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Preventive Medicine Nov 2022It is well known that the statistical analyses in health-science and medical journals are frequently misleading or even wrong. Despite many decades of reform efforts by... (Review)
Review
It is well known that the statistical analyses in health-science and medical journals are frequently misleading or even wrong. Despite many decades of reform efforts by hundreds of scientists and statisticians, attempts to fix the problem by avoiding obvious error and encouraging good practice have not altered this basic situation. Statistical teaching and reporting remain mired in damaging yet editorially enforced jargon of "significance", "confidence", and imbalanced focus on null (no-effect or "nil") hypotheses, leading to flawed attempts to simplify descriptions of results in ordinary terms. A positive development amidst all this has been the introduction of interval estimates alongside or in place of significance tests and P-values, but intervals have been beset by similar misinterpretations. Attempts to remedy this situation by calling for replacement of traditional statistics with competitors (such as pure-likelihood or Bayesian methods) have had little impact. Thus, rather than ban or replace P-values or confidence intervals, we propose to replace traditional jargon with more accurate and modest ordinary-language labels that describe these statistics as measures of compatibility between data and hypotheses or models, which have long been in use in the statistical modeling literature. Such descriptions emphasize the full range of possibilities compatible with observations. Additionally, a simple transform of the P-value called the surprisal or S-value provides a sense of how much or how little information the data supply against those possibilities. We illustrate these reforms using some examples from a highly charged topic: trials of ivermectin treatment for Covid-19.
Topics: Humans; Data Interpretation, Statistical; Bayes Theorem; COVID-19; Probability; Models, Statistical; Confidence Intervals
PubMed: 35787846
DOI: 10.1016/j.ypmed.2022.107127 -
Urologia May 2023To evaluate the value of transrectal shear-wave-elastography(SWE) to differentiate benign and malignant tissues in patients with suspected prostate cancer.
AIM
To evaluate the value of transrectal shear-wave-elastography(SWE) to differentiate benign and malignant tissues in patients with suspected prostate cancer.
MATERIALS AND METHODS
Between January and May 2019, the study was designed as a prospective clinical study. The SWE value of 504 cores measured before biopsy and the pathology result of each core were used in the statistical analysis. The SWE values of benign and malignant cores were compared according to pathology results. ROC analysis was used to calculate the best cut-off SWE value for differentiating malignancy from benign tissues. Specificity, sensitivity, negative, and positive predictive values (NPV, PPV) were also calculated for cut-off value.
RESULTS
Prostate cancer was detected in 74 (14.7%) of 504 core biopsies. The mean SWE values were found significantly higher in malignant cores (71.1 kPa) than benign cores (42.3 kPa) ( < 0.001). Cores with gleason score 7 had a significantly higher SWE value than Gleason score 6 ( = 0.009). The cut-off value to differentiate malignancy and area-under-curve were calculated 35.85 kPa, 0.733, respectively. The sensitivity, specificity, NPV, and PPV were 83%, 49%, 78%, and 95%, respectively for 35.85 kPa value.
CONCLUSIONS
The malignant tissues have significantly higher SWE values. Also high gleason score was shown to be associated with high SWE values. To predict the prostate cancer, the difference of SWE values of between benign and malignant tissues has high sensitivity. In the near future, to prevent unnecessary prostate biopsies, SWE will be part of the standard protocol for prostate imaging.
Topics: Male; Humans; Elasticity Imaging Techniques; Prospective Studies; Prostatic Neoplasms; Prostate; ROC Curve; Sensitivity and Specificity
PubMed: 37025049
DOI: 10.1177/03915603231167650 -
Experimental and Therapeutic Medicine Mar 2021The aim of the study was to explore the diagnostic value of T2 mapping in an experimental rat model of chronic liver disease. Chronic hepatitis was induced in...
The aim of the study was to explore the diagnostic value of T2 mapping in an experimental rat model of chronic liver disease. Chronic hepatitis was induced in Sprague-Dawley male rats (n=88) by intraperitoneal and abdominal subcutaneous injection of carbon tetrachloride in olive oil. The normal control rats (n=12) were similarly injected with the same dose of normal saline. All rats were randomly selected and subjected to T2-weighted/spectral adiabatic inversion recovery and multiple gradient- and spin-echo sequence. After scanning, rats were sacrificed immediately and livers removed for staining with hematoxylin and eosin, as well as Masson's trichrome, to determine the pathological stage of hepatic fibrosis, necroinflammatory activity and steatosis. The T2 values were measured and associated with histopathological findings. The T2 values were significantly associated with hepatic fibrosis (P<0.05), but not with hepatitis (P>0.05) or steatosis (P>0.05). By partial correlation analysis, a significant positive correlation was observed between the T2 values and stages of liver fibrosis (=0.820; P<0.05). T2 values increased with progressive hepatic fibrosis. The differences between T2 values and stages of liver fibrosis were statistically significant. Statistically significant differences were observed between different stages of liver fibrosis (P<0.05), with an area under the curve value of 0.944 for predicting stage F1 or greater, 0.942 for stage F2 or greater, 0.958 for stage F3 or greater, and 0.948 for F4. Thus, the T2 value is one of the quantitative indices of imaging and accurately reflects the stages of liver fibrosis.
PubMed: 33603834
DOI: 10.3892/etm.2021.9656 -
Revista Brasileira de Terapia Intensiva 2021To determine the prevalence of and risk factors for insufficient knowledge related to p-values among critical care physicians and respiratory therapists in Argentina.
OBJECTIVE
To determine the prevalence of and risk factors for insufficient knowledge related to p-values among critical care physicians and respiratory therapists in Argentina.
METHODS
This cross-sectional online survey contained 25 questions about respondents' characteristics, self-perception and p-value knowledge (theory and practice). Descriptive and multivariable logistic regression analyses were conducted.
RESULTS
Three hundred seventy-six respondents were analyzed. Two hundred thirty-seven respondents (63.1%) did not know about p-values. According to the multivariable logistic regression analysis, a lack of training on scientific research methodology (adjusted OR 2.50; 95%CI 1.37 - 4.53; p = 0.003) and the amount of reading (< 6 scientific articles per year; adjusted OR 3.27; 95%CI 1.67 - 6.40; p = 0.001) were found to be independently associated with the respondents' lack of p-value knowledge.
CONCLUSION
The prevalence of insufficient knowledge regarding p-values among critical care physicians and respiratory therapists in Argentina was 63%. A lack of training on scientific research methodology and the amount of reading (< 6 scientific articles per year) were found to be independently associated with the respondents' lack of p-value knowledge.
Topics: Critical Care; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Humans; Risk Factors; Surveys and Questionnaires
PubMed: 33886857
DOI: 10.5935/0103-507X.20210009 -
Journal of Pediatric Nursing 2022To explore the value of pediatric early warning scoring system (PEWS) in an emergency observation room in China.
OBJECTIVE
To explore the value of pediatric early warning scoring system (PEWS) in an emergency observation room in China.
METHODS
The children who had been admitted consecutively to the emergency observation room from Jan, 2019 to Aug, 2020 were selected. Three most important time-points including the first value (admission value), the highest value during the observation (highest value), and final value (discharge value) of Brighton Pediatric Early Warning Score (PEWS) was evaluated in all patients.
RESULTS
4717 patients were included. They were categorized into 3 groups, namely, discharged group (G1, n = 2320), specialized ward group (G2, n = 2128), and ICU group (G3, n = 269). The different PEWS values of admission value, highest value, and discharge value were significantly different among the 3 groups (P<0.001). Highest value of G1 and G2 were significantly lower than that of G3 (P<0.001). AUROC curves of different PEWS values were used to predict the possibility of PICU admission and PICU mortality within 24 h of admission, and the values were 0.698, 0.878, 0.974 and 0.709, 0.883, 0.951, respectively. The cutoff values for PICU admission of 3 different PEWS values were 2.5 (sensitivity 0.635, specificity 0.699), 3.5 (sensitivity 0.817, specificity 0.9), 3.5 (sensitivity 0.837, specificity 0.985). The cutoff values for PICU mortality of 3 different PEWS values were 4 (sensitivity 0.625, specificity 0.799), 4.5 (sensitivity 0.722, specificity 0.79), 4.5 (sensitivity 0.883, specificity 0.987). The discharge value had the strongest prediction ability.
CONCLUSIONS
PEWS can be used for early identification and warning of critically ill children.
Topics: Child; Early Warning Score; Emergency Service, Hospital; Hospitalization; Humans; Infant; Intensive Care Units, Pediatric; Patient Discharge; ROC Curve; Retrospective Studies
PubMed: 35597130
DOI: 10.1016/j.pedn.2022.05.011 -
Journal of Biopharmaceutical Statistics 2020The -value is a classical proposal of statistical inference, dating back to the seminal contributions by Fisher, Neyman and E. Pearson. However, -values have been... (Review)
Review
The -value is a classical proposal of statistical inference, dating back to the seminal contributions by Fisher, Neyman and E. Pearson. However, -values have been frequently misunderstood and misused in practice, and medical research is not an exception. In recent years, in several statistical and applied journals, a debate erupted about the need of clear guidelines in reporting -values, which culminated with the publication of the ASA statement in 2016. In this paper, we assess strengths and limitations of -values and we assert that in applied research the -value should be supplemented by other measures, such as the Bayes factor, the Bayes false discovery rate and the local Bayes false discovery rate. We also review a recent proposal by Bayarri et al. from a Bayesian perspective that has the advantage of introducing an indicator, the rejection odds, which keeps into account both pre- and post-experimental information, and could also have a straightforward frequentist interpretation. We conduct a delimited numerical study that investigates on the relation of the Bayes factor with its maximum, and of the local Bayes false discovery rate with its minimum under different distributional assumptions and parameter choices. We illustrate the concepts expressed in theory with an example in clinical oncology, namely a randomized trial on the effectiveness of a new chemotherapy for patients with AIDS and Kaposi's sarcoma.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bayes Theorem; Data Interpretation, Statistical; Humans; Models, Statistical; Randomized Controlled Trials as Topic; Research Design; Sarcoma, Kaposi; Treatment Outcome
PubMed: 31264506
DOI: 10.1080/10543406.2019.1632874 -
Clinical Oral Investigations Sep 2023The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet...
OBJECTIVE
The aim of this study was to investigate solubility, pH value, chemical structure, radiopacity, and cytotoxicity of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet sealers.
MATERIALS AND METHODS
Cytotoxicity analysis with direct and extraction tests at 3 different concentrations (1:1, 1:2, 1:4 v/v%) and time (24 h, 48 h, and 72 h) on Saos-2, PdLF, and THP-1 cell lines, chemical structure with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis, solubility, pH, and radiopacity values of AH Plus BC, TotalFill BC, AH Plus, and AH Plus Jet were evaluated. For statistical analyses of the groups, repeated measures, factorial, and one-way ANOVA tests were used. The statistical significance level was set at p < .05.
RESULTS
Resin-based sealers showed higher cytotoxicity values than the bioceramic-based sealers (p < 0.05). Time and concentrations were effective on the cell viabilities for cell lines. Higher peaks of calcium were detected bioceramic-based sealers and higher amount of zirconium was detected in AH Plus BC (p < 0.05). AH Plus BC showed similar radiopacity value with AH Plus, AH Plus Jet, whereas TotalFill BC showed the lowest radiopacity (p < 0.05). Bioceramic-based sealers had higher pH values in all experiment periods, and the difference between resin- and bioceramic-based sealer groups was significant (p < 0.05). However, the solubility values of the tested root canal sealers revealed no differences (p > 0.05).
CONCLUSIONS
The newly produced AH Plus BC Sealer showed similar properties with TotalFill BC, and their biological properties were better than AH Plus and AH Plus Jet.
CLINICAL RELEVANCE
AH Plus BC could be a possible alternative to other bioceramic- or resin-based sealers.
Topics: Root Canal Filling Materials; Epoxy Resins; Solubility; Calcium Compounds; Dental Pulp Cavity; Silicates; Materials Testing; Hydrogen-Ion Concentration
PubMed: 37486382
DOI: 10.1007/s00784-023-05160-6 -
Contrast Media & Molecular Imaging 2022The purpose of this study was to investigate the absolute value of peripheral blood lymphocytes in patients with primary immune thrombocytopenia and the diagnostic...
The purpose of this study was to investigate the absolute value of peripheral blood lymphocytes in patients with primary immune thrombocytopenia and the diagnostic effect on patients with primary immune thrombocytopenia. From January 2020 to June 2021, 76 patients with primary immune thrombocytopenia and 80 healthy check-ups admitted to our hospital were selected as study subjects and divided into a control group (80 patients, healthy check-ups) and an observation group (76 patients, primary immune thrombocytopenia), according to the health status of the organism. Early morning fasting venous blood was collected from both groups, and the absolute value of peripheral blood lymphocytes was measured and compared using a fully automated hematology analyzer to investigate the diagnostic value of absolute peripheral blood lymphocytes in primary immune thrombocytopenia. The CD3+, CD3+CD4+, CD4+/CD8+, and CD16+CD56+ assay values in the observation group were lower than those in the control group, and the CD3+CD8+, CD19+, and ALC assay values were higher than those in the control group ( < 0.05). The CD3+CD8+ detection values of newly diagnosed patients were similar to those of relapsed refractory patients ( > 0.05); CD3+, CD3+CD4+, CD4+/CD8+, and CD16+CD56+ detection values of newly diagnosed patients were lower than those of relapsed refractory patients, and CD19+ and ALC detection values were higher than those of relapsed refractory patients; CD3+, CD3+CD4+, CD4+, CD4+/CD8+, and CD16+CD56+ detection values of mild patients were lower than those of relapsed refractory patients; CD3+, CD3+CD4+, CD4+/CD8+, and CD16+CD56+ detection values were higher in mild patients than in severe patients, and CD3+CD8+, CD19+, and ALC detection values were lower than in severe patients ( < 0.05). The absolute lymphocyte values were of high diagnostic value in primary immune thrombocytopenia, with a sensitivity and specificity of 93.42% and 90.00%. The application of absolute peripheral blood lymphocyte value in the clinical diagnosis of primary immune thrombocytopenia can achieve a better detection and diagnosis effect, which has a positive impact on the early diagnosis rate and can help patients to obtain more timely, effective and targeted treatment, and is worthy of promotion.
Topics: Humans; Lymphocytes; Purpura, Thrombocytopenic, Idiopathic
PubMed: 36072617
DOI: 10.1155/2022/9833941 -
PloS One 2022Severe acute respiratory syndrome coronavirus (SARS-CoV2) has imposed catastrophic impressions on the world. After all the focused researches conducted in the COVID-19...
INTRODUCTION
Severe acute respiratory syndrome coronavirus (SARS-CoV2) has imposed catastrophic impressions on the world. After all the focused researches conducted in the COVID-19 area, many features remain obscure. We have surveyed 1,363 outpatients with suspected COVID-19 in Tehran, Iran. The analysis emphasized on characteristics of patients with positive PCR or serology of SARS-CoV-2.
METHODS
The nasopharyngeal swabs were tested for SARS-CoV2 PCR. Serum specimens were tested for SARS-CoV2 IgG and IgM. Clinical presentations of the patients, history of chronic diseases or drug use, contact with a possible COVID-19 patient and previous infection with SARS-COV2 were investigated.
RESULTS
Of the total 1,363 investigated patients, 22% had positive SARS-CoV-2 PCRs, 82% had positive IgG, 38% had positive IgM, and 31% had both positive IgM and IgG values. Positive serologic tests were significantly associated with a positive PCR test obtained previously in the course of the current disease (P value<0.001). IgG and IgM antibody values were significantly associated with underlying disease, cough, fever, chills, fatigue, and myalgia (all P values <0.001). Dyspnea was significantly associated with IgG levels (P value = 0.01), yet it was not associated with IgM serology (P value = 0.2). Positive serology tests were not associated with symptoms of coryza. GI symptoms were not associated with positive IgG test (P value = 0.1), yet it did show an association with positive IgM test (P value = 0.02). Cough, fever, chills, myalgia fatigue, dyspnea, and GI symptoms were all significantly associated with positive PCR (all P values <0.001), and symptoms of coryza did not show a significant relationship (P value = 0.8).
CONCLUSION
Assessing antibody titers in outpatients is invaluable due to the epidemiological importance of investigations in mild or even asymptomatic cases. Since the number of such studies in non-hospitalized patients is not high, the current study can be used as a comparison model.
Topics: Antibodies, Viral; COVID-19; Chills; Cough; Cross-Sectional Studies; Dyspnea; Fatigue; Humans; Immunoglobulin G; Immunoglobulin M; Iran; Myalgia; RNA, Viral; SARS-CoV-2; Serologic Tests
PubMed: 35421183
DOI: 10.1371/journal.pone.0266923 -
Statistical Applications in Genetics... Nov 2020Combining correlated p-values from multiple hypothesis testing is a most frequently used method for integrating information in genetic and genomic data analysis....
Combining correlated p-values from multiple hypothesis testing is a most frequently used method for integrating information in genetic and genomic data analysis. However, most existing methods for combining independent p-values from individual component problems into a single unified p-value are unsuitable for the correlational structure among p-values from multiple hypothesis testing. Although some existing p-value combination methods had been modified to overcome the potential limitations, there is no uniformly most powerful method for combining correlated p-values in genetic data analysis. Therefore, providing a p-value combination method that can robustly control type I errors and keep the good power rates is necessary. In this paper, we propose an empirical method based on the gamma distribution (EMGD) for combining dependent p-values from multiple hypothesis testing. The proposed test, EMGD, allows for flexible accommodating the highly correlated p-values from the multiple hypothesis testing into a unified p-value for examining the combined hypothesis that we are interested in. The EMGD retains the robustness character of the empirical Brown's method (EBM) for pooling the dependent p-values from multiple hypothesis testing. Moreover, the EMGD keeps the character of the method based on the gamma distribution that simultaneously retains the advantages of the z-transform test and the gamma-transform test for combining dependent p-values from multiple statistical tests. The two characters lead to the EMGD that can keep the robust power for combining dependent p-values from multiple hypothesis testing. The performance of the proposed method EMGD is illustrated with simulations and real data applications by comparing with the existing methods, such as Kost and McDermott's method, the EBM and the harmonic mean p-value method.
PubMed: 33156000
DOI: 10.1515/sagmb-2019-0057