Tag: statistics

BMC Geriatr. 2023 Jun 16;23(1):372. doi: 10.1186/s12877-023-04048-0.

ABSTRACT

BACKGROUND: Given the rapidly rising proportion of the older population in China and the relatively high prevalence of depressive symptoms among this population, this study aimed to identify the trajectories of depressive symptoms and the factors associated with the trajectory class to gain a better understanding of the long-term course of depressive symptoms in this population.

METHODS: Data were obtained from four wave’s survey of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3646 participants who aged 60 years or older during baseline survey, and completed all follow-ups were retained in this study. Depressive symptoms were measured using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D-10). Growth mixture modelling (GMM) was adopted to identify the trajectory classes of depressive symptoms, and both linear and quadratic functions were considered. A multivariate logistic regression model was used to calculate the adjusted odds ratios (ORs) of the associated factors to predict the trajectory class of participants.

RESULTS: A four-class quadratic function model was the best-fitting model for the trajectories of depressive symptoms in the older Chinese population. The four trajectories were labelled as increasing (16.70%), decreasing (12.31%), high and stable (7.30%), and low and stable (63.69%), according to their trends. Except for the low and stable trajectory, the other trajectories were almost above the threshold for depressive symptoms. The multivariate logistic regression model suggested that the trajectories of chronic depressive symptoms could be predicted by being female, living in a village (rural area), having a lower educational level, and having chronic diseases.

CONCLUSIONS: This study identified four depressive symptom trajectories in the older Chinese population and analysed the factors associated with the trajectory class. These findings can provide references for prevention and intervention to reduce the chronic course of depressive symptoms in the older Chinese population.

PMID:37328803 | DOI:10.1186/s12877-023-04048-0

BMC Ophthalmol. 2023 Jun 16;23(1):275. doi: 10.1186/s12886-023-03023-y.

ABSTRACT

BACKGROUND: Improper refractive correction can be harmful to eye health, aggravating the burden of vision impairment. During most optometry clinical consultations, practitioner-patient interactions play a key role. Maybe it is feasible for patients themselves to do something to get high-quality optometry. But the present empirical research on the quality improvement of eye care needs to be strengthened. The study aims to test the effect of the brief verbal intervention (BVI) through patients on the quality of optometry service.

METHODS: This study will take unannounced standardized patient (USP) with refractive error as the core research tool, both in measurement and intervention. The USP case and the checklist will be developed through a standard protocol and assessed for validity and reliability before its full use. USP will be trained to provide standardized responses during optical visits and receive baseline refraction by the skilled study optometrist who will be recruited within each site. A multi-arm parallel-group randomized trial will be used, with one common control and three intervention groups. The study will be performed in four cities, Guangzhou and three cities in Inner Mongolia, China. A total of 480 optometry service providers (OSPs) will be stratified and randomly selected and divided into four groups. The common control group will receive USP usual visits (without intervention), and three intervention groups will separately receive USP visits with three kinds of BVI on the patient side. A detailed outcome evaluation will include the optometry accuracy, optometry process, patient satisfaction, cost information and service time. Descriptive analysis will be performed for the survey results, and the difference in outcomes between interventions and control providers will be compared and statistically tested using generalized linear models (GLMs).

DISCUSSION: This research will help policymakers understand the current situation and influencing factors of refractive error care quality, and then implement precise policies; at the same time, explore short and easy interventions for patients to improve the quality of optometry service.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200062819. Registered on August 19, 2022.

PMID:37328796 | DOI:10.1186/s12886-023-03023-y

BMC Cardiovasc Disord. 2023 Jun 16;23(1):301. doi: 10.1186/s12872-023-03345-1.

ABSTRACT

BACKGROUND: Chronic total coronary occlusion (CTO) is serious and the “last bastion” of percutaneous coronary intervention. Hypertension and hyperhomocysteinemia (HHCY) are synergistic and significantly increase cardiovascular event risk. The relationship between H-type hypertension and CTO remains unclear; thus, this cross-sectional study investigated this potential association.

METHODS: Between January 2018 and June 2022, 1446 individuals from southwest China were recruited to participate in this study. CTO was defined as complete coronary artery occlusion persisting for over three months. H-type hypertension was defined as hypertension with plasma homocysteine levels ≥ 15 µmol/L. Multivariate logistic regression models were applied to assess the association between H-type hypertension and CTO. Receiver operating characteristic (ROC) curves were generated to determine the accuracy of H-type hypertension in predicting CTO.

RESULTS: Of the 1446 individuals, 397 had CTO, and 545 had H-type hypertension. After multivariate adjustment, the odds ratio (OR) for CTO in individuals with H-type hypertension was 2.3-fold higher (95% CI 1.01-5.26) than that in healthy controls. The risk of CTO is higher in individuals with H-type hypertension than in those with isolated HHCY and hypertension. The area under the ROC curve for CTO was 0.685 (95% CI, 0.653-0.717) for H-type hypertension.

CONCLUSIONS: In southwest China, H-type hypertension is significantly related to the occurrence of CTO.

TRIAL REGISTRATION: This retrospective study was registered with the Chinese Clinical Trials Registry ( http://www.chictr.org.cn , ChiCTR2100050519.2.2).

PMID:37328790 | DOI:10.1186/s12872-023-03345-1

BMC Med Inform Decis Mak. 2023 Jun 16;23(1):110. doi: 10.1186/s12911-023-02207-2.

ABSTRACT

OBJECTIVE: Precision medicine requires reliable identification of variation in patient-level outcomes with different available treatments, often termed treatment effect heterogeneity. We aimed to evaluate the comparative utility of individualized treatment selection strategies based on predicted individual-level treatment effects from a causal forest machine learning algorithm and a penalized regression model.

METHODS: Cohort study characterizing individual-level glucose-lowering response (6 month reduction in HbA1c) in people with type 2 diabetes initiating SGLT2-inhibitor or DPP4-inhibitor therapy. Model development set comprised 1,428 participants in the CANTATA-D and CANTATA-D2 randomised clinical trials of SGLT2-inhibitors versus DPP4-inhibitors. For external validation, calibration of observed versus predicted differences in HbA1c in patient strata defined by size of predicted HbA1c benefit was evaluated in 18,741 patients in UK primary care (Clinical Practice Research Datalink).

RESULTS: Heterogeneity in treatment effects was detected in clinical trial participants with both approaches (proportion predicted to have a benefit on SGLT2-inhibitor therapy over DPP4-inhibitor therapy: causal forest: 98.6%; penalized regression: 81.7%). In validation, calibration was good with penalized regression but sub-optimal with causal forest. A strata with an HbA1c benefit > 10 mmol/mol with SGLT2-inhibitors (3.7% of patients, observed benefit 11.0 mmol/mol [95%CI 8.0-14.0]) was identified using penalized regression but not causal forest, and a much larger strata with an HbA1c benefit 5-10 mmol with SGLT2-inhibitors was identified with penalized regression (regression: 20.9% of patients, observed benefit 7.8 mmol/mol (95%CI 6.7-8.9); causal forest 11.6%, observed benefit 8.7 mmol/mol (95%CI 7.4-10.1).

CONCLUSIONS: Consistent with recent results for outcome prediction with clinical data, when evaluating treatment effect heterogeneity researchers should not rely on causal forest or other similar machine learning algorithms alone, and must compare outputs with standard regression, which in this evaluation was superior.

PMID:37328784 | DOI:10.1186/s12911-023-02207-2

BMC Ophthalmol. 2023 Jun 16;23(1):281. doi: 10.1186/s12886-023-03014-z.

ABSTRACT

BACKGROUNDS: To investigate the changes of anterior eye segment with implantable collamer lens (ICL) under mesopic and photopic conditions.

METHOD: Forty-seven eyes of myopic patients who underwent ICL V4c implantation were included. Three months after surgery, the pupil diameter (PD), dynamic vault, ACD (distance from the posterior corneal surface to the anterior lens surface), ACD-ICL (distance from the posterior corneal surface to the anterior ICL surface), and anterior chamber angle parameters were measured using the anterior segment optical coherence tomography (AS-OCT, Carl Zeiss AG, Germany) under completely mesopic (0 lx) and photopic (5290 lx) lighting conditions.

RESULTS: Compared with mesopic conditions, a significant decreased vault was detected in photopic conditions (486.7 ± 186.1 μm versus 643.5 ± 191.2 μm, p < 0.001), while the ACD-ICL increased significantly (2.54 ± 0.24 mm versus 2.37 ± 0.23 mm, p < 0.001). The pupil was smaller in photopic condition (2.66 ± 0.23 mm versus 5.62 ± 0.55 mm, p < 0.001). ACD didn’t change(3.32 ± 0.24 mm versus 3.31 ± 0.22 mm, p = 0.079). The change of the vault was positively related to the changes of the PD (r² = 0.301, p = 0.04). There were no statistical difference between the change of vault and the change of ACD-ICL (158.0 ± 58.1 μm versus 165.9 ± 65.3 μm, p = 0.320).

CONCLUSION: When exposed to high intensity light after ICL surgery, the pupil constricted, vault decreased, ACA widened and ACD-ICL increased. All these changes were caused by the change of iris not the crystalline lens.

PMID:37328783 | DOI:10.1186/s12886-023-03014-z

BMC Nurs. 2023 Jun 16;22(1):207. doi: 10.1186/s12912-023-01378-7.

ABSTRACT

BACKGROUND: Early detection and timely treatment of atrial fibrillation (AF) remains pivotal to preventing AF-related complications. Public involvement in recognising potential AF symptoms and managing AF is vital for early detection and treatment of AF.

OBJECTIVE: The aim of the study is to assess the general public’s knowledge of AF using an online survey, disseminated via social media.

METHODS: A cross-sectional online survey of the general public was conducted between November to December 2021. The survey’s URL was shared on National University Heart Centre, Singapore’s official Facebook page. Digital marketing strategies were employed to recruit members of the public. The 27-item survey assessed public’s knowledge across five domains: basic information about AF, risk factors of AF, detection of AF, prevention of AF, and management of AF.

RESULTS: The survey involved 620 participants. Approximately two-thirds were between the ages 21 to 40 years (64.5%), female (60%) and had at least a degree (64.7%) as their highest level of education. Participants obtained a mean percentage score of 63.3 ± 26.0 for their AF knowledge. One-way ANOVA was done to examine the associations between the participants’ characteristics and their knowledge of AF. There were no statistically significant differences in the AF knowledge scores across the various sociodemographic subgroups.

CONCLUSIONS: Members of the public recruited from Facebook and via digital marketing had moderately good knowledge of AF. However, public awareness pertaining to preventing AF has potential for improvement. The utility of social media in reaching the general public was illustrated through this study.

PMID:37328774 | DOI:10.1186/s12912-023-01378-7

J Chromatogr B Analyt Technol Biomed Life Sci. 2023 Jun 10;1226:123787. doi: 10.1016/j.jchromb.2023.123787. Online ahead of print.

ABSTRACT

Metabolomics studies in human dermal fibroblasts can elucidate the biological mechanisms associated with some diseases, but several methodological issues that increase variability have been identified. We aimed to quantify the amino acid levels in cultured fibroblasts and to apply different sample-based normalization approaches. Forty-four skin biopsies from control subjects were collected. Amino acids were measured in fibroblasts supernatants by UPLC-MS/MS. Statistical supervised and unsupervised studies were used. Spearman’s test showed that phenylalanine displayed the second highest correlation with the remaining amino acids (mean r = 0.8), whereas the total protein concentration from the cell pellet showed a mean of r = 0.67. The lowest percentage of variation was obtained when amino acids were normalized by phenylalanine values, with a mean of 42% vs 57% when normalized by total protein values. When amino acid levels were normalized by phenylalanine, Principal Component Analysis and clustering analyses identified different fibroblasts groups. In conclusion, phenylalanine may be a suitable biomarker to estimate cellular content in cultured fibroblasts.

PMID:37327517 | DOI:10.1016/j.jchromb.2023.123787

Ann Am Thorac Soc. 2023 Jun 16. doi: 10.1513/AnnalsATS.202301-078OC. Online ahead of print.

ABSTRACT

Rationale/Objective: Antibiotic selection for in-hospital treated pulmonary exacerbations (PEx) in people with cystic fibrosis (PwCF) is typically guided by previous respiratory culture results or past PEx antibiotic treatment. In the absence of clinical improvement during PEx treatment, antibiotics are frequently changed in search of a regimen that better alleviates symptoms and restores lung function. The clinical benefits of changing antibiotics during PEx treatment are largely uncharacterized.

METHODS: This was a retrospective cohort study utilizing the CF Foundation Patient Registry-Pediatric Health Information System. PEx were included if they occurred in children with CF from 6 to 21 years old who had been treated with IV antibiotics between January 1st, 2006, through December 31st, 2018. PEx with lengths of stay <5 or >21 days or where treatment was delivered in an intensive care unit were excluded. An antibiotic change was defined as addition or subtraction of any IV antibiotic between hospital day 6 and the day prior to hospital discharge. Inverse probability of treatment weighting was used to adjust for disease severity and indication bias, which might influence a decision to change antibiotics.

RESULTS: In all, 4099 children with CF contributed 18,745 PEx for analysis, of which 8,169 PEx (43.6%) included a change in IV antibiotics on or after day 6. The mean change in in pre- to post-treatment percent predicted forced expiratory volume in one second (ppFEV1) was 11.3 (standard error 0.21) among events in which an IV antibiotic change occurred versus 12.2 (0.18) among PEx without an IV antibiotic change (p=0.001). Similarly, the odds of return to ≥90% of baseline ppFEV1 were less for PEx with antibiotic changes than those without changes (odds ratio (OR) 0.89; [95% Confidence Interval (CI): 0.80-0.98]). Odds of returning to ≥100% of baseline ppFEV1 did not differ between PEx with versus without antibiotic changes (OR 0.94; [0.86-1.03]). In addition, PEx treated with IV antibiotic changes were associated with higher odds of future PEx (OR 1.17 [1.12-1.22]).

CONCLUSIONS: In this retrospective study, changing IV antibiotics during PEx treatment in children with CF was common and not associated with improved clinical outcomes.

PMID:37327485 | DOI:10.1513/AnnalsATS.202301-078OC

J Glaucoma. 2023 Jun 15. doi: 10.1097/IJG.0000000000002253. Online ahead of print.

ABSTRACT

PRCIS: The thicknesses of the circumpapillary retinal nerve fiber layer and ganglion cell complex did not change during 5 years in physiological large disc cupping.

PURPOSE: We evaluated longitudinal changes in the thicknesses of the circumpapillary retinal nerve fiber layer (cpRNFL) and ganglion cell complex (GCC) in large disc cupping with a normal intraocular pressure (IOP) (<21 mmHg) and visual field.

METHODS: This retrospective, consecutive case series study included 269 eyes of 269 patients with large disc cupping and normal IOP. We analyzed patient demographics, IOP, central corneal thickness, vertical cup-to-disc ratios (vCDR) using color fundus photography, the thicknesses of the cpRNFL and GCC using RTVue-100, and mean deviation (MD) using visual field examinations.

RESULTS: The differences in IOP, vCDR, and MD between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the cpRNFL thickness were 106.5±8.5 μm and 105.1±9.3 μm, respectively; differences between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the GCC thickness were 82.8±9.7 μm and 81.5±9.2 μm, respectively; differences between baseline and each follow-up visit were not statistically significant.

CONCLUSION: The thicknesses of the cpRNFL and GCC did not change in well-maintained optic nerve head (ONH) findings with normal IOP and visual field during a 5-year follow-up period. Optical coherence tomography evaluations of the thicknesses of the cpRNFL and GCC help accurately diagnose physiological optic disc cupping.

PMID:37327476 | DOI:10.1097/IJG.0000000000002253

JCO Oncol Pract. 2023 Jun 16:OP2300068. doi: 10.1200/OP.23.00068. Online ahead of print.

ABSTRACT

PURPOSE: The COVID-19 pandemic has had deleterious effects on oncologist professional and personal well-being, the optimal delivery of quality cancer care, and the future cancer care workforce, with many departing the field. Hence, the identification of evidence-based approaches to sustain oncologists is essential to promote well-being.

MATERIALS AND METHODS: We developed a brief, oncologist-centered, virtual group peer support program and tested its feasibility, acceptability, and preliminary impact on well-being. Trained facilitators provided support to peers on the basis of burnout research in oncology with available resources to enhance oncologist resilience. Peers completed pre- and postsurvey assessment of well-being and satisfaction.

RESULTS: From April to May 2022, 11 of 15 (73%) oncologists participated in its entirety: mean age 51.1 years (range, 33-70), 55% female, 81.8% Ca, 82% medical oncologists, 63.6% trained ≥15 years, average 30.3 patients/wk (range, 5-60), and 90.9% employed in hospital/health system practice. There was a statistically significant difference in pre- and postintervention well-being (7.0 ± 3.6 v 8.2 ± 3.0, P = .03) with high satisfaction with postgroup experience (9.1 ± 2.5). These quantitative improvements were affirmed by qualitative feedback. These themes included (1) an enhanced understanding of burnout in oncology, (2) shared experience in practice of oncology, and (3) fostering connections with diverse colleagues. Future recommendations proposed included (1) restructuring group format and (2) tailoring groups according to practice setting (academic v community).

CONCLUSION: Preliminary results suggest that a brief, innovative oncologist-tailored group peer support program is feasible, acceptable, and beneficial for enhancing well-being dimensions including burnout, engagement, and satisfaction. Additional study is required to refine program components (optimal timing, format) to support oncologist well-being, now during the pandemic and well into recovery.

PMID:37327462 | DOI:10.1200/OP.23.00068