Tag: statistics

Diabetes Technol Ther. 2022 Oct 28. doi: 10.1089/dia.2022.0365. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate influence of daytime vs nighttime continuous glucose monitoring (CGM)-based metrics on A1C in adults with type 1 diabetes.

RESEARCH DESIGN AND METHODS: CGM data from 407 adults with type 1 diabetes (age 39 ± 15 years, diabetes duration 20 ± 12 years, A1C 7.3 ± 1.4% and 55% female) from two studies were included in this analysis. The association between daytime (6 AM to 10.59 PM) and nighttime (11PM to 5.59 AM) CGM variables such as mean glucose, time in range (TIR; 70-180 mg/dL), time in tight target range (TTIR; 70-140 mg/dL) and time above range (TAR >180 mg/dl) was examined within five A1C categories (<7%, 7- 7.9%, 8-8.9%, 9-9.9%, and ≥10%).

RESULTS: Although mean glucose was increasing with higher A1C, there was no statistical difference in mean glucose between daytime vs nighttime within five A1C groups [143.2±22.7 vs143.6±25.0 for A1C <7%, 171.4±17.3 vs 175.3±28.8 for A1C 7.0-7.9%, 193.4±19.4 vs 195.3±29.5 for A1C 8.0-8.9%, 214.9±28.8 vs 219.7±36.1 for A1C 9.0-9.9% and 244.0±39.0 vs 239.9±50.9 for A1C ≥10%, p>0.05]. Similarly, there was no difference various CGM metrics by daytime vs nighttime within five A1C groups. Differences between five A1C groups’ daytime vs nighttime mean glucose, TIR, TTIR and TAR were also not statistically significant (all p>0.05) Conclusion: Daytime vs nighttime glycemic control has similar influence on A1C in adults with type 1 diabetes.

PMID:36306519 | DOI:10.1089/dia.2022.0365

JMIR Public Health Surveill. 2022 Oct 28. doi: 10.2196/31237. Online ahead of print.

ABSTRACT

BACKGROUND: HIV disproportionately affects sexual minority men (SMM) in the U.S.

OBJECTIVE: We sought to determine past HIV post-exposure prophylaxis (PEP) use and current and prior pre-exposure prophylaxis (PrEP) use among an online sample of cisgender and transgender men who have sex with men.

METHODS: In 2019, HIV-negative and unknown status SMM (n = 63,015) were recruited via geosocial networking apps, social media, and other online venues to participate in a brief eligibility screening survey. Individuals were asked about past PEP and current and prior PrEP use. We examined associations of demographics, socioeconomic indicators, and recent club drug use on PEP and PrEP use, as well as the association between past PEP use on current and prior PrEP use using generalized linear models and multinomial logistic regression. Statistical significance was considered at p < 0.001 given the large sample size; 99.9% confidence intervals are reported.

RESULTS: Prior PEP use was reported by 11.3% of participants, with current or prior PrEP use reported by 22.0% and 8.1%, respectively. Nearly half (46.0%) of past PEP users were current PrEP users, and another 39.9% of participants who reported past PEP use also reported prior PrEP use. In multivariable analysis, past PEP use was associated with current (RRR = 23.53; 99.9% CI: 14.03-39.46) and prior PrEP use (RRR = 52.14; 99.9% CI: 29.39-92.50). Compared to white men, Black men had higher prevalence of past PEP use and current PrEP use, Latinx men had higher prevalence of PEP use but no significant difference in PrEP use, and those considered of another race/ethnicity reported higher prevalence of past PEP use and lower current PrEP use. Past PEP use and current PrEP use were highest in the Northeast, with those in the Midwest and South reporting significantly lower PEP and PrEP use. A significant interaction of Black race/ethnicity by past PEP use on current PrEP use was found (RRR = 0.57; 99.9% CI: 0.37-0.87), indicating Black men who previously used PEP were less likely to report current PrEP use. Participants who reported recent club drug use were significantly more likely to report past PEP use and current or prior PrEP use compared to those without recent use.

CONCLUSIONS: PrEP use continues to be the predominate HIV prevention strategy for SMM compared to PEP, but many current PrEP users had previously used PEP for HIV prevention. Higher rates of past PEP use and current PrEP use among Black SMM is noteworthy given disproportionate burden of HIV. Nonetheless, understanding the disconnect linking PEP users to PrEP among Black SMM is an important avenue for future research. Further efforts are also needed to increase PrEP use among Latinx SMM given increasing disparity between Latinx and white SMM in the U.S.

PMID:36306518 | DOI:10.2196/31237

JCO Clin Cancer Inform. 2022 Oct;6:e2200082. doi: 10.1200/CCI.22.00082.

ABSTRACT

PURPOSE: The Bone Metastases Ensemble Trees for Survival Decision Support Platform (BMETS-DSP) provides patient-specific survival predictions and evidence-based recommendations to guide multidisciplinary management for symptomatic bone metastases. We assessed the clinical utility of the BMETS-DSP through a pilot prepost design in a simulated clinical environment.

METHODS: Ten Radiation Oncology physicians reviewed 55 patient cases at two time points: without and then with the use of BMETS-DSP. Assessment included 12-month survival estimate, confidence in and likelihood of sharing estimates with patients, and recommendations for open surgery, systemic therapy, hospice referral, and radiotherapy (RT) regimen. Paired statistics compared pre- versus post-DSP outcomes. Reported statistical significance is P < .05.

RESULTS: Pre- versus post-DSP, overestimation of true minus estimated survival time was significantly reduced (mean difference -2.1 [standard deviation 4.1] v -1 month [standard deviation 3.5]). Prediction accuracy was significantly improved at cut points of < 3 (72 v 79%), ≤ 6 (64 v 71%), and ≥ 12 months (70 v 81%). Median ratings of confidence in and likelihood of sharing prognosis significantly increased. Significantly greater concordance was seen in matching use of 1-fraction RT with the true survival < 3 months (70 v 76%) and < 10-fraction RT with the true survival < 12 months (55 v 62%) and appropriate use of open surgery (47% v 53%), without significant changes in selection of hospice referral or systemic therapy.

CONCLUSION: This pilot study demonstrates that BMETS-DSP significantly improved physician survival estimation accuracy, prognostic confidence, likelihood of sharing prognosis, and use of prognosis-appropriate RT regimens in the care of symptomatic bone metastases, supporting future multi-institutional validation of the platform.

PMID:36306499 | DOI:10.1200/CCI.22.00082

J Clin Oncol. 2022 Oct 28:JCO2102726. doi: 10.1200/JCO.21.02726. Online ahead of print.

ABSTRACT

PURPOSE: Oxaliplatin-based adjuvant chemotherapy in patients with stage III colon cancer (CC) for 6 months remains a standard in high-risk stage III patients. Data are lacking as to whether early discontinuation of all treatment (ETD) or early discontinuation of oxaliplatin (EOD) could worsen the prognosis.

MATERIALS AND METHODS: We studied the prognostic impact of ETD and EOD in patients with stage III CC from the ACCENT/IDEA databases, where patients were planned to receive 6 months of infusional fluorouracil, leucovorin, and oxaliplatin or capecitabine plus oxaliplatin. ETD was defined as discontinuation of treatment and EOD as discontinuation of oxaliplatin only before patients had received a maximum of 75% of planned cycles. Association between ETD/EOD and overall survival and disease-free survival (DFS) were assessed by Cox models adjusted for established prognostic factors.

RESULTS: Analysis of ETD and EOD included 10,447 (20.9% with ETD) and 7,243 (18.8% with EOD) patients, respectively. Compared with patients without ETD or EOD, patients with ETD or EOD were statistically more likely to be women, with Eastern Cooperative Oncology Group performance status ≥ 1, and for ETD, older with a lower body mass index. In multivariable analyses, ETD was associated with a decrease in disease-free survival and overall survival (hazard ratio [HR]: 1.61, P < .001 and HR: 1.73, P < .001), which was not the case for EOD (HR: 1.07, P = .3 and HR: 1.13, P = .1). However, patients who received < 50% of the planned cycles of oxaliplatin had poorer outcomes.

CONCLUSION: In patients treated with 6 months of oxaliplatin-based chemotherapy for stage III CC, ETD was associated with poorer oncologic outcomes. However, this was not the case for EOD. These data favor discontinuing oxaliplatin while continuing fluoropyrimidine in individuals with significant neurotoxicity having received > 50% of the planned 6-month chemotherapy.

PMID:36306483 | DOI:10.1200/JCO.21.02726

Phonetica. 2022 Oct 28. doi: 10.1515/phon-2022-2024. Online ahead of print.

ABSTRACT

Glottalized sonorants are a rare sound type that has been under scrutiny for a number of reasons of general relevance to the phonetic theory. It has been claimed that the timing of glottalization of glottalized sonorants may shift in accordance with the position in the syllable onset (pre-glottalization) or coda (post-glottalization), to provide a cue for its place of articulation; other studies argued against this claim. The paper investigates acoustic properties of the glottalized lateral in Rikvani Andi, a one-village dialect of Andi (East Caucasian). Based on the data from elicitations and free narratives, we consider the acoustic correlates that have been argued in the literature to differentiate glottalized sonorants from their modal counterparts, including aperiodicity, intensity, duration and spectral tilt. In Rikvani Andi, all of the correlates prove to be statistically significant in recordings of isolated words, but the differences tend to decrease in free narratives. The timing of glottalization does not support the existing generalizations – while the glottalized lateral only occurs in Rikvani Andi in the syllable onset, it tends to be mid- to post-glottalized. We discuss two possible explanations of why the Rikvani Andi glottalized sonorant fails to comply with typological expectations.

PMID:36306469 | DOI:10.1515/phon-2022-2024

Medwave. 2022 Oct 28;22(9). doi: 10.5867/medwave.2022.09.2622.

ABSTRACT

The exponential growth of currently available evidence has made it necessary to collect, filter, critically appraise, and synthesize biomedical information to keep up to date. In this sense, systematic reviews are a helpful tool and can be reliable sources to assist in evidence-based decision-making. Systematic reviews are defined as secondary research or syntheses of evidence focused on a specific question that — based on a structured methodology — make it possible to identify, select, critically appraise, and summarize findings from relevant studies. Systematic reviews have several potential advantages, such as minimizing biases or obtaining more accurate results. The reliability of the evidence presented in systematic reviews is determined, amongst other factors, by the quality of their methodology and the included studies. To conduct a systematic review, a series of steps must be followed: the formulation of a research question using the participants, interventions, comparisons, outcomes (PICO) format; an exhaustive literature search; the selection of relevant studies; the critical appraisal of the data obtained from the included studies; the synthesis of results, often using statistical methods (meta-analysis); and finally, estimating the certainty of the evidence for each outcome. In this methodological note, we will define the basic concepts of systematic reviews, their methods, and their limitations.

PMID:36306467 | DOI:10.5867/medwave.2022.09.2622

Int J Biostat. 2022 Oct 31. doi: 10.1515/ijb-2021-0087. Online ahead of print.

ABSTRACT

Meta-analysis of binary outcome data faces often a situation where studies with a rare event are part of the set of studies to be considered. These studies have low occurrence of event counts to the extreme that no events occur in one or both groups to be compared. This raises issues how to estimate validly the summary risk or rate ratio across studies. A preferred choice is the Mantel-Haenszel estimator, which is still defined in the situation of zero studies unless all studies have zeros in one of the groups to be compared. For this situation, a modified Mantel-Haenszel estimator is suggested and shown to perform well by means of simulation work. Also, confidence interval estimation is discussed and evaluated in a simulation study. In a second part, heterogeneity of relative risk across studies is investigated with a new chi-square type statistic which is based on a conditional binomial distribution where the conditioning is on the event margin for each study. This is necessary as the conventional Q-statistic is undefined in the occurrence of zero studies. The null-distribution of the proposed Q-statistic is obtained by means of a parametric bootstrap as a chi-square approximation is not valid for rare events meta-analysis, as bootstrapping of the null-distribution shows. In addition, for the effect heterogeneity situation, confidence interval estimation is considered using a nonparametric bootstrap procedure. The proposed techniques are illustrated at hand of three meta-analytic data sets.

PMID:36306466 | DOI:10.1515/ijb-2021-0087

Am J Intellect Dev Disabil. 2022 Nov 1;127(6):455-472. doi: 10.1352/1944-7558-127.6.455.

ABSTRACT

The Nisonger Child Behavior Rating Form (NCBRF) was developed to specifically screen psychopathology and problem behavior in children and adolescents with IDD. This study aimed to update the NCBRF to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and screen for the most prevalent psychopathologies that affect children and adolescents with IDD. The authors re-aligned the existing items to fit within a DSM-5 framework, and then used the Delphi method with a panel of experts in IDD to evaluate the NCBRF items. The revision process included deleting and revising existing items and formulating new items. We obtained a final item pool after three iterations. The Delphi process and resulting item pool are described in this article.

PMID:36306412 | DOI:10.1352/1944-7558-127.6.455

Brain Behav. 2022 Oct 28:e2782. doi: 10.1002/brb3.2782. Online ahead of print.

ABSTRACT

BACKGROUND: There are few studies about the relationship between dietary patterns and aggression. The aim of this study was to assess the relationship between the main dietary patterns and aggression scores among adolescent girls in Iran.

METHODS: This cross-sectional study was conducted on 670 adolescent girls. The 168-item self-administered Semi-quantitative Food Frequency Questionnaire was used to evaluate dietary intake and to identify major dietary patterns, while factor analysis was applied. Aggression was evaluated by the validated Persian version of the Buss-Perry questionnaire. Statistical analysis was performed by crude and adjusted models.

RESULTS: Three main dietary patterns including healthy, fast food, and Western were identified. A significant positive association was found between more adherence to Western dietary pattern and the presence of a high aggression score (OR: 2.00; 95% CI: 1.32-3.05, p-_{trend =} .001); even after adjustment for potential confounders, these findings were significant.

CONCLUSION: Although Western dietary patterns were associated with increased aggression risk, there was no significant relationship between healthy and fast food dietary patterns and the prevalence of a high aggression score. Further studies, particularly longitudinal intervention studies, are required to clarify this relationship.

PMID:36306400 | DOI:10.1002/brb3.2782

Int J Gynaecol Obstet. 2022 Oct 28. doi: 10.1002/ijgo.14532. Online ahead of print.

ABSTRACT

OBJECTIVE: To study immune response of maternal Covid-19 vaccination and vertical transmission of Anti-SARS-CoV-2, S and N.

STUDY DESIGN: Retrospective study of pregnant women in Bahrain Defense Force Hospital, from March 2021 till September 2021, who were vaccinated, with Sinopharm and Pfizer/Bio NTech. Anti-N and S level from paired samples of maternal and umbilical cord blood was done at the time of delivery with Elecsys Anti-SARS-CoV-2 immunoassay. Immune response to vaccination, association with maternal and fetal factors, and the vertical transmission of antibodies were studied. Analysis was performed using SPSS (version 26.0) and Minitab (version 18) software. P-value of less than 0.05 was considered statistically significant.

RESULTS: The study included 79 pregnant women. The median gestational age for Sinopharm was 28 weeks and Pfizer was 31 weeks. 100% of the vaccinated population generated antibodies and had vertical transmission. The anti-N and S titre, and interval frequencies varied in both vaccinations. The anti-N and S and Transfer ratio are correlated statistically with maternal age, gestational age at delivery, latency period and birth weight of the neonates differently in both vaccines. Also the peak level of antibodies and transfer ratios varied.

CONCLUSION: Though variations are exhibited in both type of vaccination, the vaccinated pregnant population generated a significant level of anti-N and-S, and had vertical transmission as well.

PMID:36306398 | DOI:10.1002/ijgo.14532