Tag: statistics

J Addict Med. 2022 Jan-Feb 01;16(1):27-32. doi: 10.1097/ADM.0000000000000814.

ABSTRACT

OBJECTIVES: Infective endocarditis (IE) secondary to injection drug use (IDU-IE) is a disease with high morbidity, cost, and rapid demographic evolution. Studies frequently utilize combinations of International Statistical Classification of Diseases (ICD) codes to identify IDU-IE cases in electronic medical records. This is a validation of this identification strategy in a US cohort.

METHODS: Records from January 1, 2004 to September 31, 2015 for those aged ≥18yo with any ICD-coded IE encounter (inpatient or outpatient) were retrieved from the electronic medical record and then manually reviewed and classified as IDU-IE by strict and inclusive criteria. This registry was then used to assess the diagnostic accuracy of 10 identification algorithms that combined substance use, hepatitis C, and IE ICD codes.

RESULTS: IE was present in 629 of the 2055 manually reviewed records; 109 reported IDU within 3 months of IE diagnosis and an additional 32 during their lifetime (141 cases). In contrast, no algorithm identified more than 46 (33%) of these cases. Algorithms assessing encounters with both an IE and substance use code had specificities >99% but sensitivities ≤11% with negative predictive values of 83% to 84% and positive predictive values ranging from 75% to 91%. Use of a hepatitis C OR substance use code with an IE-coded encounter resulted in higher sensitivities of 22% to 32% but more false positives and overall positive predictive value of <70%. This algorithm limited to age ≤45yo had the best, but still low, discrimination ability with an area under the receiver operating characteristic curve of 0.62.

CONCLUSION: Substance use and hepatitis C codes have poor ability to accurately classify an IE-coded encounter as IDU-IE or routine IE.

PMID:35120064 | DOI:10.1097/ADM.0000000000000814

J Assoc Nurses AIDS Care. 2022 Feb 1. doi: 10.1097/JNC.0000000000000326. Online ahead of print.

ABSTRACT

The aim of this study was to determine the prevalence of sleep disorders and associated factors in people living with HIV (PLWH). This was a cross-sectional study with a sample of 385 participants followed-up on an outpatient basis in Fortaleza, Ceará, Brazil. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form for PLWH and the Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed, and the odds ratio (OR) and 95% confidence interval (95% CI) were calculated, considering p < .05 as statistically significant. The prevalence of sleep disorders was 43.38%. Having children (p = .0054; OR = 1.91; 95% CI = 1.21-3.01), less than 8 years of education (p = .0013; OR = 2.11; 95% CI = 1.34-3.34), and not engaging in regular physical exercise (p = .0001; OR = 2.61; 95% CI = 1.61-4.23) were factors associated with the occurrence of sleep disorders. It was concluded that almost half of the sample had sleep disorders, especially those with children, low level education, and sedentary habits. These data point to the need for increased guidance on sleep hygiene, in addition to the practice of regular physical exercise for this population.

PMID:35120074 | DOI:10.1097/JNC.0000000000000326

Blood Press Monit. 2022 Jan 31. doi: 10.1097/MBP.0000000000000584. Online ahead of print.

ABSTRACT

Accurate blood pressure (BP) measurement is necessary for the evaluation and treatment of hypertension to prevent the progression of subclinical vascular disease, including arterial stiffness. We investigated the associations between brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, and each of office brachial systolic BP (SBP) with and without an observer present (attended or unattended office brachial SBP), attended or unattended office central SBP, and home brachial SBPs (specifically, the means of morning, evening, or morning-evening home brachial SBP) in patients being treated for hypertension. Measurements were performed among 70 adults (mean age, 67.0 ± 9.4 years; women, 51.4%) with a mean attended office brachial SBP of 127.6 ± 14.5 mmHg and mean baPWV of 16.3 ± 2.8 m/s. Univariate analysis showed that higher attended office brachial SBP, morning home brachial SBP, and morning-evening home brachial SBP were each statistically significantly associated with higher baPWV (r = 0.25, P = 0.04; r = 0.37, P = 0.002; and r = 0.32, P = 0.006, respectively). Multiple linear regression analysis with adjustments for traditional cardiovascular risk factors showed that only morning home brachial SBP was statistically significantly associated with baPWV [β = 0.06, 95% confidence interval (0.01-0.11), P = 0.02). In conclusion, higher morning home brachial SBP – but none of the office-measured SBP values – was associated with arterial stiffness.

PMID:35120027 | DOI:10.1097/MBP.0000000000000584

Ann Surg. 2022 Mar 1;275(3):e547-e548. doi: 10.1097/SLA.0000000000005294.

NO ABSTRACT

PMID:35120063 | DOI:10.1097/SLA.0000000000005294

World J Mens Health. 2022 Jan 27. doi: 10.5534/wjmh.210138. Online ahead of print.

ABSTRACT

PURPOSE: To predict the probability of azoospermia without a semen analysis in men presenting with infertility by developing an azoospermia prediction model.

MATERIALS AND METHODS: Two predictive algorithms were generated, one with follicle stimulating hormone (FSH) as the only input and another logistic regression (LR) model with additional clinical inputs of age, luteinizing hormone, total testosterone, and bilateral testis volume. Men presenting between 01/2016 and 03/2020 with semen analyses, testicular ochiodemetry, and serum gonadotropin measurements collected within 120 days were included. An azoospermia prediction model was developed with multi-institutional two-fold external validation from tertiary urologic infertility clinics in Chicago, Miami, and Milan.

RESULTS: Total 3,497 participants were included (n=Miami 946, Milan 1,955, Chicago 596). Incidence of azoospermia in Miami, Milan, and Chicago was 13.8%, 23.8%, and 32.0%, respectively. Predictive algorithms were generated with Miami data. On Milan external validation, the LR and quadratic FSH models both demonstrated good discrimination with areas under the receiver-operating-characteristic (ROC) curve (AUC) of 0.79 and 0.78, respectively. Data from Chicago performed with AUCs of 0.71 for the FSH only model and 0.72 for LR. Correlation between the quadratic FSH model and LR model was 0.95 with Milan and 0.92 with Chicago data.

CONCLUSIONS: We present and validate algorithms to predict the probability of azoospermia. The ability to predict the probability of azoospermia without a semen analysis is useful when there are logistical hurdles in obtaining a semen analysis or for reevaluation prior to surgical sperm extraction.

PMID:35118840 | DOI:10.5534/wjmh.210138

World J Mens Health. 2022 Jan 25. doi: 10.5534/wjmh.210202. Online ahead of print.

ABSTRACT

PURPOSE: This study provides a comprehensive analysis of research trends on the etiology, mechanisms, potential risk factors, diagnosis, prognosis, surgical and non-surgical treatment of varicocele, and clinical outcomes before and after varicocele repair.

MATERIALS AND METHODS: Varicocele studies published between 1988 and 2020 were retrieved from the Scopus database on April 5, 2021. Original studies on human varicocele were included, irrespective of language. Retrieved articles were manually screened for inclusion in various sub-categories. Bibliometric data was subjected to scientometric analysis using descriptive statistics. Network, heat and geographic mapping were generated using relevant software.

RESULTS: In total, 1,943 original human studies on varicocele were published. These were predominantly from the northern hemisphere and developed countries, and published in journals from the United States and Germany. Network map analysis for countries showed several interconnected nodal points, with the USA being the largest, and Agarwal A. from Cleveland Clinic, USA, being a center point of worldwide varicocele research collaborations. Studies of adolescents were underrepresented compared with studies of adults. Studies on diagnostic and prognostic aspects of varicocele were more numerous than studies on varicocele prevalence, mechanistic studies and studies focusing on etiological and risk factors. Varicocele surgery was more investigated than non-surgical approaches. To evaluate the impact of varicocele and its treatment, researchers mainly analyzed basic semen parameters, although markers of seminal oxidative stress are being increasingly investigated in the last decade, while reproductive outcomes such as live birth rate were under-reported in the literature.

CONCLUSIONS: This study analyzes the publication trends in original research on human varicocele spanning over the last three decades. Our analysis emphasizes areas for further exploration to better understand varicocele’s impact on men’s health and male fertility.

PMID:35118839 | DOI:10.5534/wjmh.210202

World J Mens Health. 2022 Jan 25. doi: 10.5534/wjmh.210048. Online ahead of print.

ABSTRACT

PURPOSE: As the concept of late-onset hypogonadism (LOH) has gained increased attention, the treatment of eugonadal patients with LOH symptom has become a clinical problem. Previous studies have shown the possible benefits of 5-aminolevulinic acid (5-ALA) on the somatic, psychological and sexual functions. We therefore conducted this randomized, double-blind, placebo-controlled study to confirm the efficacy and safety of 5-ALA for LOH symptoms.

MATERIALS AND METHODS: Thirty-two eugonadal subjects with LOH symptoms were randomly divided into a 5-ALA group (n=15) and a placebo group (n=17). Treatment was continued for 8 weeks. The change of the Aging Males’ Symptoms (AMS) scale score and several biochemical and endocrinological variables during treatment were compared between the groups.

RESULTS: After treatment, the change in the total AMS in the 5-ALA group was significantly greater than that in the placebo group (-7.4±4.7 vs. -4.9±4.9, p=0.029). However, the differences between the groups in the change of the somatic, psychological, and sexual sub-scores of the AMS did not reach the statistical significance, although these changes in the 5-ALA group were greater than those in the placebo group. Furthermore, the change in the biochemical and endocrinological variables in the two groups did not differ to a statistically significant extent. During the 8-week treatment period, no patients discontinued 5-ALA due to treatment-emergent adverse events (TEAEs).

CONCLUSIONS: The intake of 5-ALA for 8 weeks was beneficial for eugonadal patients with symptoms of LOH and no severe TEAEs was experienced. 5-ALA should be considered as an option for those patients.

PMID:35118837 | DOI:10.5534/wjmh.210048

Am J Transplant. 2022 Feb 4. doi: 10.1111/ajt.16985. Online ahead of print.

ABSTRACT

Questions have arisen around new metrics for organ procurement organizations (OPO) due to the perception that low-performing OPOs may be limited by local centers’ acceptance of marginal organs. We reviewed 2013-2019 Organ Procurement and Transplantation Network (OTPN) and National Centers for Health Statistics (NCHS) data to explore the relationship between objectively measured OPO performance and utilization of deceased donor kidneys. We found that although donor recovery declined with rising age and kidney donor profile index (KDPI), OPO performance differences were evident within each age/KDPI group. By contrast, the number of discards per donor did not vary with OPO performance. Centers in donor service areas (DSAs) with lower-performing OPOs had higher local utilization and greater import of high-KDPI kidneys than did those with higher-performing OPOs. Lower rates of donor availability relative to waitlist additions may contribute to observed center acceptance behavior. Differences in center-level performance were highly visible in Scientific Registry of Transplant Recipients (SRTR) organ acceptance metrics, while SRTR OPO metrics did not detect large or persistent variation in procurement performance. Cumulatively, our findings suggest that objective measures of procurement performance can inform discussions of organ utilization, allowing for alignment of metrics in all elements of the procurement-transplantation system.

PMID:35118830 | DOI:10.1111/ajt.16985

Res Synth Methods. 2022 Feb 4. doi: 10.1002/jrsm.1550. Online ahead of print.

NO ABSTRACT

PMID:35118805 | DOI:10.1002/jrsm.1550

Endocrinol Diabetes Metab. 2022 Feb 4:e00324. doi: 10.1002/edm2.324. Online ahead of print.

ABSTRACT

INTRODUCTION: To determine the impact of real-time continuous glucose monitoring (RT-CGM) in conjunction with ‘Open loop’- continuous subcutaneous insulin infusion (CSII) as compared to conventional multiple daily injections (MDI) in type 1 diabetes.

METHODS: We explored the COCHRANE database, MEDLINE, WEB OF SCIENCE, GOOGLE SCHOLARS, PUBMED, EMBASE, and cited literature in articles retrieved (2010-2021) for all randomized controlled trials and real-world trials of more than 6 months duration in patients with type 1 diabetes that compared RT-CGM+CSII vs RT- CGM+MDI. A total of 1645 publications have been identified; however, only 3 trials fulfilled our inclusion criteria with a total number of 150 patients (72 patients using RT-CGM+CSII and 78 patients on RT-CGM+MDI). A Systematic Review and Meta-analysis were carried out.

RESULTS: No statistically significant reduction in HbA1c was found on comparing RT-CGM+CSII vs RT- CGM + MDI, with p-value = .75. Likewise, impact on TIR, weight and insulin usage was found to be statistically insignificant with p-value of 0.15, 0.75 and 0.20 respectively. There was an overall homogeneity between the 3 trials in respect to all previous variables with I² being 0%.

CONCLUSIONS: Real-time continuous glucose monitors in conjunction with MDI open-loop CSII had a similar impact on HbA1c, weight, insulin usage and TIR. In addition, RT-CGM when combined with CSII was associated with higher costs and reduced quality of life, hence RT- CGM+MDI can be considered as a cheaper, safer yet equivalent substitute.

REVIEW REGISTRATION: This study was registered in PROSPERO (International prospective register of systematic reviews). Registration Name: RT-CGM in conjunction with CSII vs MDI in optimizing glycaemic control in T1DM: a systematic review. Registration No: CRD42021255333. Accessible at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255333. Amendments: Few amendments to the above-mentioned registration were made: (1) Title (Meta-analysis was added). (2) Prof. Gleeson was added as an author. (3) Real-world trials were included. (4) Outcomes required in studies as per our inclusion criteria amended to include at least 1 outcome. (5) Bias risk was assessed by the CASP tool.

PMID:35118826 | DOI:10.1002/edm2.324