Tag: statistics

Personal Ment Health. 2026 Feb;20(1):e70067. doi: 10.1002/pmh.70067.

ABSTRACT

Many features of personality psychopathology are shared among patients with Anorexia Nervosa (AN), yet the impact of these shared features is not fully understood, and the impact of having more personality psychopathology features during adolescent onset of AN, especially among adolescents admitted to an inpatient eating disorder unit, has not been explored. This study evaluated how personality psychopathology, utilizing a measure of borderline personality disorder (BPD) symptom severity, has a potential predictive value in understanding risk of readmission for an eating disorder over time. A total of 256 adolescents were admitted for medical stability to an inpatient unit for the first time. Adolescents completed the Borderline Personality Features Scale for Children-11 (BPFSC-11) within the first 14 days of admission; demographic variables, anxiety and mood comorbidities, and readmission status were obtained through chart review. Higher scores on the BPFSC-11 were significantly associated with being readmitted within 1 year of discharge from the inpatient unit. These findings highlight how personality psychopathology features at onset of severe AN in adolescence could indicate a higher risk for recovery complications, including repeated inpatient admission. These findings may underscore the role of supplementary therapeutic interventions alongside family-based therapy, including dialectical behavior therapy.

PMID:41725590 | DOI:10.1002/pmh.70067

Ned Tijdschr Geneeskd. 2025 Sep 3;169:D8610.

ABSTRACT

OBJECTIVE: In the Netherlands, a growing group of young people requests medical assistance in dying based on psychiatric suffering (MAID-PS). This study examined trends, characteristics and outcomes of such requests at ExpertisecentrumEuthanasie (EE) between 2012 and 2021.

DESIGN: Retrospective quantitative file study.

METHOD: All young applicants (< 24 years, N = 352, 73.4% female) who requested MAID-PS at EE between January 1, 2012 and June 30, 2021, were included in the study.

RESULTS: Of N=397 applications, 47.3% were withdrawn (N=188) and 44.8% were rejected (N=178). Among N=353 unique applicants, 12 (3.0%) died by MAID and 17 (4.3%) by suicide during the application process. Deceased applicants often had multiple psychiatric diagnoses, a history of suicide attempts, and an extensive treatment history.

CONCLUSION: The findings indicate a growing group of young applicants with severe psychological suffering and high risk of suicide. More insight into persistent death wishes and effective suicide prevention is needed.

PMID:41725582

Pharmacoepidemiol Drug Saf. 2026 Mar;35(3):e70341. doi: 10.1002/pds.70341.

ABSTRACT

PURPOSE: To characterize the frequency, causes, and severity of opioid medication recalls using United States Food and Drug Administration (FDA) Enforcement Reports.

METHODS: We conducted a 2002-2025 descriptive analysis of recalls involving seven opioids. FDA free-text recall reasons were categorized into five standardized domains (wrong dose/potency, contamination, mispackaging/mislabeling, defective delivery system, and quality assurance deviations) by two independent reviewers, with agreement assessed using Cohen’s κ (95% CI). Recall severity (Class I-III) was compared across drugs using the chi-square test, and temporal trends were evaluated with linear regression.

RESULTS: We identified 286 opioid-related recalls, involving over 350 million units. Fentanyl (26.2% of events; > 30 million units), hydromorphone (20.3%; > 11 million), morphine (19.6%; > 73 million), oxycodone (12.6%; > 188 million), and hydrocodone (13.9%; > 50 million) accounted for most events. Recalls of buprenorphine (7.0%; > 3 million) and methadone (3.2%; > 400 thousand) were less frequent. Quality assurance deviations accounted for most recalls (49.5%), followed by mispackaging/mislabeling (14.4%), wrong dose/potency (13.7%), defective delivery systems (12.3%), and contamination (10.1%). Inter-rater agreement for categorization was high (κ = 0.88 [0.84-0.93]). Class I recalls (risk of death) comprised 35 events (12.2%), concentrated among fentanyl (n = 10), morphine (n = 9), and hydromorphone (n = 9) (χ² = 43.1, df = 12, p < 0.001). Recall frequency increased significantly over time (r = 0.63, p = 0.001). Unit count data were missing for 34 events (11.9%), and production denominators were unavailable.

CONCLUSIONS: Opioid recalls reflect manufacturing or quality assurance problems that may undermine product reliability. More complete recall reporting, including quantitative data, would support efforts to reduce risks associated with pharmaceutical quality failures.

PMID:41725568 | DOI:10.1002/pds.70341

Ann Med. 2026 Dec;58(1):2624215. doi: 10.1080/07853890.2026.2624215. Epub 2026 Feb 23.

ABSTRACT

BACKGROUND: Although single-agent chemotherapy is the most common approach for treating platinum-resistant or refractory ovarian cancer (PROC), there is growing evidence that combining molecular targeted agents with chemotherapy is beneficial, especially for certain patient groups. However, the most effective combination regimen remains elusive.

OBJECTIVES: This Bayesian network meta-analysis (NMA) aims to identify the best combination therapy for PROC.

METHODS: Relevant studies were searched in PubMed, EMBASE, Web of Science and the Cochrane Central Register of Controlled Trials from their inception until October 2024. The primary outcomes were overall survival (OS), progression-free survival (PFS) and adverse events (AEs). Statistical analyses were performed using the GEMTC package (1.0-2) and R 4.2.0. This review was registered in PROSPERO (CRD42023428414).

RESULTS: Our analysis of 22 randomized controlled trials (RCTs) (n = 3408) demonstrated that chemotherapy combinations with bevacizumab (hazard ratio (HR) = 0.52-0.65), sorafenib (HR = 0.65, 95% confidence interval (CI): 0.45-0.93) or adavosertib (HR = 0.56, 95%CI: 0.35-0.90) significantly improved OS and PFS versus chemotherapy alone. Notably, adavosertib + gemcitabine was associated with an increased risk of grade 3-4 AEs (relative risk (RR) = 1.8, 95%CI: 1.3-2.7), but these were generally manageable.

CONCLUSIONS: Bevacizumab-based combinations demonstrate consistent benefits across multiple regimens for PROC. Paclitaxel + bevacizumab emerges as the optimal balance of efficacy and safety. Topotecan + sorafenib could be an alternative for patients who are ineligible for anti-angiogenic therapy.

PMID:41725538 | DOI:10.1080/07853890.2026.2624215

Eur J Dent Educ. 2026 Feb 23. doi: 10.1111/eje.70119. Online ahead of print.

ABSTRACT

INTRODUCTION: Patient safety is a critical yet underemphasized aspect of dental education. This study compared the perception, knowledge and attitudes toward patient safety among postgraduate dental residents at Tehran University of Medical Sciences who had completed the Infection Control and Patient Safety course and those who had not.

METHODS: A cross-sectional study was conducted among 62 s and third-year postgraduate dental residents during the 2021-2022 academic year. A validated questionnaire, adapted from previous studies, was used to assess participants’ perceptions, knowledge and attitudes. Data were analysed using SPSS version 21, with the Mann-Whitney U test employed for comparisons.

RESULTS: Significant differences were observed between the two groups. Residents who completed the course demonstrated higher levels of knowledge, more accurate perceptions and more positive attitudes toward patient safety. Key findings included greater awareness of error reporting systems, stronger support for transparency in error management, and a deeper understanding of the importance of patient safety education. However, both groups showed limited knowledge of national and international statistics on preventable adverse events.

CONCLUSION: The Infection Control and Patient Safety course positively influenced residents’ understanding and attitudes toward patient safety, highlighting the importance of formal education. These findings suggest that integrating patient safety training into dental curricula, particularly at the undergraduate level, could significantly improve the quality of dental care. Further studies with expanded and more diverse populations are recommended to validate these results and explore broader implications.

PMID:41725519 | DOI:10.1111/eje.70119

Int J Gynaecol Obstet. 2026 Feb 23. doi: 10.1002/ijgo.70904. Online ahead of print.

ABSTRACT

OBJECTIVE: Little is known about the birthing patterns of patients having experienced a prior cesarean section (CS) in low- and middle-income countries (LMICs). We sought to estimate the prevalence of and characterize trends relating to vaginal birth after cesarean section (VBAC) and repeat CS in LMICs.

METHODS: We analyzed 107 nationally representative surveys across 59 LMICs. For countries with population CS rates above 8%, we analyzed repeat CS trends across two or three consecutive surveys and estimated the association between repeat CS and facility level and facility type.

RESULTS: The prevalence of VBAC ranged from 0.5% in Turkey (95% CI: 0.1, 3.5) to 67.6% in Niger (95% CI: 53.4, 79.2). We observed an inverse association between the population CS rate and VBAC prevalence. Of the 33 countries with CS rates below 10%, 26 countries had VBAC prevalence estimates ranging from 20% to 50% with the prevalence of six countries exceeding 50%. Of the 26 countries with CS rates at or above 10%, 19 had VBAC prevalence estimates below 20%. We observed strong associations between repeat CS and births in private facilities or hospitals, and we found that repeat CS also increases over time across multiple countries. However, many of these associations were not statistically significant across multiple countries.

CONCLUSION: VBAC prevalence is greatest in countries with the lowest population CS rates, indicating that unplanned, unmonitored, and unsafe VBACs are occurring, necessitating shifts in birth planning and preparedness strategy. Repeat cesareans predominate where population CS rates are already high.

PMID:41725444 | DOI:10.1002/ijgo.70904

Diabetes Obes Metab. 2026 Feb 23. doi: 10.1111/dom.70583. Online ahead of print.

ABSTRACT

AIMS: Assess predictors of progression to type 2 diabetes (T2D) among patients with prediabetes.

MATERIALS AND METHODS: This case-control study assessed adults with prediabetes using US claims and EMR-linked data from January 1, 2016, through January 31, 2024. T2D cases were patients with prediabetes who progressed to T2D (index: date of first T2D diagnosis); controls had prediabetes but did not progress to T2D. Control index dates were randomly assigned from cases. Demographic and clinical characteristics in the year before progression to T2D were assessed to identify progression predictors.

RESULTS: The study included 39 281 T2D cases and 58 751 controls. Data on race/ethnicity (White, Black, Hispanic, Asian-Other) were available for 62% of the study sample. Demographic characteristics for cases and controls were similar in the overall population, by sex, and by race/ethnicity. During the 1-year baseline, T2D cases had a higher prevalence of obesity, cardiovascular disease (CVD), and obstructive sleep apnea (OSA) than controls. Comorbidity patterns varied by sex and race/ethnicity. Compared with patients aged 18-34 years, patients aged 35-44 (OR, 1.37), 45-54 (OR, 1.49), and 55-64 (OR, 1.33) had higher odds of progression. Obesity (OR, 1.45), CVD (OR, 1.64), OSA (OR, 1.36), metabolic dysfunction-associated steatohepatitis (MASH; OR, 1.37), and neuropathy (OR, 1.19) were associated with T2D progression. Black (OR, 1.27) and Hispanic (OR, 1.21) patients had higher odds of progression than White patients (all p < 0.0001).

CONCLUSIONS: Among patients with prediabetes, age 35-64 years, obesity, CVD, OSA, MASH, and neuropathy in the year before progression are associated with progression to T2D.

PLAIN LANGUAGE SUMMARY: What is the context and purpose of this research study? This research study looked at why some adults with prediabetes were more likely than others to develop type 2 diabetes (T2D). The researchers wanted to know if factors like age, sex, race, history of health conditions (such as obesity, heart disease, and sleep disorders), and abnormal lab tests (like elevated blood sugar levels) could predict who will get T2D. What was done? The researchers conducted a study using a US database of insurance and medical records from 2016 to 2024. The researchers compared two groups: 39 281 adults with prediabetes who developed T2D and 58 751 adults with prediabetes who did not develop T2D. The researchers looked for patterns in these groups and used statistics to identify risk factors. What were the main results? The study found that middle-aged adults (35-64 years old) and those with health problems like obesity, heart disease, sleep apnea, neuropathy, and liver disease were more likely to get T2D. These patterns were similar across patients of different races and genders. However, Black and Hispanic patients had a higher risk of T2D compared to White patients. There was no difference in the risk of developing T2D between patients with Asian or Other ethnicities and White patients. What is the originality and relevance of this study? This study is important because it identifies factors that increase the risk of developing T2D in people with prediabetes. It suggests that age, certain health conditions, and race can affect this risk. These findings can help doctors create better treatment and prevention plans for high-risk patients.

PMID:41725435 | DOI:10.1111/dom.70583

Diabetes Obes Metab. 2026 Feb 23. doi: 10.1111/dom.70588. Online ahead of print.

ABSTRACT

AIMS: To investigate sex-stratified associations between 4-year weight loss and risk of incident atrial fibrillation (AF) in a prospective cohort study and the potential benefits of sustained weight management.

MATERIALS AND METHODS: We analysed 60 402 participants from the Kailuan Study free of AF, with body mass index (BMI) and waist circumference (WC) measured in 2006-2007 and 2010-2011. Reductions in BMI, body weight, and WC were used to define weight loss. Cox proportional hazards models assessed the association between weight loss and incident AF, adjusting for relevant covariates.

RESULTS: During a median follow-up of 13.0 years (interquartile range: 12.5-13.3), 582 participants developed AF (484 men, 98 women). In men, BMI reduction >2.5 kg/m² (hazard ratio [HR] 0.663, 95% confidence interval [CI] 0.467-0.940), body weight loss >5 kg (HR 0.662, 95% CI 0.468-0.936), and WC reduction >4 cm (HR 0.768, 95% CI 0.601-0.982) were associated with a lower risk of incident AF. In women, WC reduction >4 cm (HR 0.499, 95% CI 0.279-0.892) was associated with a lower risk. Similar patterns were observed among participants with overweight or obesity. Formal tests for sex interaction were not statistically significant.

CONCLUSIONS: Reductions in BMI, body weight, and WC were associated with lower risk of incident AF, particularly in overweight or obese participants. The magnitude of association differed by anthropometric measure and sex, with BMI change showing stronger associations in men and WC change in women. Anthropometric changes may aid risk stratification and inform prevention efforts in higher-risk groups.

PMID:41725430 | DOI:10.1111/dom.70588

Diabetes Obes Metab. 2026 Feb 23. doi: 10.1111/dom.70596. Online ahead of print.

ABSTRACT

AIMS: To evaluate whether an endocrinology-integrated transplant clinic and differing healthcare delivery models are associated with metabolic outcomes during the first year after kidney transplantation in recipients with pre-existing diabetes.

MATERIALS AND METHODS: We conducted a retrospective longitudinal cohort study of adult kidney transplant recipients with diabetes at a US and a European academic centre. Participants were classified by post-transplant diabetes care model: Cohort 1, endocrinology-led Endocrine Transplant Clinic (ETC; n = 99); Cohort 2, historical standard transplant care at the same US centre (n = 81); and Cohort 3, standard endocrinology care at a Spanish academic centre (n = 40). Pre-specified outcomes included HbA1c, body mass index (BMI), blood pressure, and lipid levels measured at baseline and 3, 6, and 12 months. Linear mixed-effects models adjusted for demographic and clinical covariates were applied. Missing longitudinal data were addressed using multiple imputation with complete-case sensitivity analyses.

RESULTS: Among 220 recipients, adjusted metabolic trajectories were broadly similar across cohorts. HbA1c was unchanged at 3 and 6 months but higher at 12 months; >50% had HbA1c >7% at 1 year. BMI remained stable, with ≥30% meeting obesity criteria throughout follow-up. Blood pressure did not improve, and systolic hypertension (>130 mmHg) remained common (49%-77%). At 12 months, LDL-C ≥70 mg/dL was present in 20.8%, 63.3%, and 42.3% of Cohorts 1-3. Findings were consistent in sensitivity analyses.

CONCLUSIONS: Metabolic control in the first post-transplant year showed stabilisation rather than improvement, with many recipients above cardiometabolic targets. Prospective studies should test whether earlier, protocolised multidisciplinary management improves cardiovascular and graft outcomes.

PMID:41725429 | DOI:10.1111/dom.70596

Leuk Lymphoma. 2026 Feb 23:1-8. doi: 10.1080/10428194.2026.2621822. Online ahead of print.

ABSTRACT

Philadelphia chromosome (Ph) status is a critical prognostic marker in B-cell acute lymphoblastic leukemia (B-ALL). This study evaluates the impact of Ph-positive (Ph+) and Ph-negative (Ph-) status on overall survival (OS) and cancer-specific survival (CSS) while analyzing the role of demographic and treatment variables. A retrospective cohort study involving 14,175 patients diagnosed with B-ALL from 2010 to 2021 was analyzed in this investigation. Primary outcomes were OS and CSS, analyzed using hazard ratios (HRs) with 95% confidence intervals (CIs) and associated p-values. Subgroup analysis by year assessed temporal trends in survival outcomes. Statistical analysis and survival rate (OS and CSS) estimations were performed using SEER*Stat software. The cohort’s mean age was 29.6 years (SD = 26.1), with 54.7% male and 43.6% Caucasian. Ph + patients comprised 7.3% of the cohort. Treatments included chemotherapy (90.9%) and radiation therapy (9.3%). The mean OS for Ph + patients was 49.75 months (95% CI: 47.098-52.402), whereas Ph- patients had a significantly longer OS of 66.541 months (95% CI: 65.715-67.366) (p < .001). Similarly, the mean CSS was 88.2 months (95% CI: 83.3-93) for Ph + patients and 103.2 months (95% CI: 102.1-104.3) for Ph- patients (p < .001). Temporal analysis of the last three years revealed no significant differences in OS (Ph+: 27.7 months vs. Ph-: 26.6 months, p = .145) or CSS (Ph+: 28.1 months vs. Ph-: 29 months, p = .183). Significant predictors of reduced OS and CSS included male sex (OS HR: 1.073, p = .019; CSS HR: 1.070, p = .041), older age (OS HR: 1.039, p < .001; CSS HR: 1.038, p < .001), and lack of chemotherapy (OS HR: 0.617, p < .001; CSS HR: 0.625, p < .001). Race was not a significant predictor of survival outcomes. This study highlights the comparable survival rates in Ph + and Ph- ALL patients in recent years. Demographic factors and treatment modalities, particularly chemotherapy, play significant roles in modulating survival outcomes. These findings underscore the importance of individualized treatment strategies based on Ph status and other prognostic indicators in B-ALL management.

PMID:41725421 | DOI:10.1080/10428194.2026.2621822