The Tukey trend test: Multiplicity adjustment using multiple marginal models

AbstractGiven increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stratified by hospital teaching status (rural/urban by teaching status), hospital bed size (≤299, 300–499, and ≥500 beds), and hospital region (Northeast, Midwest, South, and West). The Cochran–Armitage trend test (PJI prevalence) and linear regression determined significance of trends. PJI prevalence overall was 25.5% (n = 199,818) with a minor increasing trend: 25.3% (n = 7,828) in 2003 to 28.9% (n = 19,275) in 2016; p < 0.0001. Median total hospitalization costs for PJI decreased slightly ($23,247 in 2003–$20,273 in 2016; p < 0.0001) while median per-day costs slightly increased ($3,452 in 2003–$3,727 in 2016; p < 0.0001), likely as a function of decreasing length of stay. With small differences between hospitals, the lowest and highest PJI prevalences were seen in small (≤299 beds; 22.9%) and urban teaching hospitals (27.3%), respectively. In stratification analyses, an increasing trend in PJI prevalence was particularly seen in larger (≥500 beds) hospitals (24.4% in 2003–30.7% in 2016; p < 0.0001), while a decreasing trend was seen in small-sized hospitals. Overall, PJI in knee arthroplasty revisions appears to be slightly increasing. Moreover, increasing trends in large hospitals and decreasing trends in small-sized hospitals suggest a shift in patients from small to large volume hospitals. Decreasing trends in total costs, alongside increasing trends in per-day costs, suggest a strong impact of length of stay trends and a more efficient approach to PJI over the years (in terms of shorter length of stay).

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Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-048744 ◽

2021 ◽

Vol 11 (5) ◽

pp. e048744

Author(s):

Andreea Bratu ◽

Taylor McLinden ◽

Katherine Kooij ◽

Monica Ye ◽

Jenny Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

British Columbia ◽

Cohort Study ◽

Population Based ◽

Incidence Rates ◽

Trend Test ◽

People Living With Hiv ◽

Age Related ◽

Hiv Serostatus ◽

The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

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The Association between Decreased Kidney Function and FIB-4 Index Value, as Indirect Liver Fibrosis Indicator, in Middle-Aged and Older Subjects

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136980 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6980

Author(s):

Kazuko Kotoku ◽

Ryoma Michishita ◽

Takuro Matsuda ◽

Shotaro Kawakami ◽

Natsumi Morito ◽

...

Keyword(s):

Liver Fibrosis ◽

Kidney Function ◽

Survival Curve ◽

Cross Sectional Study ◽

Trend Test ◽

Healthy Population ◽

Middle Aged ◽

Cross Sectional ◽

Ckd Stage ◽

Older Subjects

Liver fibrosis might be linked to the prevalence of chronic kidney disease (CKD). However, there is little information about the association between liver fibrosis and decreased kidney function in middle-aged and older subjects. We aimed to evaluate the influence of liver fibrosis on the incidence or prevalence of CKD stage 3–5 in a retrospective cross-sectional study (Study 1, n = 806) and a 6-year longitudinal study (Study 2, n = 380) of middle-aged and older subjects. We evaluated liver fibrosis using the Fibrosis-4 (FIB-4) index and kidney function using the estimated glomerular filtration rate (eGFR) of all subjects. All subjects were divided into four groups on the basis of their FIB-4 score quartiles (low to high). In the Jonckheere–Terpstra trend test of Study 1, the eGFR decreased significantly from the lowest group to the highest group (p < 0.001). The Kaplan–Meier survival curve in Study 2 showed that the cumulative prevalence of CKD stage 3–5 was higher in the third quartile than the other quartiles. Our results suggest that liver fibrosis could be a useful indicator for the prevalence of CKD, even within a relatively healthy population, although liver fibrosis was not an independent risk factor.

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241 Trends in the percentage of modified live, killed, and combination respiratory viral vaccines administered to beef calves offered for sale in summer video auctions from 2000 through 2018

Journal of Animal Science ◽

10.1093/jas/skaa054.016 ◽

2020 ◽

Vol 98 (Supplement_3) ◽

pp. 9-10

Author(s):

Maggie J Smith ◽

Mike E King ◽

Karol E Fike ◽

Esther D McCabe ◽

Glenn M Rogers ◽

...

Keyword(s):

Trend Test ◽

Fort Worth ◽

Single Gender ◽

Beef Calves ◽

Vaccine Type ◽

Viral Vaccine ◽

Viral Vaccines ◽

Dramatic Shift ◽

Armitage Trend Test

Abstract The objective of this study was to identify trends in the percentage of type of respiratory viral vaccines administered to lots of beef calves offered for sale in summer video auctions from 2000 through 2018. There were 59,762 lots of single-gender beef calves (7,167,352 total calves) offered for sale in 145 summer video auctions during these years. Information describing calf lots was obtained from the auction service (Superior Livestock Auction, Fort Worth, TX) which included named vaccines administered to the lot. Named 4- or 5-way respiratory viral vaccines were classified into three groups based on the type of antigens they contained: all modified live antigens (MLV), all killed antigens (KILLED), and a combination of modified live and killed antigens (COMBO). The Cochran-Armitage Trend Test was used to quantify the significance of a trend in the usage of each respiratory viral vaccine type. There was an increase (P < 0.0001) in the percentage of MLV vaccines given to beef calf lots from 2000 (39.7%) through 2018 (88.9%). At the same time, the percentages of both KILLED and COMBO vaccines administered to lots of beef calves declined (P < 0.0001 and P < 0.0001, respectively). In 2000, 31.2% and 29.1% of the total respiratory viral vaccines given to beef calf lots were KILLED or COMBO vaccines, respectively. By 2018, only 4.7% of respiratory viral vaccines were KILLED, and only 6.4% were COMBO vaccines. This dramatic shift indicates an industry trend towards increasing MLV vaccine utilization compared with declining usage of KILLED and COMBO vaccines. This trend may be a result of MLV vaccine approval for use in calves nursing pregnant cows.

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Safety Level Analysis of Waterway Traffic Based on Trend Test in the Yangtze River

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/638/1/012042 ◽

2021 ◽

Vol 638 (1) ◽

pp. 012042

Author(s):

Guobo Wang ◽

Yahan Hu ◽

Yuchang Hu

Keyword(s):

Yangtze River ◽

Trend Test ◽

The Yangtze River ◽

Safety Level ◽

Level Analysis

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Lower-caloric intake but different nutrient profiles in cognition impaired and in frail elderlies

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.219 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Y Wu ◽

W H Pan

Keyword(s):

Body Weight ◽

Cognitive Impairment ◽

Dietary Fiber ◽

Energy Intake ◽

Odds Ratio ◽

Nutrient Intake ◽

Lower Energy ◽

Trend Test ◽

Impairment Score ◽

Cognition Impairment

Abstract Background Frailty and dementia are two common geriatric syndromes associated with poor nutritional status. The nutritional role in the pathogenesis of frailty and dementia remains unclear. We examined the associations between energy intake and frailty/cognition impairment and also compared the nutrient intake between frail and cognition impaired elderlies by sex. Methods Data of 1,920 elderly adults (≧65y) from the 2014-2017 Nutrition and Health Survey in Taiwan was used. Frailty was defined using modified L. Fried criteria. The Chinese Mini-Mental State Examination score was grouped into tertiles: cognitive impairment (score ≦ 23), mild cognitive impairment (score = 24-27), and the normal (score ≧28). Total energy intake was grouped into tertiles. Logistic regression adjusted for age, sex, and sampling strata was used for association test. The trend test was performed using generalized linear model with age adjustment to examine whether various nutrient intake indicators had an ordered relationship with the severity of frailty and cognitive impairment. Results Lower energy intake (men <1540 Kcal or women<1182 Kcal) was significantly associated with frailty (odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.45-2.66) and cognition impairment (OR: 1.88; 95%CI: 1.43-2.47), respectively. Larger number of micronutrients and food substances per Kg body weight exhibited decreasing trends with MCI (protein, fat, carbohydrate, vitamins B1, B2, B3, B6, B12, C, E, Ca, P, Fe, Mg, K, Zn, dietary fiber, and cholesterol) than with frailty (protein, vitamin B1, B3, B6, C, P, Mg, K, Zn, polyunsaturated fatty acids, and dietary fiber). Conclusions The lower the energy intake, the higher the odds ratio for frailty and for dementia. Dietary quality expressed by nutrient intake per Kg body weight was poorer in elderlies with cognition impairment than those with frailty. Key messages Lower energy intake is associated with MCI and with frailty, respectively. The MCI elderlies involve more micronutrient deficiencies than the frail counterpart.

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Response of LUCC on Runoff Generation Process in Middle Yellow River Basin: The Gushanchuan Basin

Water ◽

10.3390/w12051237 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1237 ◽

Cited By ~ 1

Author(s):

Caihong Hu ◽

Li Zhang ◽

Qiang Wu ◽

Shan-e-hyder Soomro ◽

Shengqi Jian

Keyword(s):

Climate Change ◽

Human Activities ◽

Yellow River ◽

Trend Test ◽

Generation Process ◽

Runoff Generation ◽

Contribution Rate ◽

Runoff Reduction ◽

Runoff Change ◽

Significant Downward Trend

Runoff reduction in most river basins in China has become a hotpot in recent years. The Gushanchuan river, a primary tributary of the middle Yellow river, Northern China, showed a significant downward trend in the last century. Little is known regarding the relative contributions of changing environment to the observed hydrological trends and response on the runoff generation process in its watershed. On the basis of observed hydrological and meteorological data from 1965–2010, the Mann-Kendall trend test and climate elasticity method were used to distinguish the effects of climate change and human activities on runoff in the Gushanchuan basin. The results indicate that the runoff in the Gushanchuan Basin has experienced significant declines as large as 77% from 1965 to 2010, and a mutation point occurred around 1997; the contribution rate of climate change to runoff change is 12.9–15.1%, and the contribution rate of human activities to runoff change is 84.9–87.1%. Then we divided long-term data sequence into two stages around the mutation point, and analyzed runoff generation mechanisms based on land use and cover changes (LUCC). We found that the floods in the Gushanchuan Basin were still dominated by Excess-infiltration runoff, but the proportion in 1965–1997 and 1998–2010 decreased gradually (68.46% and 45.83% in turn). The proportion of Excess-storage runoff and Mixed runoff has increased, which means that the runoff is made up of more runoff components. The variation law of the LUCC indicates that the forest area increased by 49.61%, the confluence time increased by 50.42%, and the water storage capacity of the watershed increased by 30.35%.

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Increased prevalence of psychosis in patients who get admitted with atrial fibrillation with worse outcomes

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.856 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S575-S576

Author(s):

Z. Mansuri ◽

S. Patel ◽

P. Patel ◽

O. Jayeola ◽

A. Das ◽

...

Keyword(s):

Atrial Fibrillation ◽

Hospital Admissions ◽

Temporal Trends ◽

International Classification Of Diseases ◽

Trend Test ◽

Classification Of Diseases ◽

Competing Interest ◽

Armitage Trend Test ◽

The Impact

ObjectiveTo determine trends and impact on outcomes of atrial fibrillation (AF) in patients with pre-existing psychosis.BackgroundWhile post-AF psychosis has been extensively studied, contemporary studies including temporal trends on the impact of pre-AF psychosis on AF and post-AF outcomes are largely lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from the healthcare cost and utilization project (HCUP) from year's 2002–2012. We identified AF and psychosis as primary and secondary diagnosis respectively using validated international classification of diseases, 9th revision, and Clinical Modification (ICD-9-CM) codes, and used Cochrane–Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 3.887.827AF hospital admissions from 2002–2012 of which 1.76% had psychosis. Proportion of hospitalizations with psychosis increased from 5.23% to 14.28% (P trend < 0.001). Utilization of atrial-cardioversion was lower in patients with psychosis (0.76%v vs. 5.79%, P < 0.001). In-hospital mortality was higher in patients with Psychosis (aOR 1.206; 95%CI 1.003–1.449; P < 0.001) and discharge to specialty care was significantly higher (aOR 4.173; 95%CI 3.934–4.427; P < 0.001). The median length of hospitalization (3.13 vs. 2.14 days; P < 0.001) and median cost of hospitalization (16.457 vs. 13.172; P < 0.001) was also higher in hospitalizations with psychosis.ConclusionsOur study displayed an increasing proportion of patients with Psychosis admitted due to AF with higher mortality and extremely higher morbidity post-AF, and significantly less utilization of atrial-cardioversion. There is a need to explore reasons behind this disparity to improve post-AF outcomes in this vulnerable population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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