Tag: statistics

Electrophoresis. 2022 Feb 7. doi: 10.1002/elps.202100290. Online ahead of print.

ABSTRACT

Cardiac glycosides digoxin and digitoxin are used in therapy for the treatment of congestive heart failure. Moreover, these compounds can be responsible of intoxication cases caused by fortuitous ingestion of leaves of Digitalis. Due to the narrow therapeutic range of these drugs, therapeutic drug monitoring is recommended in the clinical practice. In this context, immunoassays-based methods are generally employed but digoxin- and digitoxin-like compounds can interfere with the analysis. The aim of this study was to develop and validate an original UPLC-MS/MS method for the determination of digoxin and digitoxin in plasma. The method shows adequate sensitivity and selectivity with acceptable matrix effects and very good linearity, accuracy, precision and recovery. A simple liquid-liquid extraction procedure was used for sample clean-up. The method was applied for the analysis of n = 220 plasma samples collected in two different clinical chemistry laboratories and previously tested by the same immunoassay. The statistical comparison showed a relevant negative bias of the UPLC-MS/MS method vs. the immunoassay. These results are consistent with an immunoassay overestimation of digoxin plasmatic levels due to cross-reaction events with endogenous digoxin-like substances. This article is protected by copyright. All rights reserved.

PMID:35132652 | DOI:10.1002/elps.202100290

Artif Organs. 2022 Feb 7. doi: 10.1111/aor.14186. Online ahead of print.

ABSTRACT

OBJECTIVES: Development in device technology and the scarcity of donor’s hearts have increased the number of patients with advanced heart failure receiving durable left ventricular assist devices (LVADs) as a bridge to transplantation and destination therapy, with improved prognosis compared with guideline-directed medical therapy. We sought to examine the impact of modern durable LVADs on the quality of life (QoL) of the recipients.

METHODS: We carried out a systematic review of articles on QoL following the implantation of third-generation LVADs published between January 2010 and February 2021. Included studies were critically analyzed and evidence synthesis was carried out into a meta-analysis.

RESULTS: The systematic search yielded 269 articles, 11 of which met the search predefined criteria. Three of them reported results of randomized trials and eight were retrospective and registry studies. Statistically significant QoL improvement from baseline was observed in all published reports. When using the EuroQol 5L questionnaire (scale 0-100) as a QoL tool 6 months post-LVAD implantation, a meta-analysis of four included studies demonstrated a mean difference increase of 28.9 points (95% confidence interval: 26.71-31.14).

CONCLUSIONS: Third-generation LVADs confer a significant improvement in QoL and their use can be supported not only for prognosis but also for symptom control. Although methodological limitations should be considered, the available QoL outcomes can be a useful tool in patient selection and the decision-making process.

PMID:35132647 | DOI:10.1111/aor.14186

Cancer. 2022 Feb 8. doi: 10.1002/cncr.34121. Online ahead of print.

ABSTRACT

BACKGROUND: Brain tumors are the leading cause of death from disease in children. Racial/ethnic minority children have poorer outcomes than White children; however, it is not clear whether this association is mediated by treatment received.

METHODS: Children (aged 0-19 years) diagnosed with brain tumors in the National Cancer Database (2004-2016) were identified. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between race/ethnicity (Black, Hispanic, Asian/Pacific Islander, American Indian/Alaska Native, or White [reference]) and death. An inverse odds weighted mediation analysis was performed with treatment received as the mediator.

RESULTS: Among 22,469 cases, White children (69% of the sample) had significantly better overall 12.5-year survival (P < .01). Black children (13% of the sample) and Hispanic children (14% of the sample) had an increased risk of death overall and for glioblastoma and oligodendroglioma. Compared with Whites, Asian/Pacific Islander children had a higher risk of death from choroid plexus tumors and a lower risk of death from medulloblastoma. There were no statistically significant meditating effects by treatment received, although the estimate was borderline in Hispanic children (indirect HR, 1.08; 95% CI, 0.99-1.18). A treatment-independent association between race/ethnicity and death remained for Hispanic children (direct HR, 1.18; 95% CI, 1.04-1.33) and Black children (direct HR, 1.28; 95% CI, 1.13-1.45). If deaths in minorities had equaled those in White children, 5% fewer total deaths and 15% fewer minority deaths would have occurred.

CONCLUSIONS: Survival disparities exist in pediatric brain tumors and are largely independent of treatment received, but other mechanisms linked to race/ethnicity remain important.

PMID:35132615 | DOI:10.1002/cncr.34121

Health Serv Res. 2022 Feb 7. doi: 10.1111/1475-6773.13948. Online ahead of print.

ABSTRACT

OBJECTIVE: To discuss and develop difference-in-difference estimators for categorical outcomes and apply them to estimate the effect of the Affordable Care Act’s Medicaid expansion on insurance coverage.

DATA SOURCES: Secondary analysis of Survey on Income and Program Participation (SIPP) data on health insurance coverage types before (Jan 2013) and after (Dec 2015) Medicaid expansion in 39 US states (19 expansion and 20 non-expansion).

STUDY DESIGN: We develop difference-in-difference methods for repeated measures (panel data) of categorical outcomes. We discuss scale dependence of DID assumptions for marginal and transition effect estimates, and specify a new target estimand: the difference between outcome category transitions under treatment versus no treatment. We establish causal assumptions about transitions that are sufficient to identify this and a marginal target estimand. We contrast the marginal estimands identified by the transition approach versus an additive assumption only about marginal evolution. We apply both the marginal and transition approaches to estimate the effects of Medicaid expansion on health insurance coverage types (employer-sponsored; other private, non-group; public; and uninsured).

DATA EXTRACTION: We analyze 16,027 individual survey responses from people aged 18 to 62 years in the 2014 SIPP panel.

PRINCIPAL FINDINGS: We show that the two identifying assumptions are equivalent (on the scale of the marginals) if either the baseline marginal distributions are identical or the marginals are constant in both grousp. Applying our transitions approach to the SIPP data, we estimate a differencial increase in transitions from uninsured to public coverage and differential decreases in transitions from uninsured to private, non-group coverage and in remaining uninsured.

CONCLUSIONS: By comparing the assumption that marginals are evolving in parallel to an assumption about transitions across outcome values, we illustrate the scale-dependence of difference-in-differences. Our application shows that studying transitions can illuminate nuances obscured by changes in the marginals.

PMID:35132619 | DOI:10.1111/1475-6773.13948

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):134-138. doi: 10.3760/cma.j.cn112338-20210221-00132.

ABSTRACT

With the increasing demand to study the cause of complex diseases, mega cohort has gradually replaced the traditional small sample cohort and become the hotspot of epidemiological research. Follow-up is the essential step in a cohort study to obtain the information about the onset and death of diseases, migration or loss of follow-up of the cases. Its quality has a direct impact on the conclusions of cohort study. Therefore, it is necessary to develop a reasonable follow-up monitoring program for a mega cohort.In this paper, we summarized the contents and methods of the follow-up monitoring program in the mega cohorts at home and abroad, which aimed to provide suggestions for the new cohort and improve the follow-up program for the existing cohort.

PMID:35130665 | DOI:10.3760/cma.j.cn112338-20210221-00132

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):78-84. doi: 10.3760/cma.j.cn112338-20210201-00083.

ABSTRACT

Objective: To investigate the detection types and aggregation of high-risk population of cardiovascular disease (CVD) in Jiangsu province and the related influencing factors to provide reference for the prevention and control of cardiovascular disease. Methods: A total of 120 211 participants were included in the investigation. Information was collected by questionnaire based survey, physical examination and biochemical tests. χ² test and multivariate logistic regression were used for statistical analysis. Results: The detection rate of CVD high risk was 25.03%. The detection rates were 19.01%, 4.85%, 3.18% and 5.31% for hypertension, dyslipidemia, cardiovascular history and WHO assessed risk ≥20% types, respectively. Male, rural, old age, low education level, low family income, drinking, waist circumference exceeding standard, overweight and obesity were risk factors of CVD (all P<0.01). The composition ratios of aggregation of 1, 2 and ≥3 high risk types of CVD were 74.01%, 22.91% and 3.08%, respectively. With the increase of aggregation types, the correlation strength increased with age, rural residents, education level and annual family income. Conclusion: Targeted measures should be carried out according to different influencing factors for the prevention and control of CVD in Jiangsu province in order to achieve the maximum prevention and control effect with the minimum cost.

PMID:35130656 | DOI:10.3760/cma.j.cn112338-20210201-00083

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):118-122. doi: 10.3760/cma.j.cn112338-20210827-00687.

ABSTRACT

Due to the latent characteristics of HIV infection, exceptionality of HIV high-risk population, social discrimination and insufficient awareness of AIDS prevention, timely testing and diagnosis of HIV infection is still a challenge worldwide. Until recently, it is difficult to exactly understand the overall HIV epidemic only using routine surveillance data. Therefore, epidemiological and statistical modeling is widely used to address this issue. Almost at the same time when AIDS was firstly discovered firstly, scientists also began to study the methods for the estimation and prediction of HIV infection epidemic. This article summarizes the development of global and domestic HIV epidemic estimation for the further understanding of its current performance and methods applied to provide reference for the future work.

PMID:35130662 | DOI:10.3760/cma.j.cn112338-20210827-00687

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):37-43. doi: 10.3760/cma.j.cn112338-20210702-00517.

ABSTRACT

Objective: To predict the number of deaths, standardized mortality and probability of premature mortality caused by malignant cancer in the context of risk factor control at different levels in China in 2030, and assess the possibility of achieving the target of reducing the probability of premature mortality of malignant cancer. Methods: According to the risk factor control standard for malignant cancer used both at home and abroad, the results of China from Global Burden of Disease Study 2015 were used to calculate the population attributable fraction of the risk factors. Based on the comparative risk assessment theory, the deaths of malignant cancer were classified as attributable deaths and un-attributable deaths. Proportional change model was used to predict risk factor exposure and un-attributable deaths of malignant cancer in the future, then the number of deaths, standardized mortality rate and probability of premature mortality of malignant cancer in 2030 was estimated. Data analyses were performed by using software R 3.6.1. Results: If the risk factor exposure level during 1990-2015 remains, the number of deaths, standardized mortality rate, and probability of premature mortality of malignant cancer would increase to 3.62 million, 153.96/100 000 and 8.92% by 2030, respectively. If the risk factor exposure control level meets the requirement, the probability of premature mortality from cancer in people aged 30-70 years would drop to 7.57% by 2030. Conclusions: The control of risk factor exposure will play an important role in reducing deaths, standardized mortality rate and probability of premature mortality of malignant cancer. But more efforts are needed to achieve the goals of Health China Action.

PMID:35130650 | DOI:10.3760/cma.j.cn112338-20210702-00517

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):50-57. doi: 10.3760/cma.j.cn112338-20210407-00284.

ABSTRACT

Objective: To examine risk factors of simple obesity and their interaction in preschool children in China. Methods: A total of 63 292 preschool children aged 3-7 years selected by cluster random sampling in 9 cities of China, including Beijing, Harbin, Xi’an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou and Kunming, were investigated from June to November in 2016. Based on the BMI-for-age cut off points of overweight and obesity for Chinese children aged 2-18 years, a total of 1 522 obese children (1 006 boys and 516 girls) were screened. By population-based matched case-control design, a normal weight child was randomly selected to match with an obese child by sex, age (difference ≤6 months) and body height (difference ≤5 cm) from the survey area. Conditional logistic regression model was used to analyze association of risk factors with obesity and the interaction of risk factors. Results: ① Univariate conditional logistic regression model showed that 17 risk factors of simple obesity had statistical significance (P<0.001), including high birth weight, cesarean section, gestational diabetes, gestational hypertension, formula feeding in the first 6 months after birth, strong appetite, fast or slow eating speed, low intensity of outdoor activities, daily outdoor activity time <1 hour, daily screen viewing time < 1 hour or ≥2 hours, daily night sleep time <9 hours, mother overweight, father overweight, mother’s low educational level, father’s low educational level, non-nuclear family structure, and parents not being the primary caregivers of children. ②Multivariate conditional logistic regression model showed that 12 risk factors had statistical significance, including high birth weight (OR=1.83, 95%CI:1.29-2.61, P<0.001), cesarean section (OR=1.22, 95%CI:1.07-1.39, P=0.003), gestational diabetes (OR=4.57, 95%CI:2.13-9.79, P<0.001), mother’s low educational level (OR=1.52, 95%CI:1.11-2.07, P=0.008), single parent family (OR=4.79, 95%CI:1.44-15.88, P=0.010), mother overweight (OR=2.58, 95%CI:1.93-3.46, P<0.001), father overweight (OR=2.40, 95%CI:1.86-3.10, P<0.001), strong appetite (OR=7.78, 95%CI:5.38-11.27, P<0.001), fast eating speed (OR=6.59, 95%CI:4.86-8.94, P<0.001), daily outdoor activity time <1 hour (OR=1.42, 95%CI: 1.09-1.85, P=0.009), daily night sleep time <9 hours (OR=1.59, 95%CI: 1.13-2.23, P=0.007), daily screen viewing time ≥2 hours (OR=1.69, 95%CI:1.27-2.24, P<0.001). ③ Interaction of the four groups of risk factors had statistical significance, including interaction between mother overweight and father overweight (OR=5.53, 95%CI: 3.76-8.13, P<0.001), interaction between strong appetite and fast eating speed (OR=54.48, 95%CI: 32.95-90.06, P<0.001), interaction between low intensity of outdoor activity and daily outdoor activity time <1 hour (OR=2.12, 95%CI: 1.29-3.48, P=0.002), interaction between daily night sleep time <9 hours and daily screen viewing time ≥2 hours (OR=2.83, 95%CI: 1.71-4.68, P<0.001). Conclusions: This study identified 12 risk factors of childhood obesity, including high birth weight, cesarean section, gestational diabetes, mother’s low educational level, single parent family, mother overweight, father overweight, strong appetite, fast eating speed, daily short outdoor activity time, daily short night sleep time, daily long screen viewing time, and interaction of the four groups of risk factors had statistical significance, including strong interaction between mother overweight and father overweight, interaction between strong appetite and fast eating speed, interaction between low intensity of outdoor activity and daily short outdoor activity time, interaction between daily short night sleep time and daily long screen viewing time.

PMID:35130652 | DOI:10.3760/cma.j.cn112338-20210407-00284

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Jan 10;43(1):32-36. doi: 10.3760/cma.j.cn112338-20210915-00734.

ABSTRACT

Objective: To understand the epidemiological characteristics of HIV-infected adolescents outside school in China and provide reference to targeted prevention and control of HIV infection in this population. Methods: All the HIV-infected adolescents aged 15-17 years outside school reported during 2011-2019 were included this study. The information about their demographics, transmission routes and migration were collected from HIV/AIDS Comprehensive Response Information Management System. The χ² test was done for comparison among groups. The Joinpoint 4.9.0 software was applied to the annual percent change (APC) for time trends analysis using the Joinpoint regression model. The Excel 2019 and SPSS 22.0 software were used for data cleaning and statistical analysis. Results: A total of 4 919 HIV-infected adolescents aged 15-17 years outside school were reported accumulatively in China between 2011 and 2019, accounting for 63.4% (4 919/7 757) of total reported HIV-infected cases in this age group. Analysis on trend revealed that the new HIV infection diagnosis rate has become stable since 2016 (APC=2.5%, P=0.173) after the increase between 2011 and 2015 (APC=36.4%, P<0.001). The migration across provinces was discovered in 13.9% (684/4 919) of the HIV-infected adolescents outside school. Males, workers, and those diagnosed in detention centers or transmitted by injecting drugs or homosexual contacts accounted for a larger proportion in migrated cases compared with non-migrated cases. The adolescents outside school mainly got HIV infected by sexual contacts route, in which 66.5% (280/421) of the males were infected by homosexual contacts, while 97.8% (182/186) of the females were infected by heterosexual contacts in 2019. Conclusions: HIV-infected adolescents aged 15-17 years outside school were mainly infected by sexual contacts. However, adolescents outside school have low awareness of sexual health and high mobility, to whom close attention should be paid to improve their awareness of sexual health and to provide them with appropriate HIV infection prevention and treatment service.

PMID:35130649 | DOI:10.3760/cma.j.cn112338-20210915-00734