Tag: statistics

Community Dent Oral Epidemiol. 2025 Mar 10. doi: 10.1111/cdoe.13037. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate and compare the rates of antibiotic prescribing by dental practitioners across the constituent countries of the United Kingdom between March 2020 and August 2023 and to estimate the total ‘excess’ prescribing that occurred during this interval beyond the rates predicted based upon trends between March 2016 and February 2020.

METHODS: Retrospective pharmacoepidemiological study of dental practitioners’ antibiotic prescribing, by secondary analysis of population-level National Health Service dispensing data from England, Scotland, Wales and Health and Social Care dispensing data from Northern Ireland.

RESULTS: Effective August 2023, the antibiotic items dispensed rate for each country remained in excess of that predicted based upon pre-pandemic trends. Between March 2020 and August 2023, those rates were 175.6, 227.2, 195.0 and 321.8 antibiotic items per 1000 population for England, Scotland, Wales and Northern Ireland, respectively. Those represented estimated total ‘excesses’ of 27.7% (95% confidence limit [CL], 14.8, 43.7), 43.3% (95% CL, 29.9, 60.0), 33.2% (95% CL, 20.4, 49.0) and 42.9% (95% CL, 27.6, 62.3). Pairwise comparisons showed statistically significant differences between England and Scotland, England and Northern Ireland, and Wales and Northern Ireland (p < 0.001), Scotland and Wales (p = 0.001), and Scotland and Northern Ireland (p = 0.009). There was no statistically significant difference between England and Wales.

CONCLUSIONS: With shared prescribing guidelines and a single professional regulatory framework, it was unsurprising that similar antibiotic prescribing trends were found across the United Kingdom. Further research is required to investigate the reasons for the differences.

PMID:40064619 | DOI:10.1111/cdoe.13037

Clin Chem Lab Med. 2025 Mar 11. doi: 10.1515/cclm-2024-1193. Online ahead of print.

ABSTRACT

R language has gained traction in laboratory medicine for its statistical power and dynamic tools like RMarkdown and RShiny. However, there is limited literature summarizing R packages and functions tailored for laboratory medicine, making it difficult for clinical laboratory workers to access these tools. Additionally, varying algorithms across R packages can lead to inconsistencies in published reports. This review addresses these challenges by providing an overview of R’s evolution and its key features, followed by a summary of statistical methods implemented in R, including platform comparisons, precision verification, factor analysis, and the establishment of reference intervals (RIs). We also highlight the development and validation of predictive models using techniques such as linear and logistic regression, decision trees, random forests, support vector machines, naive Bayes, K-Nearest Neighbors, k-means clustering, and backpropagation neural networks – all implemented in R. To ensure transparency and reproducibility in research, a checklist is provided for authors publishing papers using R for data analysis in laboratory medicine. In the final section, the potential of R in big data analytics is explored, focusing on standardized reporting through RMarkdown and the creation of user-friendly data visualization platforms with RShiny. Moreover, the integration of large language models (LLMs), such as ChatGPT, is discussed for their benefits in enhancing R programming, automating reporting, and offering insights from data analysis, thus improving the efficiency and accuracy of laboratory data analysis.

PMID:40064613 | DOI:10.1515/cclm-2024-1193

Nurs Health Sci. 2025 Mar;27(1):e70076. doi: 10.1111/nhs.70076.

ABSTRACT

Nursing care for older people with advanced cancer who live alone during outpatient chemotherapy should address their difficulties while respecting their lives. However, their lived experiences remain underexplored. Therefore, we conducted a descriptive qualitative study to explore and describe their lives. The participants were purposively sampled, older patients (≥ 65 years) with advanced cancer who lived alone and were receiving outpatient cancer chemotherapy. Semi-structured interviews were conducted using an interview guide, and thematic analysis was applied. There were 12 participants. Nine categories and 49 subcategories were extracted. The core category was “Getting by through endurance, ingenuity, and effort in one’s increasingly fragile ‘own vessel,’ in order to survive a little longer and fulfill one’s life.” Effective support should not only address their challenges, but also respect their convictions, leverage their strengths, and enhance their self-efficacy. Further, early implementation of advance care planning (ACP) is crucial to proactively identify the needs of these patients, who rarely express their concerns. This approach facilitates their transition from full independence to autonomy, enabling them to choose and integrate necessary support into their daily lives.

PMID:40064605 | DOI:10.1111/nhs.70076

Pharm Stat. 2025 Mar-Apr;24(2):e70009. doi: 10.1002/pst.70009.

ABSTRACT

A new measure was recently developed in the context of survival analysis that can be interpreted as a weighted arithmetic mean of the hazards with the survival function as the weight. However, when the average hazard is desired, it is more appropriate to use the harmonic mean rather than the arithmetic mean. Therefore, in this article, we derive the average hazard as a harmonic mean version of the expectation for hazards and show it to be equal to the previous weighted arithmetic mean. Furthermore, we demonstrate that the average hazard should be estimated using only the times at which the event is observed, while previous studies have allowed estimating the average hazard even when the truncation time is set to a time at which the event is not observed.

PMID:40064601 | DOI:10.1002/pst.70009

World J Surg. 2025 Mar 10. doi: 10.1002/wjs.12522. Online ahead of print.

ABSTRACT

INTRODUCTION: Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by presenting different pathologies with different degrees of tumor aggressiveness, which can greatly affect the quality of life of affected patients.

OBJECTIVES: To determine the quality of life of MEN1 patients and to analyze the influence of socio-personal, clinical, and therapeutic variables.

METHODS: A study was conducted on MEN1 patients in a tertiary hospital [2018-2020]. The 36-Item Short Form Health Survey (SF-36) scores were compared with those of a control group (CG) of a healthy population.

STATISTICAL ANALYSIS: Student’s t-test/ANOVA test or the Mann-Whitney U test/Kruskal-Wallis H test. A multivariate analysis was applied to assess the SP, clinical, and therapeutic variables affecting the quality of life.

RESULTS: The quality of life scores of 101 MEN 1 patients, who presented lower levels of quality of life in various dimensions compared to the control group, (p < 0.05) were analyzed. Patients with pancreatic pathology showed a worsening in most dimensions of the SF-36 questionnaire (p < 0.05). In addition, pancreatic surgery influenced 3/9 dimensions and the mental component score (MCS) (p < 0.05). In the multivariate analysis, occupational status and pancreatic surgery were the variables most related to the quality of life of patients with MEN1 (p < 0.05) in addition to the existence of a carcinoid tumor, which influenced the physical component score (PCS) (p < 0.05).

CONCLUSION: MEN1 patients have a worse quality of life than the general population. Of the socio-personal variables analyzed, the best predictor is being unemployed. Pancreatic and carcinoid pathology affected quality of life. Pancreatic surgery fundamentally influences the mental component score, whereas total pancreatectomy influences the physical component score.

PMID:40064591 | DOI:10.1002/wjs.12522

Psychooncology. 2025 Mar;34(3):e70119. doi: 10.1002/pon.70119.

ABSTRACT

BACKGROUND: The COVID-19 pandemic exacerbated mental health challenges. This study aimed to investigate the mental health impact of the pandemic on cancer survivors from diverse backgrounds using the All of Us Research Program’s COVID-19 Participant Experience (COPE) survey.

METHODS: This analysis included respondents of the COPE survey with average depression, anxiety, and self-harm metrics computed for individuals completing multiple survey iterations. Multivariable logistic regression assessed the relationship between cancer survivorship, demographic factors, and mental health outcomes. Sensitivity analyses were conducted to investigate peak mental health challenges and time trend.

RESULTS: Among 100,203 respondents, 20,561 (20.5%) were cancer survivors. Cancer survivors differed demographically from the general population, tending to be older and more likely to report higher socioeconomic status. Cancer survivors exhibited significantly higher odds of self-harm (aOR = 1.09, 95% CI 1.01-1.18). Sensitivity analyses focusing on peak mental health scores revealed that cancer survivors had significantly increased odds of experiencing anxiety (aOR = 1.11, 95% CI 1.06-1.17), depression (aOR = 1.11, 95% CI 1.06-1.17), and self-harm tendencies (aOR = 1.09, 95% CI 1.01-1.18) compared to non-cancer survivors. Within the cancer survivor subgroup, younger age, gender and sexual minority status, lower income, and widowed/separated/divorced status were associated with worse mental health outcomes.

CONCLUSION: During the COVID-19 pandemic, cancer survivors exhibited significantly higher odds of depression, anxiety, and self-harm compared to non-survivors, with certain subgroups demonstrating heightened vulnerability. Our study highlights the critical need for integrated mental health services in cancer survivorship care programs, especially among those from underserved groups who are at high risk, as we continue to evolve with the pandemic.

PMID:40064590 | DOI:10.1002/pon.70119

Clin Lung Cancer. 2025 Feb 14:S1525-7304(25)00038-5. doi: 10.1016/j.cllc.2025.02.008. Online ahead of print.

ABSTRACT

BACKGROUND: EGFR alterations have significant therapeutic implications in lung cancer (LCa), yet their prevalence and co-mutational patterns in African American populations remain understudied. This study analyzes EGFR-mutant LCa across races using the Tempus database.

METHODS: De-identified records sequenced via Tempus xT assay, (595 to 648 gene DNA panel) were included if they had ≥ 1 pathogenic EGFR mutation (short variants (SVs), copy number amplifications (CNAs), or fusions). Race was determined based on recorded clinical records. Co-mutations were restricted to genes with ≥ 5% frequency in at least 1 race. Statistical analyses were performed using chi-squared tests with Bonferroni or false discovery rate adjustments for multiple testing.

RESULTS: Among 17,482 LCa samples, EGFR alterations occurred in 8.9% of CA, 7.6% of BAA, 39% of API, 15% of other races, and 12% of unknown races. Exon 19 deletions (P = .017) and L858R mutations (P < .001) varied by race, with higher L858R frequency in CA compared to BAA (P = .034) and in API compared to CA (P = .006). EGFR copy number variants (CNVs) were highest in BAA (P < .001). TP53 alterations occurred at a higher frequency in patients with a history of smoking, those with high tumor mutational burden (TMB), and high PD-L1. KMT2C co-mutations were significantly more common in BAA (13%) compared to CA (3%) and API (4%) (q = 0.003). Similarly, GLI1 co-mutations were most frequent in BAA (5.8%) compared to 1.5% in CA and 0% in API patients (q = 0.025).

CONCLUSIONS: EGFR mutation subtypes and co-mutations differ by race. KMT2C may influence TMB and immunotherapy response, while GLI1 is linked to TKI resistance. TP53 alterations were more commen in smokers, and patients with high PDL-1 and TMB, highlighting additional factors that drive tumors with these alterations.

PMID:40064574 | DOI:10.1016/j.cllc.2025.02.008

J Prev Alzheimers Dis. 2025 Mar 9:100129. doi: 10.1016/j.tjpad.2025.100129. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 diabetes (T2D) is commonly co-morbid with Alzheimer’s disease (AD). However, it remains unclear whether T2D itself or the antidiabetic drug metformin contributes to the progression of AD.

OBJECTIVE: This study aimed to investigate the overall and independent effects of T2D and metformin use on the risk of AD.

METHODS: Summary genome-wide association study datasets were utilized for the Mendelian randomization (MR) and multivariable MR (MVMR) analyses, including ones for T2D (N = 455,017), metformin (N = 456,276), and AD (N = 453,733). Additionally, using the proportional imbalance method, we analyzed AD-related adverse drug events in the FDA Adverse Event Reporting System (FAERS) database (covering Q1 2004 to Q2 2024).

RESULTS: Our two-sample MR analysis indicated that T2D is not associated with the risk of AD (OR: 1.03, CI: 0.99-1.08, P = 0.128). However, while not statistically significant, genetic signature for metformin exposure demonstrated a trend toward an increased risk of AD (OR: 1.05, CI: 1.00-1.09, P = 0.053). Interestingly, in MVMR analysis, which evaluates independent effects of T2D and metformin exposure on T2D, we found a robust association of T2D with a decrease in the risk of AD (OR: 0.82, CI: 0.68-0.98, P = 0.031), while the use of metformin was associated with a higher risk of AD (OR: 1.26, CI: 1.06-1.50, P = 9.45E-3). In the FAERS database, a total of 228,283 metformin-related adverse event reports from 67,742 cases were found. For metformin as the target drug and AD as the target adverse event, signal analysis reported 29 cases of AD (ROR: 0.83, 95 % CI: 0.58-1.19, P = 0.3126).

CONCLUSIONS: Our study reveals the opposite independent causal effects of T2D and metformin exposure on AD. These findings highlight the importance of assessing AD risk when prescribing metformin to patients with T2D.

PMID:40064559 | DOI:10.1016/j.tjpad.2025.100129

Nurs Health Sci. 2025 Mar;27(1):e70078. doi: 10.1111/nhs.70078.

ABSTRACT

This study examines the relationship between attitudes to aging and quality of life (QoL) among nursing home residents during “chaotic period” (within 6-8 weeks of older adults move into nursing homes) and “adjustment period” (after “chaotic period” until the third month) from a dimensional level using contemporaneous and cross-lagged panel network analyses. A total of 268 older adults completed two rounds of surveys, including the General Information Questionnaire, the Attitudes to Aging Questionnaire, and the WHO Quality of Life-Brief. Psychosocial loss-psychological health and physical change-physical health were the strongest edges during the “chaotic period” and “adjustment period,” respectively. The cross-lagged network revealed that QoL significantly predicted attitudes to aging, and the most influential dimension was environmental health. Findings suggest that there is a need to support older adults in psychologically adapting to life in nursing homes quickly during the “chaotic period” and to assist those experiencing negative physical change during the “adjustment period” by encouraging physical activity. The cross-lagged panel network indicates that we need to help older adults rapidly familiarize themselves with new surroundings when they first move into nursing homes.

PMID:40064545 | DOI:10.1111/nhs.70078

J Intellect Dev Disabil. 2025 Mar 10:1-14. doi: 10.3109/13668250.2025.2449677. Online ahead of print.

ABSTRACT

BACKGROUND: Adults with Fetal Alcohol Syndrome (FAS) experience many adverse health and social outcomes, yet their healthcare utilisation is under-researched.

METHOD: This population-based descriptive cohort study utilised ICES provincial administrative health databases and Canadian Death Vital Statistics to identify adults with FAS via usage of hospital-based services (2002-2013) and examine their demographics, healthcare utilisation, mental health and addiction diagnoses, and mortality during follow-up (2014-2017).

RESULTS: 565 adults with FAS were included in the cohort. During the follow-up period, 27% used in-patient psychiatric care; 30% the emergency department 12 + times; 28% were hospitalised at least once; and 17% used home care services. They displayed high rates of physical and mental health comorbidities, substance use disorders, history of abuse, and income from social assistance.

CONCLUSION: Adults with FAS require accessible and extensive healthcare services to address their complex needs and improve long-term outcomes.

PMID:40064542 | DOI:10.3109/13668250.2025.2449677