Tag: statistics

Acta Orthop Traumatol Turc. 2026 Apr 8;60(2). doi: 10.5152/j.aott.2026.25618.

ABSTRACT

The primary objective of this study is to compare the quality and readability of patient education materials generated by a general-purpose large language model (ChatGPT-5) versus a guideline-based, fine-tuned model (the Gonarthrosis Advisor). The study aims to quantify the performance gains achieved through domain-specific, fine-tuning, and reinforcement learning using osteoarthritis clinical guidelines. Methods: Thirty frequently asked patient questions regarding knee osteoarthritis were compiled from Google’s “People Also Ask” feature and outpatient clinical observations in May 2025. Responses were generated in Turkish by both the Gonarthrosis Advisor and ChatGPT-5 to reflect real-world patient education materials. Content quality was assessed by 2 independent orthopedic surgeons who were blinded to model identity to minimize bias. Both reviewers were co-authors of the article yet did not participate in model construction or data analysis. The assessments utilized the DISCERN instrument, a validated 16-item measure for evaluating the reliability and quality of treatment-related information. Readability was analyzed using the Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), and Turkish specific indices (Ateşman and Çakır-Demir). For comparability, English-based indices were applied to translated versions of the responses, whereas Turkish indices were applied to the original texts. All responses were anonymized and randomized prior to evaluation. Model identifiers were removed, and each response was presented in a standardized format to ensure blinding of reviewers. Inter-rater reliability was measured using Cronbach’s α. Normality assumptions were tested, and Wilcoxon signed-rank tests were used for statistical comparisons. As no human subjects or personal data were involved, ethical approval was not required. Results: Mean DISCERN scores corresponded to the “good” category (66.4) for the Gonarthrosis Advisor and the ‘moderate’ category (54.2) for ChatGPT-5, according to established cut-off thresholds. The Gonarthrosis Advisor achieved significantly higher DISCERN scores than ChatGPT-5 (66.4 ± 4.8 vs. 54.2 ± 5.6; P < .001) with high inter-rater reliability (Cronbach’s α = 0.86). Readability metrics favored the Gonarthrosis Advisor across all indices: lower FKGL (7.8 ± 0.7 vs. 9.6 ± 0.9) and higher FRES (54.3 ± 3.4 vs. 46.7 ± 3.7), Ateşman (92.0 ± 4.2 vs. 84.3 ± 4.9), and Çakır-Demir (111.7 ± 5.1 vs. 106.9 ± 5.4) scores (all P <.001). Conclusion: Fine-tuning large language models with guideline-based content and reinforcement learning improves the quality, neutrality, and accessibility of artificial intelligence-generated patient education materials, offering a scalable tool to enhance health literacy and support shared decision-making in knee osteoarthritis care. Cite this article as: Öner SK, Demirkiran ND, Canlı EA, Bilir A. Gonarthrosis Advisor vs ChatGPT-5: quality and readability of AI-generated patient education for knee osteoarthritis. Acta Orthop Traumatol Turc., 2026, 60(2), 0618, doi: 10.5152/j.aott.2026.25618.

PMID:42364231 | DOI:10.5152/j.aott.2026.25618

Urol Res Pract. 2026 May 20;52:1-6. doi: 10.5152/tud.2026.26015.

ABSTRACT

OBJECTIVE: Renal stone formation is closely linked to disturbances in urinary and serum mineral metabolism. Analysis of stone composition along with biochemical parameters is essential for understanding the pathogenesis of different stone types.

METHODS: A prospective observational study was conducted among 371 patients with renal stones. Stone composition was analyzed using Fourier transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy- Energy-Dispersive X-ray Spectroscopy techniques. Serum and 24-hour urinary biochemical parameters, including calcium, oxalate, citrate, phosphate, uric acid, pH, and urine volume, were evaluated. Statistical analysis was performed to assess differences and correlations between stone types and biochemical variables.

RESULTS: The mean age was 45.3 years, with male predominance and 39.9% recurrence. Calcium oxalate monohydrate was most common. Stone types differed significantly in urinary volume, pH, and mineral excretion. Uric acid stones showed low urine pH and volume, while calcium phosphate stones had higher calcium excretion and alkaline pH, with related serum differences.

CONCLUSION: Renal stone composition is strongly associated with specific urinary and serum biochemical abnormalities. Metabolic evaluation is crucial for identifying etiological factors and for guiding individualized preventive strategies in stone disease management. Cite this article as: Prakash P, Agarwal S, Sarpal R, Dogra AK, Prakash A. Composition and biochemical determinants of renal stones: A comprehensive analysis of urinary and serum mineral profiles. Urol Res Pract. 2026, 52, 0015, doi: 10.5152/tud.2026.26015.

PMID:42364224 | DOI:10.5152/tud.2026.26015

Eurasian J Med. 2026 Jun 11;58(4):1-5. doi: 10.5152/eurasianjmed.2026.261359.

ABSTRACT

BACKGROUND: Deaths due to lightning strikes are rare but of great forensic importance because of their sudden and fatal nature. This study aimed to evaluate the demographic characteristics, scene findings, and autopsy results of fatal lightning strike cases examined in Kars and Ardahan provinces.

METHODS: This retrospective study included 13 cases of death by lightning strike, identified from 847 autopsies performed in 2 climatically similar provinces between 2019 and 2025 via the National Judicial Network Project (UYAP) database. The research evaluates the victims’ demographic data, incident location characteristics, and macroscopic autopsy findings, alongside negative toxicological and histopathological examination results. The data were analyzed using the SPSS software, utilizing descriptive statistical methods such as frequency, percentage distribution, and mean values.

RESULTS: Between 2019 and 2025, 1.53% (n = 13) of forensic autopsies in Kars and Ardahan were attributed to lightning strikes, with all cases involving male victims and a mean age of 31.3 years. The majority of cases were shepherds (69.2%), and deaths occurred most frequently in rural pastures during the spring and summer months, particularly in May and June. While all cases exhibited first- and second-degree burns and singed body hair, characteristic Lichtenberg figures were detected in 46.1% of the victims alongside various internal hemorrhages in some instances. Crime scene investigations provided critical diagnostic evidence, including the presence of deceased livestock near the victims and partially burned or torn personal belongings.

CONCLUSION: Lightning-related deaths show a strong association with seasonal, occupational, and environmental factors. Scene investigation and the recognition of Lichtenberg figures play a crucial role in the forensic diagnosis of lightning strike fatalities. Cite this article as: Sancı A, Karaalp E, Baltacı AS, Vural T. Evaluation of lightning strike fatalities: a retrospective autopsy study from 2 centers in eastern Türkiye. Eurasian J Med. 2026, 58(4), 1359, doi: 10.5152/eurasianjmed.2026.261359.

PMID:42364222 | DOI:10.5152/eurasianjmed.2026.261359

Eurasian J Med. 2026 Jun 12;58(4):1-5. doi: 10.5152/eurasianjmed.2026.261379.

ABSTRACT

BACKGROUND: Breast cancer in very elderly women presents unique clinical and imaging characteristics, and data regarding this age group remain limited. This study aimed to evaluate the imaging characteristics of breast cancer in patients aged 80 years and older together with clinical and pathological findings.

METHODS: A retrospective analysis was performed on 23 patients aged 80 years and older diagnosed with breast cancer at a single institution between January 2021 and January 2026. Clinical presentation, tumor size, histological grade, metastasis status, and imaging findings, including mammographic features and Breast Imaging Reporting and Data System (BI-RADS) categories, were evaluated. Associations between clinical presentation and tumor characteristics were statistically analyzed.

RESULTS: Of the patients, 30.4% were diagnosed during screening and 69.6% following diagnostic presentation. Tumor size was significantly larger in the diagnostic group than in the screening group (median: 24.5 mm vs. 14.5 mm; P < .001). Distant metastasis occurred only in diagnostically presenting patients (31.3%), while lymph node metastasis rates were similar between groups (P > .05). Grade 2 tumors were the most common (39.1%). The most frequent mammographic findings were masses with or without calcifications, most commonly irregular in shape, with spiculated margins and high density. BI-RADS 5 was the most frequent category (60.9%).

CONCLUSION: Breast cancer imaging features in women aged 80 years and older resemble those of the general population. Smaller tumor sizes and absence of distant metastasis in screen-detected cases suggest that screening may still support earlier detection in selected very elderly women. Cite this article as: Seyfettin A, Gültekin S, Kantarcı M. Imaging characteristics of breast cancer in women aged 80 years and older: A single-center experience. Eurasian J Med. 2026, 58(4), 1379, doi: 10.5152/ eurasianjmed.2026.261379.

PMID:42364220 | DOI:10.5152/eurasianjmed.2026.261379

Eurasian J Med. 2026 Apr 24;58(3):1-6. doi: 10.5152/eurasianjmed.2026.251290.

ABSTRACT

Our aim was to estimate the prevalence of non-thyroidal illness syndrome in individuals with chronic obstructive pulmonary disease (COPD). A systematic review and meta-analysis of studies indexed in Embase, ScienceDirect, PubMed, Virtual Health Library, Web of Science, and Cochrane Library from inception through December 31, 2023, was performed. The protocol was registered in PROSPERO (CRD42024492108). Pooled prevalence and 95% CIs were calculated using the DerSimonian-Laird random-effects model, and heterogeneity was assessed with the I2 statistic. Meta-regression analyses examined the influence of age, sex, and smoking status. Subgroup and sensitivity analyses were performed, and associations with arterial blood gas parameters (PaO₂, PaCO₂, and SaO₂) were evaluated using the inverse-variance method within a random-effects framework. Eleven studies including 1005 chronic obstructive pulmonary disease patients met the inclusion criteria. The overall pooled prevalence of non-thyroidal illness syndrome was 44.2% (95% CI, 30.0-58.4%) with high heterogeneity (I2, 96.1%). Non-thyroidal illness syndrome was more common during acute exacerbations (54.5%) than in stable disease (13.8%). Meta-regression analyses showed that age, sex, and smoking status did not significantly account for heterogeneity. Among arterial blood gas parameters, a modest but statistically significant reduction in SaO₂ was observed in patients with non-thyroidal illness syndrome compared with those without (-2.65%, 95% CI, -4.56 to -0.74). No significant differences were detected for PaO₂ or PaCO₂. As a conclusion, non-thyroidal illness syndrome is a common finding in patients with COPD, particularly during acute exacerbations, and is associated with reduced oxygen saturation. These findings highlight the importance of monitoring thyroid function and oxygenation in this population. Cite this article as: Vázquez PF, Diez-Manglano J. High prevalence of non-thyroidal illness syndrome in patients with chronic obstructive pulmonary disease: A systematic review and metaanalysis. Eurasian J Med. 2026, 58(3), 1290, doi: 10.5152/eurasianjmed.2026.251290.

PMID:42364217 | DOI:10.5152/eurasianjmed.2026.251290

Eurasian J Med. 2026 Apr 22;58(3):1-5. doi: 10.5152/eurasianjmed.2026.251291.

ABSTRACT

BACKGROUND: Melasma is an acquired disease with an unclear etiology. This study aimed to compare the hemoglobin, serum iron, iron-binding capacity, ferritin, zinc, vitamin B12, and vitamin D levels in patients with melasma to those in controls and to investigate a possible relationship between these parameters and melasma severity.

METHODS: One hundred consecutive patients with melasma and 50 healthy controls were included in this case-control observational study. Demographic features and disease duration were recorded. Melasma lesions were scored according to the melasma area severity index (MASI). Hemoglobin, serum iron, total iron binding capacity (TIBC), ferritin, vitamin D, vitamin B12, and zinc levels were compared between patients and controls. Possible correlations between these parameters and the MASI were also investigated.

RESULTS: In terms of laboratory data, there were statistically significant differences in hemoglobin, vitamin D, ferritin, and TIBC between melasma patients and the control group, but no statistically significant difference was observed in vitamin B12, zinc, and iron levels. A statistically significant positive correlation was found between the MASI score, age, melasma disease duration, and ferritin.

CONCLUSION: The study presented lower hemoglobin, vitamin D, and ferritin levels in patients with melasma than in controls and demonstrated a relationship between lower ferritin levels and melasma severity. Considerations of these deficiencies may contribute to the holistic approach to melasma. Cite this article as: Akal E, Melikoglu M. Relationship between hemoglobin, serum iron, iron-binding capacity, ferritin, zinc, vitamin B12, and vitamin D levels in patients with melasma and the severity of their condition. Eurasian J Med. 2026, 58(3), 1291, doi: 10.5152/eurasianjmed.2026.251291.

PMID:42364216 | DOI:10.5152/eurasianjmed.2026.251291

Urol Res Pract. 2026 Jun 11;52:1-8. doi: 10.5152/tud.2026.25137.

ABSTRACT

OBJECTIVE: To evaluate the clinical impact of a modified daytime double-J (DJ) stent removal model based on comfort-oriented medical care on patient pain, anxiety, procedural efficiency, and satisfaction.

METHODS: Between January 2024 and June 2025, 160 patients undergoing ureteroscopy or percutaneous nephrolithotomy requiring DJ stent removal were randomly assigned to a comfort group (n = 80) or a conventional group (n = 80). The comfort group received structured preoperative education, intravenous sedation combined with urethral local anesthesia, pressurized irrigation-assisted cystoscopic removal, and postoperative follow-up. The conventional group underwent traditional outpatient cystoscopic stent removal. Outcomes included Visual Analog Scale (VAS) pain scores, Self-Rating Anxiety Scale (SAS) scores, stent removal time, patient satisfaction, and postoperative complications.

RESULTS: The comfort group reported significantly lower 24-hour VAS pain scores than the conventional group (2.6 ± 0.9 vs. 5.5 ± 1.0, P < .001). Baseline SAS scores were significantly lower in the comfort group than in the conventional group (30.2 ± 5.7 vs. 46.2 ± 7.0, P < .001), and postoperative SAS scores were 28.4 ± 4.7 vs. 42.0 ± 6.8, both P < .001. Stent removal time was shorter in the comfort group (1.90 ± 0.35 minutes vs. 2.20 ± 0.50 minutes, P = .014). Satisfaction scores and satisfaction rates were higher in the comfort group (4.6 ± 0.5 vs. 3.6 ± 0.7, 96.2% vs. 70.0%, P < .01). The 24-hour postoperative complication rate was low and not statistically significant (2.5% vs. 2.5%, P > .05).

CONCLUSION: The comfort-oriented daytime stent removal model significantly reduces procedural pain and anxiety while improving patient satisfaction without increasing short-term complications. Cite this article as: Xu X, Wu S, Yu Q, Tang R. A randomized study of a comfort-oriented daytime double-J stent removal protocol: effects on pain, anxiety, and patient satisfaction. Urol Res Pract. 2026, 52, 0137, doi: 10.5152/tud.2026.25137.

PMID:42364215 | DOI:10.5152/tud.2026.25137

Florence Nightingale J Nurs. 2026 May 11;34:1-12. doi: 10.5152/FNJN.2026.25346.

ABSTRACT

AIM: The aim of this study was to determine the validity and reliability of the “Cardiac Self-Efficacy Questionnaire” in Turkish.

METHODS: This methodological research was conducted among 400 patients who were hospitalised at the Cardiology Clinic of Giresun University Training and Research Hospital between 25 March 2023 and 15 May 2024. The data were collected using the “Patient Introductory Form”, “Cardiac Self-Efficacy Questionnaire”, and “Chronic Diseases Self-Efficacy Scale”.

RESULTS: The scale demonstrated excellent content validity, with a content validity index of 1.00. Construct validity was examined using factor analytic techniques. “The Kaiser-Meyer-Olkin measure indicated adequate sampling adequacy 0.878, and Bartlett’s test of sphericity was statistically significant (p < .001), confirming the appropriateness of the correlation matrix for factor analysis.” Exploratory factor analysis supported a two-factor solution control of symptoms and maintenance of functionality which collectively explained 53.55% of the total variance. The results indicated that the model provided a goodto- acceptable fit to the data, as evidenced by the following fit indices: χ2/df = 2.172, Goodness of Fit Index = 0.91, Adjusted Goodness Fit Index = 0.87, Comparative Fit Index = 0.95, Incremental Fit Index = 0.95, Tucker-Lewis Index = 0.93, Normed Fit İndex = 0.91, and Root Mean Square Error of Approximation = 0.07. The reliability analysis indicated acceptable internal consistency, with Cronbach’s α values of 0.88 for the overall scale, 0.86 for the symptom control subscale, and 0.76 for the functionality maintenance subscale.

CONCLUSION: The Cardiac Self-Efficacy Questionnaire can be considered a valid and reliable instrument for assessing cardiac self-efficacy in the Turkish population. Cite this article as: Bayram, S., & G.k Uğur, H. (2026). Turkish validity and reliability study of the cardiac self-efficacy questionnaire. Florence Nightingale Journal of Nursing, 34, 0346, doi:10.5152/FNJN.2026.25346.

PMID:42364213 | DOI:10.5152/FNJN.2026.25346

Acta Orthop Traumatol Turc. 2026 Mar 12;60(2). doi: 10.5152/j.aott.2026.25585.

ABSTRACT

This study aimed to compare the clinical and functional outcomes of Kirschner wire (K-wire) fixation versus volar locking plate (VLP) fixation for intra-articular distal radius fractures (DRFs). It also aimed to identify key patient- and fracture-related factors that influence the choice of surgical technique and to evaluate the responsiveness of specific patient-reported outcome measures in assessing recovery. Methods: A total of 201 consecutive patients with Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association-classified DRFs (Type A: n = 51; B: n = 90; C: n = 60) treated surgically between 2005 and 2022 were analyzed. Treatment allocation was based on fracture complexity and surgeon preference, resulting in a distribution where K-wire (n = 63) was primarily used for partial articular fractures (72.4% of K-wire cases were Type B), while VLP (n = 138) was preferred for complete articular fractures (83.6% of plate cases were Type C). Functional outcomes were assessed using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) (primary endpoint), Green-O’Brien, Gartland-Werley, and SF-12 at standardized intervals (6/12/24 months) during supervised physiotherapy. Results: Significant predictors of plate fixation included older age (58.1 ± 14.7 vs. 42.3 ± 12.1 years, P < .001), polytrauma (aOR: 2.4, 95% CI: 1.5-3.8), and complete articular fractures (83.6% Type C, P = .01). No statistically significant associations were found between injury type and fixation method (P = .20) or between complications and fixation method (4.8% vs. 2.2%, P = .41). Functional outcomes were comparable across all metrics, with no statistically significant differences observed: QuickDASH (34.9 ± 18.2 K-wire vs. 31.2 ± 16.8 plate, P = .146), Green-O’Brien (excellent-good: 76.2% vs. 82.6%, P = .552), Gartland-Werley (78.1% vs. 71.1% excellent-good, P = .591), and 12-Item Short Form Health Survey (SF-12) (100% vs. 99.3% good results, P = .32). Multivariable regression identified reduction quality (β = 0.81, P < .01), not implant type, as the primary outcome determinant. Conclusion: This study suggests that anatomical reduction quality-not fixation method-is the primary determinant of functional success in DRFs, with both K-wire and VLP achieving comparable outcomes (QuickDASH/Gartland-Werley P > .05). K-wires represent a cost-effective alternative for partial articular fractures (72.4% of cases), while plates were more frequently used in complex fractures and polytrauma cases (adjusted odds ratio [aOR] = 2.4). Early rehabilitation (median 4 days post-op) and condition-specific metrics (QuickDASH, Green-O’Brien) are critical for optimal recovery, whereas SF-12 proves less sensitive for wrist-specific assessment. These findings advocate for surgeon-tailored technique selection based on fracture pattern and emphasize the need for multicenter randomized controlled trials (RCTs) to evaluate long-term outcomes. Cite this article as: Yigit O, Kart H, Cat G, et al. Comparison of Kirschner wire versus volar locking plate fixation for distal radius fractures: clinical and functional outcomes. Acta Orthop Traumatol Turc. 2026; 60(2), 0585, doi: 10.5152/j.aott.2026.25585.

PMID:42364204 | DOI:10.5152/j.aott.2026.25585

Int J Clin Pharm. 2026 Jun 27. doi: 10.1007/s11096-026-02178-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Collaborative pharmacist prescribing in hospitals involves pharmacists, medical doctors, and patients working together to develop medicine plans that support shared decision-making and underpin pharmacist prescriptions. Shared decision-making is a process in which clinicians and patients make treatment decisions together, ensuring they reflect patient preferences and understanding. However, little is known about patient perspectives and experiences with collaborative pharmacist prescribing, particularly related to shared decision-making, in the inpatient hospital setting.

AIM: To examine patient perspectives and experiences of collaborative pharmacist prescribing in the hospital inpatient setting.

METHOD: A cross-sectional survey was conducted across four hospitals in South Australia. Eligible inpatients were aged ≥ 18 years and provided informed consent. The primary outcome was patient perspectives of collaborative pharmacist prescribing and experiences during medicine prescribing as an inpatient. Results were stratified by the type of prescribing model (collaborative pharmacist prescribing vs. medical prescribing) received by the patient during their admission. Free-text responses were thematically analysed using Braun and Clarke’s framework. Likert scale responses were summarised using descriptive statistics, and sub-group analysis compared categorical variables between groups.

RESULTS: Responses were received from 200 patients (100 who received collaborative pharmacist prescribing and 100 who received medical doctor prescribing). Overall, patients had a median age of 72 years and just over half were female. Qualitative analysis found that all respondents trust pharmacists’ expertise and ability to collaboratively prescribe. Patients in both groups perceived benefits of collaborative pharmacist prescribing including enhanced interprofessional communication, reductions in medication errors, and a better understanding of their medicines. These findings reinforced the quantitative results, with a higher proportion of patients who received collaborative pharmacist prescribing reporting feeling very or extremely involved in medicine decisions compared to patients who received medical prescribing (60% vs. 14%, p < 0.001).

CONCLUSION: Collaborative pharmacist prescribing enhances shared decision-making by actively involving patients in discussions about their medicines. It improves patients’ understanding of their medicines, which supports safer and more informed treatment decisions. These findings support wider adoption of collaborative pharmacist prescribing to improve patient-centered care in hospitals.

PMID:42364068 | DOI:10.1007/s11096-026-02178-0