Generalized confidence interval and p-value in location and scale family

Berdasarkan Permenkes 585/1989 dikatakan bahwa informed consent adalah persetujuan yang diberikan oleh pasien atau keluarganya atas dasar penjelasan mengenai tindakan medis yang akan dilakukan terhadap pasien tersebut. Peran dan tanggung jawab dokter terhadap pelaksanaan tindakan medis berdasarkan imformed consent sangat penting untuk mencegah kemungkinan yang akan terjadi kepada pasien nantinya. Pemahaman terhadap informasi yang diberikan dipengaruhi oleh beberapa faktor, diantaranya karakteristik orang tersebut. Survey analitik dengan desain cross sectional dengan wawancara terpimpin menggunakan kuesioner terhadap 100 responden, dan diolah menggunakan analisa univariat dan bivariat dengan uji Chi-Square. Hasil penelitian menunjukkan bahwa: yang berusia dewasa 84 responden (84%) dan yang berusia muda sebanyak 16 responden (16%), laki- laki 63 responden (63%) dan perempuan 37 responden (37%), yang berpendidikan rendah 41 responden (41%) dan yang berpendidikan tinggi 59 responden, yang tidak bekerja 24 responden (24%) sedangkan yang bekerja 76 responden (76%), yang mempunyai pemahaman baik 58 responden (58%) dan yang tidak baik sebanyak 42 responden (42%). Variabel yang terdapat hubungan bermakna dengan pemahaman terhadap persetujuan tindakan medis pada tindakan bedah di RSPBA pada bulan Maret 2015 adalah umur (nilai p value = 0,037) OR = 3.761 dengan nilai Confidence Interval (1.195-11.835)dan pendidikan (nilai p value = 0,00) OR = 8.551 dengan Confidence Interval (3.436-21.285). Sedangkan variabel yang tidak terdapat hubungan bermakna dengan pemahaman persetujuan tindakan medispada tindakan bedah di RSPBA pada bulan Maret 2015 adalah jenis kelamin (nilai p value = 0,987) dan pekerjaan (p value = 0,251). Terdapat hubungan bermakna antara umur dan pendidikan dengan pemahaman terhadap persetujuan tindakan medis pada tindakan bedah di RS Pertamina Bintang Aamin (RSPBA) pada bulan Maret 2015.

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Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

SAGE Open Medicine ◽

10.1177/20503121211020207 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110202

Author(s):

Rgda Mohamed Osman ◽

Mounkaila Noma ◽

Abdallah Elssir Ahmed ◽

Hanadi Abdelbagi ◽

Rihab Ali Omer ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Confidence Interval ◽

Statistical Tests ◽

Demographic Data ◽

Control Group ◽

P Value ◽

Case Group ◽

Molecular Technique ◽

Interleukin 17A ◽

Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

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Prostate cancer screening: A survey of medical students’ knowledge in Lome, Togo, and associated determinants in a resource-limited African context

SAGE Open Medicine ◽

10.1177/20503121211032812 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110328

Author(s):

Tchin Darré ◽

Toukilnan Djiwa ◽

Tchilabalo Matchonna Kpatcha ◽

Albadia Sidibé ◽

Edoé Sewa ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Screening ◽

Medical Students ◽

Confidence Interval ◽

Prostate Cancer Screening ◽

Specific Antigen ◽

Digital Rectal Examination ◽

P Value ◽

Theoretical Knowledge ◽

Practical Level

Objectives: The aims of this study were to assess the knowledge of medical students in Lomé about these means of screening for prostate cancer in a context of limited resources and controversy about prostate cancer screening, and to identify the determinants associated with these results. Methods: This was a prospective descriptive and cross-sectional study conducted in the form of a survey of medical students regularly enrolled at the Faculty of Health Sciences of the University of Lomé for the 2019–2020 academic years. Results: Of the 1635 eligible students, 1017 correctly completed the form, corresponding to a rate of 62.20%. The average age was 22 ± 3.35 years. The sex ratio (M/F) was 2.5. Undergraduate students were the most represented (53.69%). Students who had not received any training on prostate cancer were the most represented (57.13%). Only 12.88% of the students had completed a training course in urology. Concerning the prostate-specific antigen blood test, there was a statistically significant relationship between the students’ knowledge and some of their socio-demographic characteristics, namely age (p value = 0.0037; 95% confidence interval (0.50–1.77)); gender (p value = 0.0034; 95% confidence interval (1.43–2.38)); study cycle (p value ˂ 0.0001; 95% confidence interval (0.56–5.13)) and whether or not they had completed a placement in a urology department (p value ˂ 0.0001; 95% confidence interval (0.49–1.55)). On the contrary, there was no statistically significant relationship between students’ knowledge of the digital rectal examination and their study cycle (p value = 0.082; 95% confidence interval (0.18–3.44)). Conclusion: Medical students in Lomé have a good theoretical knowledge and a fair practical level of the digital rectal examination clinical examination and an average theoretical knowledge and a below average practical level of prostate-specific antigen, increasing however along the curriculum in the context of prostate cancer screening.

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Generalized confidence interval for an agreement between raters

Statistics in Medicine ◽

10.1002/sim.8899 ◽

2021 ◽

Vol 40 (9) ◽

pp. 2230-2238

Author(s):

Dulal K. Bhaumik ◽

Hairong Shi ◽

Domenic J. Reda ◽

Bikas K. Sinha

Keyword(s):

Confidence Interval ◽

Generalized Confidence Interval

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Peripartum depression in parents with multiple sclerosis and psychiatric disorders in children

Multiple Sclerosis Journal ◽

10.1177/1352458516631037 ◽

2016 ◽

Vol 22 (14) ◽

pp. 1830-1840 ◽

Cited By ~ 5

Author(s):

Neda Razaz ◽

Helen Tremlett ◽

Ruth Ann Marrie ◽

K.S. Joseph

Keyword(s):

Multiple Sclerosis ◽

Cohort Study ◽

Confidence Interval ◽

Psychiatric Disorders ◽

Physician Visit ◽

Drug Prescription ◽

P Value ◽

Potential Association ◽

Unaffected Parent ◽

Peripartum Depression

Background: Although many individuals with multiple sclerosis (MS) experience depression, there are no studies on the frequency and effect of peripartum depression among parents with MS. Objective: To examine the frequency of peripartum depression in individuals with MS and its potential association with children’s psychiatric disorders. Methods: We conducted a cohort study in British Columbia, Canada, using linked health databases, of parents with MS and their children, and age-matched unaffected parent–child dyads. The diagnosis of peripartum depression, MS and psychiatric disorders in children was based on information from hospital admission, physician visit and drug prescription claims. Results: Peripartum depression was significantly more common among MS parents ( n = 360) versus unaffected ( n = 1207) parents (25.8% vs 18.5%, p value 0.02), especially among MS affected fathers versus unaffected fathers (25.7% vs 10.2%, p value < 0.001). The incidence of psychiatric disorders in children was 3.3 and 2.7 per 100 child-years among children with and without an MS parent, respectively. The rate of psychiatric disorders was significantly higher in children with an MS parent (vs without, hazard ratio (HR): 1.34; 95% confidence interval (CI): 1.03–1.74) and among children with parents who had peripartum depression (HR: 1.87; 95% CI: 1.36–2.55). Conclusion: Parental MS is associated with a higher risk of peripartum depression and increases the risk of psychiatric disorders in children.

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Statistical Principles for Clinical Trials

Journal of International Medical Research ◽

10.1177/030006059802600201 ◽

1998 ◽

Vol 26 (2) ◽

pp. 57-65 ◽

Cited By ~ 2

Author(s):

R Kay

Keyword(s):

Clinical Trials ◽

Confidence Interval ◽

Sample Size ◽

Sample Size Calculation ◽

P Value ◽

Clinical Value ◽

Treatment Groups ◽

Correct Calculation ◽

Intent To Treat ◽

Comparative Trials

If a trial is to be well designed, and the conclusions drawn from it valid, a thorough understanding of the benefits and pitfalls of basic statistical principles is required. When setting up a trial, appropriate sample-size calculation is vital. If initial calculations are inaccurate, trial results will be unreliable. The principle of intent-to-treat in comparative trials is examined. Randomization as a method of selecting patients to treatment is essential to ensure that the treatment groups are equalized in terms of avoiding biased allocation in the mix of patients within groups. Once trial results are available the correct calculation and interpretation of the P-value is important. Its limitations are examined, and the use of the confidence interval to help draw valid conclusions regarding the clinical value of treatments is explored.

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Hypoxic Status Is Associated With The Intensity Of Hypoxia Inducible Factor (Hif)-1α Expression In A Premature Placenta

Saintika Medika ◽

10.22219/sm.vol17.smumm1.11685 ◽

2021 ◽

Vol 17 (1) ◽

pp. 1-11

Author(s):

Kartini Edwin

Keyword(s):

Confidence Interval ◽

Premature Birth ◽

Odds Ratio ◽

Critical Role ◽

Hypoxia Inducible Factor ◽

Biological Materials ◽

P Value ◽

Live Births ◽

Infant Morbidity ◽

The Relationship

Prematurity refers to live births before 37 weeks of gestation and associated with infant morbidity/mortality. Activation of HIF during the final pregnancy phase is believed to play a critical role in the pathogenesis of premature birth and other pregnancy disorders. This study aimed to analyze the relationship between hypoxicstatus and the intensity of HIF-1α expression in a premature placenta.Stored biological materials premature placenta (paraffin blocks) was used in this study. Thirtyone samples of placental hypoxia (H) and 28 samples of premature placental non-hypoxia (N) as controls, were selected non-random consecutively. Subsequently, immunohistochemistry was performed to analyze HIF-1α expression. TheChi-square testwas used to analyze the data and a p-value <0.05 was considered statistically significant.Moderate to strong intensity of HIF-1α expressionwas observed in 58% of hypoxic placenta samples, whereas most of non-hypoxic placental samples(86%) did not expressed or expressed weaklyHIF-1α.There was a significant correlation between the intensity of HIF-1α expression and placental hypoxia (p <0.05) and Odds Ratio (OR) value was 8.31 with a 95% confidence interval (2.32-29.77). The conclusion shows that hypoxic status is associated with intensity of hypoxia inducible factor (HIF)-1α expression in a premature placenta.

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Latrine availability and associated factors among Religious institution in Northern Ethiopia, 2018

10.21203/rs.2.13250/v1 ◽

2019 ◽

Author(s):

Mulugeta Woldu Abrha ◽

Kiros Demoz Ghebremedhin ◽

Tesfay Teklemariam Weldeslasie

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Associated Factors ◽

P Value ◽

Northern Ethiopia ◽

Religious Institutions ◽

Religious Institution ◽

Tigray Region ◽

Availability Analysis ◽

Sanitation And Hygiene

Abstract Background Religious institutions found at the community, not only uphold belief and cultural values but also as a force for positive change and development. Improved sanitation and hygiene is crucial in these institutions to decrease preventable infections due to unsanitary conditions. However, there are no studies among religious institution on availability of latrine. So this study was conducted to assess the latrine availability and associated factors among religious institution in Tigray Region, Ethiopia.Method Institution based cross – sectional study design was conducted in Tigray Region, Northern Ethiopia. Multi-stage sampling was used to sample 385 religious institutions. Data was collected using pre tested, structured questionnaire and observation checklist. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to determine the predictors of latrine availability. Analysis was carried out using SPSS 20 TM - software package.Results In this study latrine availability was 32.8%. And was significantly affected by currently saved money towards having a latrine (Adjusted Odds ratio (AOR): 0.32, 95% confidence interval (CI) [0.25, 0.42]), any messages seen, heard or received on sanitation and hygiene (AOR: 0.43, 95% CI [0.38, 0.51]) and place where messages seen, heard, received (AOR: 2.95, 95% CI [1.11, 5.55]).Conclusion Availability of latrine was very low when compared to the national target of 100% among the religious institution and was affected by the currently saved money towards having a latrine, any messages seen, heard or received on sanitation and hygiene and place where the messages receive. Information regarding latrine availability should be provided to the community visiting religious institutions through available channels and practical models promotion.

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Causal Association Between mTOR-Dependent eIF4E mRNA Cap-Dependent Translation and Type 2 Diabetes: A Mendelian Randomization Study (OR31-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz037.or31-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Ghada Soliman ◽

C Mary Schooling

Keyword(s):

Type 2 Diabetes ◽

Sensitivity Analysis ◽

Confidence Interval ◽

Mendelian Randomization ◽

Protein Translation ◽

Translation Initiation Factor ◽

Initiation Factor ◽

P Value ◽

Weighted Median

Abstract Objectives Type 2 diabetes is a prevalent chronic disease and is often associated with obesity and other comorbidities. The mammalian Target of Rapamycin complex 1 (mTORC1) nutrient-signaling pathway is a central regulator of cell growth and metabolism and is dysregulated in chronic diseases including diabetes and obesity. The eukaryotic translation initiation factor 4E (eIF-4E), a key regulator of gene translation and protein function, is under the control of mTOR and eIF4E Binding Proteins (4E-BPs). eIF-4E binds to the m7G (7-methylguanosine) cap at the 5’-UTR of most eukaryotic mRNA and mediates the recruitment of mRNA on ribosomes to start the protein translation. Both 4E-BP and ribosomal protein S6K kinase (S6K) are downstream effectors regulated by mTORC1 but converge to regulate two independent pathways. We investigated whether the risk of type 2 diabetes varied with genetically predicted eIF-4E and S6K levels using Mendelian Randomization (MR). Methods We estimated the causal role of eIF-4E and S6K plasma proteins, mTOR downstream targets, on type 2 diabetes, based on 16 single nucleotide polymorphisms (SNPs) for eIF-4E and 16 SNPs for S6K at P-value < 5x10−6. We applied these SNPs per exposure to publically available genetic associations with diabetes from the DIAbestes Genetics Replication And Meta-analysis (DIAGRAM) case (n = 26,676), and control (n = 132,532) study (mean age 57.4 years). We meta-analyzed SNP-specific Wald estimates using inverse variance weighting with multiplicative random effects. Sensitivity analysis was conducted using the weighted median, and MR-Egger estimates. Results eIF-4E cap-dependent translation factor was associated with lowered risk of type 2 diabetes with an odds ratio (OR) 0.94 per effect size, 95% confidence interval (0.88, 0.99, P = 0.03) with similar estimates from the weighted median and MR-Egger. S6K was not associated with diabetes, OR 0.95, 95% confidence interval (0.89, 1.01, P = 0.08). Sensitivity analysis using MR-Egger and weighed median analysis did not indicate pleiotropic effects suggesting a unique protective effect of eIF-4E on type 2 diabetes. Conclusions This unbiased Mendelian Randomization estimate is consistent with a causally protective association of eIF-4E on type 2 diabetes. eIF-4E may be a target for intervention by repurposing existing therapeutics to reduce the risk of type 2 diabetes. Funding Sources No specific funding.

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The moderating effect of psychedelics on the prospective relationship between prescription opioid use and suicide risk among marginalized women

Journal of Psychopharmacology ◽

10.1177/0269881118798610 ◽

2018 ◽

Vol 32 (12) ◽

pp. 1385-1391 ◽

Cited By ~ 5

Author(s):

Elena Argento ◽

Melissa Braschel ◽

Zach Walsh ◽

M Eugenia Socias ◽

Kate Shannon

Keyword(s):

Suicidal Ideation ◽

Confidence Interval ◽

Suicide Risk ◽

Moderating Effect ◽

Prescription Opioid ◽

P Value ◽

Opioid Use ◽

Marginalized Women ◽

Prescription Opioid Use ◽

The Relationship

Background/aims: Given high rates of depression and suicide among marginalized women, and increasing calls to integrate trauma-informed biomedical and community-led structural interventions, this study longitudinally examines the potential moderating effect of psychedelic use on the relationship between other illicit drug use and suicide risk. Methods: Data (2010–2017) were drawn from a community-based, prospective open cohort of marginalized women in Vancouver, Canada. Extended Cox regression analyses examined the moderating effect of psychedelic use on the association between other illicit drug use and incidence of suicidal ideation or attempt over follow-up. Results: Of 340 women without suicidal ideation or attempt at baseline, 16% ( n=53) reported a first suicidal episode during follow-up, with an incidence density of 4.63 per 100 person-years (95% confidence interval 3.53–6.07). In unadjusted analysis, psychedelic use moderated the relationship between prescription opioid use and suicide risk: among women who did not use psychedelics, prescription opioid use increased the hazard of suicide (hazard ratio 2.91; 95% confidence interval 1.40–6.03) whereas prescription opioid use was not associated with increased suicidal ideation or attempt among those who used psychedelics (hazard ratio 0.69; 95% confidence interval 0.27–1.73) (interaction term p-value: 0.016). The moderating effect of psychedelics remained significant when adjusted for confounders (interaction term p-value: 0.036). Conclusions: Psychedelic use had a protective moderating effect on the relationship between prescription opioid use and suicide risk. In the context of a severe public health crisis around prescription opioids and lack of addiction services tailored to marginalized women, this study supports calls for innovative, evidence-based and trauma-informed interventions, including further research on the potential benefits of psychedelics.

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