scholarly journals Statistical Literacy among Practicing Clinicians from India: A Brief Survey

2021 ◽  
pp. 13-18
Author(s):  
Ankush Jindal ◽  
Dr. Manishi Bansal ◽  
Dr. Anupam Jindal
Keyword(s):  
Online Survey ◽  
Graphical Representation ◽  
Medical Curriculum ◽  
Roc Curves ◽  
General Information ◽  
Statistical Literacy ◽  
Web Based ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Self Learning

Objectives: To understand statistical literacy among practicing clinicians as well as to take suggestions on its implementation in medical curriculum. Methods: A web based online survey was conducted among practising clinicians of India. The questionnaire consisted of 30questions in three parts. Part A included questions on general information (5 questions), Part B included questions on application of statistical concepts (20 questions), and Part Casked for opinions on integration of biostatistics in medical curriculum (5 questions). Part B questions were rated on a 5-point Likert scale in which 1 indicated no confidence and 5indicated complete confidence. Results: A total of 416 clinicians responded to the questionnaire. Complete confidence in the use of SPSS software was seen in 15.8% whereas 26.7% had no confidence in it. The highest confidence was seen in statistical equations like graphical representation of data (44.7%), and sensitivity and specificity (45.2%) whereas lowest confidence was seen in COX proportional hazard regression (12.9%) and ROC curves (11.7%). Out of 416 clinicians, 136 (32.4%) had done training in statistics at undergraduate level, 128 (30.5%) did self-learning and 152 (37.1%) had received no formal training.

Factors affecting progression to permanent atrial fibrillation in an unselected population of patients with non-permanent form of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V.L Malavasi ◽  
E Fantecchi ◽  
V Tordoni ◽  
L Melara ◽  
A Barbieri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Significant Difference ◽  
History Of ◽  
Unselected Population ◽  
Cox Proportional Hazard Regression

Abstract Background Natural history of atrial fibrillation (AF) shows a progression of arrhythmia from non-permanent to permanent AF. Permanent AF was found associated with a worse prognosis than non-permanent one. Aim To assess the factors associated with progression to permanent AF in an unselected population of AF patients with non-permanent AF. Methods In this prospective study we enrolled in- as well as out-patients with non-permanent AF and age ≥18 years, with at least one episode of ECG-documented AF within 1 year. The patients were followed-up at 1 month and every 6 months thereafter. Results Out of 523 patients, 314 (60%) were in non-permanent AF (80 [25.5%] paroxysmal AF, 165 [52.5%] persistent AF, 69 [2%] first diagnosed AF), mostly male (188, 59.9%), median age 71 years (IQ range 62–77), median CHA2DS2VASc 3 (1–4), median HATCH score 1 (1–2). After a median follow-up of 701 (IQ range 437–902) days, 66 patients (21%) showed permanent AF. CHA2DS2VASc and HATCH scores were incrementally associated to progression to permanent AF (CHA2DS2VASc χ2 p=0.001; HATCH χ2 p=0.017; p for trend CHA2DS2VASc <0.001, HATCH p=0.001). At multivariable Cox proportional hazard regression the following variables were significantly associated with AF progression: age (hazard ratio [HR] 1.041; 95% CI: 1.004–1.079; p=0.028), at least moderate left atrial (LA) enlargement (>42 ml/m2) (HR 2.092; 95% CI: 1.132–3.866; p=0.018), antiarrhythmics drugs after the enrollment (HR 0.087; 95% CI: 0.011–0.662; p=0.018), EHRA score >2 (HR 0.351; 95% CI: 0.158–0.779; p=0.010) and Valvular HD (HR 2.161; 95% CI: 1.057–4.420; p=0.035). Adding LA dilation to HATCH score (HATCH-LA) and assigning 2 points based on multivariable Cox regression, HATCH-LA was statistically better in ROC curves in prediction of AF progression vs HATCH score (area under the curve 0.695 vs 0.636; DeLong p=0.0225). Survival-free curves on freedom from permanent AF using as discriminator HATCH-LA score ≤2 vs >2 led to a statistically significant difference (χ2=16.080 p<0.001), but the same was not found for HATCH score (χ2 =3.099; p=0.078). Conclusions In patients without permanent AF, progression of AF was independentely related to age, LA dilation, AF symptoms severity, antiarrhythmic drugs and Valvular HD. HATCH score predicted AF progression and adding to it LA dilation (at least moderate) improved patients stratification for the risk of evolution to permanent AF. Funding Acknowledgement Type of funding source: None

scholarly journals A nomogram to predict stricture after endoscopic submucosal dissection for early esophageal cancer

2021 ◽  
Author(s):  
Xue Li ◽  
Jie Xing ◽  
Peng Li ◽  
Shengtao Zhu ◽  
Qian Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Esophageal Stricture ◽  
Operation Time ◽  
Roc Curves ◽  
Proportional Hazard ◽  
Early Esophageal Cancer ◽  
Postoperative Fever ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Abstract Background: Risk factors of esophageal stricture after ESD are inconsistent and incomprehensive, the present study aimed to identify a robust model to predict postoperative stricture.Methods: This retrospective study included 273 individuals underwent ESD for early esophageal cancer from January 1, 2014 to October 30, 2020 in Beijing Friendship Hospital. Univariate Cox proportional hazard regression was used to estimate potential factors of stricture after ESD, followed by multivariate Cox proportional hazard regression to identify significant independent predictors after adjusting for covariates. Nomogram building based on multivariate Cox regression model was used to evaluate accuracy and discrimination by ROC curves and calibration curves respectively.Results: Stricture was identified in 28 patients (10%). The other patients were enrolled in non-stricture group (n=243). Multivariate Cox proportional hazard model demonstrated that operation time (HR 1.01, 95%CI: 1.00-1.01, P<0.01), upper segment of esophagus (HR 6.48, 95%CI: 2.07-20.33, P<0.01), middle segment of esophagus (HR 3.42, 95%CI: 1.36-8.64, P<0.01), >3/4 circumferential lumen of esophagus (HR 6.32, 95%CI: 2.20-18.13, P<0.01), postoperative fever (HR 6.17, 95%CI: 1.75-21.77, P<0.01), were independent predictive factors for postoperative stricture. The predictive accuracy of the nomogram was estimated by the AUC of ROC curves was 0.93, 0.87, 0.87 at 1 year, 2 years, and 3 years respectively.Conclusion: Longer operation time, >3/4 of the circumferential lumen of esophagus, located at upper and middle esophageal segment, and postoperative fever were independent risk factors of esophageal stricture after ESD.

scholarly journals Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Gram Negative Organisms ◽  
Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

A Web-Based Interactive Map to Promote Health-Care Facility Flood Preparedness

2021 ◽  
pp. 1-4
Author(s):  
Elena Grossman ◽  
Michelle Hathaway ◽  
Amber Khan ◽  
Apostolis Sambanis ◽  
Samuel Dorevitch
Keyword(s):  
Health Care ◽  
Emergency Preparedness ◽  
Online Survey ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Interactive Map

Abstract Objectives: Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it. Methods: An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided. Results: Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications. Conclusions: Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.

scholarly journals The impact of theory-based messages on COVID-19 vaccination intentions: a structured summary of a study protocol for a randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ben Young ◽  
Marie Kotzur ◽  
Lauren Gatting ◽  
Carissa Bonner ◽  
Julie Ayre ◽  
...  
Keyword(s):  
Online Survey ◽  
Controlled Trial ◽  
Significant Proportion ◽  
General Information ◽  
School Level ◽  
Text And Image ◽  
Post Intervention ◽  
Full Protocol ◽  
The Impact ◽  
Illness Coherence

Abstract Objectives Uptake of vaccination against COVID-19 is key to controlling the pandemic. However, a significant proportion of people report that they do not intend to have a vaccine, often because of concerns they have about vaccine side effects or safety. This study will assess the impact of theory-based messages on COVID-19 vaccination intention, drawing on the Necessity-Concerns framework to address previously reported beliefs and concerns about COVID-19 vaccination, and assess whether hypothesised variables (illness coherence, perceived necessity and concerns) mediate change in vaccination intention. Trial design Prospective, parallel two-arm, individually randomised (1:1) trial. Participants Adults aged over 18 years, living in Scotland and not vaccinated for COVID-19. A quota sampling approach will be used with the aim of achieving a nationally representative sample on gender, region and ethnic group, with oversampling of individuals with no educational qualifications or with only school-level qualifications. Intervention and comparator Intervention: Brief exposure to online text and image-based messages addressing necessity beliefs and concerns about COVID-19 vaccination. Comparator: Brief exposure to online text and image-based messages containing general information about COVID-19 and COVID-19 vaccination. Main outcomes Primary outcome: Self-reported intention to receive a vaccine for COVID-19 if invited, immediately post-intervention. Secondary outcomes: Self-reported COVID-19 illness coherence, perceived necessity of a COVID-19 vaccine and concerns about a COVID-19 vaccine, immediately post-intervention. Randomisation Quasi-randomisation performed automatically by online survey software, by creating a variable derived from the number of seconds in the minute that the participant initiates the survey. Participants starting the survey at 0-14 or 30-44 seconds in the minute are allocated to the intervention and 15-29 or 45-59 seconds to the comparator. Blinding (masking) Participants will not be blinded to group assignment but will not be informed of the purpose of the study until they have completed the follow-up survey. Investigators will be blinded to allocation as all procedures will be undertaken digitally and remotely without any investigator contact with participants. Numbers to be randomised (sample size) A total of 1,094 will be randomised 1:1 into two groups with 547 individuals in each. Trial Status Protocol version number 1.0, 26th February 2021. Recruitment status: Not yet recruiting, set to start April 2021 and end April 2021. Trial registration ClinicalTrials.gov, NCT04813770, 24th March 2021. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

scholarly journals Would Parents Get Their Children Vaccinated Against SARS-CoV-2? Rate and Predictors of Vaccine Hesitancy According to a Survey over 5000 Families from Bologna, Italy

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 366
Author(s):  
Marco Montalti ◽  
Flavia Rallo ◽  
Federica Guaraldi ◽  
Lapo Bartoli ◽  
Giulia Po ◽  
...  
Keyword(s):  
Online Survey ◽  
Vaccination Campaign ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Web Based ◽  
Safe School ◽  
Efficacy Trials ◽  
Adolescent Vaccination ◽  
Web Social ◽  
Mandatory Vaccination

In the near future, COVID-19 vaccine efficacy trials in larger cohorts may offer the possibility to implement child and adolescent vaccination. The opening of the vaccination for these strata may play a key role in order to limit virus circulation, infection spreading towards the most vulnerable subjects, and plan safe school reopening. Vaccine hesitancy (VH) could limit the ability to reach the coverage threshold required to ensure herd immunity. The aim of this study was to investigate the prevalence and determinants of VH among parents/guardians toward a potentially available COVID-19 vaccination for children and adolescents. An online survey was performed in parents/guardians of children aged <18 years old, living in Bologna. Overall, 5054 questionnaires were collected. A vast majority (60.4%) of the parents/guardians were inclined to vaccinate, while 29.6% were still considering the opportunity, and 9.9% were hesitant. Highest vaccine hesitancy rates were detected in female parents/guardians of children aged 6–10 years, ≤29 years old, with low educational level, relying on information found in the web/social media, and disliking mandatory vaccination policies. Although preliminary, these data could help in designing target strategies to implement adherence to a vaccination campaign, with special regard to web-based information.

scholarly journals AB0292 EFFICACY AND SAFETY OF TWO BIOSIMILAR ETANERCEPT AFTER THE SWITCH FROM THEIR CORRESPONDING ORIGINATOR IN THE TREATMENT OF PATIENTS WITH AUTOIMMUNE ARTHRITIS; A RETROSPECTIVE ANALYSIS IN A REAL LIFE SETTING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1445.1-1445
Author(s):  
F. Girelli ◽  
A. Ariani ◽  
M. Bruschi ◽  
A. Becciolini ◽  
L. Gardelli ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Disease Duration ◽  
Retention Rate ◽  
Real Life ◽  
Autoimmune Arthritis ◽  
Proportional Hazard ◽  
Hazard Regression ◽  
Cox Proportional Hazard ◽  
Real Life Setting ◽  
Cox Proportional Hazard Regression

Background:The available biosimilars of etanercept are as effective and well tolerated as their bio originator molecule in the naive treatment of chronic autoimmune arthritis. More data about the switching from the bio originator are needed.Objectives:To compare the clinical outcomes of the treatment with etanercept biosimilars (SB4 and GP2015) naïve and after the switch from their corresponding originator in patients affected by autoimmune arthritis in a real life settingMethods:We retrospectively analyzed the baseline characteristics and the retention rate in a cohort of patients who received at least a course of etanercept (originator or biosimilar) in our Rheumatology Units from January 2000 to January 2020. We stratified the study population according to biosimilar use. Descriptive data are presented by medians (interquartile range [IQR]) for continuous data or as numbers (percentages) for categorical data. Drug survival distribution curves were computed by the Kaplan-Meier method and compared by a stratified log-rank test. A Cox proportional hazards regression analysis stratified by indication, drug, age, disease duration, sex, treatment line, biosimilar use and prescription year was performed. P values≤0.05 were considered statistically significant.Results:477 patients (65% female, median age 56 [46-75] years, median disease duration 97 [40.25-178.75] months) treated with etanercept were included in the analysis. 257 (53.9%) were affect by rheumatoid arthritis, 139 (29.1%) by psoriatic arthritis, and 81 (17%) by axial spondylarthritis. 298 (62.5%) were treated with etanercept originator, 97 (20.3%) with SB4, and 82 (17.2%) with GP2015. Among the biosimilars 90/179 (50.3%) patients were naïve to etanercept treatment. Among the 89 switchers we observed 8 treatment discontinuations: one due to surgical infection complication, three due to disease flare, two due to subjective worsening and one due to remission. The overall 6- and 12-month retentions rate were 92.8% and 80.2%. The 6- and 12-month retention rate for etanercept, SB4 and GP2015 were 92.7%, 93.4% and 90.2%, and 82%, 74.5% and 88.1% respectively, without significant differences among the three groups (p=0.374). Patients switching from originator to biosimilars showed and overall higher treatment survival when compared to naive (12-month retention rate 81.2% vs 70.8%, p=0.036). The Cox proportional hazard regression analysis highlighted that the only predictor significantly associated with an overall higher risk of treatment discontinuation was the year of prescription (HR 1.08, 95% CI 1.04 to 1.13; p<0.0001).Conclusion:In our retrospective study etanercept originator and its biosimilars (SB4 and GP2015) showed the same effectiveness. Patients switching from originator to biosimilar showed an significant higher retention rate when compared to naive. The only predictor of treatment discontinuation highlighted by the Cox proportional hazard regression analysis was the year of treatment prescription.Disclosure of Interests:Francesco Girelli: None declared, Alarico Ariani: None declared, Marco Bruschi: None declared, Andrea Becciolini Speakers bureau: Sanofi-Genzyme, UCB and AbbVie, Lucia Gardelli: None declared, Maurizio Nizzoli: None declared

scholarly journals Information Overload, Wellbeing and COVID-19: A Survey in China

2021 ◽  
Vol 11 (5) ◽  
pp. 62
Author(s):  
Jialin Fan ◽  
Andrew P Smith
Keyword(s):  
General Public ◽  
Online Survey ◽  
Information Overload ◽  
Age Distribution ◽  
General Information ◽  
Anxiety And Depression ◽  
Specific Information ◽  
Cross Sectional ◽  
Wide Range ◽  
Negative Coping

(1) Psychology must play an important role in the prevention and management of the COVID-19 pandemic. The aim of the present study was to examine associations between the perceptions of information overload and wellbeing in China during the initial phase of COVID-19. (2) Methods: The present research involved a cross-sectional online survey, which controlled for established predictors of wellbeing and the perception of general (not COVID-19-specific) information overload. The setting of the research was China, February 2020. A total of 1349 participants completed an online survey, and the results from 1240 members of the general public who stated that they were uninfected are reported here (55.6% female; 49.4% single; age distribution: 17–25 years: 26%; 26–30 years: 24.3%; 31–40 years: 23.9%; 41–50 years: 16.2%; 51 years+: 9.6%; the most frequent occupations were: 21.5% students; 19.5% teachers; 25.9% office workers; 10.8% managers, plus a few in a wide range of jobs). The outcomes were positive wellbeing (positive affect and life satisfaction) and negative wellbeing (stress, negative affect, anxiety and depression). (3) Results: Regressions were carried out, controlling for established predictors of wellbeing (psychological capital, general information overload, positive and negative coping). Spending time getting information about COVID-19 was associated with more positive wellbeing. In contrast, perceptions of COVID-19 information overload and feeling panic due to COVID-19 were associated with more negative wellbeing. (4) Conclusions: These results have implications for the communication of information about COVID-19 to the general public and form the basis for further research on the topic.

Manual occupations with high all-cause mortality: The contribution of socioeconomic and occupational characteristics

2020 ◽  
pp. 140349482096065
Author(s):  
Hanna Rinne ◽  
Mikko Laaksonen
Keyword(s):  
High Mortality ◽  
Excess Mortality ◽  
Proportional Hazard ◽  
Individual Level ◽  
Cox Proportional Hazard ◽  
Occupational Characteristics ◽  
Study Population ◽  
Cox Proportional Hazard Regression ◽  
Year 2000

Aims: Most high mortality-risk occupations are manual occupations. We examined to what extent high mortality of such occupations could be explained by education, income, unemployment or industry and whether there were differences in these effects among different manual occupations. Methods: We used longitudinal individual-level register-based data, the study population consisting of employees aged 30–64 at the end of the year 2000 with the follow-up period 2001–2015. We used Cox proportional hazard regression models in 31 male and 11 female occupations with high mortality. Results: There were considerable differences between manual occupations in how much adjusting for education, income, unemployment and industry explained the excess mortality. The variation was especially large among men: controlling for these variables explained over 50% of the excess mortality in 23 occupations. However, in some occupations the excess mortality even increased in relation to unadjusted mortality. Among women, these variables explained a varying proportion of the excess mortality in every occupation. After adjustment of all variables, mortality was no more statistically significantly higher than average in 14 occupations among men and 2 occupations among women. Conclusions: The high mortality in manual occupations was mainly explained by education, income, unemployment and industry. However, the degree of explanation varied widely between occupations, and considerable variation in mortality existed between manual occupations after controlling for these variables. More research is needed on other determinants of mortality in specific high-risk occupations.

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