Tag: statistics

Oral Radiol. 2025 Oct 7. doi: 10.1007/s11282-025-00868-5. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigated the association between the apical surface area measurement (ASAM) of impacted mandibular third molars (IMTM) and chronological age at varying impaction levels, as well as ASAM differences among levels.

METHODS: A total of 446 IMTM (227 right, 219 left) from 257 Malaysian patients aged 15.0 to 25.9 years were included and grouped into 0.9-year intervals. All CBCT images were analysed using Mimics and 3-matic software (Materialise NV, Belgium, version 21.0) to calculate the apical surface area. Impaction level was categorised according to the Pell and Gregory classification system. Spearman’s correlation and Welch’s ANOVA were conducted to assess the relationship between ASAM and age and to compare ASAM across the four levels (A, B, modified B/C, and C). Differences between left and right IMTM were assessed using an independent t-test, and analysed with SPSS (version 26).

RESULT: ASAM showed an inverse correlation with age (ρ = -0.89, ρ² = 0.79), with a median of 4.86 mm² (IQR: 2.35-11.92). The steepest decline was observed between 17-18 years, followed by a plateau from 21 years onwards. Left and right IMTM were not statistically different (p = 0.53) and subsequently pooled. ASAM increased with impaction depth; however, only level C exhibited significantly larger ASAM than levels A and B (p < 0.001), with an effect size of ω² = 0.13, indicating a notable delay in maturation.

CONCLUSIONS: This study demonstrates the relationship between ASAM in IMTM and age, with potential applicability in dental age estimation. However, caution is advised for level C impactions, as the estimated age may be biased.

PMID:41055825 | DOI:10.1007/s11282-025-00868-5

J Med Syst. 2025 Oct 7;49(1):127. doi: 10.1007/s10916-025-02276-y.

ABSTRACT

Artificial intelligence (AI), specifically large language models (LLM), have gained significant popularity over the last decade with increased performance and expanding applications. AI could improve the quality of patient care in medicine but hidden biases introduced during training could be harmful. This work utilizes GPT-4o-mini to generate patient communications based on systematically generated, synthetic patient data that would be commonly available in a patient’s medical record. To evaluate the AI generated communications for disparities, GPT-4o-mini was used to score the generated communications on empathy, encouragement, accuracy, clarity, professionalism, and respect. Disparities in scores associated with specific components of a patient’s history were used to detect potential biases. A patient’s sex and religious preference were found to have a statistically significant impact on scores. However, further work is needed to evaluate a wider collection of LLMs utilizing more specific and human validated scoring criteria. Overall, this work proposes a novel method of evaluating bias in LLMs by creating synthetic patient histories to formulate AI generated communications and score them with opportunities for further investigation.

PMID:41055822 | DOI:10.1007/s10916-025-02276-y

J Med Syst. 2025 Oct 7;49(1):126. doi: 10.1007/s10916-025-02270-4.

ABSTRACT

Normative ranges for vital signs under general anesthesia are well established for healthy pediatric patients, but the influence of The American Society of Anesthesiologists Physical Status (ASA-PS) classification on these normative ranges remains unexplored. The purpose of this study is to develop age-based normative ranges for heart rate (HR) and blood pressure (BP) in patients undergoing general anesthesia for noncardiac surgery in our institution and assess differences by ASA-PS classification. This is a retrospective observational single-center study. We reviewed all anesthetic records from the Hospital for Sick Children, Canada between March 1st and December 31st, 2023. We extracted physiological data from our in-house high-resolution physiological data repository (AtriumDB) to develop normative ranges for physiological parameters and compared them according to ASA-PS classification. We developed age-based normative ranges for BP and HR. We found significant differences between ASA-PS groups, most notably between ASA-PS 1 and 5. We found a statistically significant difference between ASA-PS 1-2 and 3-5 across all physiological parameters. This study validates existing pediatric anesthesia reference ranges while demonstrating the feasibility of incorporating patients across the spectrum of ASA-PS. Further multicenter studies are needed to generalize these findings.

PMID:41055817 | DOI:10.1007/s10916-025-02270-4

Clin Exp Nephrol. 2025 Oct 7. doi: 10.1007/s10157-025-02777-7. Online ahead of print.

ABSTRACT

BACKGROUND: Elevated parathyroid hormone (PTH) levels are associated with cardiovascular events, bone disease, and mortality in patients undergoing maintenance hemodialysis. Although PTH levels vary widely in patients undergoing hemodialysis, whether this affects mortality is unclear.

METHODS: A total of 315 maintenance hemodialysis patients who underwent PTH measurements at least twice a year were enrolled. The association between all-cause mortality, cardiovascular events, and fractures was evaluated in patients with PTH concentrations of 60-240 pg/mL (time-in-target range (TTR) 100%) and those with TTR values of 75% ≤ TTR < 100%, 50% ≤ TTR < 75%, and TTR < 50%.

RESULTS: There were 122 patients with TTR 100%, 81 patients with 75% ≤ TTR < 100%, 52 patients with 50% ≤ TTR < 75%, and 74 patients with TTR < 50%. Over the 4-year observation period, patients with TTR of 100% had significantly lower all-cause mortality than those with TTR < 50%. (HR 2.26, 95% CI 1.33-3.86) Subgroup analysis by presence or absence of pharmacological intervention showed no statistically significant difference in all-cause mortality in the treatment group (HR 2.08, 95% CI 1.16-3.72), but showed significant differences in the no-treatment group (HR 1.58, 95% CI 0.92-2.70).

CONCLUSION: A prolonged period of deviation from the optimal PTH range was associated with increased all-cause mortality, particularly among patients not receiving SHPT medication. However, this effect was not observed in patients who received pharmacological interventions. These results suggest that early intervention is desirable when PTH levels vary from the optimal range in patients with secondary hyperparathyroidism.

PMID:41055807 | DOI:10.1007/s10157-025-02777-7

Eur J Pediatr. 2025 Oct 7;184(11):660. doi: 10.1007/s00431-025-06531-9.

ABSTRACT

The increasing use of assisted reproductive technology has raised concerns about its long-term effects on offspring, including pubertal development. Evidence from large, population-based studies in non-Western countries remains limited. Using data from the Taiwan Birth Cohort Study, a nationally representative cohort of children born in 2005, we examined pubertal development at age 12 based on caregiver reports. Among 21,642 children with conception data, 172 were conceived via intrauterine insemination (IUI), 311 via in vitro fertilization (IVF), and 21,159 spontaneously (SC). Propensity score matching (1:1) yielded a final sample of 966 children. Ordinal logistic regression and parametric survival analysis assessed associations between conception method and pubertal milestones, including age at menarche. Among 966 matched children (546 boys, 420 girls), most associations between fertility treatments and pubertal development at age 12 were small and not statistically significant. Boys and girls conceived via IUI did not show a trend toward earlier or later puberty. In IVF-conceived children, odds ratios for pubertal development were near 1.0, not statistically significant and with wide 95% confidence intervals. No significant differences were found in age at menarche, either.

CONCLUSION: In this nationally representative cohort, we found no statistically significant differences in pubertal development or age at menarche by conception method at age 12. Continued follow-up is warranted to assess long-term reproductive outcomes.

WHAT IS KNOWN: • Children conceived through fertility treatment may be at risk for altered pubertal timing, but most existing evidence is from Western populations. • Prior large-scale studies suggest trends toward earlier puberty in IVF-conceived girls and later puberty in IVF-conceived boys.

WHAT IS NEW: • This study provides the first large-scale, nationally representative Asian evidence on the long-term pubertal outcomes of children conceived through fertility treatment, addressing a major geographic gap in the literature. • We did not detect statistically significant differences in pubertal stage or age at menarche at age 12 between children conceived via IUI/IVF and those conceived spontaneously.

PMID:41055806 | DOI:10.1007/s00431-025-06531-9

J Robot Surg. 2025 Oct 7;19(1):664. doi: 10.1007/s11701-025-02858-5.

ABSTRACT

Reducing surgical waiting lists remains a key national priority for healthcare systems such as the NHS in the UK. High-intensity theater (HIT) lists, designed to increase surgical throughput by optimizing theater time and perioperative care, have been proposed as a solution. However, comparative data evaluating their safety and efficiency remain limited. To evaluate the productivity and safety of robotic HIT operating lists for benign gynecological surgery, as compared to standard weekday NHS operating lists. This was a retrospective cohort study using a prospectively maintained hospital registry. Robotic gynecological procedures performed on five HIT lists between Nov 2023 and July 2024 were compared with standard elective NHS lists during the same period. Patient demographics, operative times, complication rates, and length of stay were analyzed. A total of 194 cases were included (164 standard, 30 HIT). Case complexity was lower in the HIT cohort (p = 0.049). Mean operative time was significantly reduced in the HIT group (72.5 vs. 129.3 min, p < 0.001), with no increase in postoperative complications (13% vs. 29%, p > 0.05). HIT patients had significantly shorter hospital stays (0.4 vs. 1.2 days, p < 0.001), and comparable rates of readmission and training case involvement. HIT robotic gynecological operating lists enable efficient, safe surgical care with shorter operative times and earlier discharge, without compromising training or patient safety. Wider adoption of this model may help to reduce NHS surgical backlogs and optimize theater utilization.

PMID:41055804 | DOI:10.1007/s11701-025-02858-5

Int Urol Nephrol. 2025 Oct 7. doi: 10.1007/s11255-025-04805-7. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate oncological outcome of external beam radiation therapy(EBRT) versus high-intensity focused ultrasound (HIFU) in patients with stage II prostate cancer.

MATERIALS AND METHODS: We retrospectively reviewed patients with stage II prostate cancer from the Chang Gung Research Database spanning the years 2005 to 2022. Inverse probability of treatment weighting (IPTW) method was performed to achieve baseline equivalence. Oncology outcomes including overall survival (OS) and cancer specific survival (CSS) were assessed using Kaplan-Meier curves before and after IPTW adjustment. Subgroup analysis of stage IIa, IIb, and IIc were also conducted. We use cox proportional hazards analyses to further evaluate the association between treatment and survival outcomes.

RESULTS: Total of 176 EBRT and 244 HIFU procedures were identified. EBRT group has higher overall mortality (9.2% compared to 16.7% after IPTW; standardized difference 0.224) and cancer specific mortality (5.4% compared to 9.2% after IPTW; standardized difference 0.144) after IPTW adjustment. An overall survival benefit is observed in the HIFU group for all stage II prostate cancer cases, with a particularly significant advantage in the stage IIa subgroup after IPTW adjustment (p = 0.032). Although the cancer-specific survival benefit slightly favors the HIFU stage IIa subgroup after IPTW adjustment, it does not reach statistical significance (p = 0.069). EBRT is associated with significantly worse OS compared to HIFU across univariate, multivariate, and IPTW-adjusted Cox regression models, with hazard ratios ranging from 2.03 to 2.63 (all p 0.05). However, for CSS, a significant difference was found only in the univariate model (HR = 2.38, p = 0.032), and this association was not maintained after adjustment.

CONCLUSIONS: HIFU demonstrates non-inferior overall survival and cancer specific survival compared to EBRT in patients with stage II prostate cancer, particularly in the stage IIa subgroup after more than 10 years of follow-up. Further randomized prospective studies are needed to evaluate the oncological outcomes of different prostate cancer treatment modalities.

PMID:41055797 | DOI:10.1007/s11255-025-04805-7

Laryngoscope. 2025 Oct 7. doi: 10.1002/lary.70163. Online ahead of print.

ABSTRACT

OBJECTIVES: Laryngology patient-reported outcome measures (PROMs) quantify symptoms related to voice, swallowing, and/or breathing. Vocal Cord Paralysis Experience (CoPE) is a PROM developed to evaluate disabilities associated with unilateral vocal fold paralysis (UVFP). The relationship between disease-specific and general symptom-based PROMs has not been previously studied in Laryngology. Correlations between CoPE and established Laryngology PROMs [e.g., Voice Handicap Index-10 (VHI-10), Eating Assessment Tool-10 (EAT-10), Dyspnea Index (DI)] assessed the role and added benefit of CoPE.

METHODS: Patients with UVFP at a tertiary Laryngology clinic completed CoPE, VHI-10, EAT-10, and DI during routine visits. Comparisons across PROMs were performed.

RESULTS: One hundred and eight unique data collection epochs were obtained from 80 patients (34 men, 46 women), mean age of 62.6 years. Mean scores were 43.4 ± 22 for CoPE, 21.2 ± 10.2 for VHI-10, 9.2 ± 8.5 for EAT-10, and 10.5 ± 9.9 for DI. Comparison of CoPE score to other Laryngology PROMS demonstrated statistically significant, positive correlations: CoPE versus VHI-10 (R = 0.596, p = 0.000), CoPE versus DI (R = 0.424, p = 0.000), and CoPE versus EAT-10 (R = 0.447, p = 0.000). CoPE subscale scores similarly demonstrated statistically significant, positive correlations: CoPE voice subscale versus VHI-10 (R = 0.641, p = 0.000) and CoPE swallowing subscale versus EAT-10 (R = 0.603, p = 0.000).

CONCLUSION: PROMs are critical for assessing UVFP-related functional impairments. CoPE does not appear to capture unique aspects of the UVFP experience not already covered by VHI-10, DI, and EAT-10. Furthermore, these commonly used Laryngology PROMs have broad utility across many pathologic conditions and can be implemented prior to diagnosis, offering psychometric advantages. Clinicians and researchers can confidently employ commonly used Laryngology PROMs or CoPE to report UVFP results.

PMID:41054944 | DOI:10.1002/lary.70163

Disabil Rehabil Assist Technol. 2025 Oct 7:1-13. doi: 10.1080/17483107.2025.2569791. Online ahead of print.

ABSTRACT

PURPOSE: Endometriosis is a common condition affecting around 10% of women of childbearing age worldwide. Currently, adapted physical activities (APA) are increasingly used in the context of chronic diseases, often in conjunction with digital devices to help overcome some of the barriers to regular practice. However, it is essential to examine the technological acceptability to optimise the future use of these devices. The main aim of this study is to analyse the intention of women with endometriosis to use digital tools offering physical activities and to identify the factors most likely to predict this intention.

MATERIALS AND METHODS: Participants completed an online survey, which included socio-demographic and medical questions, as well as subscales derived from the HITAM model on intention to use digital tools. The data were analysed using univariate and multivariate logistic regressions.

RESULTS AND CONCLUSION: A total of 313 women (Mean age = 34.4; SD = 8.69) met the inclusion and exclusion criteria. The statistical analyses showed that the intention to use a digital APA program was fairly high, with a preference for technologies that offer a high degree of freedom in practice. Analyses of the theoretical model showed in particular the importance of a favourable social discourse. The final model (perceived threat, norms, perceived ease of use, perceived usefulness, and age) explained 57.74% of the variance in intention. Findings should be interpreted with caution due to the self-selected online sample and the high dropout rate (899 incomplete responses).

PMID:41054937 | DOI:10.1080/17483107.2025.2569791

Head Neck. 2025 Oct 7. doi: 10.1002/hed.70066. Online ahead of print.

ABSTRACT

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, with 50% of patients recurring. A subset of patients experience rapid recurrence (RR) postoperatively but prior to adjuvant therapy. This study identifies factors associated with RR and additional recurrence intervals: short-interval recurrence (SIR) and standard recurrence (SR).

METHODS: Retrospective 10-year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (≤ 6 months post-adjuvant therapy), and SR (> 6 months post-adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.

RESULTS: Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR = 3.492, p = 0.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack-years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).

CONCLUSION: Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.

PMID:41054923 | DOI:10.1002/hed.70066