM), which regresses an outcome onto exposure history observed at multiple time points. However, the standard DLM framework does not allow for modification of the association between repeated measures of exposure and the outcome. We propose a distributed lag interaction model that allows modification of the exposure-time-response associations across individuals by including an interaction between a continuous modifying variable and the exposure history. Our model framework is an extension of a standard DLM that uses a cross-basis, or bi-dimensional function space, to simultaneously describe both the modification of the exposure-response relationship and the temporal structure of the exposure data. Through simulations, we showed that our model with penalization out-performs a standard DLM when the true exposure-time-response associations vary by a continuous variable. Using a Colorado, USA birth cohort, we estimated the association between birth weight and ambient fine particulate matter air pollution modified by an area-level metric of health and social adversities from Colorado EnviroScreen.

PMID:40693281 | PMC:PMC12278763 | DOI:10.1002/env.2843

Categories
Nevin Manimala Statistics

Development and implementation of an “Internet ” integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals: A randomized controlled trial

Digit Health. 2025 Jul 20;11:20552076251357657. doi: 10.1177/20552076251357657. eCollection 2025 Jan-Dec.

ABSTRACT

OBJECTIVE: This study investigates the effects of developing and implementing an integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals under the deep integration of Internet technology. The goal is to provide practical references for addressing declining birth rate challenges and promoting the sustainable development of maternal and child specialty hospitals.

METHODS: Using a convenience sampling method, 100 pregnant and postpartum women from a tertiary maternal and child health hospital in Chengdu, China, were selected as the participants for this study. A random number table was used to assign the participants into the control group and the intervention group, with 50 participants in each group. The control group received conventional nursing care, while the intervention group was provided with an integrated service model for antepartum, intrapartum, and postpartum care, fully implemented with Internet technology. A comprehensive comparative analysis was conducted between the two groups across several key dimensions, including the number of return visits within 42 days postpartum: The actual number of return visits for checkups, treatments, or consultations due to various health issues during this period was recorded and compared; Postpartum complications within 42 days: The occurrence rates of common complications, such as postpartum infections, hemorrhage, and milk stasis, were meticulously documented and analyzed for both groups. Service satisfaction: A nursing satisfaction questionnaire was used to objectively and comprehensively assess the satisfaction levels of participants in both groups with the care they received. Willingness for postpartum follow-up visits: Differences in participants’ subjective willingness and proactive attitudes toward arranging subsequent postpartum visits were thoroughly examined. Psychological indicators: Using psychological assessment scales, the psychological status of the two groups was evaluated from the establishment of personal health records to postpartum follow-up, analyzing the psychological differences between the two groups.

RESULTS: Through systematic data collection, organization, and rigorous statistical analysis, the results revealed that the average number of return visits within 42 days postpartum was significantly lower in the intervention group (0.16 ± 0.42) compared to the control group (1.44 ± 1.11) (t = -7.630, P < .001). For service satisfaction, 84.00% (42/50) of participants in the intervention group were very satisfied, significantly higher than 52.00% (26/50) in the control group (χ² = 3.170, P = .001). The incidence of mastitis within 42 days postpartum was 2.00% (1/50) in the intervention group, markedly lower than 28.00% (14/50) in the control group (χ² = 2.670, P < .001). For willingness to seek follow-up visit, 96.00% (48/50) of participants in the intervention group stated they would return to the hospital if they had health issues, compared to 82.00% (41/50) in the control group (χ² = 5.010, P = .025). 92.00% (46/50) of participants in the intervention group were willing to choose our hospital for the newborn’s health checkup, significantly higher than 76.00% (38/50) in the control group (χ² = 61.060, P < .001). The 28 weeks GAD-7 scored lower in the intervention group (4.14 ± 0.73) than in the control group (5.27 ± 1.00) (t = -6.430, P < .001) and also lower in the intervention group than in the control group at admission (5.58 ± 1.40 vs. 7.29 ± 1.61; t = -5.630, P < .001). There was no significant difference in 28 weeks EPDS scores between two groups (9.02 ± 0.68 vs. 9.18 ± 0.78; t = -1.110, P = .270). The intervention group showed significantly lower EPDS scores at 42 days postpartum (7.84 ± 0.71 vs. 9.61 ± 1.84; t = -6.310, P < .001).

CONCLUSION: The integrated service model for antepartum, intrapartum, and postpartum care in maternal and child specialty hospitals, based on the “Internet+” concept, effectively integrates Internet technology with critical processes in nursing services. This model precisely and efficiently addresses pregnant and postpartum women’s unique maternal and childcare needs at different physiological stages. It demonstrates significant advantages in optimizing medical resource allocation, improving the quality and efficiency of nursing services, and enhancing patients’ healthcare experiences and trust. The findings of this empirical study provide robust evidence for the model’s effectiveness in nursing care. The successful implementation of this innovative service model offers new perspectives and directions for transforming and upgrading maternal and child specialty hospitals in the face of declining birth rates and the associated challenges and opportunities. It holds significant value for broader application and promotion, with promising prospects for further development.

PMID:40693253 | PMC:PMC12277550 | DOI:10.1177/20552076251357657

Categories
Nevin Manimala Statistics

Resource management and capacity planning for clinical trial sites

J Clin Transl Res. 2024;10(4):229-236. doi: 10.36922/jctr.24.00022. Epub 2024 Aug 20.

ABSTRACT

BACKGROUND: Since 2020, the number of registered clinical trials has surged by over 30%, significantly increasing the demand for skilled coordinators. Despite this growth, a national shortage of qualified coordinators remains, driven by escalating responsibilities and workloads. Effective resource management is crucial for retention. While the Ontario Protocol Assessment Level (OPAL) helps quantify trial complexity, it overlooks key factors such as organizational structure and budget constraints that impact coordinator productivity. This project aims to refine the OPAL score by integrating it with longitudinal coordinator effort data, improving resource allocation, operational efficiency, and job satisfaction, thereby reducing burnout and turnover.

AIM: The aim of this study was to reduce burnout and turnover, ultimately contributing to the overall success of clinical trials.

METHODS: Actively enrolling interventional studies with corresponding coordinator effort tracking from June 1, 2022, to December 1, 2022, were included in the database. Protocols were graded using an adapted protocol assessment tool. Descriptive statistics compared protocol characteristics to the adapted assessment score and tracked coordinator hours, while Student’s t-test and univariate analysis evaluated differences in continuous variables. Linear regression analysis assessed the association between the adapted score and the coordinator effort.

RESULTS: Seven protocols were analyzed: five (71%) were federally funded, two (29%) were industry-sponsored; four (57%) were behavioral interventions, and three (43%) were drug studies. Significant differences were observed between industry-sponsored and federally funded studies (7.25 ± 1.77 vs. 6.45 ± 1.65; P < 0.0001) and between behavioral interventions and drug studies (6.88 ± 1.56 vs. 6.42 ± 1.91; P < 0.0001). Linear regression revealed the adapted OPAL score significantly predicted coordinator hours (β = 77.22; P = 0.01; R 2 = 0.78).

CONCLUSION: The adapted protocol complexity scores predict coordinator effort, aiding in capacity assessment and objective project distribution.

RELEVANCE FOR PATIENTS: The findings from this project can inform more precise resource allocation, potentially leading to higher-quality studies and enhanced participant safety.

PMID:40693242 | PMC:PMC12279055 | DOI:10.36922/jctr.24.00022

Categories
Nevin Manimala Statistics

Global, regional, and national burden of genitourinary cancers in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021

J Natl Cancer Cent. 2025 May 3;5(3):330-345. doi: 10.1016/j.jncc.2025.03.001. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality. However, there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers. Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease (GBD) database.

METHODS: This study presented the incidence, mortality, disability-adjusted life years (DALYs), and their respective age-standardized rates for four genitourinary cancers (bladder, kidney, prostate, and testicular cancers) by sex, age, and location from 1990 to 2021. Estimates for these data were presented with their 95% uncertainty intervals (UIs). Estimated annual percentage changes (EAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to further quantify the temporal dynamics of age-standardized rates (ASRs) in genitourinary cancers. Countries and territories were categorized according to socio-demographic index (SDI) quintiles.

RESULTS: Globally, with the exception of a sustained decline in age-standardized incidence rates (ASIRs) for bladder cancer (EAPC = -0.36%), the ASIRs for kidney, prostate, and testicular cancers demonstrated an upward trend from 1990 to 2021 (EAPC = 0.53%, 0.20%, and 1.43%, respectively). In terms of geographical regions, High-income North America had the highest ASIRs for both bladder (13.98 per 100,000 persons [95% UI, 12.96 to 14.61]) and prostate (47.02 per 100,000 persons [95% UI, 44.47 to 49.04]) cancers. Southern Latin America recorded the highest ASIRs for kidney (13.44 per 100,000 persons [95% UI, 12.27 to 14.73]) and testicular (4.98 per 100,000 persons [95% UI, 4.33 to 5.72]) cancers. Additionally, Central Europe (1.25% [95% CI, 1.12% to 1.38%]), East Asia (2.40% [95% CI, 2.21% to 2.59%]), Eastern Europe (3.74% [95% CI, 3.55% to 3.92%]), and the Caribbean (5.52% [95% CI, 4.32% to 6.74%]) exhibited the highest EAPCs for bladder, kidney, prostate, and testicular cancers, respectively. Unlike the ASIRs, age-standardized mortality rates (ASMRs) and age-standardized DALYs rates (ASDRs) showed a downward trend over time in all types of genitourinary cancers. The disease burdens of bladder, kidney, and prostate cancers were primarily distributed among older men, while testicular cancer mainly occurred in young men. Smoking remained the primary risk factor for bladder cancer. Meanwhile, high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers, respectively, during the study period. Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees. However, regional disparities in genitourinary cancer burdens are projected to persist.

CONCLUSIONS: Although the results demonstrate a marginal decline in ASRs caused by genitourinary cancers, they still impose a considerable global burden and result in numerous deaths. Our study obtained and analyzed the latest epidemiological data of genitourinary cancers from the GBD 2021, offering valuable information for national healthcare professionals and policymakers to optimize resource allocation, manage costs more efficiently, and develop practical healthcare policies.

PMID:40693231 | PMC:PMC12276558 | DOI:10.1016/j.jncc.2025.03.001

Categories
Nevin Manimala Statistics

Correction: Podocan and adverse clinical outcome in patients admitted with suspected acute coronary syndromes

Front Cardiovasc Med. 2025 Jul 7;12:1650098. doi: 10.3389/fcvm.2025.1650098. eCollection 2025.

ABSTRACT

[This corrects the article DOI: 10.3389/fcvm.2022.867944.].

PMID:40693227 | PMC:PMC12278736 | DOI:10.3389/fcvm.2025.1650098