Tag: statistics

Spine Deform. 2025 May 2. doi: 10.1007/s43390-025-01093-0. Online ahead of print.

ABSTRACT

PURPOSE: Single occupancy inpatient recovery rooms are perceived by health care professionals to positively influence patients’ experience, while double rooms are associated with higher noise levels, sleep disturbances, and a lack of privacy. These differing physical environments may manifest in differing length of stay, pain scores, and opioid use. When bed space is scarce, identifying ideal populations for double occupancy rooming is important. This study aims to assess how inpatient room assignment impacts recovery time, opioid consumption, and patient reported pain for adolescent idiopathic scoliosis (AIS) patients undergoing a posterior spinal fusion (PSF).

METHODS: A retrospective cohort study of AIS patients who underwent PSF from 2011 to 2017 at a single center was conducted. Demographics and baseline radiographic measurements were summarized using appropriate statistics. Intraoperative and postoperative outcomes, as well as numerical ranking scale (NRS) pain scores and total daily opioid administration, were compared across room types using t tests, Wilcoxon rank sum tests, Chi-squared tests, or Fisher’s exact tests, as appropriate. GEE models were constructed to examine the influence of room type and days since surgery on outcomes.

RESULTS: The cohort included 635 patients: 448 (71%) assigned to a double room and 187 (29%) to a single room. The mean age was 15 ± 2 years and 83% of patients were female. Length of hospital stay, complication rates, 2-year outcomes, inpatient pain scores, and daily opioid usage did not significantly differ between room types (all p > 0.05). Adjusted GEE models revealed no significant associations between room type and pain scores (p = 0.9) or between room type and total opioid dosage (p = 0.95).

CONCLUSION: When bed space is scarce, double occupancy rooming for pediatric patients after PSF surgery for AIS can serve as a relief valve to continue elective practices without compromising post-operative outcomes.

PMID:40314926 | DOI:10.1007/s43390-025-01093-0

Health Care Manag Sci. 2025 May 2. doi: 10.1007/s10729-025-09702-0. Online ahead of print.

ABSTRACT

Benchmark efficiency analysis in public health typically focuses on hospitals rather than primary care providers. Data Envelopment Analysis (DEA) is widely used to assess resource efficiency among decision-making units (DMUs). However, traditional DEA struggles to differentiate between efficient units and is sensitive to the selection of inputs and outputs. Methods like super-efficiency and cross-efficiency address some of these limitations but often exclude outliers and may overlook efficiency related to specialisation. DEA Visualisation integrates DEA with multivariate statistical methods allowing for the identification of inefficiency sources and specialisation patterns without losing discriminatory power or removing extreme cases from the sample. This study analyses 82 public primary health centres in Madrid serving senior citizens in 2018. The findings reveal inefficiencies such as a preference for prescribing specific rather than generic drugs, increasing public health costs. Additionally, two extreme cases (outliers or mavericks) were identified as having high infrastructure costs and disproportionate staffing. Redistributing patients from overcrowded centres could enhance efficiency, while centres focused on preventive care showed greater cost-effectiveness, particularly in reducing prescription costs.

PMID:40314922 | DOI:10.1007/s10729-025-09702-0

Eur Arch Paediatr Dent. 2025 May 2. doi: 10.1007/s40368-025-01038-1. Online ahead of print.

ABSTRACT

AIM: This in vitro study aimed to evaluate the marginal gap and fracture resistance of 3D printing microfilled hybrid resin crowns in comparison to prefabricated zirconia crowns on pulpotomized primary teeth.

MATERIALS AND METHODS: Twenty primary molars were selected for the study and randomly divided into two groups (n = 10). Group1 received 3D printed microfilled hybrid resin crowns; Group 2 received prefabricated zirconia crowns. To simulate 6 months of oral conditions, thermodynamic cycling was performed, and the marginal gap was measured using a stereomicroscope with digital camera at 40 × magnification. For each sample, eight points along the margins for each axial surface were captured. The fracture resistance of each group was assessed by applying increasing load till crown fracture using a computer-controlled universal testing machine. Data were tested for normality using the Shapiro-Wilk test. Data were analyzed using an independent t test. A significant level was set at P < 0.05.

RESULTS: Regarding fracture resistance, 3D printed crowns group had statistically significant higher mean values than the prefabricated zirconia crowns group; the values were 1235.97 ± 412.12 N and 576.56 ± 221.53 N, respectively (P < 0.001). However, there was no significant difference in the marginal gap between the two types of crowns with average 32.00 ± 7.54 for 3D printed crowns and average 34.14 ± 9.79 for zirconia crowns (P < 0.001).

CONCLUSION: 3D printed microfilled hybrid resin crowns could be a suitable esthetic alternative for restoring pulp-treated primary molars. It is possible to provide an additional esthetic solution for the parents/children to satisfy the need for esthetic restoration of primary molars.

CLINICAL TRIAL: Not applicable (in vitro study).

PMID:40314911 | DOI:10.1007/s40368-025-01038-1

Ann Surg Oncol. 2025 May 2. doi: 10.1245/s10434-025-17377-8. Online ahead of print.

NO ABSTRACT

PMID:40314903 | DOI:10.1245/s10434-025-17377-8

Discov Oncol. 2025 May 2;16(1):656. doi: 10.1007/s12672-025-02450-1.

ABSTRACT

OBJECTIVE: The causative relationship between lung cancer subtypes and lipids is yet unknown. This research aims to elucidate the potential causative link connecting lipid levels to lung cancer subtypes, particularly focusing on non-small cell lung cancer (NSCLC), using the Mendelian randomization (MR) method and meta-analysis.

METHODS: Summary statistics were obtained from genome-wide association study (GWAS) datasets. A comprehensive MR analysis was performed to explore the causal role of lipids in NSCLC subtypes. To ensure the reliability of the results, an external dataset was used for validation, and a meta-analysis was performed for further synthesis.

RESULTS: Two of the 179 lipids examined showed potential causal connection with lung adenocarcinoma (LUAD) and three with lung squamous cell carcinoma (LUSC). Specifically, phosphatidylcholine (PC) (16:0_20:4) and PC (18:0_20:4) might be connected to an elevated risk of LUSC, but PC (18:0_20:2) might be linked to a decreased risk. It was discovered that PC (16:1_20:4) and PC (18:0_20:4) might raise the risk for LUAD.

CONCLUSION: Complex lipid metabolic pathways, especially involving PC, are present in NSCLC, and distinct lipid isomers may influence various molecular subtypes in different ways.

PMID:40314895 | DOI:10.1007/s12672-025-02450-1

Can J Anaesth. 2025 May 2. doi: 10.1007/s12630-025-02949-9. Online ahead of print.

ABSTRACT

PURPOSE: According to an analysis of data from the Canadian Institutes for Health Information (CIHI) National Physician Database, the proportion of female anesthesia physicians is substantially lower than the proportion of female physicians in the total physician population. The goal of this study was to identify trends in female representation in the major subgroups of anesthesia providers, including specialists certified by the Royal College of Physician and Surgeons of Canada (RCPSC), international medical graduates, and family physician anesthetists (FPAs).

METHODS: We examined the sex distribution of the existing physician workforce, including anesthesia providers working in urban and rural Canada, using the CIHI National Physician Database (1996-2018). We also examined the sex distribution of physicians entering the workforce using the Canadian Post-MD Education Registry database and calculated descriptive statistics.

RESULTS: The proportion of female physicians increased steadily over time in all groups; nevertheless, the numbers of female FPAs and rural anesthesia providers continued to lag relative to all Canadian physicians (9.4%, 9.4%, and 26.7%, respectively, in 1996; 18.7%, 21.1%, and 42.1%, respectively, in 2018). Of the graduates from RCPSC training programs in 1996, 28% were female, whereas by 2018, 33.5% of graduates were female.

CONCLUSIONS: Female physicians were underrepresented in all subgroups, but the proportions were lowest among FPAs and rural physicians. Given that greater sex diversity in clinical teams is associated with better outcomes, and in light of ongoing workforce shortages, the barriers that prevent female physicians from entering and/or remaining in the anesthesia workforce need to be understood and ameliorated.

PMID:40314871 | DOI:10.1007/s12630-025-02949-9

Eur Geriatr Med. 2025 May 2. doi: 10.1007/s41999-025-01212-0. Online ahead of print.

ABSTRACT

PURPOSE: To validate the Hospital Frailty Risk Score (HFRS) in Chinese hospital settings, describing how patients are allocated to frailty risk groups and how frailty risk is associated with length of stay (LoS) and hospital costs.

DESIGN: Retrospective observational study.

SETTING: Forty-eight hospitals in Lvliang City, Shanxi Province, China.

SUBJECTS: Patients aged 75 years or older hospitalised between 1 January 2022 and 31 December 2023 (n = 34,731).

METHODS: A logistic regression model examined the association between long length of stay (LoS) and frailty risk. A generalised linear model assessed the association between hospital costs and frailty risk. Subgroup analyses of age group, sex, and hospital tiers were conducted.

RESULTS: 22.2% of patients were categorised as having zero risk, 62.4% as low risk, 15.3% as intermediate risk, and 0.08% as high risk. Compared to the zero risk group: for those with low risk, the probability of long LoS was 1.92 (95% CI 1.79-2.06) times higher and hospital costs were ¥1926 (95% CI 1655-2197) higher; for those with intermediate risk, the probability of long LoS was 2.7 (95% CI 2.49-2.96) times higher and hospital costs were ¥4284 (95% CI 3916-4653) higher; and for those with high risk, the probability of long LoS was 6.7 (95% CI 3.06-14.43) times higher and hospital costs were ¥16,613 (95% CI 12,827-20,399) higher. The explanatory power of the HFRS held across subgroups.

CONCLUSIONS: Compared to patients aged 75 + elsewhere, those in China had lower frailty risk scores, likely reflecting a younger age structure and recording of fewer diagnosis codes. Even so, the HFRS is a powerful predictor of long length of stay and hospital costs in China.

PMID:40314855 | DOI:10.1007/s41999-025-01212-0

Psychometrika. 2025 Mar 27:1-37. doi: 10.1017/psy.2025.10. Online ahead of print.

ABSTRACT

We present a multidimensional data analysis framework for the analysis of ordinal response variables. Underlying the ordinal variables, we assume a continuous latent variable, leading to cumulative logit models. The framework includes unsupervised methods, when no predictor variables are available, and supervised methods, when predictor variables are available. We distinguish between dominance variables and proximity variables, where dominance variables are analyzed using inner product models, whereas the proximity variables are analyzed using distance models. An expectation-majorization-minimization algorithm is derived for estimation of the parameters of the models. We illustrate our methodology with three empirical data sets highlighting the advantages of the proposed framework. A simulation study is conducted to evaluate the performance of the algorithm.

PMID:40314177 | DOI:10.1017/psy.2025.10

BJPsych Open. 2025 May 2;11(3):e91. doi: 10.1192/bjo.2025.33.

ABSTRACT

BACKGROUND: Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.

AIMS: To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).

METHOD: The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.

RESULTS: We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8-61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being ‘satisfied’ or ‘very satisfied’ compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.

CONCLUSIONS: It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.

PMID:40314156 | DOI:10.1192/bjo.2025.33

J Antimicrob Chemother. 2025 May 2:dkaf125. doi: 10.1093/jac/dkaf125. Online ahead of print.

ABSTRACT

BACKGROUND: People living with HIV (PLHIV) who fail first-line ART have a higher risk of failing subsequent ART. We examined viral suppression (VS) among adolescents and youths (AY) failing PI ART in Tanzania.

METHODS: We conducted a retrospective study nested within a national third-line cohort of PLHIV. We analysed data of 147 AY (aged 10-24 years) with failure of PI-based ART between 2020 and 2022 who were followed for 12 months to assess for VS. Descriptive statistics were summarized by demographics and clinical characteristics, and we used logistic regression to assess factors associated with virological failure (VF) and drug resistance mutations (DRMs).

RESULTS: More than 40% of 147 participants had HIV subtype A, 52% (76/147) harboured major PI DRMs and 35% had NRTI mutations. A PI regimen at ART initiation was associated with a major PI DRM adjusted relative risk (aRR) of 1.66 (95% CI: 1.13-2.44; P = 0.010). Among participants with major PI DRMs, 12.2% had intermediate to high levels of resistance to lopinavir and atazanavir, and 2.1% to darunavir, respectively. V82A was the most frequent PI DRM; NRTI mutations included thymidine analogue mutations and absent K65R. VS occurred in 65% of AY who had PI DRMs compared with 45% of those without DRMs; this difference was not statistically significant.

CONCLUSIONS: More than half of AY who had PI DRMs had a higher proportion of early VS (65%) compared with those without DRMs (45%). Optimal viral load monitoring, adherence intensification and routine drug resistance testing are key strategies to improve VS.

PMID:40314140 | DOI:10.1093/jac/dkaf125