A cluster-analytical approach toward real-world outcome in outpatients with stable schizophrenia

2016 ◽  
Vol 32 ◽  
pp. 48-54 ◽  
Author(s):  
P. Rocca ◽  
C. Montemagni ◽  
C. Mingrone ◽  
B. Crivelli ◽  
M. Sigaudo ◽  
...  
Keyword(s):  
Real World ◽  
Supported Employment ◽  
Cross Sectional Study ◽  
Therapeutic Interventions ◽  
Cross Sectional ◽  
Delivery Of Care ◽  
Cluster Membership ◽  
The Poor ◽  
Quality Of Life Scale ◽  
Good Cluster

AbstractBackgroundThis study aims to empirically identify profiles of functioning, and the correlates of those profiles in a sample of patients with stable schizophrenia in a real-world setting. The second aim was to assess factors associated with best profile membership.MethodsThree hundred and twenty-three outpatients were enrolled in a cross-sectional study. A two-step cluster analysis was used to define groups of patients by using baseline values for the Heinrichs-Carpenter Quality of Life Scale (QLS) total score. Logistic regression was used to construct models of class membership.ResultsOur study identified three distinct clusters: 50.4% of patients were classified in the “moderate” cluster, 27.9% in the “poor” cluster, 21.7% in the “good” cluster. Membership in the “good” cluster versus the “poor” cluster was characterized by less severe negative (OR = .832) and depressive symptoms (OR = .848), being employed (OR = 2.414), having a long-term relationship (OR = .256), and treatment with second-generation antipsychotics (SGAs) (OR = 3.831). Nagelkerke R2 for this model was .777.ConclusionsUnderstanding which factors are associated with better outcomes may direct specific and additional therapeutic interventions, such as treatment with SGAs and supported employment, in order to enhance benefits for patients, as well as to improve the delivery of care in the community.

scholarly journals Prevalence of psychological disorders in the COVID-19 epidemic in China: A real world cross-sectional study

2021 ◽  
Vol 281 ◽  
pp. 312-320
Author(s):  
Minghuan Wang ◽  
Qian Zhao ◽  
Caihong Hu ◽  
Yang Wang ◽  
Jie Cao ◽  
...  
Keyword(s):  
Real World ◽  
Psychological Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Prevalence, median time, and associated factors with the likelihood of initial antidepressant change: a cross-sectional study in Qatar

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nervana Elbakary ◽  
Sami Ouanes ◽  
Sadaf Riaz ◽  
Oraib Abdallah ◽  
Islam Mahran ◽  
...  
Keyword(s):  
Median Time ◽  
Cox Regression ◽  
Cross Sectional Study ◽  
Therapeutic Interventions ◽  
Patient Treatment ◽  
Cross Sectional ◽  
Disease Outcomes ◽  
Younger Age ◽  
Risk Predictors ◽  
Subsequent Failure

Abstract Background Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. Methods This was a retrospective study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using several cox regression models. Results A total of 487 patients met the inclusion criteria of the study, 431 (88%) of them had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. The factors statistically associated with higher hazard of IAD change were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Conclusions Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. Our findings offered some clues to help clinicians identify the high-risk predictors of short survival and subsequent failure of IAD.

scholarly journals Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021966 ◽  
Author(s):  
Federica Dellafiore ◽  
Cristina Arrigoni ◽  
Francesco Pittella ◽  
Gianluca Conte ◽  
Arianna Magon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Gender Differences ◽  
Chronic Heart Failure ◽  
Real World ◽  
Self Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Caregiver Relationship

AimThe aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF).Methods and resultsA monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%.ConclusionThis study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.

scholarly journals Circulating Levels of MicroRNAs Associated With Hypertension: A Cross-Sectional Study in Male and Female South African Participants

2021 ◽  
Vol 12 ◽  
Author(s):  
Don M. Matshazi ◽  
Cecil J. Weale ◽  
Rajiv T. Erasmus ◽  
Andre P. Kengne ◽  
Saarah F. G. Davids ◽  
...  
Keyword(s):  
South African ◽  
Expression Profiles ◽  
Cross Sectional Study ◽  
Therapeutic Interventions ◽  
Hypertension Status ◽  
Cross Sectional ◽  
Progression Of Disease ◽  
Polymerase Chain ◽  
Circulating Levels ◽  
Diagnosis Of Hypertension

MicroRNAs are non-coding, post-transcriptional regulators of gene expression and their dysregulation has been associated with development of various diseases, including hypertension. Consequently, understanding their role in the pathogenesis and progression of disease is essential. Prior research focusing on microRNAs in disease has provided a basis for understanding disease prognosis and offered possible channels for therapeutic interventions. Herein, we aimed to investigate possible differences in the expression profiles of five microRNAs in the blood of participants grouped on the basis of their hypertension status. This was done to elucidate the possible roles played by these microRNAs in the development of hypertension. Using quantitative reverse transcription polymerase chain reaction, we evaluated the expression levels of miR-126-3p, 30a-5p, 182-5p, 30e-3p, and 1299 in the whole blood of 1456 participants, normotensive (n = 573), screen-detected hypertensive (n = 304) and known hypertensive (n = 579). The expression of miR-126-3p and 182-5p was significantly higher in known hypertensives relative to both screen-detected hypertensives and normotensives, and also in screen-detected hypertensives vs normotensives. A significant association between the expression of miR-126-3p, 182-5p, and 30a-5p and known hypertension was also evident. This study demonstrated dysregulated miR-126-3p, 182-5p, and 30a-5p expression in hypertension, highlighting the possible efficacy of these microRNAs as targets for the diagnosis of hypertension as well as the development of microRNA-based therapies.

scholarly journals Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

2013 ◽  
Vol 39 (4) ◽  
pp. 476-483 ◽  
Author(s):  
Silvana Gomes Nunes Piva ◽  
Maria da Conceicao Nascimento Costa ◽  
Florisneide Rodrigues Barreto ◽  
Susan Martins Pereira
Keyword(s):  
Pulmonary Tuberculosis ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Nutritional Deficiency ◽  
Therapeutic Interventions ◽  
Cross Sectional ◽  
End Of Treatment ◽  
Using Data

OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age) residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9%) were in males, and 21 (29.2%) of the patients were in the 40-49 year age bracket. The majority (85.3%) described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions.

scholarly journals Motivational Profiles of Medical Students of Nepalese Army Institute of Health Sciences

2018 ◽  
Vol 15 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Lochana Shrestha ◽  
Shambhu Nath Pant
Keyword(s):  
Academic Performance ◽  
Medical Students ◽  
Academic Motivation ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Study Strategies ◽  
Cross Sectional ◽  
Cluster Membership ◽  
High Interest ◽  
Low Motivation

Background: Students enter the medical study with different types of motives. Given the importance of academic motivation for good academic achievement of the students, the present study was designed to reveal the possible relationship between academic motivation and achievement in medical students.Methods: In this cross-sectional study medical students (N=364) of Nepalese Army institute of Health Sciences were participated and classified to different subgroups using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies and academic performance. Results: Four clusters were obtained: High Intrinsic High Controlled, Low Intrinsic High Controlled, High Intrinsic Low Controlled, and Low Intrinsic Low Controlled. High Intrinsic High Controlled and High Intrinsic Low Controlled profile students constituted 36.1%, 22.6% of the population, respectively. No significant differences were observed as regards to deep strategy and surface strategy between high interest status motivated and high interest-motivated students. However, both of the clusters had significantly deeper, surface strategy and better academic performance than status-motivated and low-motivation clusters (p < 0.001). Conclusions: The interest status motivated and interest-motivated medical students were associated with good deep and surface study strategy and good academic performance. Low-motivation and status-motivated students were associated with the least academic performance with less interest learning behaviors. This reflected that motivation is important required component for good learning outcomes for medical student.

scholarly journals Comparative analysis of methods for identifying multimorbidity patterns: a study of ‘real-world’ data

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018986 ◽  
Author(s):  
Albert Roso-Llorach ◽  
Concepción Violán ◽  
Quintí Foguet-Boreu ◽  
Teresa Rodriguez-Blanco ◽  
Mariona Pons-Vigués ◽  
...  
Keyword(s):  
Real World ◽  
Hierarchical Cluster ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Real World Data ◽  
Cross Sectional ◽  
World Data ◽  
Data Usage ◽  
Classification Of Diseases ◽  
Depth Study

ObjectiveThe aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting.DesignCross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10. Multimorbidity patterns were identified using HCA and EFA. Analysis was stratified by sex, and results compared for each method.Setting and participantsElectronic health records for 408 994 patients with multimorbidity aged 45–64 years in 274 primary health care teams from 2010 in Catalonia, Spain.ResultsHCA identified 53 clusters for women, with just 12 clusters including at least 2 diagnoses, and 15 clusters for men, all of them including at least two diagnoses. EFA showed 9 factors for women and 10 factors for men. We observed differences by sex and method of analysis, although some patterns were consistent. Three combinations of diseases were observed consistently across sex groups and across both methods: hypertension and obesity, spondylopathies and deforming dorsopathies, and dermatitis eczema and mycosis.ConclusionsThis study showed that multimorbidity patterns vary depending on the method of analysis used (HCA vs EFA) and provided new evidence about the known limitations of attempts to compare multimorbidity patterns in real-world data studies. We found that EFA was useful in describing comorbidity relationships and HCA could be useful for in-depth study of multimorbidity. Our results suggest possible applications for each of these methods in clinical and research settings, and add information about some aspects that must be considered in standardisation of future studies: spectrum of diseases, data usage and methods of analysis.

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