Tag: statistics

PLoS One. 2023 Feb 8;18(2):e0276827. doi: 10.1371/journal.pone.0276827. eCollection 2023.

ABSTRACT

BACKGROUND: Mobile-linked point-of-care diagnostics forms an integral part of diagnostic health services for efficient communication between patients and healthcare professionals despite geographical location and time of diagnosis. The efficiency of this technology lies in the user experience which means that the interaction of the user with the implemented technology needs to be simple, convenient, and consistent. Having a well-structured user experience of these devices in community-based healthcare will aid in sustainable implementation. Herein, we propose to conduct a literature search to systematically map out evidence based on mobile-linked POC diagnostics user experience at a community level in resource-limited settings.

METHODOLOGY: The proposed scoping review will be guided by the advanced Arksey and O’Malley methodological framework and further advanced by Levac et al. A comprehensive search will be conducted to find relevant published literature from the following electronic databases: Scopus, Web of Science, EBSCOhost (Medline, CINAHL, Africa-wide, Academic Search Complete). Grey literature will also be searched, including reports from government and international organizations such as World Health Organization (WHO), Foundation for Innovative New Diagnostics (FIND), and the Food and Drug Administration (FDA). Two independent reviewers will screen the relevant studies and the degree of the agreement will be determined by calculating Cohen’s kappa statistic. The quality of eligible data will also be appraised using the mixed method appraisal tool version 2018.

DISCUSSION: We anticipate that the planned scoping review will present useful evidence to inform stakeholders on the integration of mobile-linked diagnostic devices in community-based healthcare which will guide further research on the subject.

PMID:36753489 | DOI:10.1371/journal.pone.0276827

PLoS One. 2023 Feb 8;18(2):e0278555. doi: 10.1371/journal.pone.0278555. eCollection 2023.

ABSTRACT

The Theory of Evolution (TE) is the backbone of biology and is the best way to explain the diversity of species that exist on the planet. However, despite all the supporting evidence, TE remains poorly understood and accepted. In this study, the levels of acceptance and understanding of TE were measured, respectively, using the Inventory of Student Evolution Acceptance (I-SEA) and Knowledge of Evolution Exam (KEE) questionnaires, in high school students in Monterrey, Mexico (N = 370). The results show that the acceptance of TE ranges from moderate (90.3 out of 120) to high (3.7 out of 5), depending on the scale with which it is measured, while the level of comprehension is low (4.5 out of 10). Statistical analysis of the data collected reveals that there is a positive relationship between acceptance and understanding of TE (r = 0.34). In addition, the proportions of I-SEA and KEE were evaluated based on several factors, such as religion and educational level of the parents, among others. It was found that the level of education of the parents positively affects the understanding of the basic concepts of TE, while religion is the main factor of negative influence on both acceptance and understanding. Finally, the low comprehension shown in this study suggests a revision and readjustment of the contents that are taught in the upper secondary education curriculum.

PMID:36753485 | DOI:10.1371/journal.pone.0278555

JMIR Med Educ. 2023 Feb 8;9:e45312. doi: 10.2196/45312.

ABSTRACT

BACKGROUND: Chat Generative Pre-trained Transformer (ChatGPT) is a 175-billion-parameter natural language processing model that can generate conversation-style responses to user input.

OBJECTIVE: This study aimed to evaluate the performance of ChatGPT on questions within the scope of the United States Medical Licensing Examination Step 1 and Step 2 exams, as well as to analyze responses for user interpretability.

METHODS: We used 2 sets of multiple-choice questions to evaluate ChatGPT’s performance, each with questions pertaining to Step 1 and Step 2. The first set was derived from AMBOSS, a commonly used question bank for medical students, which also provides statistics on question difficulty and the performance on an exam relative to the user base. The second set was the National Board of Medical Examiners (NBME) free 120 questions. ChatGPT’s performance was compared to 2 other large language models, GPT-3 and InstructGPT. The text output of each ChatGPT response was evaluated across 3 qualitative metrics: logical justification of the answer selected, presence of information internal to the question, and presence of information external to the question.

RESULTS: Of the 4 data sets, AMBOSS-Step1, AMBOSS-Step2, NBME-Free-Step1, and NBME-Free-Step2, ChatGPT achieved accuracies of 44% (44/100), 42% (42/100), 64.4% (56/87), and 57.8% (59/102), respectively. ChatGPT outperformed InstructGPT by 8.15% on average across all data sets, and GPT-3 performed similarly to random chance. The model demonstrated a significant decrease in performance as question difficulty increased (P=.01) within the AMBOSS-Step1 data set. We found that logical justification for ChatGPT’s answer selection was present in 100% of outputs of the NBME data sets. Internal information to the question was present in 96.8% (183/189) of all questions. The presence of information external to the question was 44.5% and 27% lower for incorrect answers relative to correct answers on the NBME-Free-Step1 (P<.001) and NBME-Free-Step2 (P=.001) data sets, respectively.

CONCLUSIONS: ChatGPT marks a significant improvement in natural language processing models on the tasks of medical question answering. By performing at a greater than 60% threshold on the NBME-Free-Step-1 data set, we show that the model achieves the equivalent of a passing score for a third-year medical student. Additionally, we highlight ChatGPT’s capacity to provide logic and informational context across the majority of answers. These facts taken together make a compelling case for the potential applications of ChatGPT as an interactive medical education tool to support learning.

PMID:36753318 | DOI:10.2196/45312

JAMA Psychiatry. 2023 Feb 8. doi: 10.1001/jamapsychiatry.2022.4974. Online ahead of print.

ABSTRACT

IMPORTANCE: Comorbidities and genetic correlations between gastrointestinal tract diseases and psychiatric disorders have been widely reported, with the gut-brain axis (GBA) hypothesized as a potential biological basis. However, the degree to which the shared genetic determinants are involved in these associations underlying the GBA is unclear.

OBJECTIVE: To investigate the shared genetic etiology between gastrointestinal tract diseases and psychiatric disorders and to identify shared genomic loci, genes, and pathways.

DESIGN, SETTING, AND PARTICIPANTS: This genome-wide pleiotropic association study using genome-wide association summary statistics from publicly available data sources was performed with various statistical genetic approaches to sequentially investigate the pleiotropic associations from genome-wide single-nucleotide variation (SNV; formerly single-nucleotide polymorphism [SNP]), and gene levels and biological pathways to disentangle the underlying shared genetic etiology between 4 gastrointestinal tract diseases (inflammatory bowel disease, irritable bowel syndrome, peptic ulcer disease, and gastroesophageal reflux disease) and 6 psychiatric disorders (schizophrenia, bipolar disorder, major depressive disorder, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and anorexia nervosa). Data were collected from March 10, 2021, to August 25, 2021, and analysis was performed from January 8 through May 30, 2022.

MAIN OUTCOMES AND MEASURES: The primary outcomes consisted of a list of genetic loci, genes, and pathways shared between gastrointestinal tract diseases and psychiatric disorders.

RESULTS: Extensive genetic correlations and genetic overlaps were found among 22 of 24 trait pairs. Pleiotropic analysis under a composite null hypothesis identified 2910 significant potential pleiotropic SNVs in 19 trait pairs, with 83 pleiotropic loci and 24 colocalized loci detected. Gene-based analysis found 158 unique candidate pleiotropic genes, which were highly enriched in certain GBA-related phenotypes and tissues, whereas pathway enrichment analysis further highlighted biological pathways primarily involving cell adhesion, synaptic structure and function, and immune cell differentiation. Several identified pleiotropic loci also shared causal variants with gut microbiomes. Mendelian randomization analysis further illustrated vertical pleiotropy across 8 pairwise traits. Notably, many pleiotropic loci were identified for multiple pairwise traits, such as 1q32.1 (INAVA), 19q13.33 (FUT2), 11q23.2 (NCAM1), and 1p32.3 (LRP8).

CONCLUSIONS AND RELEVANCE: These findings suggest that the pleiotropic genetic determinants between gastrointestinal tract diseases and psychiatric disorders are extensively distributed across the genome. These findings not only support the shared genetic basis underlying the GBA but also have important implications for intervention and treatment targets of these diseases simultaneously.

PMID:36753304 | DOI:10.1001/jamapsychiatry.2022.4974

JAMA Netw Open. 2023 Feb 1;6(2):e2255050. doi: 10.1001/jamanetworkopen.2022.55050.

ABSTRACT

IMPORTANCE: Use of tyrosine kinase inhibitors (TKIs) is the standard therapy for epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) with brain metastases. Several studies have shown that adding chemotherapy to EGFR-TKIs could improve progression-free survival (PFS) in patients with EGFR-mutant advanced NSCLC; however, the efficacy of these agents in patients with brain metastases remains unclear.

OBJECTIVE: To investigate the efficacy and safety of gefitinib plus chemotherapy (pemetrexed with platinum) compared with gefitinib alone in patients with untreated EGFR-mutant NSCLC brain metastases.

DESIGN, SETTING, AND PARTICIPANTS: This open-label prospective, multicenter, phase 3 randomized clinical trial was conducted in 6 centers in China from January 13, 2016, to August 27, 2021. The median follow-up time was 21.1 months (IQR, 13.5-31.8 months). Patients with untreated confirmed brain metastases and EGFR-sensitive mutated NSCLC were enrolled.

INTERVENTIONS: The eligible patients were randomly assigned (1:1) to receive gefitinib plus chemotherapy or gefitinib alone.

MAIN OUTCOMES AND MEASURES: The primary end point was intracranial PFS; secondary end points included PFS, overall survival (OS), intracranial objective response rate, overall objective response rate, and safety. Intention-to-treat analysis was performed.

RESULTS: A total of 161 patients (87 [54.0%] women; mean [SD] age, 55 [9.8] years; range, 26-80 years) were enrolled and randomized to receive gefitinib (n = 81) or gefitinib plus chemotherapy (n = 80). The median intracranial PFS was 15.6 months (95% CI, 14.3-16.9 months) in the gefitinib plus chemotherapy group vs 9.1 months (95% CI, 8.0-10.2 months) in the gefitinib group (hazard ratio, 0.36; 95% CI, 0.25-0.53; P < .001). Similarly, the median PFS was significantly longer with gefitinib plus chemotherapy than gefitinib alone (16.3; 95% CI, 14.4-18.2 months vs 9.5; 95% CI, 8.3-10.8 months; P < .001). Gefitinib plus chemotherapy had a better intracranial objective response rate (85.0%; 95% CI, 77.0%-93.0% vs 63.0%; 95% CI, 52.2%-73.7%; P = .002) and overall objective response rate (80.0%; 95% CI, 71.0%-89.0% vs 64.2%; 95% CI, 53.5%-74.9%; P = .03) than gefitinib alone. At data cutoff, the median OS was also significantly longer in the gefitinib plus chemotherapy group vs the gefitinib group (35.0 vs 28.9 months; hazard ratio, 0.65; 95% CI, 0.43-0.99; P = .04). Grade 3 or worse adverse events were more common with gefitinib plus chemotherapy, most of which were manageable.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, gefitinib plus chemotherapy significantly improved intracranial PFS, PFS, and OS compared with gefitinib alone in patients with untreated EGFR-mutant NSCLC brain metastases and could be an optional first-line treatment for these patients.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01951469.

PMID:36753281 | DOI:10.1001/jamanetworkopen.2022.55050

JAMA Netw Open. 2023 Feb 1;6(2):e2255107. doi: 10.1001/jamanetworkopen.2022.55107.

ABSTRACT

IMPORTANCE: Rights and access for transgender individuals, including the participation of transgender athletes in sports, have long been debated. These discussions often center around fairness and mental health impacts on youths associated with identity-based inclusion in sports.

OBJECTIVE: To assess the experiences and perspectives of adolescents and young adults on the inclusion of transgender individuals in competitive sports.

DESIGN, SETTING, AND PARTICIPANTS: In this qualitative study, 5 open-ended survey questions were sent to the MyVoice cohort from December 10 to 17, 2021. MyVoice is a nationwide text-message polling platform of US youths aged 14 to 24 years. All coding and subsequent analysis was completed between January 10 and December 11, 2022.

MAIN OUTCOMES AND MEASURES: Qualitative perspectives of youths regarding transgender athlete participation in sports as measured by survey responses. Responses were reviewed using an inductive approach to qualitative thematic analysis to develop a codebook. The codes were independently applied to all responses by 2 investigators; discrepancies were resolved with discussion. Summary statistics were calculated for demographic characteristics and code frequencies, and χ2 tests (α = .05, 2-tailed) were used to evaluate differences in opinion based on gender identity and participation in competitive sports.

RESULTS: A total of 905 of 1199 youths (75%) responded to the survey. Respondents had a mean (SD) age of 20 (2) years; 482 (53%) identified as male, 29 (3%) identified as transgender, and 306 (34%) reported having participated in high school and/or collegiate athletics. Three themes emerged: (1) youths differed regarding the inclusion of transgender athletes based on gender identity vs sex assigned at birth, (2) many youths did not have personal experience related to the inclusion of transgender athletes, and (3) youths were uncertain about the impacts of gender identity-based participation on cisgender individuals but perceived positive impacts for transgender individuals. Nearly half of respondents (327 of 691 [47%]) thought that transgender athletes should participate based on their gender identity or personal preference, whereas 240 (35%) favored participation based on sex assigned at birth or in a transgender-only category. Respondents mentioned concern about the fairness of identity-based participation, specifically for cisgender women, but many (410 of 697 [59%]) also reported that it would be affirming for transgender athletes to participate based on gender identity.

CONCLUSIONS AND RELEVANCE: The youths in our study differed in their opinions regarding sports participation of transgender youths, but many felt that inclusive policies would affirm and support the mental health of transgender individuals. Negative impacts on fairness were noted by some respondents. These findings suggest that nuanced policies are needed to address the participation of transgender athletes in competitive sports and should consider the impacts on and perspectives of youths most affected.

PMID:36753280 | DOI:10.1001/jamanetworkopen.2022.55107

Rev Salud Publica (Bogota). 2023 Feb 3;21(4):430-438. doi: 10.15446/rsap.V21n4.67831.

ABSTRACT

OBJETIVE: To describe and to compare the previous and the current tobacco use profile between psychiatric population of secondary and tertiary levels of care and general population of basic health care.

METHODS: Descriptive epidemiological/analytical cross sectional study with 378 participants from three Brazilian health services: a) Basic Unity of Health (BUH); b) Mental Health Ambulatory (MHA); c) Psychiatric Hospital (PH). The answers provided during individual interviews were registred in mobile device. Data were submitted to descriptive statistics, Fischer’s exact test, analysis of variance and Kruskal-Wallis test.

RESULTS: In the PH all were daily smokers, noticing lower prevalence in MHA (94.1%) and in BUH (91.7%). Among the products utilized has highlighted manufactured cigarettes (98%), followed by roll-your-own cigarettes (39%). The average of cigarettes smoked per day (MHA=19,3, PH=25,3, BUH=17,2) and the percentage of multiple tobacco products users (MHA=28.1%, PH=55.3%, BUH=9.1%) were higher in PH. 73% of smokers exceed ≥ 4% of familiar income with tobacco. In PH were identified higher commitment. Smokers of PH were less advised to stop smoking (MHA=50%, PH=39.5%, BUH=50%).

CONCLUSION: The current tobacco use profile by psychiatric hospital smokers differs from the others. Besides higher tobacco dependency, they smoked a higher amount of cigarettes per day, compromised higher perceptual of personal income to buy tobacco and used multiples tobacco products as well as received less support to stop smoking.

PMID:36753266 | DOI:10.15446/rsap.V21n4.67831

Rev Salud Publica (Bogota). 2023 Feb 3;21(4):398-403. doi: 10.15446/rsap.V21n4.75787.

ABSTRACT

OBJECTIVE: To identify the capacity to provide appropriate access to facilities and equipment that encourage drinking water consumption at the Universidad de Panamá, as part of its commitment to promote behaviors that benefit the health of this community.

MATERIALS AND METHODS: A descriptive statistical study and a multivariate analysis were carried out using the correspondence analysis technique to explore relationships among the variables “University Group” (students, teachers and administrative staff) vs. “Access to water sources” and “Access to water sources” vs. “Inputs to facilitate water consumption”.

RESULTS: 66.3% of the population surveyed recognized drinking water as the most accessible drink for consumption, mainly from water sources, followed by bottled water.

CONCLUSIONS: This work highlights the importance of promoting water consumption in the university population, suggesting that the Universidad de Panamá has infrastructure conditions that allow water intake, thus promoting healthy habits and fulfilling its commitment to the health of the population.

PMID:36753261 | DOI:10.15446/rsap.V21n4.75787

Rev Bras Enferm. 2023 Feb 6;76(2):e20220182. doi: 10.1590/0034-7167-2022-0182. eCollection 2023.

ABSTRACT

OBJECTIVE: To analyze the spatiotemporal distribution of homicide mortality and association with social determinants of health in the Northeast Region of Brazil.

METHODS: Ecological study with spatiotemporal modeling of homicide deaths between 2000 and 2019. Temporal trends were analyzed by segmented linear regression. Crude mortality was calculated and adjusted by smoothing the local empirical Bayesian method and analyzed by the Global/Local Moran Index and spatiotemporal scan statistics. The association between social determinants of health and homicide mortality was performed using multiple linear regression and autoregressive spatial models.

RESULTS: 353,089 deaths were recorded. Mortality increased from 2000 to 2019, with an annual increase of 4.37 in males and 3.57 in females. High risk spatial and spatiotemporal clusters were identified in the coastal region of the states. The spatial regression model showed an association with socioeconomic inequalities.

CONCLUSIONS: High risk areas for homicides associated with socioeconomic inequality, which should be considered as a priority for designing and investing in public health policies were investigated.

PMID:36753255 | DOI:10.1590/0034-7167-2022-0182

Rev Bras Enferm. 2023 Feb 6;76(2):e20210244. doi: 10.1590/0034-7167-2021-0244. eCollection 2023.

ABSTRACT

OBJECTIVE: To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning.

METHODS: Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher’s exact tests, with differences considered statistically significant if p < 0.05.

RESULTS: Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods.

CONCLUSIONS: The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.

PMID:36753251 | DOI:10.1590/0034-7167-2021-0244