Tag: statistics

Infect Dis (Lond). 2022 Sep 21:1-4. doi: 10.1080/23744235.2022.2125575. Online ahead of print.

NO ABSTRACT

PMID:36128939 | DOI:10.1080/23744235.2022.2125575

J Child Health Care. 2022 Sep 21:13674935221110081. doi: 10.1177/13674935221110081. Online ahead of print.

ABSTRACT

Hypermobile Ehlers-Danlos syndrome (hEDS) is a common disorder in children and adolescents that negatively impacts health-related quality of life (HRQOL). It can include chronic pain, fatigue, autonomic dysfunction, and mood problems. The objective of this study was to examine levels of agreement between children and parents in the setting of hEDS and HRQOL. Individuals with hEDS, ages 10-20 years, and their parents were recruited to complete a series of surveys. Instruments included pediatric quality of life generic and multidimensional fatigue scales, Functional Disability Index, Pain-Frequency-Severity-Duration scale, Brief Illness Perception Questionnaire, and Herth Hope Index. Agreement on each measure was evaluated using statistical calculations. Thirty-six parent-child dyads completed the surveys. There were no significant differences between the means of parent and child scores. There was moderate to strong agreement on all survey scores. However, the proportion of dyads with disagreement was relatively high for each individual score. Eighteen dyads disagreed on at least half of the surveys. Body mass index centile and child perception of cognitive fatigue most strongly predicted disagreement in total HRQOL score. Proxy-reporters for children and adolescents with hEDS may agree with their child on average. However, due to significant frequency of clinically important disagreement, information from both children and their parents should be sought whenever possible.

PMID:36128922 | DOI:10.1177/13674935221110081

Turk Neurosurg. 2022 Aug 13. doi: 10.5137/1019-5149.JTN.40096-22.3. Online ahead of print.

ABSTRACT

AIM: Neural tube defects (NTDs) are the most common congenital anomalies, and prenatal prediction of the disease is essential. The underlying factors of the disease have not been determined. The aim of this study is to investigate the predictive role of thiol/disulfide homeostasis and Ischemia-modified albumin (IMA) levels for NTDs.

MATERIAL AND METHODS: A total of 71 pregnant women (31 with NTD and 42 healthy controls) were enrolled in this study. This prospective case-control study included pregnant women with NTDs as the study group and randomly selected age-matched pregnant women with healthy fetuses as the control group. The two groups were compared on the basis of thiol/disulfide and IMA levels in the maternal and fetal samples.

RESULTS: No statistically significant difference in native thiol, total thiol, disulfide, and calculated ratios was observed between the groups. However, maternal IMA values were significantly higher in the study group. The IMA was proven to be a predictor with a sensitivity of 77.4% and specificity of 100% for NTDs at a cut-off value of 1.32.

CONCLUSION: The examination of the maternal levels of IMA may be useful in the detection of NTDs.

PMID:36128919 | DOI:10.5137/1019-5149.JTN.40096-22.3

Surg Innov. 2022 Sep 21:15533506221120484. doi: 10.1177/15533506221120484. Online ahead of print.

ABSTRACT

OBJECTIVE: The mainstay of first-line treatment of parotid tumors is adequate surgical removal. The present study was conducted to compare the differences between parotidectomy with postauricular incision (PI) and modified Blair incision (MBI).

DATA SOURCES: A systematic search of PubMed, Embase and the Cochrane Library was performed.

METHODS: The data of interest and study characteristics were extracted from the included studies. Statistical analysis was performed with Comprehensive Meta-Analysis software (version 3; BioStat, Englewood, NJ). Dichotomous data and continuous data were analyzed by calculating the risk difference and the mean difference with the 95% confidence interval respectively.

RESULTS: Four retrospective studies were included in the present meta-analysis. The pooled results revealed that the cosmetic satisfaction score was higher in the PI group (MD = 2.67; 95% CI, 2.12 to 3.23) and that intraoperative blood loss was lower in the PI group (MD = -55.35; 95% CI, -100.33 to -10.36). The operative duration (MD = -5.15; 95% CI, -24.06 to 13.75), tumor size (MD = -.07; 95% CI, -.27 to .13) and incidences of common postoperative complications were comparable between the two groups.

CONCLUSIONS: According to these findings, the use of PI in parotidectomies may be one of the options for improving cosmetic outcomes. This technique may be considered if oncological safety can be secured.

PMID:36128913 | DOI:10.1177/15533506221120484

Stat Methods Med Res. 2022 Sep 21:9622802221122403. doi: 10.1177/09622802221122403. Online ahead of print.

ABSTRACT

Dichotomous response data observed over multiple time points, especially data that exhibit longitudinal structures, are important in many applied fields. The multivariate probit model has been an attractive tool in such situations for its ability to handle correlations among the outcomes, typically by modeling the covariance (correlation) structure of the latent variables. In addition, a multivariate probit model facilitates controlled imputations for nonignorable dropout, a phenomenon commonly observed in clinical trials of experimental drugs or biologic products. While the model is relatively simple to specify, estimation, particularly from a Bayesian perspective that relies on Markov chain Monte Carlo sampling, is not as straightforward. Here we compare five sampling algorithms for the correlation matrix and discuss their merits: a parameter-expanded Metropolis-Hastings algorithm (Zhang et al., 2006), a parameter-expanded Gibbs sampling algorithm (Talhouk et al., 2012), a parameter-expanded Gibbs sampling algorithm with unit constraints on conditional variances (Tang, 2018), a partial autocorrelation parameterization approach (Gaskins et al., 2014), and a semi-partial correlation parameterization approach (Ghosh et al., 2021). We describe each algorithm, use simulation studies to evaluate their performance, and focus on comparison criteria such as computational cost, convergence time, robustness, and ease of implementations. We find that the parameter-expanded Gibbs sampling algorithm by Talhouk et al. (2012) often has the most efficient convergence with relatively low computational complexity, while the partial autocorrelation parameterization approach is more flexible for estimating the correlation matrix of latent variables for typical late phase longitudinal studies.

PMID:36128906 | DOI:10.1177/09622802221122403

J Pathol Transl Med. 2022 Sep;56(5):260-269. doi: 10.4132/jptm.2022.07.05. Epub 2022 Sep 13.

ABSTRACT

BACKGROUND: Gastric-type endocervical adenocarcinoma (GEA) is unrelated to human papillomavirus (HPV) infection and is clinically aggressive compared with HPV-associated usual-type endocervical adenocarcinoma (UEA). The cytological diagnosis falls short of a definitive diagnosis of GEA and is often categorized as atypical glandular cells (AGCs). To improve cytologic recognition, cytological findings of HPV-independent GEA were analyzed and the results compared with HPV-associated UEA.

METHODS: Cervical Papanicolaou (Pap) smears from eight patients with a histopathologic diagnosis of GEA and 12 control cases of UEA were reviewed. All slides were conventionally prepared and/or liquid-based prepared (ThinPrep) and stained following the Pap method. A mucinous background, architectural, nuclear, and cytoplasmic features were analyzed and compared with UEA.

RESULTS: Preoperative cytologic diagnoses of the eight GEA cases were AGCs, favor neoplastic in three cases, adenocarcinoma in situ in one case, and adenocarcinoma in four cases. Cytologically, monolayered honeycomb-like sheets (p = .002) of atypical endocervical cells with vacuolar granular cytoplasm (p = .001) were extensive in GEA, and three-dimensional clusters (p = .010) were extensive in UEA. Although the differences were not statistically significant, background mucin (p = .058), vesicular nuclei (p = .057), and golden-brown intracytoplasmic mucin (p = .089) were also discriminatory findings for GEA versus UEA.

CONCLUSIONS: Although GEA is difficult to diagnose on cytologic screening, GEA can be recognized based on cytologic features of monolayered honeycomb sheets of atypical endocervical cells with abundant vacuolar cytoplasm and some golden-brown intracytoplasmic mucin. UEA cases are characterized by three-dimensional clusters.

PMID:36128862 | DOI:10.4132/jptm.2022.07.05

Orthop Surg. 2022 Sep 21. doi: 10.1111/os.13499. Online ahead of print.

ABSTRACT

OBJECTIVE: Soft tissue sarcomas (STSs) arising from the popliteal fossa pose surgical challenges due to their proximity to critical neurovascular structures. This study aimed to investigate whether a novel 3D imaging technique highlighting these key anatomical structures could facilitate preoperative planning and improve surgical outcomes in STS.

METHODS: This was a prospective, observational, pilot study. Between November 2019 and December 2020, 27 patients with STS of the popliteal fossa undergoing limb-sparing procedures were enrolled and assigned to either a control or intervention group. Control patients underwent traditional preoperative planning with separate computed tomography angiography, magnetic resonance imaging, and magnetic resonance hydrography. In the intervention group, 3D images were generated from these images, the tumor and skeletomuscular and neurovascular structures were revealed in three dimensions, and this was visualized on the surgeon’s smartphone or computer. Primary endpoints were surgical margins and complications. Secondary endpoints included operative time, blood loss, serum C-reactive protein and interleukin-6, length of in-hospital stay, and limb function. Comparisons between groups were made using independent-sample t-tests for continuous data and the Mann-Whitney U and Fisher’s exact tests for categorical data.

RESULTS: There was a lower but not significantly different inadvertent positive margin rate (1/15 vs. 3/12, P = 0.294), significantly shorter hospital stay (P = 0.049), and less numbers ≥75th percentile of operative time (P = 0.037) and blood loss (P = 0.024) in the intervention group. Differences in surgical complications, operative time, blood loss, C-reactive protein and interleukin-6 levels on the second postoperative day, and limb functional scores were statistically insignificant.

CONCLUSIONS: The novel 3D imaging technique facilitates complex preoperative planning and limb-salvage surgical procedures for patients with STS of the popliteal fossa, and this may affect how surgical planning is performed in the future.

PMID:36128857 | DOI:10.1111/os.13499

Thyroid. 2022 Sep 21. doi: 10.1089/thy.2022.0280. Online ahead of print.

ABSTRACT

BACKGROUND: The most prevalent extrathyroidal manifestation of Graves’ disease (GD) is Graves’ ophthalmopathy (GO). However, only few methods allow for predictions of GO occurrence or progression in patients with GD.

METHODS: We retrospectively analyzed 1,074 patients with new-onset GD, and divided them into a derivation and a validation cohort based on the date of their GD diagnosis. We then separately analyzed clinical risk factors affecting the occurrence and progression of GO using multivariable regression analysis and created a predictive model based on the factors we identified as significant.

RESULTS: Of the 853 GD patients included in the derivation cohort, 101 (11.8%) developed GO. Those who developed GO were more likely to be smokers (25.7% vs. 8.5%, P < 0.001), were younger at the time of their GD diagnosis (35.0 years vs. 42.0 years, P < 0.001), more commonly had a family history of GD (27.7% vs. 17.2%, P = 0.015), and had higher thyrotropin-binding inhibitor immunoglobulin (TBII) levels at the time of their diagnosis (13.5 IU/L vs. 10.0 IU/L, P = 0.020) than those who did not develop GO. Of the 101 GO patients in the derivation cohort, after excluding eight who initially had active and moderate-to-severe GO, 11 of the remaining 93 had progressed to more active or severe GO. GO patients with confirmed progression had a higher proportion of those older than 45 years (54.5% vs. 19.8%, P = 0.031), and they had a different initial CAS distribution. The multivariable regression analysis identified age at GD diagnosis, sex, smoking history, family history of GD, total cholesterol level, and TBII level at the time of the diagnosis as significant risk factors of GO occurrence, and a predictive model including these risk factors was built to create a nomogram.

CONCLUSIONS: The predictors of GO occurrence in patients with new-onset GD were female sex, positive smoking history, young age, family history of GD, high cholesterol level, and high TBII level. The predictive nomogram developed in this study may be useful in patient counseling and facilitating informed treatment decision-making.

PMID:36128837 | DOI:10.1089/thy.2022.0280

Stat Methods Med Res. 2022 Sep 21:9622802221125912. doi: 10.1177/09622802221125912. Online ahead of print.

ABSTRACT

The median is a robust summary commonly used for comparison between populations. The existing literature falls short in testing for equality of survival medians when the collected data do not form representative samples from their respective target populations and are subject to right censoring. Such data commonly occur in prevalent cohort studies with follow-up. We consider a particular case where the disease under study is stable, that is, the incidence rate of the disease is stable. It is known that survival data collected on diseased cases, when the disease under study is stable, form a length-biased sample from the target population. We fill the gap for the particular case of length-biased right-censored survival data by proposing a large-sample test using the nonparametric maximum likelihood estimator of the survivor function in the target population. The small sample performance of the proposed test statistic is studied via simulation. We apply the proposed method to test for differences in survival medians of Alzheimer’s disease and dementia groups using the survival data collected as part of the Canadian Study of Health and Aging.

PMID:36128831 | DOI:10.1177/09622802221125912

Dent Med Probl. 2022 Sep 20. doi: 10.17219/dmp/149342. Online ahead of print.

ABSTRACT

BACKGROUND: The outbreak of the coronavirus disease 2019 (COVID-19) pandemic was associated with the provision of multiple guidelines for the dental profession. All elective procedures were restricted, and only emergency procedures were performed. There was fear and anxiety among dentists while performing aerosol-generating procedures (AGPs), as they were considered to pose a high risk of COVID-19 transmission.

OBJECTIVES: The aim of this study was to assess the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during AGPs, and to examine the association between risk severity and the number of AGPs performed per day. The efficacy of personal protective equipment (PPE) was also assessed.

MATERIAL AND METHODS: This cross-sectional cohort study was based on an online questionnaire form completed by 629 general and specialized dentists between January 1 and February 28, 2021. The collected data referred to the sources of COVID-19 infection, the type of PPE used and the number of AGPs performed each day by dental healthcare professionals (DHCPs). For each question, the absolute numbers of responses as well as percentages were calculated.

RESULTS: Among the 629 DHCPs, 113 (17.97%) contracted COVID-19. The risk of contracting COVID-19 during AGPs was the same as in the case of non-AGPs, and the infection risk was not associated with the number of AGPs performed per day. The efficacy of a surgical mask with a face shield/eye goggles was higher in comparison with all other types of PPE. Differences in the infection risk across the different types of PPE used were statistically significant (p < 0.001).

CONCLUSIONS: The risk of COVID-19 transmission during AGPs is the same as in the case of non-AGPs. Thus, restrictions on the performance of elective AGPs should be lifted. On the other hand, the best protection during AGPs is provided by a surgical mask with a face shield/eye goggles.

PMID:36128802 | DOI:10.17219/dmp/149342