scholarly journals Relationship Between Unbound Bilirubin Levels and Acute Bilirubin Encephalopathy in Exchange Transfusion Neonates

2021 ◽  
Author(s):  
Yiyi Ding ◽  
Shuo Wang ◽  
Rui Guo ◽  
Aizhen Zhang ◽  
Yufang Zhu
Keyword(s):  
Logistic Regression ◽  
Blood Glucose ◽  
Odds Ratio ◽  
Exchange Transfusion ◽  
Binary Logistic Regression ◽  
P Value ◽  
Bilirubin Encephalopathy ◽  
Unbound Bilirubin ◽  
Independent Variable ◽  
The Relationship

Abstract BACKGROUND: Evidence regarding the relationship between unbound bilirubin levels and acute bilirubin encephalopathy was limited. Therefore, this study set out to investigate whether the unbound bilirubin level was independently related to acute bilirubin encephalopathy in children who underwent exchange transfusion after adjusting for other covariates. METHODS: A total of 46 neonates who underwent exchange transfusion were involved in The First People's Hospital Of Changde City in China from 2016-1-1 to 2018-12-31. The target independent variable and the dependent variable were unbound bilirubin levels measured at baseline and acute bilirubin encephalopathy respectively. Covariates involved in this study included sex, age, birth weight, blood glucose, red blood cell, hemolysis, receive phototherapy before exchange transfusion. RESULTS: The average gestational age of 46 selected participants was 38.6 ± 1.3 weeks old, the average age was 146.5 ± 86.9 hours old, 52.17% of them were male. Result of fully-adjusted binary logistic regression showed unbound bilirubin levels were positively associated with risk of acute bilirubin encephalopathy after adjusting confounders (Odds ratio = 1.41, 95% confidence intervals 1.05-1.91, P value <0.05). CONCLUSION: Unbound bilirubin levels are associated with neonatal acute bilirubin encephalopathy. The mechanism of unbound bilirubin levels leading to neonatal acute bilirubin encephalopathy needs to be further explored.

scholarly journals High levels of unbound bilirubin are associated with acute bilirubin encephalopathy in post-exchange transfusion neonates

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Yiyi Ding ◽  
Shuo Wang ◽  
Rui Guo ◽  
Aizhen Zhang ◽  
Yufang Zhu
Keyword(s):  
Exchange Transfusion ◽  
Binary Logistic Regression ◽  
Positive Association ◽  
Binary Logistic Regression Analysis ◽  
Bilirubin Encephalopathy ◽  
Red Blood Cell Count ◽  
Unbound Bilirubin ◽  
Independent Variable ◽  
The Mean ◽  
The Brain

Abstract Background Although it is known that unbound bilirubin can enter the brain, there is little evidence of its association with the development of acute bilirubin encephalopathy. Here, we investigated this potential relationship in neonates who had undergone exchange transfusion. Methods Data from 46 newborns who underwent exchange transfusion between 2016 and 1-1 to 2018-12-31 at the First People’s Hospital of Changde City in China were analyzed. The unbound bilirubin level was taken as the independent variable and the development of the acute bilirubin encephalopathy as the dependent variable. The covariates were age, birth weight, sex, red blood cell count, blood glucose, hemolytic disease, and whether the infant had received phototherapy. Results The mean age and gestational age of the neonates were 146.5 ± 86.9 h and 38.6 ± 1.3 weeks [38.7(34.6–41.1) weeks] old, respectively; 52.17% were male. Binary logistic regression analysis after adjustment for covariates showed a positive association between the levels of unbound bilirubin and the development of acute bilirubin encephalopathy (odds ratio = 1.41, 95% confidence intervals 1.05–1.91, P = < 0.05). Conclusion There is a significant association between unbound bilirubin levels and the development of acute bilirubin encephalopathy in neonates. Further investigations are required to explore the mechanisms.

Is there a relationship between gestational diabetes and postpartum depression?

2020 ◽  
Vol 16 ◽  
Author(s):  
Salman Khazaei ◽  
Erfan Ayubi ◽  
Saeid Bashirian ◽  
Ronak Hamzehei ◽  
Ensiyeh Jenabi
Keyword(s):  
Gestational Diabetes ◽  
Postpartum Depression ◽  
Odds Ratio ◽  
Depression Scale ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
University Education ◽  
P Value ◽  
Cross Sectional ◽  
The Relationship

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

scholarly journals The human factor: does the operator performing the embryo transfer significantly impact the cycle outcome?

2020 ◽  
Vol 35 (2) ◽  
pp. 275-282 ◽  
Author(s):  
F Cirillo ◽  
P Patrizio ◽  
M Baccini ◽  
E Morenghi ◽  
C Ronchetti ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Uterine Cavity ◽  
P Value ◽  
Ongoing Pregnancy Rate ◽  
The Mean ◽  
The Relationship

Abstract STUDY QUESTION Is Ongoing Pregnancy Rate (OPR) operator-dependent, and can experience improve embryo transfer efficiency? SUMMARY ANSWER OPR is influenced by the operators who perform the embryo transfer (ET), and experience does not assure proficiency for everyone. WHAT IS KNOWN ALREADY ET remains the critical step in assisted reproduction. Although many other factors such as embryo quality and uterine receptivity impact embryo implantation, the proper ET technique is clearly an operator-dependent variable and as such it should be objectively standardized. STUDY DESIGN, SIZE, DURATION Retrospective comparative analysis including all fresh ETs performed between January 1996 and December 2016 at the Humanitas Fertility Center after IVF—ICSI cycles. PARTICIPANTS/MATERIALS, SETTING, METHODS IVF/ICSI fresh ETs performed by 32 operators, 19 824 cycles in all, were analyzed. All transfers consisting of freehand insertion of a preloaded soft catheter into the uterine cavity under transabdominal ultrasound guidance were considered. Two different statistical analyses were performed. First, a logistic regression model with a random intercept for the operator was used to estimate the heterogeneity of the rate of success among operators, accounting for woman age, FSH, number of oocytes retrieved, fertilization rate, year of the procedure, number and stage of transferred embryos and operator’s experience. Second, the relationship between experience and pregnancy rate was estimated separately for each operator by logistic regression, and operator-specific results were combined and compared in a random-effects meta-analysis. In both analyses, the operator’s experience at time t was measured in terms of number of embryo transfers performed before t. MAIN RESULTS AND THE ROLE OF CHANCE The heterogeneity among operators was highly significant (P value &lt;0.001) and explained 44.5% of the total variability. The odds ratio of success of the worst operator in respect to the mean was equal to 0.84. For the best operator, the odds ratio of success was equal to 1.13 in respect to the mean. Based on the meta-analysis of the relationship between operator’s experience and success rate, it resulted that, on average, the operators’ performance did not improve with additional transfers. LIMITATIONS, REASONS FOR CAUTION At our center, operators become independent for ET’s after performing between 30 and 50 transfers under supervision. It is also possible that other relevant factors, such as embryologists on duty for the ET, have not been included in the present analysis and this may represent a potential bias. Among these, it should be mentioned that the embryologists on duty for the ET were not taken into consideration. WIDER IMPLICATIONS OF THE FINDINGS Continued performance analysis and the use of a digital simulator could help operators to test their expertise over time and either correct poor performance or avoid doing transfers. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER NCT03561129.

scholarly journals Hubungan Tingkat Stres, Pengaruh Keluarga, dan Teman Sebaya dengan Status Merokok pada Mahasiswa Laki-Laki UIN Syarif Hidayatullah Jakarta Tahun 2019

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Eva Dwiyanti Lestari ◽  
Siti Ahlan Sarmadani ◽  
Safira Hani Pratiwi ◽  
Novera Nur Fikri ◽  
Ahmad Solihin Hafi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
University Students ◽  
Odds Ratio ◽  
Smoking Status ◽  
Binary Logistic Regression ◽  
Male Students ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional

Abstract Smoking is an unhealthy behavior that causes high morbidity and mortality. In Indonesia the prevalence of smokers is still high, and the number of smokers among university students tends to increase. Smoking status among male students of Syarif Hidayatullah State Islamic University (UIN) Jakarta and factors related to  smoking status behavior are not yet clearly known. This study was conducted to determine the relationship of stress levels, the influence of family and peers with smoking status on  male students of UIN Syarif Hidayatullah Jakarta in 2019. This study used a cross sectional study design to determine  the smoking status of male students of UIN Syarif Hidayatullah Jakarta. A purposive sampling technique was used to select 424 male university students. Data analysis was performed using the chi square test and binary logistic regression. The Results is the prevalence of smokers among male students of UIN Jakarta was 42.2%. The results of multivariate analysis showed that family and peers were significantly related to smoking status of students (p-value <0.05), while stress levels were not related. Odds ratio (OR) associated for family influence is 1.9 (95% Confidence Interval (CI): 1.24-2.93) and OR (95% CI) for with peer influence  is  13.6 (6.20-29.81). The Conclusion is the prevalence of smokers is still quite high among male students at UIN Syarif Hidayatullah Jakarta. The influence factor of family and peers is related to smoking status of UIN Syarif Hidayatullah Jakarta student.   Abstrak Merokok merupakan perilaku tidak sehat yang menyebabkan tingginya angka kesakitan dan kematian. Di Indonesia prevalensi perokok masih tinggi dan jumlah perokok di kalangan mahasiswa cenderung mengalami peningkatan. Status merokok mahasiswa Universitas Islam Negeri (UIN) Syarif Hidayatullah Jakarta dan faktor yang berhubungan dengan status merokok belum diketahui dengan jelas. Penelitian ini dilakukan untuk mengetahui hubungan tingkat stres, pengaruh keluarga, dan teman sebaya dengan status merokok pada mahasiswa UIN Syarif Hidayatullah Jakarta Tahun 2019. Penelitian ini menggunakan desain studi cross sectional untuk mengetahui status merokok mahasiswa laki-laki UIN Syarif Hidayatullah Jakarta. Teknik purposive sampling dilakukan untuk memilih 424 responden. Analisis data dilakukan dengan menggunakan uji chi square dan binary logistic regression. Hasil menunjukan prevalensi perokok pada mahasiswa laki-laki di UIN Syarif Hidayatullah Jakarta sebesar 42,2%. Hasil analisis multivariat menunjukkan bahwa keluarga dan teman sebaya berhubungan bermakna dengan status merokok mahasiswa (p-value <0,05), sedangkan level stres tidak berhubungan. Odds ratio (OR) untuk pengaruh keluarga sebesar 1,9 (95% Confidence Interval (CI): 1,24-2,93) dan OR (95% CI) untuk pengaruh teman sebaya sebesar 13,6 (6.20-29.81). Kesimpulannya adalah prevalensi perokok masih cukup tinggi pada mahasiswa laki-laki di UIN Syarif Hidayatullah Jakarta. Faktor pengaruh keluarga dan teman sebaya berhubungan dengan status merokok mahasiswa UIN Syarif Hidayatullah Jakarta.  

Abstract 3734: Presurgical fMRI and Morbidity Outcomes in Patients with Vascular Lesions

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andrew C Radtke ◽  
Joshua Pankratz ◽  
Ryan Holdsworth ◽  
Dovile Baniulis ◽  
Nicole Kornder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preoperative Planning ◽  
Binary Logistic Regression ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Binary Logistic Regression Analysis ◽  
Language Mapping ◽  
Motor Mapping ◽  
The Relationship

Background fMRI is being increasingly used as an adjunct imaging technique for preoperative planning for patients with various brain lesions. The proximity of the lesion to eloquent cortex is a major factor in guiding surgical planning. Our group has previously reported significant association between the distance between brain tumor periphery and area of fMRI activation (Lesion-Activation Distance; LAD) and morbidity and mortality outcomes. This study investigated the relationship between vascular lesion LAD and morbidity. Methods This study was a retrospective analysis of data from patients with vascular lesions [arteriovenous malformations (AVMs) (n=49), and cavernomas (n=57)], who had received fMRI as part of their preoperative planning. The preoperative fMRI included motor mapping (n=87) and/or language mapping (n=102). The fMRI paradigms were chosen based on observed preoperative weakness (aphasia, paresis) and anticipated functional areas of the brain that may be affected by treatment. Results Multiple logistic regression analyses showed that a model that combines Age and Language LAD was a significant predictor of postoperative deficits (p= 0.04). Broca’s LAD(1-2 cm) X Age was a significant predictor of postoperative deficits (change in odds ratio (OR) =0.82, CI:0.68-0.98). The relationship between Brocas’s LAD and postoperative aphasia and Broca’s LAD and pre and postoperative aphasia trended towards significance (p = .08 and p =.07 respectively). Wernicke’s LAD, independently or combined with Age, was not a significant predictor of postoperative deficits. Binary logistic regression analysis for SMC LAD and postop deficits did not reach significance (p =.10). There were no significant differences in postoperative language or motor deficits as a function of gender or handedness. Conclusions These results suggest that both age and the proximity of a vascular lesion to language LAD are factors that can help predict postoperative outcomes, especially for Broca’s LAD. The lack of similar results when investigating the relationship between Wernicke’s LAD and postoperative deficits suggests potential brain reorganization and/or robustness of this brain region. These results have implications for the potential use of fMRI as a presurgical tool for language mapping in patients with vascular lesions.

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

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.

scholarly journals The Relationship between Non-audit Services and Auditor Independence: Evidence from Chinese Listed Companies

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Xiaobo Hao
Keyword(s):  
Rapid Development ◽  
Binary Logistic Regression ◽  
Listed Companies ◽  
Auditor Independence ◽  
Binary Logistic Regression Model ◽  
Western Countries ◽  
Chinese Listed Companies ◽  
Independent Variable ◽  
The Relationship ◽  
Non Audit Services

The rapid development of non-audit services (NAS) has jeopardized the independence of auditors, which has led many Western countries to enact regulations that restrict the provision of NAS. While in China, NAS have just emerged, and its development in China is far less mature than in Western countries. The purpose of this paper is to explore whether NAS in China have damaged auditor independence and whether Chinese regulators need to emulate Western countries and strongly limit the provision of NAS. In order to achieve this objective, 213 Chinese listed companies are selected in this study. The audit opinions issued by the auditors are used as substitute variables for auditor independence (dependent variables), and the ratio of non-audit service fees to the total of audit service fees and non-audit service fees as a substitute variable for the provision of NAS (independent variable), and meanwhile some suitable control variables are also selected. Analyse these data by building a binary logistic regression model. The results show that there is no evidence in China that NAS can undermine auditor independence and there is no need for China to enact regulations to prohibit the provision of NAS.

scholarly journals Loyalitas Konsumen Terhadap Konsumsi Kopi Tubruk di Meulaboh

2017 ◽  
Vol 2 (2) ◽  
pp. 147-155
Author(s):  
Dina Fida ◽  
Ismayani Ismayani ◽  
Fajri Jakfar
Keyword(s):  
Logistic Regression ◽  
Customer Satisfaction ◽  
Customer Loyalty ◽  
Binary Logistic Regression ◽  
Validity And Reliability ◽  
Chi Square ◽  
Plantation Species ◽  
Long Time ◽  
Coffee Powder ◽  
The Relationship

Abstrak.Kopi adalah salah satu jenis tanaman perkebunan yang sudah lama dibudidayakan dan memiliki nilai ekonomi yang dapat menghasilkan keuntungan. Kopi tubruk merupakan kopi tradisional yang umumnya lebih keras karena bubuk kopi murni yang langsung diseduh dengan air  mendidih, teksturnya lebih kasar, lebih banyak mengandung ampas, aroma kopi yang lebih menyengat, serta tingkat kekentalan yang bisa disesuaikan dengan lidah penikmatnya. Loyalitas konsumen pada umumnya merupakan suatu sikap konsumen yang loyal terhadap pilihan dan penggunaan produk dalam waktu yang lama dan untuk masa yang akan datang, Sedangkan kepuasan konsumen ialah perasaan senang atau kecewa seseorang yang berasal dari perbandingan antara kesannya terhadap kinerja (hasil) sesuatu produk dengan harapannya. Pada penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi loyalitas konsumen terhadap minuman kopi tubruk di Meulaboh, Mengetahui hubungan antara tingkat kepuasan konsumen dengan loyalitas konsumen terhadap konsumsi kopi tubruk di Meulaboh.Adapun metode yang digunakan adalah Uji Validitas dan Reliabilitas,Regresi Logistik Biner dan Chi Square.Hasil Regresi Biner Logistik menunjukkan bahwa citarasa, harga, kualitas pelayanan dan lokasi merupakan faktor yang mempengaruhi loyalitas konsumen terhadap minuman kopi tubruk.Hasil Uji Chi-Square menunjukkan bahwa adanya hubungan yang signifikan antara kepuasan konsumen dengan loyalitas konsumen terhadap minuman kopi tubruk di Meulaboh.Consumer Loyality To The Consumption Of Coffee Brewed In MeulabohAbstract.Coffee is one of the plantation species has long been cultivated and have a mutually beneficial economic value.The brewed coffee is a traditional coffee are generally harder for pure coffee powder that instantly brewed with boiling water, rough texture, contains more dregs, pungent coffee aroma, as well as the level of consistency that can be adapted to the tongue of the audience.Consumer loyalty is generally a loyal consumer attitudes towards choice and use of the product for a long time and for the future.While customer satisfaction is feeling happy or disappointed someone who comes from a comparison between her impression of the performance (yield) of a product with expectations.In this study aims to determine the factors that influence consumer loyalty to the coffee beverage brewed in Meulaboh.Determine the relationship between the level of customer satisfaction and customer loyalty towards the consumption of instant coffee in Meulaboh.The methods used are validity and reliability, Binary Logistic Regression and Chi Square.Binary logistic regression results show that the simultaneous testing of the factors that influence loyalty is taste, price, service quality, and location. While testing only partially furnished variables that influence loyalty.Chi-Square test results indicate that there is a significant relationship between customer satisfaction and customer loyalty so that customer satisfaction is influenced flavors that suit the tastes of consumers. 

scholarly journals Epidemiological study on the relationship among menopausal condition, bone fragility, and knee osteoarthritis

2020 ◽  
Author(s):  
Eiji Sasaki ◽  
Daisuke Chiba ◽  
Seiya Ota ◽  
Yuka Kimura ◽  
Shizuka Sasaki ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Knee Osteoarthritis ◽  
Epidemiological Study ◽  
Odds Ratio ◽  
Weight Bearing ◽  
Predictive Marker ◽  
P Value ◽  
Mineral Density ◽  
High Turnover ◽  
The Relationship

Abstract Background: Knee osteoarthritis (KOA) occurs more often in middle-aged females. While this age-group experiences comorbid osteoporosis with menopause, its influence on KOA has not been clarified. This epidemiological study aimed to investigate the relationship between menopausal conditions, bone mineral density (BMD), and KOA. Methods: A total of 518 female volunteers who participated in the Iwaki cohort study were enrolled and divided into groups (pre- and post-menopause). Antimullerian hormone (AMH) was measured as a predictive marker for menopause in the pre-menopausal subjects. Weight-bearing anterior-posterior knee radiographs were classified by Kellgren-Lawrence grade, and grade ≥ 2 was defined as definitive KOA (DKOA). Early KOA (EKOA) was defined by Luyten’s criteria, and BMD was measured at a distal radius. The relationship between menopausal condition, BMD, and KOA was analyzed by ROC and regression analysis. Results: Fifty-two participants (10.0%) were diagnosed with EKOA and 204 (39.4%) with DKOA. A total of 393 (75.9%) females began menopause, and the prevalence of DKOA was up to 48.1% and >12.0% in pre-menopause females (p < 0.001, Odds ratio: 6.79). From the ROC analysis in pre-menopausal females, cut-off value of AMH for detecting EKOA was 0.08 ng/ml (AUC: 0.712, p5%CI: 0.527 to 0.897, p-value: 0.025, Odds ratio: 8.28). Regression analysis showed that lower AMH was related to EKOA (p=0.035, Odds ratio: 5.55) and DKOA (p=0.032, Odds 1.59), and lower BMD and high turnover bone metabolism were correlated with DKOA. Conclusions: KOA increased after menopause and was correlated with lower BMD. Furthermore, reduction in AMH was a valuable biomarker for the detection of EKOA.

scholarly journals Ultrasound shows swollen joints are the better proxy for synovitis than tender joints in DMARD-naïve, early psoriatic arthritis

2021 ◽  
Author(s):  
Sayam R Dubash ◽  
Oras A Alabas ◽  
Xabier Michelena ◽  
Leticia Garcia-Montoya ◽  
Gabriele De Marco ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Odds Ratio ◽  
Power Doppler ◽  
Mixed Effects ◽  
Grey Scale ◽  
The Individual ◽  
The Relationship ◽  
Early Psoriatic Arthritis ◽  
Joint Assessment ◽  
Subclinical Synovitis

Abstract Objective To evaluate the relationship between clinical examination/ultrasound (US) synovitis in DMARD-naïve early PsA. Methods Eligible patients underwent matched clinical/US 44 joint assessment for tender and/or swollen joints (TJ/SJ) and US synovitis [grey scale (GS) ≥2 or power Doppler (PD) ≥1]. Statistical agreement between TJ/SJ, GS ≥ 2 or PD ≥ 1 was calculated by prevalence-adjusted and bias-adjusted kappa (PABAK). To derive probabilities of GS ≥ 2/PD ≥ 1, mixed-effects logistic regression modelled odds of US synovitis in TJ/SJ were conducted. Results In 155 patients, 5,616 joints underwent clinical/US examination. Of these joints, 1039/5616 (18.5%) were tender, 550/5616 (9.8%) were swollen, 1144/5616 (20.4%) had GS ≥ 2, and 292/5616 (5.2%) had PD ≥ 1. GS ≥ 2 was most prevalent in concomitantly tender and swollen joints [205/462 (44%)] followed by swollen non-tender joints [32/88 (36.4%)], tender non-swollen joints [148/577 (25.7%)], and non-tender non-swollen joints (subclinical synovitis) [759/4489 (16.9%)]. Agreement between SJ/PD ≥ 1 was high at the individual joint level (82.6%-96.3%, PABAK 0.65–0.93) and for total joints combined (89.9%, PABAK 0.80). SJ/GS ≥ 2 agreement was greater than between TJ/GS ≥ 2 [73.5%-92.6% vs 51.0%-87.4% (PABAK 0.47–0.85 vs PABAK 0.35–0.75) respectively]. Swelling was independently associated with higher odds of GS ≥ 2 [odds ratio (OR) (95% CI); 4.37 (2.62, 7.29); p &lt; 0.001] but not tenderness [OR = 1.33 (0.87, 2.06); p = 0.192]. Swelling [OR = 8.78 (3.92, 19.66); p &lt; 0.001] or tenderness [OR = 3.38 (1.53, 7.50); p = 0.003] were independently associated with higher odds of PD ≥ 1. Conclusion Synovitis (GS ≥ 2 and/or PD ≥ 1) was more likely in swollen joints than tender joints in DMARD-naïve, early PsA. Agreement indicated swollen joints were the better proxy for synovitis, adding to greater understanding between clinical/US assessments.

Sign in / Sign up

Export Citation Format

Share Document