Tag: statistics

Eur J Surg Oncol. 2025 May 20;51(9):110180. doi: 10.1016/j.ejso.2025.110180. Online ahead of print.

ABSTRACT

OBJECTIVE: Limited data exists on health-related quality of life (HRQoL) after robot-assisted surgery (RAL) for rectal cancer beyond one-year post-surgery. This study compares long-term HRQoL following RAL total mesorectal excision (TME) to conventional laparoscopic (CL) TME.

METHODS: All rectal carcinoma patients from the 63-center Prospective National CRC cohort (PLCRC) who completed pre- and post-operative HRQoL questionnaires (EQ-5D, QLQ-C30, and QLQ-CR29) were retrospectively included. Delta scores per parameter were calculated by subtracting pre-operative scores from scores at one year. Sensitivity analysis included all patients with beyond one-year post-operative questionnaires, regardless of a pre-operative questionnaire. Data were analyzed using multivariate linear regression.

RESULTS: Patients undergoing RAL TME more often had low rectal tumors, more post-operative complications and more stomas. In patients with both pre- and post-operative questionnaires, no significant differences were found in the EQ-5D delta score (n = 591). The QLQ-C30 (n = 709) showed statistically significant and clinical relevant difference in fatigue favored CL TME (4.4 ± 1.9, p = 0.021). The QLQ-CR29 (n = 696) showed small, statistically significant differences favoring RAL in body image and stoma-related issues, but no clinical relevance. Sensitivity analysis EQ-5D (n = 1250), QLQ-C30 (n = 1423) or QLQ-CR29 (n = 1453) showed no clinically relevant differences.

CONCLUSION: This is the first study comparing long-term HRQoL between CL and RAL surgery for rectal cancer. Although several statistically significant differences were found, no clinically relevant differences were observed except for a small difference in the subdomain fatigue of the EORTC QLQ-C30 favoring CL surgery. Furthermore, the current study underlines the relevance of a pre-operative HRQoL assessment.

PMID:40418864 | DOI:10.1016/j.ejso.2025.110180

JMIR Rehabil Assist Technol. 2025 May 26;12:e68967. doi: 10.2196/68967.

ABSTRACT

BACKGROUND: An accurate tongue strength and endurance assessment is necessary for pediatric dysphagia. TongueFit is a new, portable orofacial manometer for measuring tongue strength and endurance and a game-based training app for children.

OBJECTIVE: This study aimed to test the validity of TongueFit compared with a standard manometer as the current gold standard for measuring air pressure.

METHODS: This laboratory study compared TongueFit and a standard manometer as the gold standard for measuring air pressure. This study was conducted in 3 different experimental conditions. The first experiment compared TongueFit and the standard manometer using a force tester (MCT-2150), with pressure controlled by MSatLite software. The second and third experiments involved 2-cm and 3-cm bulbs between the 2 devices. This study used Lin concordance correlation to measure the level of agreement.

RESULTS: There was a mean absolute difference of 0.005 kilopascals (kPa) between the TongueFit and the standard manometer (n=35, ρC=1). Statistical analysis showed perfect agreement correlation (ρC=1). By using the 2-cm bulb, TongueFit’s mean was 0.007 kPa lower, also showing perfect agreement (ρC=1). Furthermore, using the 3-cm bulb, results showed almost perfect agreement (ρC=0.999) with the TongueFit’s mean, which was 0.044 kPa lower.

CONCLUSIONS: This study confirms the high validity of TongueFit as an orofacial manometer compared with a standard manometer, with negligible mean differences, as well as near-perfect and perfect agreement in the experiments. These results confirm that TongueFit is a valid and accurate tool for assessing tongue strength.

PMID:40418854 | DOI:10.2196/68967

Biomed Tech (Berl). 2025 May 23. doi: 10.1515/bmt-2025-0026. Online ahead of print.

ABSTRACT

OBJECTIVES: Identification of bony landmarks in medical images is of high importance for 3D planning in orthopaedic surgery. Automated landmark identification has the potential to optimize clinical routines and allows for the scientific analysis of large databases. To the authors’ knowledge, no direct comparison of different methods for automated landmark detection on the same dataset has been published to date.

METHODS: We compared 3 methods for automated femoral landmark identification: an artificial neural network, a statistical shape model and a geometric approach. All methods were compared against manual measurements of two raters on the task of identifying 6 femoral landmarks on CT data or derived surface models of 202 femora.

RESULTS: The accuracy of the methods was in the range of the manual measurements and comparable to those reported in previous studies. The geometric approach showed a significantly higher average deviation compared to the manually selected reference landmarks, while there was no statistically significant difference for the neural network and the SSM.

CONCLUSIONS: All fully automated methods show potential for use, depending on the use case. Characteristics of the different methods, such as the input data required (raw CT/segmented bone surface models, amount of training data required) and/or the methods robustness, can be used for method selection in the individual application.

PMID:40418844 | DOI:10.1515/bmt-2025-0026

Int J Risk Saf Med. 2025 May 26:9246479251346181. doi: 10.1177/09246479251346181. Online ahead of print.

ABSTRACT

BackgroundPatient safety is a global public health issue. It aims to reduce medical errors to ensure patients’ health and achieve the best possible outcomes.PurposeThis study aims to examine the perceptions of healthcare workers about medical errors in a tertiary hospital in Jordan.Methodology/approachThe descriptive-analytical cross-sectional study included 246 healthcare workers in a tertiary hospital in Jordan. Systematic random sampling technique was used to select the participants. Data were collected using a questionnaire that was used in previous literature. The Statistical Package for the Social Sciences Software (SPSS), version 27, was used to analyze the data. Descriptive and inferential statistics were used to address research objectives.ResultsThe majority of the participants were females and had a bachelor’s degree. Human error, lack of resources and failure of the communication system were the most frequently reported causes of errors (38.2%, 32.5%, and 30.0%, respectively). The findings show that disclosure of patient errors was perceived by 78% of the participants as a method to reduce the effect of medical errors on patient health. Raising awareness and training were perceived as the most impactful way in which hospitals could reduce medical errors. Reporting errors was stated by 52% of the respondents as a method to deal with medical errors. However, the commonest barriers to reporting errors were identified as culture (38.2%) and a long complicated process of errors reporting (28.9%). The emergency department was reported as the commonest place for medical errors occurrence.ConclusionThe findings revealed the experience of a Jordanian hospital regarding medical errors. Healthcare organizations and policymakers can utilize the findings presented in this paper to reduce medical errors, therefore promoting quality healthcare and patient safety.

PMID:40418842 | DOI:10.1177/09246479251346181

J Complement Integr Med. 2025 May 23. doi: 10.1515/jcim-2025-0054. Online ahead of print.

ABSTRACT

OBJECTIVES: Diabetic neuropathy results in chronic pain. Traditional treatments often offer limited relief, prompting the exploration of alternative therapies like Evening Primrose Oil (EPO). This study aimed to assess the efficacy of EPO in the treatment of painful diabetic neuropathy.

METHODS: In this interventional clinical trial, Patients were randomly assigned to three groups. Group A, consisted of 24 patients, received 1,000 mg of EPO soft gel capsules every 12 h. Group B, consisted of 21 patients, received 1,000 mg of EPO soft gel capsules daily. Group C, also with 21 patients, was divided so that half of the patients received placebo capsules daily and the other half every 12 h. After 4 weeks, patients returned, and questionnaires were completed. Statistical analysis of the data was conducted using SPSS version 25.

RESULTS: Groups A and B showed significant reductions in visual analog scale (VAS) pain scores, with Group A achieving the most improvement (mean pre-test: 5.96; post-test: 4.63). Analysis of covariance (ANCOVA) revealed significant differences in post-intervention scores (p<0.001) for VAS and Neuropathy total symptom score-6 (NTSS-6), indicating effective interventions. Treatment A was more effective than Treatment B for reducing pain (VAS mean difference= -0.52; p=0.044) and McGill Pain Questionnaire (MPQ) scores (mean difference= -9.56; p<0.001).

CONCLUSIONS: EPO could serve as a valuable alternative therapy for managing painful diabetic neuropathy with fewer side effects than traditional treatments. Further research is warranted to validate these results and explore EPO treatment long-term efficacy and safety.

PMID:40418820 | DOI:10.1515/jcim-2025-0054

JMIR Hum Factors. 2025 May 26;12:e66750. doi: 10.2196/66750.

ABSTRACT

BACKGROUND: While the health benefits of physical activity are well-known, adherence to regular physical activity remains a major challenge. Just-in-time adaptive intervention (JITAI) has been proposed as one method to increase physical activity by delivering an intervention at a time when individuals are more likely to make behavioral changes. However, most studies that have implemented JITAI have used uniform intervention criteria (UIC) across participants rather than personalized intervention criteria (PIC) for the individual.

OBJECTIVE: The objective of this paper was to examine the effectiveness of using JITAI implemented with PIC to increase physical activity.

METHODS: Healthy university students wore a wrist activity monitor for 2 weeks. Participants were divided into 2 groups, which received JITAI to promote physical activity according to either PIC or UIC. In the first week, the mean distance moved and sedentary time per hour for each participant were calculated to derive PIC. UIC was obtained from a 2-week study with a different sample (n=47) conducted under the same conditions. In the second week, JITAI prompts were sent every hour if both of the following criteria were met: the distance moved was shorter, and sedentary time was longer than PIC or UIC. Differences in changes in physical activity as a result of implementing interventions according to PIC and UIC were analyzed using multilevel models.

RESULTS: We analyzed data from 28 healthy university students (18-23 y old, female n=12). Both PIC (P<.001) and UIC (P<.001) significantly increased physical activity in the first hour after JITAI was received. In that first hour, PIC increased physical activity more than UIC; more calories were burned (P=.02), more steps were taken (P=.007), and distance moved was increased (P=.003). However, over the course of the week, the use of JITAI did not significantly increase physical activity levels.

CONCLUSIONS: Our results appear to suggest that PIC-based JITAI is more effective than UIC-based JITAI, consistent with the idea of a need for precision health approaches. Further research is needed to develop effective long-term intervention designs with sustainable effects.

PMID:40418819 | DOI:10.2196/66750

JMIR Infodemiology. 2025 May 26;5:e69040. doi: 10.2196/69040.

ABSTRACT

BACKGROUND: Eosinophilia and hypereosinophilic syndrome (HES) are rare disorders grouped under the term hypereosinophilic disorders. They are diagnosed based on an increased number of eosinophils. They can also cause serious symptoms, including skin, lung, and gastrointestinal problems. These disorders are very rarely recognized due to their rarity and misdiagnosis.

OBJECTIVE: This study analyzes public interest in hypereosinophilic disorders using data on internet search volume in Germany between 2020 and 2023. Objectives include identifying frequently searched terms, evaluating temporal trends, analyzing seasonal patterns, evaluating geographic differences in search behavior, and identifying unmet information needs and frequently searched risk factors.

METHODS: A retrospective analysis using Google Ads Keyword Planner gathered monthly search volume data for 12 German terms related to hypereosinophilic disorders. These terms were selected based on their medical relevance and common usage identified from medical literature. Data were analyzed descriptively, with trends, seasonal variations, and geographical distributions examined. Chi-square tests and correlation analysis assessed statistical significance.

RESULTS: A total of 178 keywords were identified, resulting in a search volume of 1,745,540 queries. The top keyword was “eosophile,” a misspelling, followed by “eosinophilia” and “HES.” The main categories included “Eosinophilia,” “Eosinophils,” and “Churg-Strauss syndrome.” Temporal analysis showed seasonal growth in search volumes, peaking in January 2023, with higher interest during winter. Geographical analysis showed regional variations.

CONCLUSIONS: This research shows a growing public interest in eosinophilic diseases, reflected by a steadily increasing search volume over time. This is particularly evident in searches for basic definitions and diagnostic criteria, such as “eosinophils” or “symptoms of eosinophilic diseases.” This increase in search volume, which peaked in January 2023, indicates an increased interest in accurate and readily available information for rare conditions.

PMID:40418815 | DOI:10.2196/69040

JMIR Aging. 2025 May 26;8:e60311. doi: 10.2196/60311.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, telemedicine services represented a widely implemented alternative to in-person doctor and therapist appointments. Consequently, rates of telemedicine use rapidly increased worldwide, also in Germany. Research regarding longitudinal determinants of telemedicine use is needed, particularly from nationally representative German samples, to improve understanding of the use behavior of major target groups such as middle-aged and older adults.

OBJECTIVE: This study aimed to longitudinally investigate determinants of online health consultation use among middle-aged and older individuals during the COVID-19 pandemic in Germany.

METHODS: Nationally representative longitudinal data of German middle-aged and older adults (≥46 years old) were taken from the German Ageing Survey (DEAS). Data from the Compact Survey (conducted between June and July 2020) and wave 7 (conducted between November 2020 and March 2021) of the DEAS were observed (pooled analytic sample N=5456). Having experienced consultations with doctors or therapists on online platforms served as the outcome measure. Associations with socioeconomic, health- and health behavior-related, psychological, and COVID-19-related determinants were tested using random effects logistic regressions.

RESULTS: In our sample, 49% (2673/5456) of participants were female and the mean age of the participants was 67.8 (SD 9.4) years. Past experience with online health consultations was reported by 10.3% (561/5456) of the sample. Online health consultation use was associated with high education (OR 1.43, 95% CI 1.06-1.93; P=.02), poor self-rated health (OR 0.60, 95% CI 0.49-0.75; P<.001), and higher frequency of physical activity (reference: low frequency; medium frequency: OR 1.58, 95% CI 1.15-2.17; P=.005; high frequency: OR 1.73, 95% CI 1.09-2.76; P=.02). Moreover, greater levels of loneliness (OR 1.43, 95% CI 1.06-1.93; P=.04) and life satisfaction (OR 1.33, 95% CI 1.02-1.73; P=.04) as well as perceiving the COVID-19 crisis as a greater personal threat (OR 1.08, 95% CI 1.01-1.15; P=.02) were associated with having online health consultations during the COVID-19 pandemic.

CONCLUSIONS: Online health consultation use does not seem to be exclusively associated with the health of middle-aged and older patients. Study findings emphasize the longitudinal association of education and psychosocial factors as well as health factors with telemedicine use during the COVID-19 pandemic in Germany. This knowledge may help to improve and adapt services to this patient group, which could contribute to higher utilization rates in the future. Future studies are needed to verify these initial findings under postpandemic circumstances and across different countries.

PMID:40418806 | DOI:10.2196/60311

J Particip Med. 2025 May 26;17:e65046. doi: 10.2196/65046.

ABSTRACT

BACKGROUND: The Pancreatic Cancer Action Network (PanCAN) established its Patient Registry to gather real-world data from patients with pancreatic cancer and their caregivers, related to their diagnosis, symptoms and symptom management, treatments, and more. Results from version 2 of the PanCAN Registry are presented here.

OBJECTIVE: We sought to gather and evaluate patient-reported outcomes data inputted into the PanCAN Patient Registry from December 2020 to January 2024. Statistical analyses were used to identify findings from a relatively small sample size (271 participants, as defined by people who filled out the Basics survey of the PanCAN Registry).

METHODS: Participation in the PanCAN Patient Registry was voluntary, and participants filled out an electronic consent form before joining the registry. Participants were identified through the PanCAN Patient Services Help Line or navigated to the registry directly via the PanCAN website. Data analysis took place via bivariate analysis using the chi-square test for categorical variables. Statistical significance was defined as a P value of <.05, with P values between .05 and .1 considered marginally significant, and P values >.1 considered insignificant.

RESULTS: Pain was reported by 186 out of the 207 (89.9%) PanCAN Patient Registry participants who filled out the pain-related questions in the General Assessment survey. We observed a marginally significant (P=.06) difference between the reporting of pain by patients aged younger than 65 years (86/92, 93.5%) and those aged 65 years or older (66/78, 84.6%). Depression was also a common condition experienced by patients with pancreatic cancer, with 64/103 (62.1%) indicating that they were experiencing or had experienced depression during the course of their illness. A trend suggested that depression was more frequently reported among the subset of patients who also reported pain (53/80, 66.3%) compared with those who did not report pain (5/13, 38.5%; P=.07).

CONCLUSIONS: The use of patient-reported outcomes and real-world data for patients with pancreatic cancer has the potential to have direct impact on clinical practice. Through a relatively small sampling of patients, trends were identified that suggest a higher reporting of pain amongst patients in a younger age group as well as concurrence of pain and depression. These findings underscore the importance of a multidisciplinary team of health care professionals addressing patients’ needs beyond the treatment of their cancer.

PMID:40418805 | DOI:10.2196/65046

JMIR Hum Factors. 2025 May 26;12:e59363. doi: 10.2196/59363.

ABSTRACT

BACKGROUND: Web-based health courses providing lifestyle-related information can potentially increase knowledge, facilitate behavior change, and improve health outcomes for people living with multiple sclerosis (MS). Despite the low engagement with web-based programs by this population, few studies have evaluated factors influencing engagement. This study evaluated engagement with our 6-week lifestyle-related course (Multiple Sclerosis Online Course; MSOC) by participants enrolled in a large, international randomized controlled trial, as well as preliminary outcomes.

OBJECTIVE: This study aimed to quantitatively assess engagement with the MSOC (the intervention course [IC] and standard-care course [SCC]), motivators of and barriers to participants’ course completion, course satisfaction, engagement with the community forum, and intentions to implement lifestyle changes.

METHODS: We collected data via a baseline survey before course commencement and an evaluation survey 1 month after the 6-week course. Course completers were queried on motivators of completion, course satisfaction, previous knowledge, forum participation, and intentions to adopt lifestyle changes. Noncompleters were queried on barriers to course completion. Differences between the 2 study arms were examined using chi-square and 2-tailed t tests. Multivariable linear regression models assessed factors (sociodemographic and course and health related) associated with participants’ intentions to adopt lifestyle changes adjusting for baseline lifestyle factors. Moderation analyses were conducted to test group differences.

RESULTS: Of the 857 participants, 442 (51.6%) completed the MSOC (IC: n=218, 49.3%; SCC: n=224, 50.7%), and 291 (34%) completed the evaluation survey (n=254, 87.3% course completers; n=37, 12.7% noncompleters). Key motivators of course completion included an interest in participating in MS research, optimizing health, course flexibility, and relevant and useful course content. Barriers to course completion included time constraints and technical issues. Most course completers rated the MSOC as “excellent/very good” (IC: 92/126, 73%; SCC: 78/128, 60.9%; P=.17). Engagement with the facilitator-led community forum was higher in the IC than in the SCC (56/126, 44.4% vs 32/128, 25%; P=.003). More IC completers versus SCC completers expressed their intention to adopt dietary changes (89/125, 71.2% vs 74/127, 58.3%; P=.04), increase their sun exposure (82/124, 66.1% vs 62/124, 50%; P=.01), supplement with omega-3 (84/125, 67.2% vs 60/126, 47.6%; P=.004), and practice meditation (85/124, 68.5% vs 66/126, 52.4%; P=.009). Forum engagement, course satisfaction, new course content, and an interest in receiving additional course content were associated with intentions to adopt lifestyle changes across both study arms.

CONCLUSIONS: The web-based lifestyle IC provided new and satisfactory content and facilitated intentions to adopt lifestyle changes. Positive associations between engagement with the community forum and intentions to implement lifestyle changes and identifying barriers to completion such as time constraints provide important insights to inform the design of future digital health interventions for people living with MS and possibly other chronic conditions.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001605886; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382778&isReview=true.

PMID:40418803 | DOI:10.2196/59363