Tag: statistics

Perioper Med (Lond). 2026 Feb 24. doi: 10.1186/s13741-026-00659-4. Online ahead of print.

ABSTRACT

Bayesian methods offer an intuitive and coherent statistical framework for updating probabilistic beliefs by integrating prior knowledge-whether from existing data or expert consensus-with new evidence via likelihood functions to generate posterior probability distributions. This approach yields clinically meaningful outputs, such as credible intervals and probabilities of treatment benefit, and can incorporate thresholds relevant to practice, like the region of practical equivalence (ROPE). Recent advances in computation-including Markov chain Monte Carlo (MCMC) sampling, Hamiltonian Monte Carlo algorithms, and probabilistic programming languages like Stan and JAGS- have made Bayesian approaches feasible even for complex hierarchical models. In perioperative medicine, these methods are particularly valuable for (1) complementing trial results by quantifying clinically important effects in the context of statistically nonsignificant findings or modest probabilities of benefit despite statistical significance, (2) enhancing meta-analyses through coherent integration of heterogeneous studies and sparse data, and (3) enabling adaptive and platform trial designs through continuous evidence synthesis. The ability to incorporate informative priors can complement existing knowledge, especially in small-sample studies, which are common in perioperative medicine, where traditional approaches provide insufficient precision. Although concerns remain regarding subjectivity in prior specification, these are increasingly addressed through structured guidelines, benchmark priors, and comprehensive sensitivity analyses. Altogether, Bayesian methods provide a flexible and powerful alternative for generating actionable insights in complex clinical settings, including in perioperative care.

PMID:41736024 | DOI:10.1186/s13741-026-00659-4

BMC Med Educ. 2026 Feb 24. doi: 10.1186/s12909-026-08821-8. Online ahead of print.

ABSTRACT

BACKGROUND: In undergraduate medical education, the ability to manage clinical-cases is a core competency expected of future physicians. Traditionally, this skill is developed through repeated exposure to real patient encounters in clinical settings. However, increasing patient safety concerns, limited clinical opportunities, and faculty workload constraints have made it increasingly difficult for students to access sufficient clinical practice. As a result, innovative solutions such as AI-based simulations are being explored to supplement clinical training. Among these, large language models (LLMs) offer promising potential for generating diverse, interactive, and context-specific clinical scenarios that can support competency-based education. This study aims to evaluate and compare the effectiveness and educational utility of four widely used and accessible LLMs; ChatGPT-4o, Claude 3.7 Sonnet, Gemini 1.5, and DeepSeek (Chat), in generating clinical scenarios for Turkish undergraduate medical education, and to identify the model that produces the most accurate, understandable, and pedagogically appropriate content aligned with national medical education standards.

METHODS: A convergent parallel mixed methods design was employed. Using standardized prompts based on Türkiye’s National Core Undergraduate Medical Education Program-2020, scenarios on three common infectious diseases were generated by each LLM. Twenty-five senior medical students and five expert clinicians evaluated the Turkish-language scenarios using structured rating forms and open ended feedback. Quantitative data were analyzed with Friedman and Wilcoxon tests; qualitative data underwent thematic analysis.

RESULTS: Claude received the highest ratings for clarity, realism, and support for clinical reasoning. Statistically significant differences favored Claude over Gemini and DeepSeek (p < 0.05). Qualitative feedback supported these results, highlighting Claude’s educational value and linguistic precision. ChatGPTperformed moderately, while Gemini and DeepSeek exhibited issues with realism and coherence.

CONCLUSIONS: In this study, Claude was rated highest for generating Turkish-language scenarios perceived as clinically appropriate and pedagogically useful for undergraduate medical education in Türkiye. Overall, the findings provide preliminary evidence on perceived scenario quality across models and support further multicenter and outcomes-focused studies to evaluate feasibility, implementation, and educational impact in diverse settings. Future research should also examine how LLM-generated scenarios can be used as supplementary materials in simulation-based learning.

PMID:41736016 | DOI:10.1186/s12909-026-08821-8

BMC Endocr Disord. 2026 Feb 24. doi: 10.1186/s12902-026-02205-1. Online ahead of print.

ABSTRACT

BACKGROUND: Negative perceptions of insulin therapy are common in diabetes mellitus (DM) patients and may delay treatment. Insulin perception has been studied in type 2 diabetics but not type 1 or prediabetics. The aim of this study was to determine the differences in perceptions of insulin use between diabetes types.

METHODS: This cross-sectional study was conducted at a tertiary care hospital between December 2023 and April 2024. Participants were adult diabetes outpatient clinic patients with T1DM, T2DM, or prediabetes. The validated Insulin Therapy Appraisal Scale (ITAS) quantified patients’ insulin therapy perceptions. Patients who did not use insulin and were in the prediabetes category answered the questions based on their current knowledge about insulin treatment. Higher scores on the positive sub-dimension indicate more favorable perceptions of insulin therapy, whereas higher scores on the negative sub-dimension and total ITAS reflect more negative perceptions. p-value < 0.05 was considered statistically significant.

RESULTS: A total of 160 adult patients were included in the study. Patients with T1DM demonstrated significantly higher ITAS positive sub-dimension scores and lower negative sub-dimension and total ITAS scores compared with patients with T2DM and prediabetes (p < 0.05). No significant differences in ITAS scores were observed between the T2DM and prediabetes groups. Correlation analyses showed that the ITAS positive sub-dimension score was inversely associated with age and C-peptide levels. In contrast, negative sub-dimension and total ITAS scores were positively correlated with age and C-peptide levels but negatively correlated with diabetes duration. Marital status, highest education level, and regular blood glucose monitoring were found to significantly influence insulin perception (p < 0.05). Female patients exhibited more positive perceptions, whereas insulin users, patients without diabetes-related complications, and those who exercised regularly demonstrated less negative attitudes toward insulin therapy.

CONCLUSION: Patients with T1DM have significantly more positive perceptions of insulin therapy compared with patients with T2DM and prediabetes. Identifying factors influencing insulin-related perceptions may help improve acceptance of insulin therapy and enhance treatment adherence in patients with diabetes.

CLINICAL TRIAL NUMBER: N/A.

PMID:41736002 | DOI:10.1186/s12902-026-02205-1

BMC Med. 2026 Feb 24. doi: 10.1186/s12916-026-04716-z. Online ahead of print.

ABSTRACT

BACKGROUND: Sex and gender influence medical decision making, yet little is known about how the sex of a consultant shapes the prescribing behaviour of female primary care physicians (PCPs). This study examined whether consultant sex affects female PCPs’ likelihood of following recommendations that conflict with clinical guidelines and explored the factors underlying trust in consultants.

METHODS: We conducted a web-based experimental study using case vignettes on sleeping medication and antibiotics. A total of 482 female PCPs in England were randomly assigned to conditions with no recommendation or with recommendations from male or female consultants. The outcomes included prescribing decisions, confidence, perceived difficulty, and effort.

RESULTS: In the absence of recommendations, female PCPs rarely prescribe non-guideline medications, reflecting cautious baseline behaviour. Consultant recommendations increased prescribing across both vignettes, with higher rates in both consultant conditions than in the control condition (sleeping medication: 43.3% male vs. 33.6% female vs. 30.4% control, χ²(2, N = 482) = 6.61, p = 0.037; antibiotics: 14.9% male vs. 14.5% female vs. 5.3% control, χ²(2, N = 482) = 9.55, p = 0.008). Regression analyses confirmed that both male and female consultant recommendations significantly increased the odds of prescribing antibiotics compared with the control condition (male: OR = 3.33, 95% CI [1.43-7.76]; female: OR = 3.29, 95% CI [1.39-7.79]). Only the male consultant’s recommendation significantly increased the prescribing of sleeping medication (OR = 1.89, 95% CI [1.13-3.15]), whereas the female consultant’s recommendation had no significant effect (OR = 1.22, 95% CI [0.71-2.10]). However, direct comparisons between male and female consultants were not statistically significant. Across conditions, participants generally reported high confidence in their decisions and perceived low difficulty and effort. Consultant recommendations in the antibiotic vignette were associated with lower confidence and higher perceived difficulty and effort.

CONCLUSIONS: Consultant recommendations, independent from consultant’s sex, increased the likelihood of non-guideline prescribing among female PCPs. The absence of statistically significant differences between male and female consultants suggests that the presence of a recommendation itself may be more influential than consultant sex. Strengthening physicians’ confidence and supporting guideline-based decision-making may help reduce susceptibility to social influence.

PMID:41735981 | DOI:10.1186/s12916-026-04716-z

BMC Oral Health. 2026 Feb 24. doi: 10.1186/s12903-026-07974-8. Online ahead of print.

ABSTRACT

OBJECTIVES: This in vitro study aimed to evaluate the effect of laser photobiomodulation on the structural integrity and degradation resistance of two types of platelet-rich fibrin membranes: Leukocyte- and Platelet-Rich Fibrin (L-PRF) and Titanium-Prepared Platelet-Rich Fibrin (T-PRF). Structural changes in the fibrin network were assessed using Scanning Electron Microscopy (SEM) and light microscopy.

MATERIALS AND METHODS: Our study was performed on 15 systemically healthy individuals and four L-PRF and four T-PRF membranes obtained from each individual, totaling 120 samples. L-PRF was prepared first using standard vacuum glass tubes. Two weeks later, new blood samples were collected from the same individuals, and T-PRF membranes were prepared using sterile titanium tubes to enhance biocompatibility. Both membrane types were obtained by centrifugation at 2700 revolutions per minute (rpm) for 12 min. Two of the four membranes were treated with a diode laser device at a wavelength of 980 nanometers (nm) and a power of 0.5 W (W) in continuous mode for 3 min at a distance of 1-2 milimeters (mm). The other two membranes were not lasered. One of the laser treated L-PRF and T-PRF membranes was cut in half and stored under appropriate conditions for histological examination and SEM analysis. The other membrane was separated for degradation. The same procedures were performed for L-PRF and T-PRF membranes without laser treatment.

RESULT: Laser-treated L-PRF and T-PRF membranes showed lower degradation percentages compared to non-laser-treated membranes, but this difference did not reach statistical significance (p > 0.05). However, when laser treated L-PRF and T-PRF membranes were compared, the degradation percentage was significantly higher in L-PRF membrane (p < 0.05). Histologic examination showed that the fibrin network structure of the laser-applied L-PRF and T-PRF membrane groups was significantly denser than the non-laser-applied groups (p < 0.05). SEM analysis revealed that the fibrin network was denser, thicker and more complex in the laser-applied L-PRF and T-PRF membrane groups.

CONCLUSION: In this study, the biostimulative effect of laser increased the fibrin network thickness, cross-link structure and density of L-PRF and T-PRF membranes. When the degradation percentages on the membranes were evaluated, no significant difference was observed between the groups.

CLINICAL RELEVANCE: Understanding how laser photobiomodulation affects the structure and degradation resistance of both L-PRF and T-PRF membranes can guide clinicians in selecting the most suitable autologous biomaterial for enhancing wound healing and regenerative outcomes in dental procedures. The structure of PRF membranes used in dentistry can be improved using the biostimulative effect of the laser. This application may increase the use of these autologous and easily obtainable materials in treatments.

PMID:41735954 | DOI:10.1186/s12903-026-07974-8

BMC Med Educ. 2026 Feb 24. doi: 10.1186/s12909-026-08858-9. Online ahead of print.

ABSTRACT

BACKGROUND: Subspecialty choice plays a pivotal role in physicians’ career satisfaction and professional trajectory. However, decision regret regarding subspecialty selection has been underexplored, despite its potential impact on well-being and retention.

METHODS: A cross-sectional study was conducted among 615 young and middle-aged physicians (aged 25-55) from secondary and tertiary hospitals in China. Participants completed an online questionnaire including the Decision Regret Scale (DRS), a simplified Maslach Burnout Inventory (MBI), Minnesota Satisfaction Questionnaire (MSQ), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses involved ANOVA, Spearman’s correlation, and multivariate linear regression to identify factors associated with decision regret.

RESULTS: Among participants, 9.4% reported high regret, 37.6% moderate regret, and 53.0% low regret. Higher regret was significantly associated with male gender (P = 0.039), younger age (P = 0.019), and higher professional title (P = 0.003). Regression analysis revealed that greater burnout (B = 1.521, P < 0.001) predicted higher regret, while higher job satisfaction (B = – 0.339, P < 0.001) and resilience (B = – 0.588, P = 0.001) were protective factors.

CONCLUSION: Nearly one in five young and middle-aged Chinese physicians experience high regret in subspecialty choice, influenced by gender, age, burnout, satisfaction, and resilience. Targeted interventions addressing these factors may mitigate regret and enhance physician well-being and retention.

PMID:41735953 | DOI:10.1186/s12909-026-08858-9

BMC Pediatr. 2026 Feb 24. doi: 10.1186/s12887-026-06583-2. Online ahead of print.

NO ABSTRACT

PMID:41735929 | DOI:10.1186/s12887-026-06583-2

BMC Infect Dis. 2026 Feb 24. doi: 10.1186/s12879-026-12576-4. Online ahead of print.

NO ABSTRACT

PMID:41735928 | DOI:10.1186/s12879-026-12576-4

BMC Cancer. 2026 Feb 24. doi: 10.1186/s12885-026-15779-9. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer is one of the malignant tumors, and postoperative recurrence or metastasis is a key factor to the survival of patients.

METHODS: Patients who underwent colorectal cancer surgery between January 2016 and December 2020 were included. Multivariate Logistic regression was used to analysis statistically, including recurrence or metastasis, liver metastasis, lung metastasis and death respectively.

RESULTS: 419 cases of colorectal cancer were included in the clinical study according to the screening criteria. Multivariate Logistic regression analysis showed that Mesocolon fascia infiltration (OR,2.769; 95%CI, 1.374-5.579, P = 0.004), Total number of lymph nodes (OR,0.949; 95%CI, 0.99-0.988, P = 0.011), The number of metastatic lymph nodes (OR,1.173; 95%CI, 1.063-1.294, P = 0.001), Tumor TNM stage (P < 0.001), were independent risk factors for postoperative recurrence or metastasis of colorectal cancer. Mesocolic fascia infiltration (OR,3.113; 95%CI, 1.209-8.015, P = 0.019) and TNM stage (P = 0.014) were independent risk factor for postoperative liver metastasis of colorectal cancer. TNM stage of tumor (P = 0.037) was an independent risk factor for pulmonary metastasis after colorectal cancer surgery.

CONCLUSIONS: Multifactor logistic regression analysis showed mesocolon fascia infiltration, total number of lymph nodes, the number of metastatic lymph nodes and tumor TNM stage were independent risk factor for postoperative recurrence and metastasis of colorectal cancer.

PMID:41735923 | DOI:10.1186/s12885-026-15779-9

BMC Public Health. 2026 Feb 24. doi: 10.1186/s12889-026-26680-2. Online ahead of print.

ABSTRACT

BACKGROUND: Air pollution remains one of the most significant environmental health threats in urban areas. Ground-level O₃, a secondary pollutant formed through photochemical reactions of nitrogen oxides (NOx) and volatile organic compounds (VOCs) under sunlight, can lead to serious respiratory and cardiovascular effects. This study aimed to quantify the short-term mortality and economic burden attributable to O₃ exposure in Qom, central Iran, during the summer of 2019, providing local evidence to support air quality management policies.

METHODS: Hourly O₃ concentration data were collected from the Qom Environmental Protection Agency for April to August 2019. After data cleaning and interpolation, the daily maximum 8-h average O₃ concentration was calculated. Health impact and related economic burden were estimated using the U.S. EPA’s BenMAP-CE model (version 1.5.8.11). Relative risk (RR) and baseline incidence (BI) values for cardiovascular and respiratory mortality were obtained from previous epidemiological studies. The Value of Statistical Life (VSL) was adjusted for Iran’s gross domestic product (GDP) to estimate the economic cost. Descriptive statistics and concentration-response functions were applied to determine avoidable deaths and associated losses.

RESULTS: The mean 8-h maximum O₃ concentration during the study period was 0.16 ppm, exceeding the EPA guideline (0.07 ppm) by 2.18 times. Short-term exposure at this level was linked to an estimated 239 premature deaths, including 190 from cardiovascular and 49 from respiratory diseases. The highest impact was observed in adults aged 30-39 years. The total economic loss attributed to these deaths was approximately 43.6 million USD, indicating a substantial burden on public health and the economy.

CONCLUSIONS: This study highlights the urgent need for effective air quality management in Qom. Reducing emissions of O₃ precursors such as NOx and VOCs, especially during warm months, could yield considerable public health and economic benefits. Localized assessments using tools like BenMAP-CE can inform evidence-based policymaking and contribute to sustainable urban development.

PMID:41735903 | DOI:10.1186/s12889-026-26680-2