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Nevin Manimala Statistics

Associations between type of blood collection, analytical approach, mean haemoglobin and anaemia prevalence in population-based surveys: A systematic review and meta-analysis

J Glob Health. 2022 Nov 23;12:04088. doi: 10.7189/jogh.12.04088.

ABSTRACT

BACKGROUND: Previous studies have observed that haemoglobin concentrations can be affected by type of blood collection, analysis methods and device, and that near-in-time population-based surveys report substantially different anaemia prevalence. We investigated whether differences in mean haemoglobin or prevalence of anaemia between near-in-time surveys of the same population were associated with differences in type of blood collection or analytic approach to haemoglobin measurement.

METHODS: We systematically identified pairs of population-based surveys that measured haemoglobin in the same population of women of reproductive age (WRA) or preschool-aged children (PSC). Surveys were matched on geographic coverage, urban/rural place of residence, inclusion of pregnant women, time of data collection (within 18 months), and, to the extent feasible, age range. Differences in anaemia prevalence were presented graphically. Random-effects meta-analysis and meta-regression of difference in mean haemoglobin were carried out, with subgroups defined by comparison of type of blood collection and analytic approach within each survey pair.

RESULTS: We included 23 survey pairs from 17 countries for PSC and 17 survey pairs from 11 countries for WRA. Meta-regression indicates that surveys measuring haemoglobin with HemoCue® Hb 301 found higher haemoglobin concentrations than near-in-time surveys using HemoCue® Hb 201+ in non-pregnant women ((NPW); 5.8 g/L (95% confidence interval (CI) = 3.2-8.3) mean difference, n = 5 pairs) and PSC (4.3 g/L (1.4-7.2), n = 6). Surveys collecting venous blood found higher haemoglobin concentrations than near-in-time surveys collecting capillary blood in PSC (3.8 g/L (0.8-6.7), n = 8), but not NPW (0.4 g/L (-1.9-2.8), n = 9).

CONCLUSIONS: Because this study is observational, differences in haemoglobin concentrations in near-in-time surveys may be caused by other factors associated with choice of analytic approach or type of blood collected. The source or sources of differences should be clarified to improve use of surveys to prioritize and evaluate public health programs.

REGISTRATION: PROSPERO CRD42022296553.

PMID:36412108 | DOI:10.7189/jogh.12.04088

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Nevin Manimala Statistics

Standard error estimation in meta-analysis of studies reporting medians

Stat Methods Med Res. 2022 Nov 22:9622802221139233. doi: 10.1177/09622802221139233. Online ahead of print.

ABSTRACT

We consider the setting of an aggregate data meta-analysis of a continuous outcome of interest. When the distribution of the outcome is skewed, it is often the case that some primary studies report the sample mean and standard deviation of the outcome and other studies report the sample median along with the first and third quartiles and/or minimum and maximum values. To perform meta-analysis in this context, a number of approaches have recently been developed to impute the sample mean and standard deviation from studies reporting medians. Then, standard meta-analytic approaches with inverse-variance weighting are applied based on the (imputed) study-specific sample means and standard deviations. In this article, we illustrate how this common practice can severely underestimate the within-study standard errors, which results in poor coverage for the pooled mean in common effect meta-analyses and overestimation of between-study heterogeneity in random effects meta-analyses. We propose a straightforward bootstrap approach to estimate the standard errors of the imputed sample means. Our simulation study illustrates how the proposed approach can improve the estimation of the within-study standard errors and consequently improve coverage for the pooled mean in common effect meta-analyses and estimation of between-study heterogeneity in random effects meta-analyses. Moreover, we apply the proposed approach in a meta-analysis to identify risk factors of a severe course of COVID-19.

PMID:36412105 | DOI:10.1177/09622802221139233

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Nevin Manimala Statistics

Can late lymphoscintigraphy be omitted in the sentinel node procedure in early-stage vulvar cancer?

Acta Obstet Gynecol Scand. 2022 Nov 22. doi: 10.1111/aogs.14476. Online ahead of print.

ABSTRACT

INTRODUCTION: In the Netherlands, the sentinel lymph node procedure protocol consists of preoperative lymphoscintigraphy combined with intraoperative blue dye for identifying sentinel lymph nodes in early vulvar squamous cell carcinoma. This study aimed at investigating the role of early and late lymphoscintigraphy.

MATERIAL AND METHODS: From January 2015 to January 2019, early and late lymphoscintigraphies of 52 women were retrospectively analyzed. Lymphoscintigraphy was performed 30 minutes (early) and 2.5-4 hours (late) after vulvar injection of 99m Tc-labeled nanocolloid. We calculated the concordance correlation coefficient (CCC) between number of sentinel lymph nodes detected on both images using the Lins concordance coefficient and correlated with clinicopathological data.

RESULTS: Thirty-four women had a midline tumor and 18 had a lateral tumor. Detection rates with early and late scintigraphy were 88.5% and 98.1%, respectively. Median number of detected nodes was 1.0 (0-7) and 2.0 (0-7). Good statistical correlation between number of sentinel lymph nodes detected on early and late imaging was found (CCC = 0.76) in most patients. In 18 women (35%) a mismatch occurred: a higher number of nodes was detected on late imaging. In 11 of 18 women re-injection was performed because no sentinel lymph nodes were visualized on early images. Late imaging and intraoperative detection showed a good statistical correlation (CCC = 0.61). One woman showed an isolated groin recurrence despite negative sentinel lymph nodes.

CONCLUSIONS: This study showed good statistical correlations between early and late scintigraphy in most patients. However, in 35% of women late scintigraphy detected more nodes. In case of poor visualization after the first scintigraphy, re-injection should be considered. Late scintigraphy is probably helpful in confirming successful re-injection and in showing deviating lymph flow in women with failed mapping after the first injection and successful re-injection. Because missing metastatic sentinel lymph nodes often leads to a poor prognosis, we prefer optimal correlations between imaging and intraoperative identification. Hence, late scintigraphy cannot be safely omitted.

PMID:36412099 | DOI:10.1111/aogs.14476

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Nevin Manimala Statistics

Language and gender barriers to pain control after general surgery

ANZ J Surg. 2022 Nov 22. doi: 10.1111/ans.18164. Online ahead of print.

ABSTRACT

BACKGROUND: Effective pain control is crucial to postoperative recovery and is affected by biopsychosocial factors. This study aimed to evaluate how non-English primary language, gender, and marital status may influence pain, length of stay, and mortality after general surgery.

METHODS: Consecutive general surgical admissions over a two-year period to two tertiary hospitals were included. Multivariable logistic regression analyses were conducted to evaluate the relationship between non-English primary language, gender, and marital status, and pain scores, length of stay, and in-hospital mortality. Explanatory variables that were controlled for in these analyses included age, birth country, whether a religion was specified, socioeconomic percentile, Charlson comorbidity index, and time of admission.

RESULTS: A total of 12 846 general surgery patients were included. When controlling for the aforementioned variables, including having a specified religion and being born overseas, having a non-English primary language was significantly independently associated with lower pain scores (odds ratio 0.61, 95% CI 0.52-0.71, P < 0.001). Female gender was independently associated with an increased likelihood of higher pain scores (odds ratio 1.09, 95% CI 1.01-1.18, P = 0.024) and a lower likelihood of prolonged length of stay (odds ratio 0.88, 95% CI 0. 80-0.95, P = 0.002). None of the evaluated variables had a statistically significant association with in-hospital mortality.

CONCLUSIONS: This study is the first to characterize an association between general surgery patients with a non-English primary language and lower levels of postoperative pain. It was also found that female gender was associated with higher postoperative pain but lower length of hospital stay.

PMID:36412097 | DOI:10.1111/ans.18164

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Nevin Manimala Statistics

Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic

Int J Lang Commun Disord. 2022 Nov 22. doi: 10.1111/1460-6984.12823. Online ahead of print.

ABSTRACT

BACKGROUND: Much has been written about the changes in use and perspectives of telepractice among speech and language therapists (SLTs) during the global COVID-19 pandemic. However, no long-term study has been done to examine whether there is a permanent shift in attitudes towards telepractice as the world adjusts to new norms and endemic COVID-19.

AIMS: To compare the speech telepractice use and perspectives of SLTs at two time points of the pandemic: during and after the height of the pandemic.

METHODS & PROCEDURES: Two online surveys were distributed a year apart among SLTs in Singapore. The first survey was disseminated during an initial lockdown period in 2020 and the second survey was done in 2021 when Singapore was starting to reduce strict quarantine and safe-distancing regulations. These surveys were distributed via communication channels of the local speech therapy association. A total of 115 and 71 responses to the survey were collected in 2020 and 2021, respectively. Responses were captured and analysed using descriptive statistics and statistical analysis while qualitative content analysis was used to derive key themes from open-ended questions.

OUTCOMES & RESULTS: Telepractice use across all age groups and client types peaked at the height of the pandemic. Even as lockdown measures were eased, telepractice utilization was still higher than what it was before the pandemic. Dysphagia management was the only area where SLTs reduced their use of telepractice during the stabilization phase. After more experience with telepractice during the height of the pandemic, SLTs acknowledged the benefit of being able to use a wide range of media through telepractice and were less worried about not having the resources or knowledge to set up telepractice. SLTs also reported increased confidence in providing telepractice, which was reflected in their willingness to continue to provide telepractice even after the pandemic ends.

CONCLUSIONS & IMPLICATIONS: The increase in use of telepractice during this pandemic is likely to be sustained as a majority of respondents believed they would continue to provide this mode of service delivery even after the pandemic ends. However, clinicians will still have to assess for client suitability, as clients with more complex medical or behavioural issues may still require in-person therapy. Additionally, dysphagia management via telepractice will still be limited given that swallow presentations may be more variable. Lastly, although generic resources are helpful for clinicians, the long-term sustainability of telepractice can be boosted by the sharing of resources that are suitable for the local context.

WHAT THIS PAPER ADDS: What is already known on this subject Current studies have examined telepractice use and perspectives of SLTs before and during the COVID-19 pandemic. Despite the evidence for the efficacy of telepractice, uptake was low due to perceived lack of training and resources. Although more clinicians provided telepractice during the pandemic, many still doubted its efficacy over in-person therapy and most studies concluded that longer term studies are required to ascertain if SLTs will continuing providing telepractice after the pandemic. What this paper adds to existing knowledge This study shows that there is a definitive shift in perspectives in favour of telepractice after the pandemic, as clinicians continued to provide telepractice across most service areas even without lockdown restrictions. The previous challenges of insufficient resources, knowledge and privacy concerns were reduced with more experience in providing telepractice. Although client suitability remained a major barrier, more clinicians saw benefits of easy access to therapy and range of resources used as benefits that they could harness from telepractice. What are the potential or actual clinical implications of this work? A majority of respondents stated that they are more confident in providing telepractice and would want to continue providing this service delivery mode after the pandemic, so more training and resources suitable for the local contexts can be provided by national associations to sustain this. More research and resources can be gathered to make telepractice more efficacious for dysphagia management and clients who may be deemed unsuitable for telepractice.

PMID:36412089 | DOI:10.1111/1460-6984.12823

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Nevin Manimala Statistics

Intra- and inter-operator variability of refractometric total proteins measurement of canine plasma

J S Afr Vet Assoc. 2022 Nov 8. doi: 10.36303/JSAVA.516. Online ahead of print.

ABSTRACT

Refractometric total proteins are commonly used in practice as a quick and inexpensive way to measure total protein concentration in bodily fluids. Little information is available about how the operator performing the measurement affects the results. The aim of our study was to determine the inter- and intra-operator variability of refractometric total proteins measured on canine plasma using a temperature-compensated handheld refractometer. A pooled sample of canine lithium-heparin plasma was created using leftover samples from dogs presented to our hospital. The sample was then divided into three aliquots. Total proteins of these aliquots were measured by veterinary nurses, interns, residents and specialists working at our hospital. Statistical analysis revealed excellent inter-operator (ICC 0.99, CI 95%: 0.971-1.00) and intra-operator (ICC 0.997, CI 95%: 0.990- 0.999) variability. Having different operators measuring refractometric total plasma proteins in practice should not affect the results. This suggests different operators can be used when monitoring total plasma proteins of a patient over time and when designing a study that involves this test.

PMID:36412080 | DOI:10.36303/JSAVA.516

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Nevin Manimala Statistics

GALTectomy increases the risk of allergic rhinitis: A nationwide population-based cohort study

Allergy. 2022 Nov 22. doi: 10.1111/all.15588. Online ahead of print.

NO ABSTRACT

PMID:36412075 | DOI:10.1111/all.15588

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Nevin Manimala Statistics

Clinical features, therapeutic outcomes and recovery period of long COVID

J Med Virol. 2022 Nov 22. doi: 10.1002/jmv.28316. Online ahead of print.

ABSTRACT

To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May 2021 through December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID-19 severity, the number of manifestations and delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, a smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs. This article is protected by copyright. All rights reserved.

PMID:36412057 | DOI:10.1002/jmv.28316

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Nevin Manimala Statistics

Quantifying inherent predictability and spatial synchrony in the aphid vector Myzus persicae: field-scale patterns of abundance and regional forecasting error in the UK

Pest Manag Sci. 2022 Nov 22. doi: 10.1002/ps.7292. Online ahead of print.

ABSTRACT

BACKGROUND: Sugar beet is threatened by virus yellows, a disease complex vectored by aphids that reduces sugar content. We present an analysis of Myzus persicae population dynamics with and without neonicotinoid seed treatment. We use six years’ yellow water trap and field-collected aphid data and two decades of 12.2 m suction-trap aphid migration data. We investigate both spatial synchrony and forecasting error to understand the structure and spatial scale of field counts and why forecasting aphid migrants lacks accuracy. Our aim is to derive statistical parameters to inform regionwide pest management strategies.

RESULTS: Spatial synchrony, indicating the coincident change in counts across the region over time, is rarely present and is best described as stochastic. Uniquely, early season field populations in 2019 did show spatial synchrony to 90 km compared to the overall average weekly correlation length of 23 km. However, 70% of the time series were spatially heterogenous, indicating patchy between-field dynamics. Field counts lacked the same seasonal trend and did not peak in the same week. Forecasts tended to under-predict mid-season log10 counts. A strongly negative correlation between forecasting error and the proportion of zeros was shown.

CONCLUSION: Field populations are unpredictable and stochastic, regardless of neonicotinoid seed treatment. This outcome presents a problem for decision-support that cannot usefully provide a single regionwide solution. Weighted permutation entropy inferred that M. persicae 12.2 m suction-trap time series had moderate to low intrinsic predictability. Early warning using a migration model tended to predict counts at lower levels than observed. This article is protected by copyright. All rights reserved.

PMID:36412050 | DOI:10.1002/ps.7292

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Nevin Manimala Statistics

A Comparison of Caffeine Intake and Physical Activity According to Fatigue Severity in University Students

Eval Health Prof. 2022 Nov 22:1632787221141504. doi: 10.1177/01632787221141504. Online ahead of print.

ABSTRACT

This study aims to compare caffeine intake and physical activity levels in university students with severe and ineffective fatigue and examine the relationship between them. A total of 647 (F:527; M:120) university students were included in this cross-sectional study. Individuals’ socio-demographic information, severity of fatigue (Fatigue Severity Scale (FSS)), amount of caffeine intake and physical activity level (International Physical Activity Questionnaire-Short Form (IPAQ-SF)) were evaluated. It was determined that 56.5% of the university students (age: 21.21 ± 2.57) participating in the study had severe fatigue. Caffeine intake and physical activity level of students with severe fatigue were statistically significantly lower than those with ineffective fatigue (p < 0.05). In addition, there was a weak negative correlation between fatigue and caffeine intake (r = -0.157; p < 0.001) and physical activity level (r = -0.096; p < 0.017). There was a significant positive correlation between caffeine intake and physical activity (r = 0.143; p < 0.001). This study showed that a significant portion of university students have severe fatigue. In addition, individuals with severe fatigue have decreased caffeine intake and lower physical activity levels. To reduce fatigue, caffeine intake in safe doses should be encouraged in accordance with the individual’s metabolic and physiological parameters. In addition, physical activity counseling should be given to encourage physical activity.

PMID:36412049 | DOI:10.1177/01632787221141504