Tag: statistics

Inquiry. 2025 Jan-Dec;62:469580251320174. doi: 10.1177/00469580251320174.

ABSTRACT

Health care price transparency aims to empower patients to make better-informed purchasing decisions. However, the prospective availability of patients’ out-of-pocket costs may lead to an increased rate of forgone care. The objective of this study was to examine whether obtaining a prospective out-of-pocket cost estimate is associated with the likelihood of canceling or not arriving at a scheduled outpatient health care appointment. We surveyed adult individuals with scheduled outpatient imaging appointments at a large health care system in Georgia. In this case-control pilot study, we estimated the adjusted association between obtaining an out-of-pocket cost estimate for a scheduled imaging appointment (did not obtain an estimate, did not seek an estimate but received it via an unsolicited phone call from the health care system, and actively sought and obtained an estimate) and not attending the appointment using multivariable logistic regression that controlled for the type of primary health insurance and patient demographics. Actively seeking an out-of-pocket cost estimate was not associated with appointment cancelation or no-show (adjusted odds ratio [aOR] = 0.81, P = .75). Passively receiving an out-of-pocket cost estimate via an unsolicited phone call from the health care system was marginally associated with lower odds of appointment cancelation or no-show (aOR = 0.24; P = .076). This study did not find evidence of an association between prospective exposure of patients to out-of-pocket cost information and the likelihood of health care appointment cancelation or no-show.

PMID:39950202 | DOI:10.1177/00469580251320174

Int J Public Health. 2025 Jan 29;70:1607605. doi: 10.3389/ijph.2025.1607605. eCollection 2025.

ABSTRACT

OBJECTIVES: Physical activity and costs have been consistently related each other, but mostly in cross-sectional investigations. This study aims to investigate the relationship between changes in physical activity level and changes in healthcare costs among older diabetic adults in an 8-year follow-up study.

METHODS: The study followed 151 diabetic adults ≥50 years of age, for a period of 8 years, who were patients of Basic Health Care Units in the city of Bauru (Brazil). Medical records were consulted to obtain information on healthcare costs. Physical activity level was assessed through an interview. Data analysis included descriptive statistics, analysis of variance, and linear regression.

RESULTS: Participants who increased leisure-time physical activity from 2010 to 2018 accumulated less healthcare costs from 2020 to 2018. The magnitude of the relationship was small (r = -0.233 [95% CI: -0.379 to -0.076]).

CONCLUSION: In summary, among diabetic patients, to increase leisure-time physical activity from 2010 to 2018 was inversely related to the amount of healthcare costs spent over the same period of 8 years.

PMID:39950195 | PMC:PMC11813648 | DOI:10.3389/ijph.2025.1607605

Front Pediatr. 2025 Jan 30;13:1519017. doi: 10.3389/fped.2025.1519017. eCollection 2025.

ABSTRACT

PURPOSE: To explore the consistency and efficacy of optical coherence tomography (OCT) for the evaluation of ocular torsion angle compared to fundus photography in children.

METHOD: Patients who had undergone fundus photography and OCT within 1 day were included in this study. The fundus photographs were taken using a fundus camera and then imported into the Adobe Photoshop 2021 software. The fovea-disc angle (FDA) was calculated manually. OCT was used to automatically detect the centers of the optic disc and fovea, and the software then calculated the FDA on the same device. The means and ranges of variables were calculated in this study. Group differences were assessed using the paired t-test. Statistical significance was determined when P-values were <0.05. Bland-Altman plots were constructed to verify the agreement of the FDAs measured by fundus photography and OCT respectively.

RESULTS: A total of 100 patients were included and the objective measurements of the ocular torsion angles via OCT and fundus photography were similar. The mean FDA of 32 patients aged 2-6 years old was -7.84 ± 4.67° via fundus photography and -6.71 ± 6.19° via OCT. The mean FDA of 68 patients aged 6-18 years old was -8.47 ± 5.22° via fundus photography and -8.97 ± 5.41° via OCT. According to the receiver operational characteristic (ROC) curves of the FDA for diagnosing ocular extorsion, the area under the ROC curve was greatest for OCT (0.943, 95% CI: 0.902-0.984), followed by fundus photography (0.92, 95% CI: 0.86-0.979). With the Youden method, the optimal cut-off point for diagnosing ocular extorsion with OCT was -6.35°. OCT demonstrated a sensitivity of 100% and a specificity of 49.2%. Furthermore, the optimal cut-off point for diagnosing ocular extorsion with fundus photography was -6.5°.

CONCLUSION: The comparison of FDAs showed good agreement between fundus photography and OCT. Thus, OCT can evaluate ocular torsion angle effectively in children.

PMID:39950158 | PMC:PMC11821915 | DOI:10.3389/fped.2025.1519017

Front Pediatr. 2025 Jan 30;13:1500500. doi: 10.3389/fped.2025.1500500. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the diagnostic efficacy and determine the optimal cut-off values of lung ultrasound score for diagnosing neonatal respiratory distress syndrome and its accuracy in assessing the efficacy of neonatal respiratory distress syndrome.

METHOD: This prospective study included 100 neonates with suspected neonatal respiratory distress syndrome. Each patient underwent both the 14-zone and 12-zone lung ultrasound methods, as well as a chest x-ray, performed after birth and before initiating drug treatment. Surfactant replacement therapy was administered to patients who were diagnosed with neonatal respiratory distress syndrome and met the criteria for medication. Lung ultrasound was conducted and recorded at the 24th hour, the 48th hour, the 72nd hour, and the 7th day after drug administration. ROC curve analysis, Kappa statistics, and ANOVA were utilized to identify the optimal cut-off values for the lung ultrasound scores in diagnosing neonatal respiratory distress syndrome.

RESULTS: 89 neonates were diagnosed with respiratory distress syndrome, of whom 64 received surfactant replacement therapy. The mean scores of 12-zone lung ultrasound score, 14-zone lung ultrasound score, and chest x-ray score are 18.22 ± 7.15, 38.92 ± 9.69, and 2.15 ± 0.97, respectively. The diagnostic AUC for the 12-zone lung ultrasound score is 0.84 (95% CI: 0.73-0.95), with an optimal cut-off value of 13.5 for diseased vs. not diseased, while the AUC for the 14-zone lung ultrasound score is 0.88 (95% CI: 0.76-0.99), with an optimal cut-off value of 34 for diseased vs. not diseased. There is significant concordance between the neonatal lung ultrasonography scores and the chest x-ray score for diagnosis respiratory distress syndrome (P < 0.01). The optimal cut-off values for the grading diagnosis of neonatal respiratory distress syndrome using the 14-zone lung ultrasound score are identified as 36.5, 40.5, and 44.5. The 12-zone lung ultrasound score does not have a significant difference between the 12th hour after receiving surfactant replacement therapy and the 48th hour after treatment (P = 0.08). All other comparisons demonstrated significant differences.

CONCLUSION: The 14-zone lung ultrasound score demonstrates higher diagnostic efficacy in diagnosing neonatal respiratory distress syndrome and can accurately evaluate the early efficacy of surfactant replacement therapy in neonates.

PMID:39950156 | PMC:PMC11821582 | DOI:10.3389/fped.2025.1500500

Front Med (Lausanne). 2025 Jan 30;12:1528613. doi: 10.3389/fmed.2025.1528613. eCollection 2025.

ABSTRACT

BACKGROUND: Research indicates that the ratio of fasting blood glucose (FBG) to serum high-density lipoprotein cholesterol (HDL-C) (GHR) can accurately predict many diseases. Nevertheless, the relationship between GHR and the risk of gallbladder stones remains unclear. This study investigates the possible relationship between GHR and the incidence of gallbladder stones.

METHODS: This research used information gathered from the National Health and Nutrition Examination Survey (NHANES) between March 2017 and March 2020. A calculation was made to determine the GHR by dividing the fasting blood glucose level by the HDL-C level. Several statistical methods, including analysis of threshold effects, smoothed curve fitting, multiple logistic regression modeling, and subgroup analysis, were utilized to investigate the connection between GHR and gallstones.

RESULTS: In 3898 U.S. adults, GHR was significantly positively associated with the prevalence of gallbladder stones. In a fully adjusted model, the incidence of gallbladder stones increased by 7% with each 1-unit increase in GHR (OR [95% Cl] = 1.07 [1.02, 1.14]). Compared with members in the low group, those in the high group had a 100% higher likelihood of getting gallbladder stones (OR [95% CI] = 2.00 [1.31, 3.04]), and this stabilizing connection was always present in the different subgroups. With the help of smooth curve fitting, the research also showed that there was a connection that was formed like an upside-down L shape between GHR and gallbladder stones. The analysis of the threshold effect revealed that the inflection point was 4.28.

CONCLUSION: The results revealed an inverted L-shaped connection between GHR and gallbladder stones. Keeping GHR levels within a certain range is associated with a lower incidence of gallstones in the general population.

PMID:39950129 | PMC:PMC11821630 | DOI:10.3389/fmed.2025.1528613

Front Pharmacol. 2025 Jan 30;16:1454029. doi: 10.3389/fphar.2025.1454029. eCollection 2025.

ABSTRACT

INTRODUCTION: Traditional Chinese medicine (TCM) prescriptions are generally formulated by experienced TCM researchers based on their expertise and data statistical methods.

METHODS: In order to predict TCM formulas for diabetes more accurately, this paper proposes a novel multi-source ensemble prediction method that combines machine learning ensemble techniques and multi-source data. In this method, the multi-source data contain datasets based on the components and targets (DPP-4 and GLP-1). Gradient boosting decision tree (GBDT), flexible neural tree (FNT), and Light Gradient Boosting Machine (LightGBM) algorithms are trained using these two types of datasets, respectively. The compound dataset from the TCMSP database is then used as testing data to predict and screen the active ingredients. The frequencies of occurrences of medicinal herbs corresponding to these three algorithms are obtained, each containing an active ingredient list. Finally, the frequencies of occurrences of the medicinal herbs obtained from the three algorithms using the component and target datasets are integrated to select duplicate drugs as the candidate drugs for diabetes treatment.

RESULTS: The identification results reveal that theproposed ensemble method has higher accuracy than GBDT, FNT, and LightGBM. The medicinal herbs predicted include Lycii fructus, Amygdalus communis vas, Chrysanthemi flos, Hippophae fructus, Mori folium, Croci stigma, Maydis stigma, Ephedrae herba, Cimicifugae rhizoma, licorice, and Epimedii herba, all of which have been proven effective in the treatment of diabetes.

DISCUSSIONS: The results of network pharmacology show that myrrha can play a role in treating diabetes through multiple targets and pathways.

PMID:39950110 | PMC:PMC11822566 | DOI:10.3389/fphar.2025.1454029

Front Pharmacol. 2025 Jan 30;16:1475297. doi: 10.3389/fphar.2025.1475297. eCollection 2025.

ABSTRACT

BACKGROUND: The World Health Organization (WHO) reports that a significant portion of the global population relies on traditional herbal medicine (THM) due to limited access to safe and high-quality modern medical care. In developing countries, it is difficult to guarantee the safety and quality of THM due to weak enforcement of the legal and regulatory framework. Hence, the study attempted to evaluate the country’s legislative and regulatory framework by comparing it with developed and developing countries that have well-established systems and identify gaps for future roadmaps in the THM landscape.

METHODS: A cross-sectional study and archival review were performed from November 2021 to March 2022 G.C. to contrast the legislative and regulatory framework for THM regulation with other selected countries like Africa, India, and China. A total of 237 regulatory personnel participated in the study. Data were collected through an archive assessment, self-administrative questionnaires, and literature searches. Secondary data were extracted from the archival review, and the findings were summarized and presented in tabular and text formats. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) software version 26, with outputs presented in text, table, and figure form.

RESULTS: The archival review of the study found that Ethiopia’s THM legislative and regulatory framework is still in a developmental phase, particularly when compared with countries that have more established systems. A cross-sectional study indicated that approximately 79.7% of participants were aware of THM-related content in the current legislation. However, 82.3% reported they had not received any formal training on THM regulations. For future roadmaps, 73.8% of respondents believed the government showed a commitment to supporting THM regulation, though 51.9% of participants noted limited knowledge and awareness of THM practices and product regulations. In terms of quality, safety, efficacy, rational use, and storage conditions, 49.8% of respondents rated regulatory implementation practice as not satisfactory. In this study, most study participants raised concerns about the performance of quality control parameters. Among regulatory experts, weak performance was identified in the practical implementation of THM regulatory activities, with 70.2% of weak performance observed at the federal level and 41.7% at the regional level. Key barriers to effective regulation included a lack of research on herbal medicines (90.3%) and insufficient regulatory mechanisms (87.8%). Additional challenges for regulatory offices included traditional healers’ reluctance to engage with scientific communities (56.5%), inadequate inspections (55.3%), and limited data on the safety, quality, and efficacy of certain medicinal plants (54.4%).

CONCLUSION: Overall, the Ethiopian Food and Drug Authority (EFDA) is significantly strengthening the legislative and regulatory framework for traditional herbal medicines (THM), although full implementation is still forthcoming. This study highlights the need for comprehensive policy development, improved training initiatives, and reinforced regulatory systems to effectively monitor and regulate THM practices. For future roadmaps, collaboration among traditional healers, regulatory bodies, and scientific communities, along with supporting evidence-based research, could further enhance THM regulation in Ethiopia. These collaborative endeavors are critical for promoting the safety and quality of products derived from herbal medicines.

PMID:39950109 | PMC:PMC11821589 | DOI:10.3389/fphar.2025.1475297

Front Oncol. 2025 Jan 30;14:1491159. doi: 10.3389/fonc.2024.1491159. eCollection 2024.

ABSTRACT

BACKGROUND: Prostate cancer is the second most diagnosed cancer in men globally, with high prevalence in North America, Europe, and Australia. Occupational exposures, including metalworking fluids (MWFs), have emerged as a potential risk factor for prostate cancer, yet comprehensive studies on this association are limited.

OBJECTIVE: This study aims to systematically review and conduct a meta-analysis to examine the incidence and mortality of prostate cancer linked to MWF exposure.

METHODS: A systematic review and meta-analysis were conducted following the PRISMA guidelines. A comprehensive search strategy was developed to identify relevant studies from PubMed, Scopus, Embase, and Web of Science. Inclusion criteria encompassed studies reporting on the association between MWF exposure and prostate cancer incidence or mortality. Data extraction and risk of bias assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analyses were conducted using STATA version 17.

RESULTS: The search identified 1376 unique references, with 5 studies meeting the inclusion criteria for the meta-analysis. These studies, conducted in the USA, primarily involved auto workers and reported Standardized Mortality Ratio (SMR), Relative Risk (RR) and 95% Confidence Interval (95%CI) measures. Meta-analysis revealed an overall RR of 1.06 (95% CI: 1.01-1.11) for prostate cancer incidence and an overall SMR of 1.20 (95% CI: 1.09-1.31) for prostate cancer mortality, indicating a statistically significant increased risk and mortality among MWF-exposed workers.

CONCLUSIONS: These findings carry significant implications for workplace safety regulations. Given the observed association between MWF exposure and prostate cancer risk, it is imperative to minimize occupational exposure through the implementation of effective engineering controls, personal protective equipment, and substitution of less hazardous fluids. Regular health surveillance and education programs for workers in industries utilizing MWFs are also essential to mitigate risk. Additionally, regulatory agencies should consider revising exposure limits and safety guidelines to account for emerging evidence on the carcinogenic potential of newer MWF formulations.

PMID:39950100 | PMC:PMC11821483 | DOI:10.3389/fonc.2024.1491159

Clin Implant Dent Relat Res. 2025 Feb;27(1):e70010. doi: 10.1111/cid.70010.

ABSTRACT

OBJECTIVE: In this update of a previous systematic review, we compared the effects of surgical and non-surgical treatments for peri-implantitis through the component network meta-analysis (CNMA) with probing depth (PD) reduction as the outcome.

MATERIALS AND METHODS: Literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Embase databases from August 2010 to June 2023. Randomized controlled trials (RCTs), comparing non-surgical or surgical treatments for peri-implantitis with 6-12 months of follow-up and reported changes in PD, were included. Treatment effects were assessed using a CNMA model based on additivity assumption. We calculated the intraclass correlation coefficient (ICC) to adjust the standard errors for multiple implants within the same patient.

RESULTS: Our systematic review identified 44 RCTs, which included 46 treatment regimens consisting of 15 components. These RCTs formed a disconnected network consisting of 11 subnetworks. Surgical treatments with bone grafts and membranes generally attained greater PD reduction than non-surgical treatments, although bone grafts and membranes as components provided moderate benefits. The effect size of antibiotics is greater in non-surgical than surgical treatments, while there is considerable uncertainty regarding the effect size of implantoplasty. Additionally, the effectiveness of components varied between surgical and non-surgical treatments.

CONCLUSION: Current evidence does not yield sufficiently robust estimates for identifying optimal surgical and non-surgical treatment regimens for peri-implantitis, so the findings of our study should be interpreted cautiously. A coordinated strategy is required for designing future trials to fill the gaps in our current knowledge and develop more reliable recommendations.

PMID:39948703 | DOI:10.1111/cid.70010