Tag: statistics

Malays Fam Physician. 2026 Jun 26;21:33. doi: 10.51866/oa.1109. eCollection 2026.

ABSTRACT

INTRODUCTION: Sarcopaenia is underdiagnosed in primary care due to limitations in available tools. The SARC-F questionnaire is a recommended screening tool, but its diagnostic accuracy among Malaysian community-dwelling older adults is not well established. This study aimed to determine the diagnostic accuracy of the SARC-F score against hand grip strength (HGS) for identifying possible sarcopaenia among community-dwelling older adults.

METHODS: A cross-sectional study was conducted from January to November 2024 across 11 public health clinics. Community-dwelling older adults aged ≥60 years were recruited. Sarcopaenia risk was assessed using the SARC-F questionnaire, with scores of ≥4 indicating a high risk. HGS was measured using a Jamar dynamometer, with possible sarcopaenia defined according to the Asian Working Group for Sarcopenia 2019 criteria (<28 kg for men, <18 kg for women). Statistical analysis included the Mann-Whitney U test to compare mean rank distributions of HGS between SARC-F risk groups and Cohen’s kappa to assess the agreement between the SARC-F score- and HGS-based classifications. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory performance of the SARC-F score in identifying possible sarcopaenia, using HGS as the reference standard.

RESULTS: Among 578 participants, the median HGS was significantly lower in the high-risk SARC-F group for both men (19.0 kg vs 28.0 kg, P<0.001) and women (14.0 kg vs 18.0 kg, P<0.001). The agreement between the SARC-F score- and HGS-based classifications was poor to fair (kappa=0.219). The SARC-F score demonstrated low sensitivity (34.7%) but high specificity (87.5%); it showed poor discriminative ability in detecting possible sarcopaenia (area under the ROC curve=0.67; 95% confidence interval=0.622-0.710; P<0.001). The positive predictive value was 74.6%; negative predictive value, 55.9%; and overall accuracy, 60.4%.

CONCLUSION: While a high SARC-F score is significantly associated with low HGS, the low sensitivity of the SARC-F score limits its use as a standalone screening tool in primary care. A two-step approach, using the SARC-F questionnaire followed by objective HGS measurement, may enhance early detection efforts in primary care.

PMID:42437303 | PMC:PMC13355861 | DOI:10.51866/oa.1109

Malays Fam Physician. 2026 Jun 7;21:26. doi: 10.51866/rv.1027. eCollection 2026.

ABSTRACT

INTRODUCTION: Ischaemic heart disease (IHD) remains a major cause of mortality among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Conventional cardiovascular risk models, such as the Framingham risk score, often show limited calibration in Asian populations. Artificial intelligence (Al)-calibrated models have emerged as potential alternatives, yet their generalisability and clinical utility across different populations remain uncertain. This narrative review aimed to summarise existing prognostic models for IHD in patients with T2DM and identify methodological gaps relevant to the development of a locally calibrated model.

METHODS: This narrative review employed a structured search strategy guided by PRISMA principles but was not conducted as a full systematic review. We synthesised evidence from epidemiological and prognostic research. Studies comparing conventional statistical approaches (e.g. logistic regression and Cox models) with AI-calibrated models such as extreme gradient boosting, random forest and support vector machines were reviewed.

RESULTS: Eleven studies met the inclusion criteria; four used conventional statistical methods, and seven applied AI or machine learning algorithms. The reported discrimination (area under the curve=0.66-0.94) varied widely. Conventional models commonly lacked external validation and demonstrated restricted applicability beyond their original cohorts. AI-calibrated models showed promising discrimination in some datasets but similarly experienced limited validation and lacked benchmarking against traditional statistical methods. Across the studies, limited calibration and validation reduced generalisability to heterogeneous Malaysian populations.

CONCLUSION: Developing a locally AI-calibrated i-IHD score could enable early risk identification, guide targeted interventions and support national health initiatives, including the Health White Paper 2023 and 13th Malaysia Plan.

PMID:42437302 | PMC:PMC13355864 | DOI:10.51866/rv.1027

SAGE Open Nurs. 2026 Jul 10;12:23779608261468455. doi: 10.1177/23779608261468455. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Digital health technologies are increasingly embedded in Neonatal Intensive Care Units (NICUs), yet the role of nurse-led governance in shaping safe, sustainable implementation for high-risk neonates remains underexplored. This review synthesized evidence on nursing leadership and digital health integration in NICUs.

METHODS: Following PRISMA 2020, six databases were searched (January 2013-January 2025), supplemented by grey literature, reference-list screening, and forward citation tracking. The protocol was prospectively registered with PROSPERO. Eligible empirical studies (n = 18) addressed formal nurse-led governance, operational governance enactment by nurses, or leadership-relevant determinants. Risk of bias was appraised with design-specific tools (Cochrane RoB 2, ROBINS-I, JBI, MMAT); synthesis combined structured narrative and reflexive thematic analysis.

RESULTS: Findings are presented as associations, not causal effects. Favorable signals included a 60% reduction in high-stage device-related pressure injuries in one quality-improvement initiative; 30-day readmission rates of 13.8% among enrolled versus 30.9% among non-enrolled caregivers in a nurse-led post-discharge telehealth intervention; and an approximately 12-day shorter length of stay favoring the intervention in one randomized trial of nurse-led developmental care. Using conservative, author-reported coding, organizational/leadership support (17/18; 94%) and structured training (8/18; 44%) were most frequently documented; funding/IT (22%) and clinical champions (17%) less so. Nurse-led governance could not be statistically separated from co-occurring implementation activities.

CONCLUSION: Across a predominantly observational, low-to-moderate-certainty evidence base, nurse-led governance was consistently associated with stronger implementation processes and selected family- and clinical-level signals when embedded in coordinated training, workflow redesign, and audit-and-feedback. Findings are hypothesis-generating. Comparative-effectiveness and economic evaluations decomposing leadership from co-occurring implementation components are needed.

PMID:42437296 | PMC:PMC13354904 | DOI:10.1177/23779608261468455

Cureus. 2026 Jun 11;18(6):e110670. doi: 10.7759/cureus.110670. eCollection 2026 Jun.

ABSTRACT

Background Hamstring tendon (HT) autografts are commonly used in anterior cruciate ligament reconstruction (ACLR), although graft dimensions may vary among patients. Smaller graft diameters have been associated with higher graft failure rates, emphasizing the clinical importance of understanding factors related to the graft size. Consequently, preoperative anthropometric measurements have been investigated for their association with hamstring graft dimensions. However, findings from previous studies remain inconsistent across different populations, and data from Southeast Asian populations are still limited. Therefore, this study aimed to examine the relationship between preoperative anthropometric parameters and intraoperative hamstring graft dimensions, including diameter and length, in single-bundle ACLR patients using a five-strand hamstring autograft. Methods We retrospectively analyzed 91 patients who underwent primary single-bundle ACLR from 2018 to 2023 at a single institution. Preoperative data, including age, gender, height, weight, body mass index (BMI), and thigh circumference, were collected. Intraoperative graft diameter and length were obtained from the operative records. Pearson correlation and simple linear regression analyses were used to evaluate associations between anthropometric parameters and graft diameter. A p-value < 0.05 was considered statistically significant. Results Graft diameter showed a positive correlation with weight (r = 0.22, p = 0.040) and height (r = 0.51, p < 0.001), while graft length was positively correlated with height (r = 0.31, p = 0.003). Regression analysis confirmed a significant association between height and graft diameter (F (1, 89) = 30.649, p < 0.001), with height showing moderate explanatory power (R² = 0.256) and the strongest predictive relationship. In contrast, weight showed a statistically significant but weak association with graft diameter, explaining only a minimal proportion of variance (R² = 0.046). Conclusion Patient height showed a significant yet modest association with five-strand hamstring autograft diameter. These findings may provide supportive reference data for preoperative assessment in similar populations. Further studies are required to refine and validate predictive models for graft size estimation.

PMID:42437261 | PMC:PMC13355849 | DOI:10.7759/cureus.110670

Cureus. 2026 Jun 11;18(6):e110672. doi: 10.7759/cureus.110672. eCollection 2026 Jun.

ABSTRACT

Introduction Acne scarring represents a permanent structural sequela of acne vulgaris and is predominantly characterized by atrophic morphological patterns. Beyond cosmetic disfigurement, facial acne scars may contribute to significant psychosocial distress, including body image disturbance and quality-of-life impairment. Limited data are available correlating scar morphology with body image concerns and scar-specific quality-of-life impairment in the Indian population. Objectives The objectives of this study are to examine the morphological profile of facial acne scars, evaluate the body image concerns and quality of life among patients with acne scars, and determine the correlation of facial acne scarring with body image concerns and quality-of-life impairment. Materials and methods This cross-sectional observational study was conducted in the Department of Dermatology, Venereology and Leprosy, Adichunchanagiri Hospital and Research Centre, Karnataka, over a period of 18 months. It included 150 patients of either gender, aged 18-40 years, with facial acne scars. Morphological assessment was performed under standardized illumination. Scar severity was graded using the Goodman and Baron qualitative grading system and the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire. The Body Image Concern Inventory (BICI) and Facial Acne Scar Quality of Life (FASQoL) questionnaires were used for fulfilling the respective objective. Statistical analysis was performed using Epi Info software. Correlations were assessed using Spearman’s rank correlation coefficient. A p-value of < 0.05 was considered statistically significant. Results The majority of participants (63.3%; n=95) were aged 21-25 years, and 69.3% (n=104) were female. Icepick scars were the most common morphological type at 78.7% (n=118), followed by boxcar scars at 61.3% (n=92). Clinician-based grading revealed that 72.6% (n=109) of participants had moderate to severe acne scarring. Based on a SCARS assessment, 36.0% (n=54) had mild, 30.0% (n=45) had moderate, and 15.3% (n=23) had severe/very severe scarring. Mean BICI scores increased significantly across SCARS severity categories (p<0.001). The mean FASQoL score was 6.79 ± 7.11, with higher scores observed in severe scarring (p<0.001). Moderate positive correlations were observed between SCARS and BICI (rₛ=0.419, p<0.001), SCARS and FASQoL (rₛ=0.500, p<0.001), Goodman-Baron grade and FASQoL (rₛ=0.448, p<0.001), and Goodman-Baron grade and BICI (rₛ=0.367, p<0.001). Conclusion Body image concern is evident across domains of dissatisfaction with appearance, preoccupation with perceived flaws, and mirror-checking behaviors. Scar-specific quality-of-life impairment manifests as emotional distress, social self-consciousness, and reduced interpersonal confidence. Patient-perceived severity demonstrates a particularly strong relationship with psychosocial burden, underscoring the importance of integrating clinician-based grading with validated patient-reported outcome measures for comprehensive assessment and patient-centered management.

PMID:42437257 | PMC:PMC13355855 | DOI:10.7759/cureus.110672

Cureus. 2026 Jun 11;18(6):e110683. doi: 10.7759/cureus.110683. eCollection 2026 Jun.

ABSTRACT

Chronic low back pain (LBP) is a major cause of disability around the world, and pharmaceutical treatments like opioids are often used to treat it. However, the efficacy and safety of opioids in LBP continue to be controversial due to inconsistent results and associated side effects. This systematic review assesses the effectiveness and safety of opioid medication in the treatment of LBP. A systematic search was performed utilising various electronic databases, including PubMed, Scopus, Google Scholar, MEDLINE, the Cochrane Library, and Web of Science, following a structured methodology in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles. Randomised controlled trials that were published in English within the past two decades and evaluated the use of opioids in adults with LBP were included. The Cochrane Risk of Bias tool and the Critical Appraisal Skills Programme (CASP) checklist were used to screen for bias, and a narrative synthesis was done because the studies were not all the same. There were six randomised, double-blind, placebo-controlled trials involving between 83 and 905 people. Opioid formulations, including buprenorphine, hydrocodone, oxycodone/naloxone, and oxymorphone, exhibited overall efficacy in diminishing pain intensity relative to placebo, especially in opioid-naïve individuals. But the magnitude and consistency of the advantage varied across studies, and some treatments showed only a small statistical difference. There were only a few reports of functional improvement, and they were not always constant. Nausea, constipation, and drowsiness were common side effects, although long-term safety outcomes were not fully evaluated. In general, opioids may help with short-term pain relief in people with LBP, but they aren’t very useful in the long term because they aren’t very effective and very safe and there isn’t much evidence for their long-term use. It is advisable to select patients and use them with caution. More high-quality research is needed to understand their role in long-term management better.

PMID:42437252 | PMC:PMC13355912 | DOI:10.7759/cureus.110683

Cureus. 2026 Jun 11;18(6):e110639. doi: 10.7759/cureus.110639. eCollection 2026 Jun.

ABSTRACT

Background and aim Artificial intelligence (AI) has become an indispensable component of medical practice. Studies have shown that medical students worldwide are often ill-prepared to take full advantage of these technologies in their future practice due to inadequate training and a shortage of qualified instructors. These factors hinder the adoption of AI-focused curricula; therefore, this study aims to explore medical students’ and faculty’s knowledge and attitudes toward AI applications in the medical field, as well as their readiness for its integration into the medical curriculum, highlighting both the benefits and barriers. Methods A cross-sectional study was conducted on medical students (years 1-5) and faculty members from the University of Sharjah College of Medicine (UOSCOM), Sharjah, UAE. They were recruited via convenience sampling between February and March 2023. Students and faculty completed self-administered questionnaires, both online and in person. Analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, NY, USA). Results Of a total of 413 participants, 74.3% (faculty and students) agreed that the medical field has benefited from AI. Interestingly, 54.3% of students agreed on implementing AI in the curriculum, and 79.3% believe it is necessary, as they see it as a way to empower their careers in the future. However, 51.9% expressed concerns regarding the increase in workload. Of the 45 faculty participants, 66.7% believe that teaching AI would be an addition to their CVs, while 40% disagree that adding the course will increase their workload. Moreover, 77.8% are willing to participate in the course. Conclusions and recommendations The findings revealed a general positive perception, with both groups acknowledging the benefits of AI in medicine. Students show awareness of AI applications in education and healthcare, while faculty express willingness to teach AI courses for professional development. However, we recommend that future studies assess students’ baseline computer knowledge and correlate faculty members’ specialty fields with their willingness to teach.

PMID:42437241 | PMC:PMC13355148 | DOI:10.7759/cureus.110639

Cureus. 2026 Jun 11;18(6):e110691. doi: 10.7759/cureus.110691. eCollection 2026 Jun.

ABSTRACT

Background Caudal epidural analgesia is a widely used and effective regional anesthetic technique for pediatric infraumbilical surgeries. Although bupivacaine provides reliable analgesia, its relatively short duration has prompted the use of adjuvants to prolong postoperative pain relief. Dexmedetomidine, a selective α2-adrenergic agonist, and tramadol, a centrally acting analgesic, are commonly employed caudal adjuvants; however, their comparative effects when combined with bupivacaine remain incompletely defined. Methods This prospective, randomized, double-blind study included 60 pediatric patients aged two to eight years undergoing elective infraumbilical surgeries under general anesthesia. All patients received a caudal block with 0.25% bupivacaine (1 mL/kg) and were randomized into two groups: Group D received dexmedetomidine 0.5 µg/kg (n = 30), and Group T received tramadol 1 mg/kg (n = 30). Hemodynamic parameters, including heart rate (HR) and mean arterial pressure (MAP), were recorded intraoperatively and at extubation. The primary outcome was time to first rescue analgesia, defined as the time from skin closure to a Face, Legs, Activity, Cry, Consolability (FLACC) score >4. Data were analyzed using appropriate parametric tests, with p < 0.05 considered statistically significant. Results Demographic characteristics and duration of surgery were comparable between the groups. Mean age was 4.19 ± 1.91 years in Group D and 4.55 ± 2.10 years in Group T (p = 0.49), while mean body weight was 14.15 ± 4.00 kg and 15.16 ± 4.24 kg, respectively (p = 0.35). The duration of postoperative analgesia was significantly longer in the dexmedetomidine group compared with the tramadol group (812.70 ± 46.15 minutes vs. 605.53 ± 45.12 minutes; p < 0.0001). HR and MAP decreased gradually in both groups following induction, with lower values observed in the dexmedetomidine group; however, differences in HR at all measured time points were not statistically significant. MAP after extubation was significantly lower in Group D compared with Group T (66.73 ± 5.96 mmHg vs. 70.17 ± 6.86 mmHg; p = 0.04). No episodes of bradycardia or hypotension requiring intervention occurred in either group. Conclusion Dexmedetomidine (0.5 µg/kg) as an adjuvant to caudal bupivacaine provided significantly prolonged postoperative analgesia compared with tramadol (1 mg/kg) in pediatric infraumbilical surgeries. Both agents maintained stable perioperative hemodynamics without clinically significant adverse effects; however, dexmedetomidine demonstrated better attenuation of hemodynamic responses, particularly after extubation. Low-dose dexmedetomidine appears to be an effective and safe caudal adjuvant in pediatric patients undergoing infraumbilical surgical procedures.

PMID:42437239 | PMC:PMC13355903 | DOI:10.7759/cureus.110691

Cureus. 2026 Jun 11;18(6):e110643. doi: 10.7759/cureus.110643. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Acute pancreatitis is a common inflammatory disease with variable clinical outcomes. Diabetes mellitus may worsen the severity and increase complications in these patients. This study was conducted to evaluate the association of diabetes mellitus with severity, complications, and mortality in acute pancreatitis patients.

METHODS: This prospective observational study was conducted at Ayub Medical College, Abbottabad from April 2025 to September 2025. A total of 160 patients with confirmed acute pancreatitis were included through consecutive sampling. Patients were divided into diabetic and non-diabetic groups. Severity was assessed by the Revised Atlanta Classification. Demographic profile, laboratory findings, complications, ICU admission, hospital stay, and mortality were recorded. Data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2018; IBM Corp., Armonk, New York, United States). The chi-square test, independent sample t-test, and multivariable logistic regression analysis were applied. A p-value less than 0.05 was considered significant.

RESULTS: Out of 160 patients, 68 (42.5%) were diabetic, and 92 (57.5%) were non-diabetic. Severe acute pancreatitis was significantly more common in diabetic patients (30.9% vs 15.2%, p=0.017). Persistent organ failure (27.9% vs 13.0%, p=0.019), pancreatic necrosis (25.0% vs 12.0%, p=0.031), ICU admission (29.4% vs 14.1%, p=0.018), and mortality (16.2% vs 8.7%, p=0.041) were also higher among diabetic patients. Mean hospital stay was significantly prolonged in diabetics (8.7±3.9 vs 5.9±2.8 days, p<0.001). Multivariable analysis showed diabetes mellitus as an independent predictor of severe acute pancreatitis and mortality.

CONCLUSION: Diabetes mellitus was significantly associated with increased severity, complications, prolonged hospital stay, and mortality in acute pancreatitis. Early identification of diabetic patients may help improve clinical outcomes.

PMID:42437237 | PMC:PMC13355151 | DOI:10.7759/cureus.110643

Cureus. 2026 Jun 11;18(6):e110649. doi: 10.7759/cureus.110649. eCollection 2026 Jun.

ABSTRACT

Aim Chatbots are emerging as a new and valuable tool in healthcare, offering a wide range of applications. Their use as a tool in medical physics has immense future potential. This study aimed to evaluate the performance of three artificial intelligence (AI) chatbots – ChatGPT, DeepSeek, and Gemini – in response to questions or queries related to medical physics in oncology. Materials and methods A total of 11 questions from the field of medical physics pertaining to oncology were formulated by medical physics experts. These queries were presented to the AI chatbots – ChatGPT 5.2, DeepSeek V 3.2, and Gemini 3.0 – on a predetermined date. Responses were obtained by repeating the same question once for each chatbot. The initial responses were noted and evaluated by three experts based on their correctness, completeness, ease of understanding, reliability, and applicability in the national scenario. Results The mean correctness scores were 3.4, 3.81, and 3.09 for ChatGPT, DeepSeek, and Gemini, respectively. Regarding completeness, the DeepSeek gave the maximum responses, that is, 10 complete responses to the 11 questions. No statistically significant difference was foundin real-world applicability score for the three models. Conclusion In terms of performance metrics such as correctness, DeepSeek gave better results. None of the chatbots were seen to be good enough to replicate human intelligence in metrics such as correctness, completeness, or real-world applicability. A symbiotic collaboration between AI chatbots and medical professionals is essential for enhancing healthcare delivery.

PMID:42437234 | PMC:PMC13355276 | DOI:10.7759/cureus.110649