Category: Statistics

BMC Pregnancy Childbirth. 2026 Feb 23. doi: 10.1186/s12884-026-08856-1. Online ahead of print.

NO ABSTRACT

PMID:41731395 | DOI:10.1186/s12884-026-08856-1

BMC Microbiol. 2026 Feb 23. doi: 10.1186/s12866-026-04848-5. Online ahead of print.

NO ABSTRACT

PMID:41731354 | DOI:10.1186/s12866-026-04848-5

Br J Pharmacol. 2026 Feb 23. doi: 10.1111/bph.70391. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Network meta-analysis (NMA) enables the simultaneous comparison of multiple treatments by combining direct and indirect evidence across a network of studies. While its application is rapidly expanding in pharmacological research and clinical guideline development, performing NMA typically requires advanced statistical knowledge and access to specialized software, limiting its broader adoption. Here, we present NetMetaEasy, a user-friendly, web-based platform that allows rapid execution and visualization of network meta-analyses from standard input formats, with minimal technical expertise required.

EXPERIMENTAL APPROACH: NetMetaEasy is an R/Shiny-based platform supporting binary, continuous and summary-effect data (e.g. odds ratios, hazard ratios). It offers frequentist and Bayesian network meta-analysis with P-score and SUCRA-based treatment ranking. It generates standard outputs including network diagrams, forest plots, netleague tables, inconsistency assessments and funnel plots using fixed- and random-effects models implemented via the netmeta and gemtc R packages.

KEY RESULTS: We demonstrate the functionality of NetMetaEasy using a real-world pharmacological dataset evaluating the cardiovascular outcomes of sodium/glucose cotransporter 2 (SGLT2) inhibitors. The platform successfully generated all standard NMA outputs, identified treatments with statistically significant benefits over placebo and showed no evidence of small-study bias. The entire workflow, from data upload to interpretation-ready plots,was completed within minutes. The registration-free NetMetaEasy analysis platform is accessible at http://www.metaanalysisonline.com/netmetaeasy.

CONCLUSION AND IMPLICATIONS: NetMetaEasy provides an accessible solution for conducting network meta-analyses by streamlining data processing, analysis and visualization into a single online interface, thereby enabling more widespread and rapid evidence synthesis in pharmacology, particularly for researchers without formal statistical training.

PMID:41731347 | DOI:10.1111/bph.70391

Alcohol Clin Exp Res (Hoboken). 2026 Feb;50(2):e70254. doi: 10.1111/acer.70254.

ABSTRACT

BACKGROUND: Clinical and preclinical alcohol use disorder (AUD) research demonstrates that males and females differ in motivations behind drinking, patterns of drinking behaviors, and alcohol-related physiological responses and health consequences. Nonhuman primate (NHP) models of AUD have the potential to enhance our understanding of such sex differences. In NHP models, schedule-induced polydipsia is a common method to initiate ethanol drinking. In males, characteristics of drinking during the final stage of induction, when monkeys consume 1.5 g/kg/day, predict subsequent drinking patterns when monkeys have unlimited access to ethanol. The present study assessed sex differences in those predictive behaviors during induction and characterized patterns and intakes during 6 months of ethanol drinking.

METHODS: Eleven singly housed adult cynomolgus monkeys (six male, five female) were induced to consume water, then increasing doses of ethanol for 4 weeks per dose (0.5, 1.0, and 1.5 g/kg) using a 300-s fixed-time schedule of food pellet delivery. Following induction, monkeys switched to an “open-access” regimen wherein water and ethanol were available 22 h/day, 5 days/week.

RESULTS: Predictive relationships between drinking characteristics during the final phase of induction and subsequent open-access drinking were replicated, with no evidence of sex differences. Although weekly and total ethanol intakes were higher in males over 6 months of open access, the difference did not reach statistical significance. However, there were sex differences in the distribution of ethanol intake across the day. Males drank significantly more when meals were available, whereas females spread their drinking throughout the first half of the session; these differences were exacerbated in Month 2 and remained for the duration of the study.

CONCLUSIONS: These results replicate previous findings of a predictive relationship between drinking variables during induction and later open-access drinking and reveal sex differences in daily patterns of ethanol intake that may inform treatment approaches.

PMID:41731324 | DOI:10.1111/acer.70254

Psychol Psychother. 2026 Feb 23. doi: 10.1111/papt.70047. Online ahead of print.

ABSTRACT

INTRODUCTION: Emotional Disorders (EDs) are highly prevalent among university students, with only a small percentage (16.4%) receiving treatment. This study examines the feasibility and acceptability of delivering the Unified Protocol (UP) in two scalable formats and explores preliminary clinical outcomes in a university student population.

METHODS: Thirty-five university students (80% women, mean age = 21.29 years, SD = 1.87) with primary diagnoses of EDs were randomly assigned to either the blended-UP condition (n = 18) or the synchronous online UP condition (n = 17). The intervention involved 8 UP modules, delivered as either 9 weekly 2-h synchronous online group sessions or a blended format (4 synchronous online group sessions for modules 1, 4, 6 and 7+ autonomous work via the UP-APP). Depression, anxiety, transdiagnostic variables, difficulties in emotion regulation, maladjustment and quality of life were assessed at baseline, post-treatment and at 3- and 6-month followups. Satisfaction with the intervention received was also measured.

RESULTS: Statistically significant changes were observed over time (main effect of time) for all evaluated variables (except in quality of life and positive temperament), with no ‘Time × Condition’ interaction, meaning that the scores evolved similarly in both conditions. Participants reported high satisfaction scores (8.91/10 in the blended condition and 9.38/10 in the synchronous online UP condition) and rated highly how the intervention had helped them to properly regulate their emotions (8.83/10 in the blended condition and 9.00/10 in the synchronous online UP condition).

CONCLUSIONS: This study demonstrates that both the blended and synchronous online group formats of the UP are feasible and well accepted by university students, with associated improvements in emotional symptoms, and that the UP in these formats could be an efficient alternative to address the high demand for mental health support among university students.

PMID:41731322 | DOI:10.1111/papt.70047

Am J Sports Med. 2026 Feb 23:3635465251408855. doi: 10.1177/03635465251408855. Online ahead of print.

ABSTRACT

BACKGROUND: Shoulder stiffness after rotator cuff repair (RCR) represents a primary determinant of patient-reported quality of life. The implementation of predictive strategies for the early identification of risk factors is critical for mitigating this complication.

PURPOSE: To evaluate the incidence of shoulder stiffness after RCR and to identify associated risk factors.

STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 4.

METHODS: A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to February 28, 2025. Factors reported in ≥2 studies with extractable data underwent meta-analysis; otherwise, a qualitative synthesis was performed. Sensitivity analyses were executed for risk factors exhibiting substantial heterogeneity or potential reporting bias. Effect sizes for risk factors were calculated using odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs).

RESULTS: This meta-analysis incorporated 20 studies comprising 34,565 patients undergoing RCR. The pooled incidence of postoperative stiffness was 12.9% (95% CI, 8.5%-18.0%), with significant variations based on diagnostic criteria (15.8% for range of motion vs 2.2% for intervention-based definitions; P < .001) and follow-up duration (18.9% at <6 months vs 9.2% at ≥6 months; P < .05). Overall, 33 potential risk factors for stiffness after RCR were identified, with 11 amenable to meta-analysis. Significant associations emerged for diabetes mellitus (OR, 1.51 [95% CI, 1.07-2.14]), fatty infiltration (OR, 1.58 [95% CI, 1.08-2.31]), concomitant subacromial decompression (OR, 3.26 [95% CI, 1.88-5.65]), and older age (MD, 1.33 [95% CI, 0.39-2.27]) (all P < .05). No statistically significant correlations were observed for sex, body mass index, symptom duration, dyslipidemia, hypothyroidism, tear size, or surgical approach (all P > .05).

CONCLUSION: This study revealed a pooled incidence of 12.9% for stiffness after RCR, with notable variations observed across diagnostic criteria and follow-up durations. Additionally, older age, diabetes, fatty infiltration, and concomitant subacromial decompression were identified as significant risk factors for postoperative stiffness. Clinicians should prioritize recognizing these risk factors and implementing evidence-based preventive strategies to reduce the incidence of stiffness after RCR.

PMID:41731320 | DOI:10.1177/03635465251408855

Acad Emerg Med. 2026 Feb;33(2):e70248. doi: 10.1111/acem.70248.

ABSTRACT

BACKGROUND: Iatrogenic medication errors are a preventable source of harm in older adults. Yet their prevalence, types, and outcomes remain poorly characterized. This study aims to describe healthcare-associated iatrogenic medication errors in older adults, including those occurring in the emergency department (ED) and prehospital settings.

METHODS: An Institutional Review Board-approved retrospective cohort study was conducted among patients aged 65 years and older who had an iatrogenic medication exposure reported to a regional poison center network between January 1, 2020, and May 23, 2025. Cases were extracted from the poison center network’s electronic health record and manually reviewed for inclusion as healthcare-associated medication errors. Error severity was assessed using the National Poison Data System (NPDS) medical outcome scale and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index. Clinical effects, implicated medications, and treatment data were collected and analyzed using descriptive statistics.

RESULTS: Out of 192 potential cases, 182 met inclusion criteria. Most errors occurred in a healthcare setting (nursing facility 32%, non-critical care unit 14%, or ED 12%) and were managed in an ED (60%, 110). Cardiovascular (32%, 129) agents were most often implicated. Most errors occurred during the administration phase (77%, 138), primarily due to medication given to the wrong patient (24%, 43) or at the wrong dose (20%, 36). More than half of cases were classified as NCC MERP Category E or higher, indicating patient harm.

CONCLUSIONS: Iatrogenic medication errors in older adults occur across care settings and are most often managed in the ED. While many cause minor harm, a subset results in serious outcomes, with ED-based errors posing higher risk. These findings underscore the need for targeted interventions, particularly during administration and for cardiovascular agents, and provide data to guide strategies and future research to protect this vulnerable population.

PMID:41731318 | DOI:10.1111/acem.70248

J Paediatr Child Health. 2026 Feb 23. doi: 10.1111/jpc.70334. Online ahead of print.

ABSTRACT

AIM: Use of social media platforms such as TikTok within the adolescent population is widespread. Harnessing its accessibility and prevalence provides health professionals an opportunity to disseminate positive, evidence-based health information. However, infiltrating this domain brings challenges such as countering abundant misinformation and understanding the target audience. Creating successful short-form videos for social media is a nuanced skill. University health students produced videos focusing on common adolescent issues for a health-promoting TikTok channel. The aim of this study was to explore secondary school student perceptions of these videos.

METHODS: A mixed methods evaluation was undertaken using surveys and focus group interviews. Teachers from participating secondary schools recruited parents and students via the school online communication system. Descriptive statistics from survey responses were used to analyse demographics and scale responses. A uses and gratification lens was used for inductive content analysis of qualitative data.

RESULTS: Participant students were predominantly from Year 9 (age 14-15 years), 161/212 (76%). The median score for enjoyment and positive learnings from videos was 5/10 and for likelihood of sharing videos was 3/10. Three themes emerged from the qualitative data: (1) mixed perceptions of video content with a preference for health not disease, (2) engagement driven by entertainment and 3) social media platforms for enjoyment versus education.

CONCLUSIONS: Social media platforms are an accessible source of health information for adolescents. Health professionals have an opportunity to provide evidence-based health information and combat misinformation. Creating effective and targeted video content can increase the positive impact on adolescent audiences.

PMID:41731313 | DOI:10.1111/jpc.70334

Int J Stroke. 2026 Feb 23:17474930261430342. doi: 10.1177/17474930261430342. Online ahead of print.

ABSTRACT

BACKGROUND: Outcome prediction after endovascular thrombectomy (EVT) for ischemic stroke is important for patient counseling and rehabilitation planning. MR PREDICTS @24H, a nine-predictor model, showed excellent performance in predicting functional outcome at 90 days of patients with acute ischemic stroke. With the expanding treatment indications, we validated the model for patients receiving EVT within 24 hours after stroke onset and simplified it for easier clinical implementation.

METHODS: We used individual patient data from the Dutch MR CLEAN-Registry (2014-2018), a prospective observational cohort enrolling patients treated with EVT, and three randomized controlled trials MR CLEAN-MED, MR CLEAN-NOIV, and MR CLEAN-LATE (2018-2022). We included patients with an intracranial large vessel occlusion in the anterior circulation treated with EVT within 24 hours of symptom onset or last seen well. We assessed the effect of predictors on functional outcome (modified Rankin Scale [mRS]) at 90 days with ordinal logistic regression. Predicted probabilities of functional independence (mRS 0-2) and survival (mRS 0-5) were derived from the model formula. We evaluated predictive performance with discrimination (C-statistic) and calibration (intercept, slope). The model was simplified by excluding predictors based on the Akaike information criterion (AIC). We applied leave-one-study-out cross validation to evaluate heterogeneity in model performance between the cohorts.

RESULTS: The validation cohort included 6154 patients: 4737 from the Registry and 1417 from the trials. External validation of the original model showed excellent discrimination in predicting functional independence (C statistic 0.91, 95% CI 0.90-0.92) and survival (C statistic 0.90, 95% CI 0.89-0.91). The simplified model, comprising four predictors – NIHSS at 24 hours after EVT, age, pre-stroke mRS, and symptomatic intracranial hemorrhage – performed comparably (functional independence C statistic 0.91, 95% CI 0.90-0.92; and survival 0.89, 95% CI 0.88-0.90). Cross validation revealed heterogeneity between LATE and the other cohorts, with the model overestimating the probability of functional independence in LATE (observed 39.1% vs predicted 44.2%), whereas the observed and predicted probability of survival was similar (75.5% vs 75.7%).

CONCLUSIONS: A simplified version of MR PREDICTS @24H including only four predictors performed as good as the full model, providing a practical tool that can be applied one day after EVT for reliable outcome estimation. Further validation and updating of the model are needed for patients treated in the late time window (6-24h).

PMID:41731306 | DOI:10.1177/17474930261430342

Cytometry A. 2026 Feb 23. doi: 10.1002/cyto.a.70016. Online ahead of print.

ABSTRACT

In flow cytometry, raw detector values do not directly represent fluorochrome abundances and must be mathematically unmixed using coefficients derived from single-stained reference controls. Inaccuracies in these controls, referred to as reference errors, can distort the estimated fluorochrome abundances, leading to skewed population distributions. However, as panel complexity and dataset sizes increase, manually inspecting all marker combinations for such artifacts becomes impractical. To address this challenge, we developed CompensAID, an open-source R-based tool that automatically flags marker combinations potentially affected by reference errors, thereby supporting quality control workflows in flow cytometry. Preprocessed data from both conventional and spectral flow cytometry were used to develop and validate the tool. CompensAID applies a density-based cutoff detection to automatically gate the negative and positive populations. The positive population is then divided into equally sized segments, after which the Secondary Stain Index (SSI) is computed for each segment. Marker combinations are flagged if the last segment yields an SSI value below -1. The tool’s performance was evaluated against the consensus of five flow cytometry specialists. For the conventional dataset, 1761 out of 2240 marker combinations (79%) were unanimously classified as free of reference errors, while 24 marker combinations received a consensus score of three or higher, indicating that most flow cytometry specialists suspected reference errors. CompensAID successfully identified 23 out of these 24 marker combinations, achieving a sensitivity of 0.96. The single missed case involved a spillover spread error. In the spectral dataset, 1505 out of 1656 marker combinations (90%) were deemed free of reference errors. Of the 28 marker combinations suspected of reference errors, CompensAID flagged 21 marker combinations (sensitivity, 0.74). Five out of the seven missed marker combinations had SSI values close to the threshold. In both datasets, false positive findings were observed, often attributable to suboptimal gating or low event counts within the segments contributing to negative SSI values. CompensAID offers a robust approach for detecting marker combinations exhibiting signs of reference errors. While some false positives occur, the tool significantly reduces the burden of manual inspection. Its integration into quality control pipelines can enhance the reliability of flow cytometry data analysis. The R package is available at https://github.com/Olsman/CompensAID and will be made available through the Bioconductor platform.

PMID:41731288 | DOI:10.1002/cyto.a.70016