Tag: statistics

Am J Emerg Med. 2025 Jun 27;96:201-207. doi: 10.1016/j.ajem.2025.06.067. Online ahead of print.

ABSTRACT

INTRODUCTION: Gastroparesis (GP), cyclic vomiting syndrome (CVS), and cannabinoid hyperemesis syndrome (CHS) are chronic disorders of gut-brain motility. Though GP, CVS, and CHS are relatively common, recent, large scale data on their incidence and acute management are lacking. Thus, we sought to assess the incidence, rates of admission, medication administrations, and demographic data among emergency department (ED) visits for GP, CVS, and CHS in the United States.

METHODS: This was a retrospective cohort study of all ED presentations for GP, CVS, and CHS from 1/1/2016 to 12/31/2024 in the Epic Cosmos database. Emergency department visits for adults with GP, CVS, and CHS were identified by ICD-10 codes. Outcomes included incidence, admission rates, medications administered, and hospital length of stay (LOS). Data were analyzed using descriptive statistics and compared using multilevel chi-squared tests.

RESULTS: Out of 248,293,507 ED encounters over a nine-year period from 2016 to 2024, there were 165,857 (0.07 %), 204,636 (0.08 %), and 134,059 (0.05 %) encounters with an ICD-10 code corresponding to GP, CVS, and CHS, respectively. Gastroparesis and CVS were most prevalent in the southern United States; CVS was equally prevalent in the South and the Midwest. All three conditions primarily affected females. The mean age of patients with GP, CVS, and CHS is 44.7 years, 36.5 years, and 32 years, respectively. Mean admission rates for patients with GP and CHS remained steady over the nine-year period at approximately 25.4 % and 13.5 %, respectively. Admission rates for patients with CVS dropped from 20.3 % in 2016 to 11.5 % in 2024. The mean LOS for GP, CVS, and CHS were 5.8, 4.7, and 3.8 days, respectively. For all conditions, ondansetron was the most commonly administered medication (61.3 % for GP, 63 % for CVS, and 58.7 % for CHS). For GP and CVS, the second most commonly administered medication was metoclopramide (48.2 % and 27.4 %, respectively). For CHS, the second most commonly administered medication was haloperidol (32.6 %).

CONCLUSION: Gastroparesis, CVS, and CHS are common reasons for presentation to the ED. Ondansetron remains the most common treatment for acute exacerbations of GP, CVS, and CHS. Rates of admission and hospital LOS for all three conditions demonstrate that GP, CVS, and CHS continue to pose a significant burden on healthcare systems.

PMID:40602005 | DOI:10.1016/j.ajem.2025.06.067

Geriatr Nurs. 2025 Jul 1;64:103414. doi: 10.1016/j.gerinurse.2025.103414. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to test the psychometric properties of the Papadum/Pizza Test.

DESIGN: This was a descriptive study.

SAMPLE: Participants included 80 individuals living in low-income senior housing. The majority were female (70 %) and Black (70 %) older adults.

MEASURES: Demographics, the Patient Health Questionnaire-2, the Papadum/Pizza test, and the Clock test were obtained.

DATA ANALYSIS: Descriptive statistics were done. A Cohen’s Kappa was calculated to evaluate inter-rater reliability. Rasch analysis using Winsteps was done to test internal consistency, Differential Item Functioning (DIF), and model testing for construct validity. Hypothesis testing was done using Pearson correlations.

RESULTS: There was a Cohen’s kappa of .98, an alpha coefficient of .95, no DIF between groups, and all items fitting the model, and all hypotheses tested were supported.

CONCLUSION: The study provided support for reliability and validity of the Pizza Test when used with older adults in senior housing.

PMID:40602003 | DOI:10.1016/j.gerinurse.2025.103414

Aust J Gen Pract. 2025 Jul;54(7):477-483. doi: 10.31128/AJGP-04-24-7229.

ABSTRACT

BACKGROUND AND OBJECTIVES: In July 2022, a policy change was enacted in the National Cervical Screening Program (NCSP) to allow all women and people with a cervix (hereafter people) the choice of a self-collected sample. This study aimed to understand healthcare practitioners’ decisions, and factors related to, the provision (or not) of this change.

METHOD: Semi-structured interviews (n=28) were conducted between February and July 2023 with general practitioners, nurses and practice managers. The COM-B model of behaviour change framework informed the analysis.

RESULTS: Although most (n=22) interviewees reported that they, or healthcare practitioners at their practice, were providing a choice of self-collection to all, a minority (n=6) reported that either they (n=4) or their practice (n=2) were not. Factors that informed the selective provision of self-collection are reported.

DISCUSSION: For self-collection to facilitate improved equity in the NCSP, strategies are needed to reassure healthcare practitioners that self-collection is an appropriate screening modality, and ensure people are aware of their screening choices.

PMID:40601982 | DOI:10.31128/AJGP-04-24-7229

Aust J Gen Pract. 2025 Jul;54(7):471-476. doi: 10.31128/AJGP-04-24-7242.

ABSTRACT

BACKGROUND AND OBJECTIVES: Relatively little is known about public understanding of the secondary use of general practice data. We investigated what the Australian public knows about the secondary use of information in their general practice records.

METHOD: The investigation used a mixed methods approach with four focus groups (n=22) and a cross-sectional survey that was weighted to be nationally representative (n=2604).

RESULTS: Participants broadly understood what was in their general practice record. Most believed it was shared with hospital health professionals and other medical staff to support their care. Fewer than 30% thought their health information was shared with health administrators, planners and researchers, and fewer than half believed it was used for planning, to improve health services generally or for research.

DISCUSSION: The secondary use of general practice data outside the clinical encounter is poorly understood by the public. More and better information about how, where and with whom general practice data are shared is needed.

PMID:40601981 | DOI:10.31128/AJGP-04-24-7242

Aust J Gen Pract. 2025 Jul;54(7):459-464. doi: 10.31128/AJGP-04-24-7247.

ABSTRACT

BACKGROUND AND OBJECTIVES: Comprehensive nicotine and smoking cessation interventions can be crucial for successful and sustained cessation, but require adequate time, training and experience. This study aimed to quantify uptake of the temporary Medicare Benefits Schedule (MBS) smoking cessation services from July 2021 to December 2023.

METHOD: MBS nicotine and smoking cessation claims processed for face-to-face and telehealth services from July 2021 to December 2023 were examined. Quarterly rates of claims and 95% confidence intervals per 1000 people who smoke were calculated.

RESULTS: Overall, 188,904 claims were processed during this period. The national trends in the rate of face-to-face (P<0.001) and telephone (P<0.001) services increased significantly. The quarterly rate of claims processed for face-to-face services increased by 16-fold, from a rate of 1 to 16 per 1000 people who smoke.

DISCUSSION: This study highlights that the temporary MBS smoking cessation services were increasingly used, but that changes to this service might deter smoking cessation efforts.

PMID:40601979 | DOI:10.31128/AJGP-04-24-7247

Knee Surg Sports Traumatol Arthrosc. 2025 Jul 2. doi: 10.1002/ksa.12763. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to compare the difference in limb length and angular deformity between two cohorts of patients who have underwent anterior cruciate ligament (ACL)-reconstruction using a femoral non-physeal sparing technique (N-PS) and a physeal sparing technique (PS). It was hypothesised that N-PS would result in less discrepancy in limb length and knee angles than PS.

METHODS: This is a comparative cohort study of 113 patients: 33 in N-PS who underwent ACL reconstruction between 2001 and 2010, and 80 in PS who underwent ACL reconstruction between 2013 and 2019. Radiographic evaluation, knee stability measurements and patient-reported outcomes (PROMS) were completed at the two-year minimum follow-up examination. Student’s t-test, Wilcoxon signed-rank sum test and chi-squared test were used to analyse the data.

RESULTS: At time of surgery, the patients were 11.7 (standard deviation [SD]: 1.4) and 14.0 (SD: 1.3) years old in N-PS AND PS, respectively. N-PS showed a statistically significant difference in femoral length of 3.5 mm (95% confidence interval [CI]: 1.1-5.9) compared to the non-operated side, with no effect on femoral length in PS of 1.0 mm (95%CI: 0.0-1.9).Only a minor impact on tibial angulation (p = 0.07) was observed between the techniques. Sensitivity analysis showed that patients younger than 12.5 years at time of surgery were five times more likely to have a total length difference of more than 10 mm in N-PS than in PS (p = 0.05). Statistically significant differences (p = 0.02) were observed in knee laxity between the N-PS 1.5 mm (95%CI: 1.0-1.2) and PS 2.4 mm (95%CI: 1.9-2.8).

CONCLUSIONS: A femoral physeal sparing technique for paediatric ACL-reconstruction reduced femoral limb length growth disturbance compared with non-physeal sparing technique. Knee laxity was affected and PROMS were unaffected by the type of technique.

LEVEL OF EVIDENCE: Level III.

PMID:40601968 | DOI:10.1002/ksa.12763

Knee Surg Sports Traumatol Arthrosc. 2025 Jul 2. doi: 10.1002/ksa.12758. Online ahead of print.

ABSTRACT

PURPOSE: The durability and effectiveness of total knee arthroplasty (TKA) depend on secure implant fixation and efficient bone integration. While cemented tibial components provide immediate mechanical stability, the addition of a short stem may be indicated in selected cases to enhance fixation. However, the stem does not allow for biological integration. The advantages of cementation over press-fit fixation remain a subject of debate, particularly regarding their impact on periprosthetic bone mineral density (BMD) over time. This study aims to compare periprosthetic BMD changes between cemented and noncemented tibial stems in primary TKA.

METHODS: In this prospective, monocentric study, we compared periprosthetic BMD changes in 60 patients undergoing primary TKA, randomised into two groups: 30 with cemented and 30 with noncemented tibial stems. Dual-energy X-ray absorptiometry (DEXA) measured BMD preoperatively and at 3, 6, 12 and 24 months postoperatively across six zones: beneath the tibial tray (R1, R2), around the stem (R3, R4), at the apex (R5), and a control zone below the stem (R6). Statistical analyses included repeated measures analysis of variance and independent t-tests.

RESULTS: Cemented stems showed a significant increase in BMD at 12 months (+0.10 g/cm², p = 0.03) and 24 months (+0.12 g/cm², p = 0.04), outperforming noncemented stems (+0.06 g/cm², p = 0.12). Overall, cemented stems demonstrated greater BMD gains (+0.15 g/cm² vs. +0.08 g/cm², p = 0.03). Minimal changes were observed in both groups, with cemented stems showing slightly higher BMD retention (+0.05 g/cm² vs. -0.02 g/cm², p = 0.09). No statistically significant differences were recorded in certain regions.

CONCLUSION: Cemented stems demonstrated greater periprosthetic BMD retention, which may contribute to improved mechanical environment for the implant. These findings may help guide the selection of fixation methods in primary TKA, particularly for patients with compromised bone quality.

LEVEL OF EVIDENCE: Level I.

PMID:40601967 | DOI:10.1002/ksa.12758

Mil Med. 2025 Jul 2:usaf351. doi: 10.1093/milmed/usaf351. Online ahead of print.

ABSTRACT

INTRODUCTION: The Patient Health Questionnaire-8 (PHQ-8) is a measure of depression symptom severity that is the 8-item version of the more widely used Patient Health Questionnaire-9 (PHQ-9). However, the PHQ-8 lacks the question about suicide ideation and is often used when questions about suicide ideation cannot be administered. A recent review of the literature on the PHQ-9 indicates mixed findings on factor structure, with evidence for both a unidimensional model and a 2-factor model of somatic and non-somatic symptoms. To date, few studies have explored the factor structure of the PHQ-8, and none to our knowledge have examined this in military samples. This secondary analysis examined this in a sample of military sexual assault survivors given their heightened risk for depression.

MATERIALS AND METHODS: Service members and veterans who experienced assault (N = 346; 49.1% female) completed the PHQ-8 in a previously published study. The parent study was approved by the Utah State University Institutional Review Board (IRB) and secondary analyses were exempted from IRB review by the Arizona State University IRB. Five structural models were tested using confirmatory factor analysis, including 1 unidimensional factor model and 4 2-dimensional factor models. The following goodness of fit statistics were compared between models: Chi-squared testing, Comparative Fit Index (CFI), Tucker Lewis Index (TLI), root mean square error of approximation (RMSEA), Bayesian Information Criterion (BIC) and standardized root mean square residual (SRMR). Strong model fit was determined by a CFI and TLI ≥ .95, RMSEA ≤ .06, and SRMR ≤ .08.

RESULTS: The 2-dimensional model with anhedonia, depressed mood, feelings of worthlessness, concentration difficulties, and psychomotor agitation/retardation specified on the non-somatic factor, and sleep difficulties, fatigue, and appetite changes specified on the somatic factor had the most optimal fit (X2 [df] = 46.19 [19], CFI = 0.98, TLI = 0.97, RMSEA = 0.06, SRMR = 0.03, BIC = 6,130.98). Other models had adequate fit, though the fit for the unidimensional model was statistically inferior.

CONCLUSION: The use of 2-factor models of depression might be superior compared to the unidimensional model in samples of military sexual assault survivors which may provide clinical utility in treating specific depression symptom clusters. Studies that wish to examine potential differences in outcomes as a function of somatic and non-somatic depressive symptoms may consider this model. Future studies should examine model fit in samples that may not have been exposed to military sexual assault.

PMID:40601935 | DOI:10.1093/milmed/usaf351

Retina. 2025 Jun 24. doi: 10.1097/IAE.0000000000004577. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the retinal displacement and metamorphopsia in patients with primary rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV) or scleral buckling (SB).

METHODS: This is a prospective non-randomized interventional study. A total of 107 patients were studied over a period of 6 months postoperatively. The vessel printing on the fundus autofluorescence (FAF) photos and the M-CHART were used to evaluate the retinal displacement and the metamorphopsia, respectively. We also assessed the vision-related quality of life, the postoperative visual acuity and the optical coherence tomographic (OCT) findings.

RESULTS: Sixty-five male and forty-two female patients were recruited in the study. The mean age was 54.8 years (SD 14.7, range 18-82). The proportion of eyes detected with retinal displacement at six months postoperatively was significantly lower in the SB group (4.3%) than in the PPV group (30.9%) (26.6% difference, 95% CI 13.1% – 40.1%, p<0.001). The SB group had significantly lower postoperative vertical and horizontal metamorphopsia (45.5% difference, 95% CI 28.3% – 62.7% p<0.001 and 38.2% difference 95% CI 20.7 % – 55.7%, p<0.001, respectively). There was no significant difference between the two study groups regarding the vision-related quality of life (1.19 difference, 95% CI -5.76, 7.70, p=0.783) and visual acuity (0.08 difference, 95% CI 0.00, 0.17, p=0.051).

CONCLUSION: Although scleral buckling is not superior in visual acuity improvement and quality of life, it improves anatomical outcomes with less retinal displacement and functional outcomes with less metamorphopsia.

PMID:40601930 | DOI:10.1097/IAE.0000000000004577

J Med Internet Res. 2025 Jul 2;27:e65226. doi: 10.2196/65226.

ABSTRACT

BACKGROUND: The use of web-based search and social media can help identify epidemics, potentially earlier than clinical methods or even potentially identifying unreported outbreaks. Monitoring for eye-related epidemics, such as conjunctivitis outbreaks, can facilitate early public health intervention to reduce transmission and ocular comorbidities. However, monitoring social media content for conjunctivitis outbreaks is costly and laborious. Large language models (LLMs) could overcome these barriers by assessing the likelihood that real-world outbreaks are being described. However, public health actions for likely outbreaks could benefit more by knowing additional epidemiological characteristics, such as outbreak type, size, and severity.

OBJECTIVE: We aimed to assess whether and how well LLMs can classify epidemiological features from social media posts beyond conjunctivitis outbreak probability, including outbreak type, size, severity, etiology, and community setting. We used a validation framework comparing LLM classifications to those of other LLMs and human experts.

METHODS: We wrote code to generate synthetic conjunctivitis outbreak social media posts, embedded with specific preclassified epidemiological features to simulate various infectious eye disease outbreak and control scenarios. We used these posts to develop effective LLM prompts and test the capabilities of multiple LLMs. For top-performing LLMs, we gauged their practical utility in real-world epidemiological surveillance by comparing their assessments of Twitter/X, forum, and YouTube conjunctivitis posts. Finally, human raters also classified the posts, and we compared their classifications to those of a leading LLM for validation. Comparisons entailed correlation or sensitivity and specificity statistics.

RESULTS: We assessed 7 LLMs for effectively classifying epidemiological data from 1152 synthetic posts, 370 Twitter/X posts, 290 forum posts, and 956 YouTube posts. Despite some discrepancies, the LLMs demonstrated a reliable capacity for nuanced epidemiological analysis across various data sources and compared to humans or between LLMs. Notably, GPT-4 and Mixtral 8x22b exhibited high performance, predicting conjunctivitis outbreak characteristics such as probability (GPT-4: correlation=0.73), size (Mixtral 8x22b: correlation=0.82), and type (infectious, allergic, or environmentally caused); however, there were notable exceptions. Assessing synthetic and real-world posts for etiological factors, infectious eye disease specialist validations revealed that GPT-4 had high specificity (0.83-1.00) but variable sensitivity (0.32-0.71). Interrater reliability analyses showed that LLM-expert agreement exceeded expert-expert agreement for severity assessment (intraclass correlation coefficient=0.69 vs 0.38), while agreement varied by condition type (κ=0.37-0.94).

CONCLUSIONS: This investigation into the potential of LLMs for public health infoveillance suggests effectiveness in classifying key epidemiological characteristics from social media content about conjunctivitis outbreaks. Future studies should further explore LLMs’ potential to support public health monitoring through the automated assessment and classification of potential infectious eye disease or other outbreaks. Their optimal role may be to act as a first line of documentation, alerting public health organizations for the follow-up of LLM-detected and -classified small, early outbreaks, with a focus on the most severe ones.

PMID:40601927 | DOI:10.2196/65226