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Deutsches Arzteblatt International Feb 2023Refeeding syndrome (RFS) can occur in malnourished patients when normal, enteral, or parenteral feeding is resumed. The syndrome often goes unrecognized and may, in the... (Review)
Review
BACKGROUND
Refeeding syndrome (RFS) can occur in malnourished patients when normal, enteral, or parenteral feeding is resumed. The syndrome often goes unrecognized and may, in the most severe cases, result in death. The diagnosis of RFS can be crucially facilitated by the use of clinical decision support systems (CDSS).
METHODS
The literature in PubMed was searched for current treatment recommendations, randomized intervention studies, and publications on RFS and CDSS. We also took account of insights gained from the development and implementation of our own CDSS for the diagnosis of RFS.
RESULTS
The identification of high-risk patients and the recognition of manifest RFS is clinically challenging due to the syndrome's unspecific symptoms and physicians' lack of awareness of the risk of this condition. The literature shows that compared to patients without RFS, malnourished patients with RFS have significantly greater 6-month mortality (odds ratio 1.54, 95% confidence interval: [1.04; 2.28]) and an elevated risk of admission to intensive care (odds ratio 2.71 [1.01; 7.27]). In a prospective testing program, use of our own CDSS led to correct diagnosis in two thirds of cases.
CONCLUSION
RFS is difficult to detect and represents a high risk to the patients affected. Appropriate CDSS can identify such patients and ensure proper professional care.
Topics: Humans; Hospitalization; Malnutrition; Odds Ratio; Prospective Studies; Refeeding Syndrome
PubMed: 36482748
DOI: 10.3238/arztebl.m2022.0381 -
The Journal of Clinical Psychiatry Jul 2015Risk, and related measures of effect size (for categorical outcomes) such as relative risks and odds ratios, are frequently presented in research articles. Not all...
Risk, and related measures of effect size (for categorical outcomes) such as relative risks and odds ratios, are frequently presented in research articles. Not all readers know how these statistics are derived and interpreted, nor are all readers aware of their strengths and limitations. This article examines several measures, including absolute risk, attributable risk, attributable risk percent, population attributable risk percent, relative risk, odds, odds ratio, and others. The concept and method of calculation are explained for each of these in simple terms and with the help of examples. The interpretation of each is presented in plain English rather than in technical language. Clinically useful notes are provided, wherever necessary.
Topics: Biostatistics; Humans; Odds Ratio; Risk
PubMed: 26231012
DOI: 10.4088/JCP.15f10150 -
JAMA Pediatrics Apr 2022It is unclear to what extent the duration of screen time in infancy is associated with the subsequent diagnosis of autism spectrum disorder.
IMPORTANCE
It is unclear to what extent the duration of screen time in infancy is associated with the subsequent diagnosis of autism spectrum disorder.
OBJECTIVE
To examine the association between screen time in infancy and the development of autism spectrum disorder at 3 years of age.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study analyzed data from mother-child dyads in a large birth cohort in Japan. This study included children born to women recruited between January 2011 and March 2014, and data were analyzed in December 2020. The study was conducted by the Japan Environment and Children's Study Group in collaboration with 15 regional centers across Japan.
EXPOSURES
Screen time at 1 year of age.
MAIN OUTCOMES AND MEASURES
The outcome variable, children diagnosed with autism spectrum disorder at 3 years of age, was assessed using a questionnaire administered to mothers of the participating children.
RESULTS
A total of 84 030 mother-child dyads were analyzed. The prevalence of children with autism spectrum disorder at 3 years of age was 392 per 100 000 (0.4%), and boys were 3 times more likely to have been diagnosed with autism spectrum disorder than were girls. Logistic regression analysis showed that among boys, when "no screen" was the reference, the adjusted odds ratios were as follows: less than 1 hour, odds ratio, 1.38 (95 % CI, 0.71-2.69; P = .35), 1 hour to less than 2 hours, odds ratio, 2.16 (95 % CI, 1.13-4.14; P = .02), 2 hours to less than 4 hours, odds ratio, 3.48 (95% CI, 1.83-6.65; P < .001), and more than 4 hours, odds ratio, 3.02 (95% CI, 1.44-6.34; P = .04). Among girls, however, there was no association between autism spectrum disorder and screen time.
CONCLUSIONS AND RELEVANCE
Among boys, longer screen time at 1 year of age was significantly associated with autism spectrum disorder at 3 years of age. With the rapid increase in device usage, it is necessary to review the health effects of screen time on infants and to control excessive screen time.
Topics: Autism Spectrum Disorder; Child, Preschool; Cohort Studies; Female; Humans; Infant; Japan; Male; Odds Ratio; Screen Time
PubMed: 35099540
DOI: 10.1001/jamapediatrics.2021.5778 -
Clinical Infectious Diseases : An... Jun 2021Case reports have described instances of peripheral and central nervous system toxicity during treatment with metronidazole; however, no large-scale studies have...
BACKGROUND
Case reports have described instances of peripheral and central nervous system toxicity during treatment with metronidazole; however, no large-scale studies have examined this association.
METHODS
We conducted a population-based nested case-control study of adults aged 66 years or older living in Ontario, Canada, between 1 April 2003 and 31 March 2017. Cases were individuals who attended hospital for any of cerebellar dysfunction, encephalopathy, or peripheral neuropathy within 100 days of a prescription for either metronidazole or clindamycin. We matched each case patient with up to 10 event-free control subjects who also received metronidazole or clindamycin. We used conditional logistic regression to test the association between metronidazole exposure and neurologic events, with clindamycin as the reference exposure.
RESULTS
We identified 1212 cases with recent use of either metronidazole or clindamycin and 12 098 controls. Neurologic adverse events were associated with an increased odds of metronidazole exposure compared to clindamycin (odds ratio [OR], 1.72 [95% confidence interval {CI}, 1.53-1.94]), which persisted after accounting for patient demographics, comorbidities, and other medication exposures (adjusted odds ratio [aOR], 1.43 [95% CI, 1.26-1.63]). We found a consistent association limited to either central (aOR, 1.46 [95% CI, 1.27-1.68]) or peripheral (aOR, 1.34 [95% CI, 1.02-1.76]) nervous system events. Among metronidazole recipients, the overall incidence of neurologic events at 100 days was approximately 0.25%.
CONCLUSIONS
Metronidazole is associated with an increased risk of adverse peripheral and central nervous system events relative to clindamycin. Clinicians and patients should be aware of these rare but potentially serious adverse events.
Topics: Adult; Case-Control Studies; Clindamycin; Humans; Metronidazole; Odds Ratio; Ontario
PubMed: 32303736
DOI: 10.1093/cid/ciaa395 -
Revista Espanola de Salud Publica Oct 2021Depression is a disease prevalent in most older people and is negatively associated with suicidal ideation and behaviour in the elderly. The objective of this systematic... (Review)
Review
BACKGROUND
Depression is a disease prevalent in most older people and is negatively associated with suicidal ideation and behaviour in the elderly. The objective of this systematic review was to study the relationship between suicidal behaviour and the associated risk factors that lead older people to commit it.
METHODS
We searched systematically in the PubMed, Web of Science, SciELO and CUIDEN database, in addition, we used a search engine, Google Scholar, including studies when they were observational, with population of 60 years or more, whose patients had made any suicide attempt and instead were excluded when the participants were children or adolescents, reported cases of homicide or only reported the methods used in the suicide. The search was not delimited based on filters or time periods. The data is presented based on Odds Ratio, Relative Risk and percentage (%).
RESULTS
Eighteen studies were included in this systematic review. Various factors associated with the appearance of suicidal behaviour in the elderly were reported, the following are the most relevant: serious mental disorders (mean OR/RR value of 157.80); depression (mean OR/RR value of 16.53); and previous suicide attempts (average OR/RR value of 12.33).
CONCLUSIONS
Pathological, sociodemographic and psychosocial factors related to the ideation and appearance of suicidal behaviour in the elderly have been differentiated.
Topics: Adolescent; Aged; Child; Humans; Odds Ratio; Risk Factors; Spain; Suicidal Ideation; Suicide, Attempted
PubMed: 34620818
DOI: No ID Found -
Annals of Neurology Jan 2021
Topics: COVID-19; Data Interpretation, Statistical; Humans; Infections; Odds Ratio; SARS-CoV-2
PubMed: 33210320
DOI: 10.1002/ana.25960 -
American Journal of Epidemiology Nov 2023The classical Cornfield inequalities state that if a third confounding variable is fully responsible for an observed association between the exposure and the outcome...
The classical Cornfield inequalities state that if a third confounding variable is fully responsible for an observed association between the exposure and the outcome variables, then the association between both the exposure and the confounder, and the confounder and the outcome, must be at least as strong as the association between the exposure and the outcome, as measured by the risk ratio. The work of Ding and VanderWeele on assumption-free sensitivity analysis sharpens this bound to a bivariate function of the 2 risk ratios involving the confounder. Analogous results are nonexistent for the odds ratio, even though the conversion from odds ratios to risk ratios can sometimes be problematic. We present a version of the classical Cornfield inequalities for the odds ratio. The proof is based on the mediant inequality, dating back to ancient Alexandria. We also develop several sharp bivariate bounds of the observed association, where the 2 variables are either risk ratios or odds ratios involving the confounder.
Topics: Humans; Odds Ratio; Confounding Factors, Epidemiologic
PubMed: 37312597
DOI: 10.1093/aje/kwad137 -
Statistics in Medicine Sep 2022Factorial trials offer an efficient method to evaluate multiple interventions in a single trial, however the use of additional treatments can obscure research... (Randomized Controlled Trial)
Randomized Controlled Trial
Factorial trials offer an efficient method to evaluate multiple interventions in a single trial, however the use of additional treatments can obscure research objectives, leading to inappropriate analytical methods and interpretation of results. We define a set of estimands for factorial trials, and describe a framework for applying these estimands, with the aim of clarifying trial objectives and ensuring appropriate primary and sensitivity analyses are chosen. This framework is intended for use in factorial trials where the intent is to conduct "two-trials-in-one" (ie, to separately evaluate the effects of treatments A and B), and is comprised of four steps: (i) specifying how additional treatment(s) (eg, treatment B) will be handled in the estimand, and how intercurrent events affecting the additional treatment(s) will be handled; (ii) designating the appropriate factorial estimator as the primary analysis strategy; (iii) evaluating the interaction to assess the plausibility of the assumptions underpinning the factorial estimator; and (iv) performing a sensitivity analysis using an appropriate multiarm estimator to evaluate to what extent departures from the underlying assumption of no interaction may affect results. We show that adjustment for other factors is necessary for noncollapsible effect measures (such as odds ratio), and through a trial re-analysis we find that failure to consider the estimand could lead to inappropriate interpretation of results. We conclude that careful use of the estimands framework clarifies research objectives and reduces the risk of misinterpretation of trial results, and should become a standard part of both the protocol and reporting of factorial trials.
Topics: Data Interpretation, Statistical; Humans; Models, Statistical; Odds Ratio; Research Design
PubMed: 35751568
DOI: 10.1002/sim.9510 -
Korean Journal of Radiology Aug 2022
Topics: Humans; Logistic Models; Odds Ratio; Proportional Hazards Models
PubMed: 35695319
DOI: 10.3348/kjr.2022.0249 -
Indian Pediatrics Jun 2022Observational study designs are those where the investigator/researcher just observes and does not carry out any intervention(s)/actions to alter the outcome. The three... (Observational Study)
Observational Study
Observational study designs are those where the investigator/researcher just observes and does not carry out any intervention(s)/actions to alter the outcome. The three most common types of observational studies are cross-sectional, case control and cohort (or longitudinal). In cross-sectional studies, both the exposure/risk factor(s) and the outcome(s) are determined at a single time point. They can provide information on prevalence of a condition and snapshot of probable associations that can be used to generate hypothesis. Case-control studies are where subjects are selected based on presence/absence of outcome and the risk factors are determined during the study after enrolment of study subjects. The association between exposure and outcome is reported as odds ratio. These studies; however, have high risk of bias, which must be taken care of during study design. Cohort studies are prospective in nature, where subjects are selected based on presence/absence of exposure, and the outcome(s) is determined at the end of study. These studies can provide incidence of disease/outcome and the association between exposure and outcome is reported as relative risk. They are useful to ascertain causality. High dropouts of study participants and confounding can be problems encountered in these studies.
Topics: Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Humans; Odds Ratio; Prospective Studies
PubMed: 35481482
DOI: No ID Found