Tag: statistics

Scand J Surg. 2026 Jun 28:14574969261458557. doi: 10.1177/14574969261458557. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: A large variation in surgery rates can be indicative of its overuse. In Finland, surgeries for carpal tunnel syndrome (CTS) and ulnar nerve disorder (UN) are common, but regional differences in their incidence rates remain unexplored. This study examined how the incidence rates of these surgeries vary across hospital districts in Finland to evaluate regional consistency.

METHODS: We compared regional age- and sex-adjusted incidence rates per 100,000 person-years based on data from Finland’s Care Register for Health Care for CTS and UN surgeries from 2010 to 2021, calculated relative to population size as reported by Statistics Finland. The study included 21 hospital districts in Finland.

RESULTS: During the 4-year period from 2018 to 2021, the difference between the lowest (99.6 cases per 100,000 person-years (95% confidence interval (CI) 80.7-122)) and the highest (351 cases per 100,000 person-years (95% CI 336-367)) adjusted incidence rates for CTS surgery was 3.5-fold, with a median adjusted incidence rate of 213 cases per 100,000 person-years. Over the same period, the difference between the lowest (1.04 cases per 100,000 person-year (95% CI 0.03-5.78)) and the highest (81.9 cases per 100,000 person-years (95% CI 73.2-91.5)) adjusted incidence rates for UN surgery was up to 79-fold, with a median adjusted incidence rate of 17.8 cases per 100,000 person-years.

CONCLUSIONS: Surgery for CTS shows up to a 3.5-fold variation across Finland’s hospital districts. Although less common in absolute numbers, surgical treatment rates for UN vary up to 79-fold among these regions. Such significant variations are unlikely to be attributed solely to differences in population morbidity. Instead, the findings indicate that the criteria for performing these surgeries vary considerably across the Finland’s hospital districts, suggesting a potential overuse in certain areas.

PMID:42365503 | DOI:10.1177/14574969261458557

J Nurs Manag. 2026;2026(1):e8184283. doi: 10.1155/jonm/8184283.

ABSTRACT

Digital services allow patients to efficiently access healthcare. These services work more effectively than traditional paper-based systems by delivering better patient outcomes, helping address global health challenges, and promoting the universal adoption of health technology. This study examined the impact of digital healthcare adoption and service quality on patient satisfaction in Pakistan’s public healthcare sector and the moderating effect of telehealth services on this relationship. This study adopted the technology acceptance model to understand technology sophistication and how electronic medical records, digital patient systems, and technology impact healthcare through efficiency and communication. Simultaneously, the study examined the role of doctor services, nurse services, pharmacy services, and laboratory services in the patient experience. Random sampling techniques were employed, and questionnaires were distributed to 573 respondents across five central districts of Punjab, Pakistan. The hypotheses were tested using IBM SPSS Statistics, Amos, and structural equation modeling. These findings show that digital healthcare adoption and service quality significantly improve patient satisfaction, whereas telehealth services reinforce these relationships by overcoming geographical and logistical hurdles. The conclusions of this study offer pragmatic guidance to policymakers and healthcare administrators for devising digital healthcare strategies to improve patient outcomes.

PMID:42365466 | DOI:10.1155/jonm/8184283

J Nurs Manag. 2026;2026(1):e3021423. doi: 10.1155/jonm/3021423.

ABSTRACT

INTRODUCTION: Postgraduate education is critical for advancing nursing competence, yet enrolment has declined as nurses struggle to balance clinical, academic and personal responsibilities. Workplace learning offers a flexible, context-driven alternative, allowing nurses to integrate academic development into their clinical practice and potentially mitigating work-life conflicts. However, adoption of structured workplace learning remains limited across healthcare organisations.

AIM: This study aimed to explore how workplace learning can be integrated into healthcare settings to inform curriculum design, resource allocation and organisational support in postgraduate nursing education.

DESIGN AND METHODS: An explanatory sequential mixed-methods study comprising a single-cohort quantitative pre-post knowledge assessment and repeated competence assessments, followed by qualitative focus groups to explain implementation enablers and barriers. Twenty-three postgraduate nurses enrolled in a 13-week workplace learning course participated; 22 completed the study. Quantitative data were analysed with nonparametric statistics, while qualitative data underwent thematic analysis.

RESULTS: We observed a slight improvement in median knowledge scores and increasing competence scores across four time points. As this was a single-group evaluation without a control group, quantitative findings cannot be interpreted as causal effects. Qualitative analysis generated three themes: (1) learning and assessment, (2) integration of workplace learning in the organisation and (3) organisational impact on workplace learning.

CONCLUSION: Workplace learning was feasible and valued when supported by peer learning structures, appropriately timed assessments and organisational enablers such as protected time, adequate infrastructure and leadership support.

PMID:42365465 | DOI:10.1155/jonm/3021423

J Nurs Manag. 2026;2026(1):e4803748. doi: 10.1155/jonm/4803748.

ABSTRACT

INTRODUCTION: This review aimed to identify existing workplace violence (WPV) reporting forms worldwide, examine their domains and determine the essential information required to develop a more comprehensive and effective WPV reporting form.

MATERIALS AND METHODS: A systematic search of PubMed, Web of Science and Google Scholar from 1990 to 2025 was conducted. Data extracted included study characteristics, populations, reporting form names, number of items and reporting approaches. Descriptive analysis and hierarchical cluster analysis were performed to determine the number of items and domains included in each WPV reporting form.

RESULTS: A total of 22 WPV reporting forms were included. Across these forms, 148 reporting items were identified and grouped into 13 domains: sociodemographic data of the victim, job characteristics of the victim, characteristics of the notifier, characteristics of the incident, characteristics of the injury, measures taken during the violence, consequences of the violence, postviolence treatment, aftermath of the violence, reporting of the violence, perception of victim postviolence, characteristics of the assailant and characteristics of the witness. Hierarchical cluster analysis classified the 22 WPV reporting forms into three clusters based on comprehensiveness: rapid forms (three items), brief forms (mean 13.75 items) and detailed forms (mean 27.77 items).

CONCLUSIONS: Substantial variation exists in the content of WPV reporting forms. Future WPV reporting forms should, at minimum, include seven most commonly reported domains, particularly job characteristics of the victim, characteristics of the incident, characteristics of the injury, measures taken during the violence, characteristics of assailant, characteristics of the witness and reporting of the violence.

IMPLICATIONS FOR NURSING MANAGEMENT: The findings highlight substantial variability in the content, structure and domains of existing WPV reporting forms used in healthcare institutions, indicating the need for standardised, evidence-based reporting tools that capture essential information relevant to nursing practice. Standardisation would improve comparability of WPV data across institutions and countries, facilitating more accurate benchmarking and global surveillance, particularly as nurses constitute the largest proportion of frontline healthcare workers. Additionally, nursing leaders, hospital administrators and health authorities can utilise these findings to strengthen institutional WPV policies by implementing clear and accessible reporting procedures and integrating domains related to prevention programmes, incident management and postincident support to guide policy development, staff training and resource allocation.

PMID:42365458 | DOI:10.1155/jonm/4803748

Breast J. 2026;2026(1):e4333748. doi: 10.1155/tbj/4333748.

ABSTRACT

INTRO: Divergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real-world patients with MBC in Washington State.

METHODS: Data were retrospectively analyzed using a linked cancer registry and insurance claims platform for patients with recurrent or de novo MBC diagnosed between 2008 and 2019.

RESULTS: We identified 1101 patients with MBC (median age: 66), 715 recurrent and 386 de novo. Most patients were White (89%), all were insured (Commercial [47%], Medicaid [4%], Medicare [35%], or multiple [13%]), and 15% lived in areas of high deprivation (Area Deprivation Index [ADI]: 8-10). Of the patients with recurrent MBC, less than half received a biopsy (49.5%) or biomarker reassessment (48.7%) to confirm the diagnosis of MBC. Patients treated at high- and medium-volume centers had higher rates of biopsy than low-volume clinics (51.9%, 54.3%, and 40.7%, respectively, p = 0.03). ET alone was more common in patients who did not undergo biopsy (62.3% vs. 37.7%, p < 0.001) or biomarker reassessment (62.7% vs. 37.3%, p < 0.001). Among the 677 patients with estrogen receptor (ER)+/HER2- MBC (de novo and recurrent), most received ET alone (69%), followed by CT (22%) and CDKi + ET (9%). Importantly, 40% of patients were treated before CDK4/6i approval. Most patients who received CDKi + ET were < 65 years old (65.2%, p < 0.02). Patients with commercial insurance were more likely to receive CDKi + ET compared to those with Medicare/Medicaid. (60.9% vs. 26.1%, p = 0.10).

CONCLUSION: Our findings highlight key gaps in MBC management and serve as a launch point for patient-centered and quality-promoting initiatives.

PMID:42365454 | DOI:10.1155/tbj/4333748

Expert Opin Biol Ther. 2026 Jun 28. doi: 10.1080/14712598.2026.2694688. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess prescription patterns and describe the long-term real-life effectiveness of different TNF inhibitors (TNFi) in juvenile idiopathic arthritis related uveitis (JIA-U).

METHODS: Patients with JIA-U treated with TNFi were retrospectively enrolled.

RESULTS: 96 JIA-U patients (77% female) with an age at diagnosis of 2.44 [interquartile range (IQR) 1.56-3.81] and a median follow-up of 19 years were included. Adalimumab was the most frequently prescribed TNFi (61%), followed by etanercept (19%), infliximab (15%) and golimumab (5%). Overall, adalimumab showed the lowest complications rate (51%; p < 0.001) and median number of uveitis relapse (1; IQR 0-2; p = 0.012). Conversely etanercept showed the highest median number of uveitis relapses (4; IQR 1-5). The cumulative incidences curves for ‘uveitis relapse’ were similar among TNFi. Conversely, when ‘treatment change’ was considered as the event, a significantly higher risk for patients treated with infliximab compared with those receiving adalimumab emerged (HR 3.06, 95% CI 1.41-6.63; p < 0.01).

CONCLUSIONS: All TNFi appear to be effective for long-term management of JIA-U. We observed some differences in number of uveitis relapses and ocular complication rates favoring adalimumab over infliximab and etanercept, findings to be further confirmed in prospective studies.

PMID:42365450 | DOI:10.1080/14712598.2026.2694688

Med Sci Monit. 2026 Jun 28;32:e951082. doi: 10.12659/MSM.951082.

ABSTRACT

BACKGROUND Migraine, a prevalent neurological disorder characterized by recurrent episodes of severe headache, significantly impacts individuals worldwide. This study aimed to evaluate migraine prevalence, identify key risk factors, assess the impact on job performance, and explore commonly used management strategies. MATERIAL AND METHODS This cross-sectional study involved corporate sector employees visiting outpatient neurology departments in Pakistan. A questionnaire was developed to quantify the overall burden of migraine. Inferential statistics, including the Mann-Whitney U test and Kruskal-Wallis H test, were used to evaluate group differences. An exploratory factor analysis (EFA) was conducted to confirm the questionnaire’s structural validity. RESULTS The questionnaire showed strong reliability (Cronbach’s alpha=0.81) and validity (S-CVI=0.86, KMO=0.82, P<0.001). Migraines significantly impacted job efficiency (p=0.015), with 43.8% experiencing episodes lasting 4 to 8 h. Gender (P=0.012), age (P=0.029), and income (P=0.045) were significantly associated with migraine burden. The most common triggers were stress (27.7%) and sleep deprivation (23.2%), while over-the-counter medication (62.5%) was the most commonly used treatment. Gender (ß=0.23, P=0.012), age (ß=-0.19, P=0.029), and income (ß=-0.17, P=0.045) significantly predicted the migraine burden. A higher migraine burden significantly predicted lower job efficiency (ß=-0.31, P=0.015). CONCLUSIONS Migraines have a significant impact on job efficiency in the Pakistani corporate sector, necessitating comprehensive management strategies and targeted interventions to mitigate their effects.

PMID:42365430 | DOI:10.12659/MSM.951082

J Tradit Chin Med. 2026 Jun;46(3):715-725. doi: 10.19852/j.cnki.jtcm.2026.03.011.

ABSTRACT

OBJECTIVE: To investigate the association between Traditional Chinese Medicine (TCM) constitution and fear of cancer recurrence (FCR) in breast cancer survivors.

METHODS: A cross-sectional study was conducted among breast cancer patients at Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine, China, during the period from April 9, 2023, to July 2, 2024. Data were collected on participants’ common sociodemographic characteristics, medical history, scores on the Fear of Cancer Recurrence Inventory (FCRI), and TCM constitution classification. Statistical analyses employed independent samples t-test, χ ² test, Fisher’s exact test, one-way analysis of variance, Spearman’s correlation coefficient, multiple linear regression analysis, and multivariate logistic regression analysis.

RESULTS: A total of 279 eligible breast cancer patients enrolled in this study. The most prevalent TCM constitutions were ‘Qi-depression’, ‘Peaceful’ and ‘Yang-deficiency’. All nine TCM constitutions of breast cancer patients exhibited significant correlations with FCR scores. The strongest positive correlation was observed between ‘Qi-stagnation’ and FCR (r= 0.5576, P < 0.0001), followed by ‘Qi-deficiency’ (r = 0.4465, P < 0.0001). By contrast, the Peaceful correlation showed a significant negative correlation with FCR (r = －0.363, P < 0.0001). Multiple linear regression analysis showed that TCM constitution, lymph node metastasis, and endocrine therapy were influencing factors for FCR in breast cancer patients (P < 0.05). Additionally, multivariate logistic regression analysis was performed to identify factors associated with TCM constitution in breast cancer patients. After adjusting for potential confounding factors including age, disease stage, pathological type, immunohistochemical status, lymph node metastasis, disease duration, and treatment modality, FCR, disease stage, age, and surgical modality were found to be significantly associated with TCM constitution (all P < 0.05).

CONCLUSION: This study demonstrates a significant association between TCM constitution and FCR in breast cancer patients, suggesting that FCR can potentially be interpreted within the theoretical framework of TCM. These findings thus provide a theoretical foundation for TCMC-informed management strategies targeting FCR in breast cancer patients.

PMID:42365418 | DOI:10.19852/j.cnki.jtcm.2026.03.011

J Tradit Chin Med. 2026 Jun;46(3):684-694. doi: 10.19852/j.cnki.jtcm.20251030.001.

ABSTRACT

OBJECTIVE: To observe the characteristics of acupoint sensitization in patients with essential hypertension, analyze the mechanical pain threshold and tenderness threshold of each acupoint, and summarize the clinical characteristics of high-sensitivity acupoints.

METHODS: This study employed a cross-sectional matched case-control design and enrolled a total of 448 volunteer participants, including 224 patients with hypertension and 224 healthy controls. The main outcome measures included measuring the mechanical pain threshold and tenderness threshold of 16 highly sensitive acupoints in both hypertensive subjects and healthy controls. The receiver operating characteristic curve method was used to evaluate the sensitivity of each acupoint. Additionally, the rules of mechanical pain threshold, tenderness threshold sensitization rate, and degree of sensitization of each acupoint in hypertension patients were summarized to identify the optimal highly sensitive acupoints related to hypertension.

RESUITS: The mechanical pain threshold and tenderness threshold of hypertensive patients were significantly lower than those of healthy subjects, the difference was statistically significant (P < 0.001), indicating that the mechanical pain threshold and tenderness threshold of hypertensive patients at various points had a downward trend. Acupoints with high incidence of sensitization in hypertensive patients include Quchi (LI11), Taichong (LR3), Fenglong (ST40), Xingjian (LR2), Taixi (KI3) and Renying (ST9).

CONCLUSION: This study successfully achieved the objective of exploring acupoint sensitization in patients with primary hypertension. Hypertensive patients exhibited significantly lower mechanical pain thresholds and pressure pain thresholds compared to healthy subjects. These findings provide clinical evidence for acupoint selection in acupuncture treatment for primary hypertension.

PMID:42365415 | DOI:10.19852/j.cnki.jtcm.20251030.001

BMC Pharmacol Toxicol. 2026 Jun 27. doi: 10.1186/s40360-026-01171-7. Online ahead of print.

ABSTRACT

BACKGROUND: Oral ivermectin is commonly used as a second-line treatment for classic scabies, particularly in cases of treatment failure or poor adherence to topical permethrin, the standard of care. However, the comparative efficacy and safety of oral ivermectin, alone or in combination with permethrin, remains unclear. This systematic review and network meta-analysis evaluated the efficacy and safety of these treatments to guide clinicians and policymakers.

METHODS: On April 17, 2022, we conducted a comprehensive search of databases, including MEDLINE and CENTRAL, as well as secondary sources for randomized controlled trials comparing oral ivermectin, alone or in combination with topical permethrin, and topical permethrin, or any of the three with other scabicides or placebo/vehicle/no treatment among patients with classic scabies. The primary outcomes were clinical cure and serious adverse events. We assessed the risk of bias using the Cochrane Risk of Bias 2.0 and evaluated the certainty of evidence using the GRADE approach. Network meta-analyses were performed using available case analysis and a random-effects model. Sensitivity and subgroup analyses explored the impact of methodologic decisions and known effect modifiers. Effect estimates and certainty of evidence ratings were presented in the Summary of Findings tables.

RESULTS: We included 38 RCTs (N = 4879), most of which had moderate or high overall risk of bias. Oral ivermectin, given in varying dosing regimens (single dose, two-dose, or flexible dosing) showed little or no difference in clinical cure rates compared to permethrin, which was also administered in different dosing schedules, at one to two weeks post-treatment (network RR 0.95, 95% CI [0.89, 1.02]; 30 RCTs, N = 3469; global inconsistency P = 0.42; low certainty evidence). Serious adverse events were rare (1/3212; 0.03%, 95% CI [0.000079, 0.17]; 29 RCTs; very low certainty evidence). One child who received oral ivermectin was hospitalized for cellulitis but eventually recovered. Limited data (1 RCT; n = 100) suggested that combination oral ivermectin/permethrin may be as effective or more effective than permethrin for clinical cure at one to two weeks (network RR 1.21, 95% CI [0.94, 1.56]; low certainty evidence).

CONCLUSION: There may be little or no difference between oral ivermectin and permethrin in clinical cure. However, combination therapy with oral ivermectin and permethrin may be as good as or better than permethrin alone. The rate of serious adverse events is uncertain. Further well-designed RCTs should be conducted to confirm the findings and inform clinical practice and public health policy on scabies control.

STUDY REGISTRATION: UPM RGAO-2021-1058; PHRR230322-005013; PROSPERO CRD42022278007.

PMID:42365388 | DOI:10.1186/s40360-026-01171-7