Tag: statistics

Clin Kidney J. 2025 Feb 17;18(5):sfaf045. doi: 10.1093/ckj/sfaf045. eCollection 2025 May.

ABSTRACT

BACKGROUND: Postoperative acute kidney injury (PO-AKI) is a critical complication of adverse kidney outcomes, both short and long-term. We aimed to expand our pre-existing PO-AKI prediction model to predict mid-to long-term adverse kidney outcomes.

METHODS: We included patients who underwent major non-cardiac surgeries from the original SPARK cohort, two external validation cohorts, and a temporal validation cohort. Mid-to-long-term adverse kidney outcomes were defined as end-stage kidney disease progression or death within 1 or 3 years after surgery. We verified and tuned the original Simple Postoperative AKI RisK (SPARK) model to predict mid-to-long-term adverse kidney events.

RESULTS: We included 33 636 patients in development, 71 232 patients in external validation, and 33 944 patients in temporal validation cohorts, respectively. One- and 3-year adverse kidney events occurred in 5.5% and 13.2% in the development cohort, respectively. The original SPARK score demonstrated an acceptable discriminative power for 1-year and 3-year adverse outcome risks with C indices mostly >0.7. However, the power was relatively poor when restricted to high-risk patients or those who actually developed PO-AKI. When we re-calculated the regression coefficients from a Cox model, the discriminative performances were better, especially for those with high-risk characteristics (e.g. 1-year outcome, C-index 0.72 in developmental and 0.73‒0.77 in validation datasets). Furthermore, when the model integrated the PO-AKI stage and history of malignancy with the SPARK variables, the performance was significantly enhanced (1-year, C-index 0.86 in development and 0.86‒0.88 in validation results). With the above findings, we constructed an online postoperative risk prediction system (https://snuhnephrology.github.io/postop/).

CONCLUSIONS: The addition of two clinical factors and recalibration of SPARK variables significantly improved mid-to-long-term postoperative risk prediction for mortality or dialysis after non-cardiac surgery. Our calculator helps clinicians easily predict a mid-to-long-term risk and PO-AKI occurrence by entering a few variables.

PMID:40322677 | PMC:PMC12044331 | DOI:10.1093/ckj/sfaf045

Int J Womens Health. 2025 Apr 30;17:1193-1201. doi: 10.2147/IJWH.S496137. eCollection 2025.

ABSTRACT

OBJECTIVE: Tumor markers such as CA125 are highly beneficial in predictive ovarian malignancy; however, this advanced test is not always available in remote areas. To address this issue, the author aimed to explore the use of systemic inflammatory biomarkers as complementary modalities for diagnosis of ovarian malignancy.

METHODS: This diagnostic study utilized a cross-sectional approach, with outcomes measured by AUC and sensitivity. A total of 132 patients with adnexal tumors were consecutively included and measured a complete blood count. From this, the MLR (Monocyte Lymphocyte Ratio), NLR (Neutrophil Lymphocyte Ratio), PLR (Platelet Lymphocyte Ratio), SII (Systemic Immune Inflammation Index), and SIRI (Systemic Inflammatory Response Index) biomarkers were calculated. After surgery, histopathological examination was performed as the gold standard and the biomarker predictions were then compared to it, followed by statistical analysis.

RESULTS: The AUC values for MLR, NLR, PLR, SII, and SIRI were 0.70, 0.731, 0.696, 0.743, and 0.722, respectively. The p-values were MLR (0.005), NLR (0.001), PLR (0.001), SII (<0.001), and SIRI (<0.001), respectively. In multivariate analysis, only SII was significant (p = 0.015). The Exp(B) and 95% CI were 5.472 (1.383-21.655). The validity test for SII showed satisfactory results: sensitivity 71.64%, specificity 73.84%, PPV 73.84%, NPV 71.64%, accuracy 72.72%, LR+ 2.74%, and LR- 0.38%.

CONCLUSION: Systemic inflammatory biomarkers, particularly SII may aid in the predictive markers of early ovarian with diagnostic values nearly as good as CA125 (sensitivity 71.64% vs 75.97%). These biomarkers can serve as complementary predictive markes modalities for ovarian malignancy, especially when advanced tumor marker tests like CA125 are not available in remote areas.

PMID:40322664 | PMC:PMC12050043 | DOI:10.2147/IJWH.S496137

JAMIA Open. 2025 May 2;8(3):ooaf027. doi: 10.1093/jamiaopen/ooaf027. eCollection 2025 Jun.

ABSTRACT

OBJECTIVE: Electronic patient portals (PP) allow for targeted and efficient research recruitment. We assessed pre- and postnatal women’s recruitment methods preferences, focusing on PP.

MATERIALS AND METHODS: We conducted 4 in-person focus groups with new and expecting mothers. Participants reported demographics, health status, and comfort with technology including PP. We used descriptive statistics to characterize quantitative data and a quasi-deductive approach to analyze qualitative data.

RESULTS: Participants (n = 32) were an average age of 31.9 years, mostly White (65.6%), married (90.6%), and had a 4-year degree or higher (71.9%). Although they preferred PP for research recruitment over other methods (eg, in-person, physical mail), participants suggested potential barriers, including high message frequency, messages feeling like spam, and concerns about confidentiality. Participants suggested solutions, including enhancing autonomy through opt-in methods; integrating their healthcare provider’s feedback; sending personal and relevant messages; and assuring their PP data are confidential.

DISCUSSION: PPs are a promising recruitment method for pre- and postnatal women including for maternal-child health studies. To ensure engagement with the method, researchers must respond to known patient concerns and incorporate their feedback into future efforts.

CONCLUSION: Although PP were generally viewed as an acceptable recruitment method, researchers should be mindful of barriers that may limit its reach and effectiveness.

PMID:40322631 | PMC:PMC12047077 | DOI:10.1093/jamiaopen/ooaf027

Middle East J Dig Dis. 2025 Jan;17(1):12-18. doi: 10.34172/mejdd.2025.403. Epub 2025 Jan 31.

ABSTRACT

BACKGROUND: The quality of bowel preparation is one of the key determinants of a successful colonoscopy. Bowel preparation regimens have evolved greatly over the past few decades, with attempts to improve the efficiency and tolerability; still an ideal agent or regimen continues to be oblivious. To compare the efficacy, safety, and tolerance of three bowel preparation regimens for colonoscopy: split dose of oral sulfate solution (OSS), split dose of polyethylene glycol (PEG), and same-day single dose PEG.

METHODS: This study was a randomized, single-blind control design with three study groups. Group A received a split dose of OSS, group B received a split dose of PEG, and Group C received a single dose of PEG for bowel preparation. The quality of preparation was assessed using the Boston Bowel Preparation Scale (BBPS), and the adverse effects and tolerance were noted. The data were compared statistically for any significant difference between the regimens.

RESULTS: Mean total BBPS scores were 8.08, 7.52, and 7.92 for groups A, B, and C, respectively (P=0.076). Segmental BBPS scores were statistically similar for the right and transverse colon but differed for the left colon (A: B: C=2.79: 2.54: 2.75; P<0.01). Gastrointestinal side effects and electrolyte disturbances were similar across the three groups. Split-dose preparations were associated with more significant sleep disturbances than single-dose PEG (P<0.001). Patients who received OSS reported more taste intolerance (P<0.01), while those who received single PEG reported more volume intolerance (P<0.001).

CONCLUSION: Split-dose OSS, split-dose PEG, and single-dose PEG regimens provide adequate and comparable bowel preparation for colonoscopy with good patient tolerance and no significant adverse effects. Overnight PEG and OSS preparations were associated with more substantial sleep disturbances. OSS is associated with more taste intolerance, while single PEG is associated with more volume intolerance.

PMID:40322569 | PMC:PMC12048835 | DOI:10.34172/mejdd.2025.403

J Immunol Res. 2025 Apr 27;2025:6468979. doi: 10.1155/jimr/6468979. eCollection 2025.

ABSTRACT

Background: The relationship between autoimmune diseases (AIDs) and cancer is unclear and this study aimed to investigate the relationship between AIDs and cancer at the genetic level using Mendelian randomization (MR). Methods: The study employed two-sample MR and meta-analysis to investigate the association between AIDs and 33 types of cancer, following STROBE-MR guidelines. Single nucleotide polymorphisms (SNPs) associated with AIDs were used as instrumental variables, with data from FinnGen, UK Biobank, and other databases. MR analyses included sensitivity checks, heterogeneity assessments, and reverse causality tests, using multiple MR methods (inverse-variance weighted (IVW), weighted median, MR-Egger, etc.). Meta-analysis was performed on validated results to confirm findings, with statistical analyses conducted using R software. Results: The results identified eight significant associations in both discovery and replication stages. Key findings include that myasthenia gravis (MG) significantly increases the risk of oral cavity cancer, multiple sclerosis (MS) is linked to increased risks of chronic lymphocytic leukemia (CLL) and small intestine cancer, and ulcerative colitis (UC) has mixed effects, reducing the risk of uterine cervix and larynx cancers, but increasing risks for pancreatic and bladder cancers. Meta-analysis confirmed eight secondary findings, highlighting pathogenic associations such as type 1 diabetes with esophagus cancer and protective effects like systemic lupus erythematosus (SLE) against acute myelocytic leukemia. Conclusions: This study provides evidence of a causal relationship between multiple AIDs and different cancer risks at the genetic level and provides a reference for the health management of patients with AIDs.

PMID:40322556 | PMC:PMC12050153 | DOI:10.1155/jimr/6468979

Biomed Rep. 2025 Apr 22;22(6):104. doi: 10.3892/br.2025.1982. eCollection 2025 Jun.

ABSTRACT

Genome-wide association studies (GWAS) have identified the potassium voltage-gated channel subfamily Q member 1 (KCNQ1) gene, as a potential contributor to the pathogenesis of type 2 diabetes (T2D). Given the known genetic overlap between T2D and polycystic ovary syndrome (PCOS), the present study aimed to investigate the potential association between KCNQ1 gene variants and PCOS susceptibility in a population of Tunisian women. A total of 230 patients and 230 healthy controls were recruited for this case control study. The Rotterdam consensus criteria were used to diagnose patients with PCOS. Genotyping of three KCNQ1 variants (rs231361, rs151290 and rs2237895), was performed using allelic discrimination (real-time PCR). After excluding false positive associations using the false discovery rate adjustment and ensuring statistical power >80%, the present results suggested that the KCNQ1 gene may play a role in PCOS susceptibility. Specifically, the rs231361 variant showed a significant association with an increased risk of PCOS through multiple genetic inheritance models. Additionally, the A/A genotype of the rs231361 variant displayed a correlation with increased levels of triglycerides compared with those with the G/G wild-type and the G/A heterozygous genotypes. To the best of our knowledge, this is the first study to identify the KCNQ1 rs231361 variant as a potential genetic risk factor for PCOS. These findings have important implications for risk assessment and the development of personalized treatment approaches for affected women.

PMID:40322554 | PMC:PMC12046284 | DOI:10.3892/br.2025.1982

Adv Simul (Lond). 2025 May 4;10(1):26. doi: 10.1186/s41077-025-00355-1.

ABSTRACT

BACKGROUND: Simulation-based medical education (SBME) is a critical training tool in healthcare, shaping learners’ skills, professional identities, and inclusivity. Leadership demographics in SBME, including age, gender, race/ethnicity, and medical specialties, influence program design and learner outcomes. Artificial intelligence (AI) platforms increasingly generate demographic data, but their biases may perpetuate inequities in representation. This study evaluated the demographic profiles of simulation instructors and heads of simulation labs generated by three AI platforms-ChatGPT, Gemini, and Claude-across nine global locations.

METHODS: A global cross-sectional study was conducted over 5 days (November 2024). Standardized English prompts were used to generate demographic profiles of simulation instructors and heads of simulation labs from ChatGPT, Gemini, and Claude. Outputs included age, gender, race/ethnicity, and medical specialty data for 2014 instructors and 1880 lab heads. Statistical analyses included ANOVA for continuous variables and chi-square tests for categorical data, with Bonferroni corrections for multiple comparisons: P significant < 0.05.

RESULTS: Significant demographic differences were observed among AI platforms. Claude profiles depicted older heads of simulation labs (mean: 57 years) compared to instructors (mean: 41 years), while ChatGPT and Gemini showed smaller age gaps. Gender representation varied, with ChatGPT and Gemini generating balanced profiles, while Claude showed a male predominance (63.5%) among lab heads. ChatGPT and Gemini outputs reflected greater racial diversity, with up to 24.4% Black and 20.6% Hispanic/Latin representation, while Claude predominantly featured White profiles (47.8%). Specialty preferences also differed, with Claude favoring anesthesiology and surgery, whereas ChatGPT and Gemini offered broader interdisciplinary representation.

CONCLUSIONS: AI-generated demographic profiles of SBME leadership reveal biases that may reinforce inequities in healthcare education. ChatGPT and Gemini demonstrated broader diversity in age, gender, and race, while Claude skewed towards older, White, and male profiles, particularly for leadership roles. Addressing these biases through ethical AI development, enhanced AI literacy, and promoting diverse leadership in SBME are essential to fostering equitable and inclusive training environments.

TRIAL REGISTRATION: Not applicable. This study exclusively used AI-generated synthetic data.

PMID:40320548 | DOI:10.1186/s41077-025-00355-1

Matern Health Neonatol Perinatol. 2025 May 5;11(1):13. doi: 10.1186/s40748-025-00211-0.

ABSTRACT

BACKGROUND: Preventing infection in primary sutured perineal tears after childbirth is crucial to avoid systemic antibiotic use and potential complications from poor healing. This study aimed to investigate the efficacy of an antibacterial, triclosan-coated suture (VicrylPlus^®) in reducing infection in primary sutured childbirth-related perineal tears.

METHODS: The PLUS study was a single-center, single-blinded, adaptive parallel-group randomized trial conducted at Lund University Hospital, Sweden. Women aged ≥ 18 years with a perineal tear at childbirth were randomly assigned in a 1:1 ratio to either the control group (conventional-absorbable suture, Vicryl^®) or the intervention group (triclosan-coated- absorbable suture, VicrylPlus^®).

RESULTS: Out of 1921 eligible women, 1890 were randomized to either Vicryl^® (n = 953) or VicrylPlus^® (n = 937). There were no significant demographic differences between the groups. The most common type of tear in both groups was a second-degree tear (Vicryl^® 66.2% (n = 625), VicrylPlus^® 67.5% (n = 625)). Encompassing all types of deeper tears in the analysis there was a significantly decrease in infection after suturing with VicrylPlus^® 4% (n = 28) versus Vicryl^® 6.8% (n = 47); (OR 0.57, 95% CI 0.35-0.91, P = 0.024). When analyzing different tears separately, there was a non-significant increase in infection for first-degree tears with VicrylPlus^® 0.8% (n = 2) versus Vicryl^® 3.9% (n = 8); (OR 4.75, 95% CI 1.00-22.63, P = 0.050). However, for second-degree tears, the infection rate was significantly reduced with VicrylPlus^® 4.4% (n = 27) versus Vicryl^® 7.2% (n = 44); (OR 0.63, 95% CI 0.36-0.98, P = 0.05) and for third-degree and unclassified tears there was a non-significant decrease in infections with VicrylPlus^® 5.3% (n = 1) versus Vicryl^® 14.3% (n = 2); (OR 0.33, 95% CI 0.03-4.10, P = 0.561), respectively, VicrylPlus^® 0% versus Vicryl^® 1.7% (n = 1); (OR 0.98, 95% CI 0.95-1.02, P = 0.462).

CONCLUSION: The use of triclosan coated sutures significantly reduces the risk of infection in primary sutured childbirth-related perineal tears by 43%, except for first-degree tears. Further research is needed to determine whether their effectiveness remains consistent across the other specific types of deeper tears in a larger study population.

TRIAL REGISTRATION: ClinicalTrials (NCT02863874), posted 11/08/2016, retrospectively registered. Approved by the regional ethical committee before start of enrollment (Dnr 2015/774).

PMID:40320545 | DOI:10.1186/s40748-025-00211-0

BMC Infect Dis. 2025 May 4;25(1):651. doi: 10.1186/s12879-025-11026-x.

ABSTRACT

BACKGROUND: The study aimed to assess the willingness of receiving tuberculosis preventive treatment (TPT) and identify influence factors on their decisions among individuals with latent tuberculosis infection (LTBI).

METHODS: Individuals diagnosed with LTBI at a designated tuberculosis (TB) hospital were recruited from July 2023 to June 2024. Data on socio-demographic characteristics, knowledge of TB, the decision to receive TPT along with the underlying reasons were collected using electronic questionnaires. Binary logistic regression analysis was employed to identify independent factors associated with the willingness of receiving TPT. A P value less than 0.05 was considered statistically significant.

RESULTS: A total of 317 individuals with LTBI were included in this study. Among them, 254 (80.13%) expressed a willingness to receive TPT, while 63 declined. Of those 254, 58 (22.83%) ultimately refused treatment. Gender (P < 0.05; OR = 1.983; 95% CI:1.052-3.738), educational level (P < 0.01; OR = 3.489; 95% CI:1.524-7.985) and knowledge of TB (P < 0.05; OR = 3.688; 95% CI:1.835-16.278) were significantly associated with willingness to receive TPT. The top three reasons for willingness to receive TPT were: concern about developing active tuberculosis (ATB), reducing the risk and severity of ATB, and doctor’s recommendation, accounting for 69.09%, 46.69%, and 42.90%, respectively. The top four reasons for refusal TPT included: fear of adverse drug reactions, perceived low risk of developing ATB, fear of adverse drug events and uncertainty about the effectiveness of TPT, accounting for 9.46%, 6.94%, 4.73%, and 4.73%, respectively.

CONCLUSIONS: TPT acceptance remained suboptimal and was influenced by gender, education level and TB knowledge. Improving LTBI patient and health care provider education on TB risks and TPT benefits could enhance adherence.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40320539 | DOI:10.1186/s12879-025-11026-x

Nutr J. 2025 May 4;24(1):71. doi: 10.1186/s12937-025-01138-0.

ABSTRACT

BACKGROUND: A posteriori dietary patterns (DPs) are critical for capturing actual dietary behaviour. However, assessing their reproducibility across (sub)populations requires novel modelling approaches beyond descriptive statistics. Multi-study factor analysis derives DPs that are shared among all studies/subpopulations and those specific to a study or subpopulation of interest. Bayesian implementation of the multi-study factor analysis (BMSFA) is more flexible than frequentist as it imposes fewer assumptions and improves factor selection.

METHODS: We applied BMSFA to 24-h dietary recalls from the baseline visit (2008-2011) of the US Hispanic Community Health Study/Study of Latinos (n = 16,415). The analysis was conducted on 42 common nutrients to identify shared and subpopulation-specific DPs. Subpopulations were defined based on the cross-classification of ethnic background (Cuban, Dominican Republic, Mexican, Puerto Rican, Central and South American) and study site (Bronx, Chicago, Miami, San Diego) resulting in 12 Ethnic Background Site (EBS) categories. Regression analysis characterized DPs in terms of food groups, overall diet quality, socio-demographic/lifestyle factors, adjusting for survey design.

RESULTS: We identified four shared DPs across all EBS categories: Plant-based foods, Processed foods, Dairy products, and Seafood. Additionally, twelve EBS-specific DPs were identified-one for each EBS category. Most EBS-specific DPs were further grouped into overarching profiles: Animal vs. vegetable source, Animal source only, and Poultry vs. dairy products, to capture nuances within animal-based DPs. Puerto Rican background participants from Chicago expressed a strikingly different DP from all others (i.e., high on beta-carotene and low on starch/iron/thiamin). Higher overall diet quality was observed with increasing categories of Plant-based foods, Seafood, and the “Puerto Rican background – Chicago” EBS-specific DP, whereas increasing categories of Dairy products, Processed foods, and the remaining EBS-specific DPs were related to lower diet quality. Compared to non-US-born participants, US-born individuals had significantly higher adjusted mean scores in absolute value for most DPs. Specifically, they exhibited lower adherence to the Plant-based foods and Dairy products DPs but higher adherence to Processed foods, Seafood, and six EBS-specific DPs.

CONCLUSIONS: The BMSFA successfully captured sources of dietary homogeneity and heterogeneity among US Hispanic/Latino adults across ethnic backgrounds and study sites. The study highlighted the crucial role of nativity on DPs.

PMID:40320535 | DOI:10.1186/s12937-025-01138-0