Tag: statistics

J Endourol. 2023 Mar 16. doi: 10.1089/end.2022.0819. Online ahead of print.

ABSTRACT

OBJECTIVE: to apply the Reverse Systematic Review (RSR) to compare three radical prostatectomies (RP) techniques: open (RRP), laparoscopic (LRP), and robotic (RARP) in relation to oncological outcomes: positive surgical margin (PSM) and biochemical recurrence rate (BCR).

EVIDENCE ACQUISITION: a search was carried out in 8 databases between 2000 and 2020 through SR studies referring to RRP, LRP, or RARP (80 SR). All references used in these SRs were captured referring to 1,724 reports. Preoperative and oncological outcomes were compared and correlated among RRP, LRP, and RARP.

EVIDENCE SYNTHESIS: 559 (32.4%) reports for RRP, 413 (23.9%) for LRP, and 752 (43.7%) for RARP, and a total of 1,353,485 patients were found. Regarding PSM, 284 reports were collected for RRP, 324 for LRP, and 499 for RARP, with rates of 23.6%, 20.7%, and 19.2%, respectively, and only the RRP with a statistical difference (P<0.001). Using a non-linear regression model, the BCR rate was correlated with follow-up time at 1, 2, 3, 5, 7, and 10 years: 10%, 15%, 18%, 20%, 23 %, and 38% for RRP; 6%, 9%, 13%, 20%, 23%, 10% for LRP; 8%, 12%, 16%, 23%, 27%, 19% for RARP. The absence of long-term work for RARP prevented more accurate projections of BCR.

CONCLUSIONS: RSR proved to be effective in generating a population and heterogeneous sample capable of demonstrating better oncological results for minimally invasive surgery (LRP and RARP) compared to RRP. It demonstrated the maturity of temporal follow-up data for RRP and LRP and the impact of lack of late follow-up from RARP studies on the long-term rate of BC.

PMID:36924303 | DOI:10.1089/end.2022.0819

Thyroid. 2023 Mar 16. doi: 10.1089/thy.2022.0600. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between isolated hypothyroxinemia (IH) in pregnancy and adverse pregnancy outcomes is controversial, with no consensus on the need for treatment.

METHODS: We conducted a systematic review and meta-analysis examining adverse pregnancy and neonatal outcomes in women with isolated hypothyroxinemia (IH) in pregnancy. We searched PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials for publications from inception to December 2022. Randomized clinical trials and cohort studies were included. Random effects meta-analyses were used to estimate pooled relative risks (RRs) for each outcome.

RESULTS: We included 21 articles, of which 19 investigated the relationship between IH and maternal and neonatal outcomes and 4 investigated the efficacy of LT4 treatment. Compared with euthyroid pregnancies, IH pregnancies were associated with an increased risk of preterm birth (RR 1.35 [CI 1.16-1.56]; I2 = 9%), premature rupture of membranes (RR 1.41 [CI 1.08-1.84]; I2 = 0%), gestational diabetes (RR 1.34 [CI 1.07-1.67]; I2 = 76%), macrosomia (RR 1.62 [CI 1.31-2.02]; I2 = 42%), and fetal distress (RR 1.72 [CI 1.15-2.56]; I2 = 0%). However, no statistically significant differences were noted in adverse outcomes according to LT4 treatment status.

CONCLUSIONS: There is evidence suggesting that that IH in pregnancy may be associated with an increased risk of adverse pregnancy and neonatal outcomes. However, it is unclear whether LT4 may mitigate the risk of these adverse outcomes.

PMID:36924297 | DOI:10.1089/thy.2022.0600

CNS Neurosci Ther. 2023 Mar 16. doi: 10.1111/cns.14169. Online ahead of print.

ABSTRACT

AIMS: To estimate the proportions of specific hypometabolic patterns and their association with neuropsychiatric symptoms (NPS) in patients with cognitive impairment (CI).

METHODS: This multicenter study with 1037 consecutive patients was conducted from December 2012 to December 2019. ¹⁸ F-FDG PET and clinical/demographic information, NPS assessments were recorded and analyzed to explore the associations between hypometabolic patterns and clinical features by correlation analysis and multivariable logistic regression models.

RESULTS: Patients with clinical Alzheimer’s disease (AD, 81.6%, 605/741) and dementia with Lewy bodies (67.9%, 19/28) mostly had AD-pattern hypometabolism, and 76/137 (55.5%) of patients with frontotemporal lobar degeneration showed frontal and anterior temporal pattern (FT-P) hypometabolism. Besides corticobasal degeneration, patients with behavioral variant frontotemporal dementia (36/58), semantic dementia (7/10), progressive non-fluent aphasia (6/9), frontotemporal lobar degeneration and amyotrophic lateral sclerosis (3/5), and progressive supranuclear palsy (21/37) also mostly showed FT-P hypometabolism. The proportion of FT-P hypometabolism was associated with the presence of hallucinations (R = 0.171, p = 0.04), anxiety (R = 0.182, p = 0.03), and appetite and eating abnormalities (R = 0.200, p = 0.01) in AD.

CONCLUSION: Specific hypometabolic patterns in FDG-PET are associated with NPS and beneficial for the early identification and management of NPS in patients with CI.

PMID:36924296 | DOI:10.1111/cns.14169

AIDS Res Hum Retroviruses. 2023 Mar 16. doi: 10.1089/AID.2022.0117. Online ahead of print.

ABSTRACT

Presentation to care with advanced HIV disease (AHD) is a significant problem in Sub-Saharan Africa. We evaluated factors associated with immune recovery among individuals presenting to care with AHD in Zimbabwe. We conducted a retrospective evaluation of outcomes among adult (>18 years old) individuals with AHD (CD4 count ≤ 200 cells/mm3) receiving care at 18 outpatient primary care clinics in Harare, Zimbabwe. Baseline and 12-month CD4 count data were extracted from medical records. CD4 count recovery (defined as CD4 count > 200 cells/mm3) after 12 months on NNRTI-based antiretroviral therapy (ART) regimen was determined and factors associated with CD4 count recovery were established using logistic regression. All statistical analysis was performed on SPSS v23. A total of 1338 participant records were included in the analysis. The median interquartile range (IQR) age was 37 (30-43) years and 52% were females. The baseline median (IQR) CD4 count was 50 (28-75) cells/mm3 and was significantly lower among patients with history of cryptococcal meningitis compared to those without (25(10-52) vs 52(32-77), respectively; p=0.0009). The median (IQR) CD4 count at 12 months after ART initiation increased from 50 (28-75) at baseline to 180 (92-290) cells/mm3. Immune recovery with a CD4 count > 200 cells/mm3, was observed in 181/417 (43%). Male gender and low baseline CD4 count were strong predictors of poor immunological recovery on ART. Immunological recovery following ART initiation was 43% among individuals with AHD. Male patients are most vulnerable to persistent immunological failure.

PMID:36924288 | DOI:10.1089/AID.2022.0117

AIDS Res Hum Retroviruses. 2023 Mar 16. doi: 10.1089/AID.2022.0076. Online ahead of print.

ABSTRACT

Epidemiological results have shown that some factors such as co-infection of SARS-COV-2 and HIV is associated with COVID-19 severity, rates of hospitalization, and mortality. Thus, this meta-analysis aims to assess the odds ratio of hospitalization rate, mortality and average standardized difference of CD4 counts in COVID-19/ HIV co-infection patients vs control group.This meta-analysis was examined by PRISMA-P checklist. Studies were obtained from online databases such as Science direct, Pub med, Scopus, Web of Science, and Google scholar using Mesh و Non-Mesh keywords. NOS checklist was used to assess the quality of studies. According to the random effect models, the odds ratio of hospitalization, mortality, and average standardized difference of CD4 counts was estimated. Data analysis was performed using Stata ver.14 software. By the use of strict inclusion criteria, 8 initial studies entered into the meta-analysis. The odds ratio of hospitalization and mortality rates in COVID-19 patients with HIV was 1.67(95% CI: 0.76, 3.71) and 0.80 (95% CI: 0.57, 1.11) times higher than that of the control group. In this meta-analysis, there was no observed a statistically significant difference in the rate of hospitalization, mortality and CD4 counts in COVID-19 patients with HIV and the control group. However, the hospitalization rate in COVID-19/ HIV co-infection patients was 67% higher than the control group. The similarity results between two groups can probably be attributed to some factors, such as the low number of COVID-19/ HIV co-infection patients and the presence of random error, HIV patients receiving antiretroviral therapy, and early hospitalization in COVID-19/ HIV co-infection patients.

PMID:36924275 | DOI:10.1089/AID.2022.0076

Stat Methods Med Res. 2023 Mar 16:9622802231163334. doi: 10.1177/09622802231163334. Online ahead of print.

ABSTRACT

Unmeasured baseline information in left-truncated data situations frequently occurs in observational time-to-event analyses. For instance, a typical timescale in trials of antidiabetic treatment is “time since treatment initiation”, but individuals may have initiated treatment before the start of longitudinal data collection. When the focus is on baseline effects, one widespread approach is to fit a Cox proportional hazards model incorporating the measurements at delayed study entry. This has been criticized because of the potential time dependency of covariates. We tackle this problem by using a Bayesian joint model that combines a mixed-effects model for the longitudinal trajectory with a proportional hazards model for the event of interest incorporating the baseline covariate, possibly unmeasured in the presence of left truncation. The novelty is that our procedure is not used to account for non-continuously monitored longitudinal covariates in right-censored time-to-event studies, but to utilize these trajectories to make inferences about missing baseline measurements in left-truncated data. Simulating times-to-event depending on baseline covariates we also compared our proposal to a simpler two-stage approach which performed favorably. Our approach is illustrated by investigating the impact of baseline blood glucose levels on antidiabetic treatment failure using data from a German diabetes register.

PMID:36924264 | DOI:10.1177/09622802231163334

Eur J Transl Myol. 2023 Mar 16. doi: 10.4081/ejtm.2023.10675. Online ahead of print.

ABSTRACT

The aim of this study was to assess prevalence of anti-thyroid peroxidase (anti-TPO) antibody and thyroid hormones in Iranian female breast cancer patients, compare them to a control population, and investigate their association with prognostic factors. In this case-control study, breast cancer patients were selected from a surgery clinic in a tertiary hospital and control group participants were enrolled from those who had visited for mammography screening. Participants with any history of thyroid disease, or thyroid related medication were excluded from both groups. Groups were assessed for levels of thyroid stimulating hormone (TSH), T3, T4, and anti-TPO. In addition, the status of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) was determined for cancer patients. Overall 69 participants (39 cancer patients and 30 controls) were included. Difference in serum anti-TPO levels between the two groups was not statistically significant (p-value: 0.184). While a significant difference was observed for T4 and TSH levels between groups (p-value: 0.034 and <0.001, respectively), T3 levels did not reveal any significant difference (p-value: 0.177). In addition, ER, PR, and HER2 status were not correlated with anti-TPO levels. This results can serve as preliminary evidence that thyroid autoimmunity is not correlated with breast cancer incidence in Iranian female population. However, additional studies with larger sample sizes are required for more conclusive evidence.

PMID:36924246 | DOI:10.4081/ejtm.2023.10675

J Int AIDS Soc. 2023 Mar;26(3):e26059. doi: 10.1002/jia2.26059.

ABSTRACT

INTRODUCTION: In people living with human immunodeficiency virus (PLHIV), traditional cardiovascular risk factors, exposure to HIV per se and antiretroviral therapy (ART) are assumed to contribute to cardiometabolic diseases. Nevertheless, controversy exists on the relationship of HIV and ART with diabetes. To clarify the relationship between HIV and type 2 diabetes, this review determined, in PLHIV in Africa, diabetes and prediabetes prevalence, and the extent to which their relationship was modified by socio-demographic characteristics, body mass index (BMI), diagnostic definitions used for diabetes and prediabetes, and HIV-related characteristics, including CD4 count, and use and duration of ART.

METHODS: For this systematic review and meta-analysis (PROSPERO registration CRD42021231547), a comprehensive search of major databases (PubMed-MEDLINE, Scopus, Web of Science, Google Scholar and WHO Global Health Library) was conducted. Original research articles published between 2000 and 2021 in English and French were included, irrespective of study design, data collection techniques and diagnostic definitions used. Observational studies comprising at least 30 PLHIV and reporting on diabetes and/or prediabetes prevalence in Africa were included. Study-specific estimates were pooled using random effects models to generate the overall prevalence for each diagnostic definition. Data analyses used R statistical software and “meta” package.

RESULTS: Of the 2614 records initially screened, 366 full-text articles were assessed for eligibility and 61 were selected. In the systematic review, all studies were cross-sectional by design and clinic-based, except for five population-based studies. Across studies included in the meta-analysis, the proportion of men was 16-84%. Mean/median age was 30-62 years. Among 86,412 and 7976 participants, diabetes and prediabetes prevalence rates were 5.1% (95% CI: 4.3-5.9) and 15.1% (9.7-21.5). Self-reported diabetes (3.5%) was lower than when combined with biochemical assessments (6.2%; 7.2%).

DISCUSSION: While not statistically significant, diabetes and prediabetes were higher with greater BMI, in older participants, urban residents and more recent publications. Diabetes and prediabetes were not significantly different by HIV-related factors, including CD4 count and ART.

CONCLUSIONS: Although HIV-related factors did not modify prevalence, the diabetes burden in African PLHIV was considerable with suboptimal detection, and likely influenced by traditional risk factors. Furthermore, high prediabetes prevalence foreshadows substantial increases in future diabetes in African PLHIV.

PMID:36924213 | DOI:10.1002/jia2.26059

Otolaryngol Head Neck Surg. 2023 Mar 16. doi: 10.1002/ohn.322. Online ahead of print.

ABSTRACT

OBJECTIVE: Identify the age at diagnosis and intervention of immigrant and/or non-English-speaking children with hearing loss (HL) and risk factors associated with delays. Identify barriers for non-English-speaking caregivers of deaf/hard-of-hearing children.

STUDY DESIGN: Sequential mixed methods.

SETTING: Tertiary care center in an urban city.

METHODS: The analysis includes descriptive statistics, and 1-way and 2-way analysis of variance of the retrospective chart review. The quantitative study demonstrated foreign-born experienced disparities, so we conducted semistructured interviews on a subset of non-English-speaking families in the cohort that was then thematically analyzed using a human-centered design strategy.

RESULTS: We divided 532 children into 3 groups: US-born with English as the preferred language (N = 294), US-born and non-English language preferred (N = 173), and foreign-born (N = 67). The laterality of HL and pure-tone averages were similar among the groups (p = .972 and .071, respectively). Age at diagnosis and time to the intervention were significantly different (39.7, 31.5, 75.8 months, p < .001 and 24.6, 29.2, 48.9 months, p = .001, respectively). Ages at diagnosis and intervention were associated with birthplace (p = .005, p = .0005, respectively) but not preferred language (p = .667, p = .343, respectively). Included in the qualitative interviews were Mandarin- (n = 5), Arabic- (n = 4), and Spanish-speaking families (n = 3). Insights revealed participants’ quest for anticipatory guidance and social support, the consequences of cultural stigma, and the complexity of caring for a child with HL in an immigrant family.

CONCLUSION: Foreign-born children with HL have significant delays in diagnosis and intervention compared to US-born children. For non-English-speaking parents, the diagnosis of HL presents challenges beyond that of the immigrant experience.

PMID:36924195 | DOI:10.1002/ohn.322

Otolaryngol Head Neck Surg. 2023 Mar 16. doi: 10.1002/ohn.321. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate harms reporting in systematic reviews (SRs) of microvascular free flap (MFF) in head and neck reconstruction.

DATA SOURCES: This cross-sectional analysis included searches from the following major databases from 2012 to June 1, 2022: MEDLINE (Pubmed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews.

REVIEW METHODS: In a masked duplicate manner, screening was performed using Rayyan, and data were extracted using a pilot-tested Google form. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of reviews and the corrected covered area was calculated to detect primary study overlap across all reviews. Reviews were then grouped in pairs of 2, called dyads, and the corrected covered area was calculated again for each individual dyad. Dyads with high overlap (≥50%) were further investigated for the accuracy of harms reporting.

RESULTS: Our initial search yielded 268 records, with 50 SRs meeting the inclusion criteria. A total of 46 (92%) of the included reviews demonstrated 50% or more adherence to the items assessed in our harms checklist. Our corrected covered area tool revealed 0.6% primary study overlap across all reviews, and 1 dyad with high overlap (≥50%). No statistically significant relationship was observed between the completeness of harms reporting and reviews listing harms as a primary outcome, reviews reporting adherence to Preferred Reporting Items of Systematic Reviews and Meta-Analyses, or a review’s AMSTAR rating.

CONCLUSION: This study identifies how harms reporting in SRs of MFF reconstruction of the head and neck can be improved and provides suggestions with the potential to mitigate the paucity in current literature.

PMID:36924192 | DOI:10.1002/ohn.321