Test Bias Research Articles

Spontaneous theory of mind in autism: are anticipatory gaze and reaction time biases consistent?

BackgroundIndividuals with autism spectrum disorder (ASD) exhibit persistent deficits in social interaction and communication in adulthood. Pioneering studies have suggested that these difficulties arise from a lack of immediate, spontaneous mentalizing (i.e., theory of mind: ToM), specifically, an ability to attribute false beliefs to others, which should be usually acquired during neurotypical development. However, this view has been challenged by recent reports of nonreplications of spontaneous mentalizing, even in neurotypical adults.ObjectivesWe aimed to evaluate (1) whether measurements of spontaneous ToM in two representative paradigms, gaze bias in the anticipatory looking (AL) test and reaction time bias in the object detection (OD) test, are correlated in neurotypical adults and (2) whether these two measurements are altered in individuals with ASD.MethodsWe developed a novel hybridized spontaneous false belief test combining the AL and OD paradigms to enable within-subject comparison of different spontaneous ToM measurements.ResultsThe results obtained with our hybridized test replicated the earlier positive evidence for spontaneous ToM in both AL and OD paradigms. Our results also revealed a correlation between the participants’ spontaneous gaze bias in the AL paradigm and reaction time bias in the OD paradigm, indicating that the participants who had spontaneously anticipated other’s false belief driven actions more quickly detected the object. We further found that spontaneous gaze and reaction time biases were altered in individuals with ASD. Finally, we ascertained those inclusions of these biases as diagnostic variables in a regression model improved the accuracy of diagnosing ASD. ASD diagnosis was best predicted by the model when variables obtained from both AL and OD methods were included in the model.Conclusions/implicationsOur hybridized paradigm not only replicated spontaneous gaze bias in early AL studies and reaction time bias in the OD paradigms, but indicated significant correlation between them, suggesting that different implicit tasks tap the same spontaneous ToM in neurotypical adults. Group differences of these indices between ASD and neurotypical adult groups indicated that our task could help diagnose ASD, which is essential for evaluating the social difficulties that individuals with ASD face in adulthood.

Application of an attention bias test after surgical castration in piglets

Surgical castration of male piglets is a routine procedure performed to improve meat quality. Prior studies have shown that pain due to castration can last for up to 4 days, negatively impacting animal welfare, however the impact on affect, such as anxiety, is unclear. The objective of this study was to test the application of a novel attention bias test to assess anxiety in piglets that underwent surgical castration with or without practical pain alleviation methods. Piglets were surgically castrated (n = 22), castrated with analgesics (n = 21), or sham-handled (n = 22) at 3 days of age. An attention bias test was performed in week 1 (n = 32, 10–11/treatment) and 12 (n = 29, 9–10/treatment) to assess anxiety (an affective state), with feed (positive stimulus), loud bangs, and flashing lights (negative stimuli) presented simultaneously. Latency to visit the feeder, behavioral responses, and activity were recorded during the test. Additional data on piglets’ activity, tails, and grimaces were collected at three timepoints, at 1, 6, and 24 h after castration to determine pain experience. Piglets’ increased activity (P = 0.065), the fact that fewer piglets visited the feeder (P = 0.029), and tended to have longer latencies to visit the feeder (P = 0.092) in the attention bias test in week 1 might suggest that pain caused by surgical castration increased anxiety. No differences were detected in week 12. Castration treatment and sampling timepoint impacted activity levels hours after treatments, however, other measures were not impacted. These results suggest that more research is needed to determine how affect is impacted by pain caused by surgical castration. Activity and behavioral results somewhat support previous findings that surgical castration causes pain in piglets. As this is the first study assessing the relationship between painful procedures and piglet anxiety, more research is needed to determine a valid method to understand the impacts of these procedures on pig affect.

Effect of preventive chemotherapy for neglected tropical diseases in Indonesia from 1992 to 2022: A systematic review and meta-analysis.

This study aimed to describe the prevalence of lymphatic filariasis (LF), soil-transmitted helminthiasis (STH) and schistosomiasis (SC) in Indonesia before and after PC implementation through a systematic review and meta-analysis. Embase, MEDLINE, PubMed, Scopus, Web of Science and Google Scholar were searched for articles published between 1 January 1992 and 31 December 2022, reporting LF, STH and SC in Indonesia. Using the Ministry of Health lists of districts receiving PC programs, we identified whether data collection was conducted before or after PC implementation in that particular district. A meta-analysis was performed with a random-effects model applied to pool pre- and post-PC prevalence of LF, STH and SC. Overall, 195 studies were included. The pooled prevalence of LF was 9.72% (95% CI, 5.56%-13.87%). The pre-PC pooled prevalence of LF was 11.48% (95% CI, 5.52%-17.45%). The prevalence decreased after PC implementation, and the pooled prevalence was 7.12% (95% CI, 1.79%-12.44%). The overall prevalence of STH was 35.16% (95% CI, 30.36%-39.96%). The pre-PC prevalence of STH was 36.29% (95% CI, 30.37%-42.20%). The post-PC prevalence of STH decreased at 31.93% (95% CI, 24.25%-39.62%), although the difference between before and after PC was not significant (p = 0.379). Only nine studies investigated the prevalence of SC; based on the random-effects model, the pooled prevalence was 21.90% (95% CI, 4.88%-38.92%). Owing to the scarcity of studies, we could not perform the funnel tests for publication bias and moderating variables of the pooled prevalence for SC. The prevalence of LF and STH decreased after PC implementation, although it was not significant. The difference for SC could not be assessed because of limited post-PC data. The uneven distribution of research and the lack of standardised sampling methods may not fully capture the situation.

The effect of neuroticism on mobile phone addiction among undergraduate nursing students: a moderated mediation model

BackgroundMobile phone addiction (MPA) has numerous deleterious effects on college students, including depression, anxiety, cognitive impairments, and sleep disorders. Undergraduate nursing students play a crucial role as a significant reserve workforce in clinical nursing practice, and their compromised mental health status significantly influences the quality of nursing work and nurse-patient relationships in the future.ObjectivesThis study aims to investigate the associations between neuroticism and MPA among undergraduate nursing students, the mediating effect of self-control and the moderating effect of psychological capital.MethodsA total of 900 undergraduate nursing students participated in the survey, wherein the Eysenck Personality Questionnaire Short Form Scale China Version-Neuroticism Subscale (EPQ-RSC-N), Self-Control Scale (SCS), Positive Psychological Capital Questionnaire (PPQ), and Mobile Phone Addiction Tendency Scale (MPATS) were employed for assessment. To analyze the available data, various statistical methods were utilized, including common method bias test examination, descriptive statistics, chi-square tests, independent samples t-tests, Pearson’s correlation analyses, as well as the Hayes’ PROCESS Macro models 4 and 14.Results(1) The prevalence of MPA in this study was found to be 34.89%. (2) The MPA was positively correlated with neuroticism (r = 0.287, p < 0.001), and was negatively correlated with self-control (r = -0.467, p < 0.001) and psychological capital (r = -0.260, p < 0.001). (3) Self-control played a partially mediating role in the association between neuroticism and MPA, with an effect size of 0.151, accounting for 52.98% of the total effect. (4) Psychological capital played a moderating role in the association between self-control and MPA. More specifically, with an increase in the level of psychological capital increases, the predictive effect of self-control on MPA gradually strengthens (β = -0.072, SE = 0.019, t = -3.708, p < 0.001).ConclusionThe prevalence of MPA was relatively high among undergraduate nursing students, with neuroticism exerting a direct influence on it. Self-control served as a mediating factor that could partially alleviate MPA associated with neuroticism. Psychological capital has the ability to regulate the relationship between self-control and MPA. Therefore, enhancing self-control capabilities and cultivating psychological capital levels can effectively manage MPA among undergraduate nursing students.

A behavioural test of depression-related probability bias

ABSTRACT Individuals high in depressive symptom severity show probability bias: they believe negative events are relatively probable, and positive events relatively improbable, compared to those with less severe symptoms. However, this has only ever been demonstrated using self-report measures, in which participants explicitly estimate events’ probabilities: this leaves open the risk that “probability bias” is merely an artefact of response bias. We tested the veracity of probability bias using an indirect behavioural measure, based on a sentence-reading task. Study 1 tested 112 Turkish students; Study 2 tested 117 international users of online groups for people with depressive and anxiety disorders. As predicted, participants with higher depressive symptom scores responded relatively quickly to sentences stating negative events might occur, and relatively slowly to sentences stating positive events might occur, compared to those with lower scores. This effect was only marginal in Study 1, but reached significance in Study 2. However, contrary to predictions, this effect was not moderated by the probability level stated in the sentence. This makes our findings difficult to interpret, and we must present these studies as a failure to convincingly demonstrate depression-related probability bias. We hope this stimulates more work on the nature and veracity of probability bias.

Abstract 4136358: Diagnostic accuracy of Apple Watch Electrocardiogram for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Background: Electrocardiography (ECG) stands as the gold standard for the evaluation of cardiac arrhythmias. Recent smartwatches aim to promptly detect rhythm abnormalities enhancing user experience. However, the accuracy of these devices remains controversial. Our purpose was to perform a systematic review and meta-analysis evaluating the diagnostic performance of the Apple Watch electrocardiogram in detecting atrial fibrillation (AF). Methods: The literature search was conducted on PubMed, Embase, and Cochrane through April, 2024 for studies comparing the diagnostic accuracy of Apple Watch to standard 12 Lead ECG. Statistical analysis was performed using R Software version 4.4.0. Pooled analyses of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were determined along with their 95% confidence intervals (CI). The quality of studies was analyzed using the QUADAS-2 tool. Results: The meta-analysis included 11 studies comprising 13,490 participants. Their mean age was 62.56 ± 3.92 years and 28% of the population were females. The pooled sensitivity and specificity of Apple Watch for detecting AF was 94.8% (95% CI 91.7 - 96.8%) and 95% (95% CI 88.6 - 97.8%) respectively. The AUC was 0.96 (95% CI 0.92 - 0.97; Figure 1). Sensitivity analysis for heterogeneity revealed no significant change in values for sensitivity 94.8% (95% CI 91.7-96.8%) and specificity 94.9% (95% CI 88.6-97.8%). The studies had a low risk of bias in Index test and reference standard domains, but a high risk of bias in patient selection and Flow and timing domains. Conclusion: The Apple Watch ECG shows a high accuracy in detecting atrial fibrillation, providing a convenient and timely option for such patients.

The power functions of Begg's and Egger's tests for publication bias

The power functions of Begg's and Egger's tests for publication bias

Risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer: outcomes from a pooled analysis.

The purpose of this study is to explore the risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer through meta-analytic approach, and provide a better evidence-based basis for clinicians to perform surgery. We conducted a comprehensive search across databases including PubMed, Embase, Web of Science, and the Cochrane Library database to identify relevant English-language studies published up to February 2024. The pooled effect estimate was calculated using the odds ratio (OR) and a 95% confidence interval (CI). We also conducted sensitivity, subgroup, and publication bias tests. Meta-analysis was performed by using stata18MP software. The study was registered with PROSPERO(ID: CRD42024524790). We included a total of 8 studies. We discovered that gender (OR: 1.58; 95% CI: 1.23-2.03; P < 0.001), chronic obstructive pulmonary disease (COPD) (OR: 1.13; 95% CI: 1.04-1.23; P = 0.005), location of the tumor (OR: 1.21; 95% CI: 1.12-1.31; P < 0.001) were all linked to an increased risk of conversion. Additionally, the type of surgery (OR: 0.14; 95% CI: 0.05-0.39; P < 0.001) was associated with a reduced risk of conversion. Nevertheless, age, smoking, and obesity showed no association with the risk of conversion. The current meta-analysis suggests that the male gender, COPD, upper lobe tumor location, and the video-assisted approach are risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer. More high-quality studies are required to validate the above results due to the limited number and types of studies included.

Social Enrichment Improves Affective State and Foraging Behavior Compared to Physical Enrichment, While Maintaining Growth Performance in Broiler Chickens.

Environmental enrichment is key for improving the broiler welfare in intensive production systems. This study lasted for 43 days and evaluated the effects of physical and social enrichment on broiler welfare. A total of 96 one-day-old male broilers were divided into two treatments: control treatment, provided with physical enrichment (n = 48) including perches, platforms, and straw bales; and social treatment (n = 48), involving regular positive interactions with a human. The behavioral repertoire, footpad health, taste preferences for sweet and umami compounds, affective states (through tonic immobility and attention bias tests), and growth performance were evaluated. No effects were found for feeding, drinking, locomotion, lying, or standing behaviors, although differences were observed at specific time points: the Social group had more feeding time on day 21 (p = 0.046), while physical treatment showed reductions on days 28 and 35 (p < 0.001). The Social group showed increased drinking on day 42 (p < 0.001), reduced locomotion (p = 0.022), and increased lying (p = 0.046) on day 42. Foraging was higher in the Social group (p = 0.027), but preening showed no differences. Footpad lesions showed no significant differences. The Control group preferred sucrose 100 mM (p = 0.022), but no preference for MSG 300 mM was observed. With regard to tonic immobility, the Control group showed a tendency towards larger durations (p = 0.078), indicating a potential increase in fearfulness. In the attention bias test, although the freezing behavior increased, the latency to begin feeding was shorter in the Social group (p < 0.001), suggesting an improved affective state. Lastly, no significant differences were observed for any of the growth parameters, including average daily feed intake, average daily gain, feed conversion ratio, or final body weight, indicating that the Social group maintained productivity. This approach provides a practical solution for improving the quality of life for broilers in intensive systems.

Lack of Efficacy of Pomegranate Supplementation on Insulin Resistance and Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective of this study is to assess the impact of pomegranate supplements on insulin resistance (IR) and insulin sensitivity through a systematic review and meta-analysis of randomized controlled trials (RCTs). Additionally, we aim to analyze the differences in efficacy among various pomegranate extracts and the sensitivity of different diseases to pomegranate supplementation. We conducted searches in PubMed, Embase, Web of Science, and Cochrane Library up to October 30, 2023, for relevant studies published in English. The treatment group required the intake of pomegranate extract for a minimum of 4 weeks, with no restrictions on the extract type. The control group received a placebo or a treatment excluding pomegranate extract. The primary outcome was homeostatic model assessment for insulin resistance (HOMA-IR) and fasting insulin (FI), and the secondary outcome was quantitative insulin sensitivity check index (QUICKI). RoB 2 was used to assess the risk of bias in the original studies. We pre-specified subgroup analyses based on types of intervention, intervention duration, health condition, and intervention dose. Sensitivity analysis was conducted to validate result stability, utilizing Begg's test and Egger's test for publication bias. Data synthesis and analysis were performed using Stata 15.1 software. This study included a total of 15 RCTs with 673 participants conducted in 7 countries. Risk of bias results indicated an overall low risk of bias of the articles. Participants included healthy individuals, overweight and obese individuals, non-alcoholic fatty liver disease (NAFLD) patients, type 2 diabetes (T2DM) patients, polycystic ovary syndrome (PCOS) patients, metabolic syndrome (MS) patients, and individuals with hyperlipidemia. Pomegranate extract variations included pomegranate juice (PJ), pomegranate seed oil (PSO) capsule, pomegranate/pomegranate peel (PP) extract capsule, and pomegranate peel-added bread. The control groups primarily received placebo treatments with varying dosage and frequency. No adverse reactions were reported in any of the studies. The summary results showed that compared to the control groups, pomegranate extract had no significant impact on improving HOMA-IR levels in participants (WMD = -0.03, 95%CI: -0.37 to 0.31, and p = 0.851) and FI (WMD = -0.03, 95%CI: -0.42 to 0.36, and p = 0.862). Additionally, there was no significant advantage of pomegranate extract on QUICKI changes in T2DM and PCOS patients (WMD = 0.00, 95%CI: 0.00 to 0.01, and p = 0.002). Subgroup analysis results indicated that pomegranate extract could improve HOMA-IR levels in PCOS patients (WMD = -0.42, 95%CI: -0.54 to -0.29, and p < 0.001) and FI levels in T2DM, PCOS, and NAFLD patients. Our results indicate that pomegranate extract only improves HOMA-IR and FI levels in PCOS patients and FI levels in T2DM and NAFLD patients. No significant difference has been found for HOMA-IR, FI, or QUICKI in other metabolic diseases. The current evidence suggests that we should interpret the value of pomegranate extract in regulating IR and sensitivity cautiously. In the future, there is a need for more rigorously designed RCTs to specifically evaluate the impact of pomegranate supplementation on insulin sensitivity in patients with NAFLD, PCOS, and T2DM.

Cognitive behavioral therapy combined with selective serotonin reuptake inhibitors for premature ejaculation: A systematic review and meta-analysis.

Premature ejaculation (PE) remains one of the most common male disorders. Many clinical trials have shown that cognitive behavioral therapy (CBT) has significant efficacy in the treatment of PE. The purpose of this article is to review the current evidence regarding the efficacy and safety of CBT combined with selective serotonin reuptake inhibitors (SSRIs) for treating PE. We selected eligible randomized controlled trials (RCTs) from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM), Pubmed, Embase, and Cochrane Library. All data in this paper were analyzed using STATA 17.1 software. Cochrane Evaluator's Manual 5.3 was used to assess the quality of the included literature. Data collection was conducted up until May 2024. Finally, 15 high-quality randomized controlled trials were included, with 1243 patients, 653 experimental groups and 590 control groups. The meta-analysis showed that, compared with SSRIs alone, behavioral therapy combined with SSRIs can significantly prolong the IELT of PE patients, and improve perceived control over ejaculation, Chinese Index of Premature ejaculation-5 (CIPE-5), sexual life satisfaction, and spouses' sexual life satisfaction. Furthermore, there were no significant differences in side effects between the two groups. In addition, the published bias test results showed no significant bias. CBT combined with SSRIs could be a viable alternative for the treatment of PE. Both cognitive and behavioral training or behavioral training alone as a supplement to SSRIs are effective, with no significant increase in adverse reactions.

Posttraumatic stress disorder in diverse populations: Testing for assessment bias in a nationally representative sample.

A growing body of research has emerged to characterize differences in posttraumatic stress disorder (PTSD) symptom presentations in individuals from diverse racial and ethnic groups. However, less research has examined if these observed differences can be attributed to bias within PTSD assessments. Knowledge about potential bias in PTSD assessment is essential for interpreting group differences. If PTSD assessments do not perform similarly across diverse demographic groups, then observed differences may be artificial products of inaccurate measurement, new assessments could be required for individuals from different demographic groups, and we would be unable to accurately detect PTSD treatment effects in patients from diverse groups. We evaluated PTSD assessment bias through tests of measurement invariance for the semistructured, clinician-administered AUDADIS-5 diagnostic assessment of participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants included those who reported having experienced at least one potentially traumatic event in their lifetime (N = 23,936). Measurement invariance was assessed for participants who identified from several demographic groups (Asian, Native Hawaiian, or Pacific Islander; Hispanic; American Indian/Alaskan Native; and Black) compared to participants who identified as White (non-Hispanic). Overall, PTSD assessment was largely invariant across groups, while small amounts of measurement invariance were detected that can inform future research and clinical adaptations. This work validates prior research that relies on a common conceptualization of PTSD, and it provides several paths for future improvement in research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Basis of Cognitive and Behavioral Dysfunction in Amyotrophic Lateral Sclerosis.

To summarize and evaluate evidence pertaining to the clinical, genetic, histopathological, and neuroimaging correlates of cognitive and behavioral dysfunction in amyotrophic lateral sclerosis (ALS). We comprehensively reviewed the literature on cognitive and behavioral manifestations of ALS, narrating findings from both cross-sectional and longitudinal studies. We discussed knowledge gaps in the evidence base and key limitations affecting studies to date, before formulating a framework for future research paradigms aimed at investigating clinicopathological correlates of neuropsychological dysfunction in ALS. Studies have demonstrated clinical associations with cognitive dysfunction in ALS e.g., bulbar-onset of symptoms, pathological associations (extramotor TDP-43 deposition), and imaging associations (frontotemporal involvement). The most common behavioral deficit, apathy, is highly associated with verbal fluency, but longitudinal studies assessing behavioral dysfunction in ALS are comparatively lacking. Longitudinal studies have been helpful in identifying several potential correlates of cognitive and behavioral dysfunction but have frequently been confounded by selection bias and inappropriate testing platforms. This review provides a framework for more robust assessment of clinicopathological associations of neuropsychological abnormalities in ALS in the future, advocating for greater utilization of pre-symptomatic C9orf72 repeat expansion-carrying cohorts.

Study on High Voltage Reverse Bias (HTRB) Test Method of 6.5 kV High-Voltage IGBT Modules for Railway

Study on High Voltage Reverse Bias (HTRB) Test Method of 6.5 kV High-Voltage IGBT Modules for Railway

Strategi Tata Kelola Kolaboratif Dalam Meningkatkan Motivasi Pelayanan Publik: Peran Gaya Kepemimpinan Transformasional Dan Kualitas Relasional.

The main objective of this study is to analyze theoretical models to develop empirical research models on factors that influence collaborative governance and public service motivation. The analysis method uses SEM PLS with 367 respondents. All questions related to research data have been tested for validity and reliability and have met the common method bias and nonresponse bias tests. The analysis presented consists of three parts, namely analysis of research respondents, descriptive analysis of research data and PLS analysis. The results show that transformational leadership style and relational quality have a significant effect on collaborative governance. Collaborative governance also affects public service motivation, with transformational leadership style and relational quality playing an important role. The practical implications of this study are the emphasis on collaborative governance in the public sector with the importance of strong transformational leadership style and relational quality so that public service motivation can run optimally through effective and sustainable collaborative governance. Keywords: collaborative governance, public service motivation, transformational leadership, relational quality

Long-term cognitive outcomes after decompressive hemicraniectomy for right-hemisphere large middle cerebral artery ischemic stroke.

Decompressive hemicraniectomy (DH) improves survival and functional outcome in large middle cerebral artery (MCA) infarcts. However, long-term cognitive outcomes after DH remain underexplored. In a cohort of patients with large right-hemisphere MCA infarction undergoing DH, we assessed the rates of long-term cognitive impairment over 3-year follow-up. We prospectively evaluated consecutive patients included in the Lille Decompressive Surgery Database (May 2005-April 2022) undergoing DH according to existing guidelines for large hemisphere MCA infarction. We included patients with right-sided stroke andscreened with the Mini-Mental State Examination (MMSE) in at least one of the prespecified follow-ups (3-month, 1-year, 3-year). Cognitive impairment was defined as an MMSE score < 24. We included only right-hemisphere strokes to avoid testing biases related to severe aphasia. We compared clinical and neuroimaging data in patients with and without cognitive impairment. Three hundred four patients underwent DH during the study period. Among 3-month survivors, 95 had a right-hemisphere stroke and underwent at least one cognitive screening (median age = 51 years, 56.8% men). Forty-four patients (46.3%) exhibited cognitive impairment at least once during the 3-year follow-up. Baseline characteristics did not significantly differ between patients with and without cognitive impairment. Regarding long-term temporal trends, cognitive impairment was observed in 23 of 76 (30.3%), 25 of 80 (31.3%), and 19 of 66 (28.8%) patients at 3-month, 1-year, and 3-year follow-up, respectively, and it was associated with higher rates of functional disability (all p < 0.05). The persistently high rates of cognitive impairment after DH highlight the importance of cognitive monitoring to improve the long-term management of survivors.

CEO Age and Capital Structure Dynamics: The Moderating Effect of Overconfidence and Tenure

ABSTRACTThe Upper Echelons theory suggests that managerial characteristics will likely influence their financial decisions. Consistent with this theory, we examine CEO age's impact on Chinese firms' capital structure dynamics. We also investigate the moderating effects of overconfidence and tenure on the relationship between CEO age and capital structure. Using 18,235 firm‐year observations from Chinese listed firms, we document a positive relationship between CEO age and leverage. The results show that the CEOs' age‐overconfidence and age‐tenure relationship have an inverse relationship with leverage. Particularly, we find that CEO overconfidence and tenure impact market leverage more than book leverage. Our sensitivity analysis indicates that young CEOs use less debt, consistent with the market‐leaning hypothesis. We also find a positive relationship between CEO age and leverage in state‐owned enterprises. Our results are robust for decomposition analysis, selection bias test and endogeneity.

Association between gout and cancers: A systematic review and meta-analysis.

This study aimed to investigate the association between gout and cancer risk. This study was registered with the Prospective Registry for International Systematic Reviews (ID: CRD42023465587). We searched PubMed, Embase, Scopus, Cochrane, and Web of Science databases for studies related to gout and cancer risk, with a timeframe from the date the database was created to September 2023. We assessed the methodological quality of the included studies using the Newcastle-Ottawa scale and assessed heterogeneity between studies using the I2 statistic. Depending on the heterogeneity, we calculated pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using fixed-effects or random-effects models. In addition, we performed sensitivity analyses and publication bias tests. In this study, we conducted a meta-analysis of 6 studies encompassing a total of 1279,804 participants. Our analysis revealed that individuals with gout are at a heightened risk of developing cancer in general (HR = 1.18, 95% CI = 1.04-1.34, P < .001). Moreover, specific types of cancer displayed a significant correlation with gout, including gastric cancer (HR = 1.31, 95% CI = 1.07-1.62, P = .012), liver cancer (HR = 1.24, 95% CI = 1.01-1.52, P < .001), lung cancer (HR = 1.26, 95% CI = 1.03-1.53, P = .001), and bladder cancer (HR = 1.57, 95% CI = 1.02-2.41, P < .001). Furthermore, gout exhibited a marginally increased risk for other cancer types, such as head and neck cancer and esophageal cancer, although these associations did not attain statistical significance. Our study suggests that gout is a risk factor for cancer, especially for stomach, liver, lung, and bladder cancers. Patients with gout have an increased risk of developing overall cancers, lung cancer, liver cancer, stomach cancer, and bladder cancer. However, more high-quality epidemiologic studies are needed to explore the association between gout and individual cancers more accurately.

COVID-19 testing and reporting behaviours in England across different sociodemographic groups: a population-based study using testing data and data from community prevalence surveillance surveys

Understanding underlying mechanisms of heterogeneity in test-seeking and reporting behaviour during an infectious disease outbreak can help to protect vulnerable populations and guide equity-driven interventions. The COVID-19 pandemic probably exerted different stresses on individuals in different sociodemographic groups and ensuring fair access to and usage of COVID-19 tests was a crucial element of England's testing programme. We aimed to investigate the relationship between sociodemographic factors and COVID-19 testing behaviours in England during the COVID-19 pandemic. We did a population-based study of COVID-19 testing behaviours with mass COVID-19 testing data for England and data from community prevalence surveillance surveys (REACT-1 and ONS-CIS) from Oct 1, 2020, to March 30, 2022. We used mass testing data for lateral flow device (LFD; data for approximately 290 million tests performed and reported) and PCR (data for approximately 107 million tests performed and returned from the laboratory) tests made available for the general public and provided by date and self-reported age and ethnicity at the lower tier local authority (LTLA) level. We also used publicly available data on mean population size estimates for individual LTLAs, and data on ethnic groups, age groups, and deprivation indices for LTLAs. We did not have access to REACT-1 or ONS-CIS prevalence data disaggregated by sex or gender. Using a mechanistic causal model to debias the PCR testing data, we obtained estimates of weekly SARS-CoV-2 prevalence by both self-reported ethnic groups and age groups for LTLAs in England. This approach to debiasing the PCR (or LFD) testing data also estimated a testing bias parameter defined as the odds of testing in infected versus not infected individuals, which would be close to zero if the likelihood of test seeking (or seeking and reporting) was the same regardless of infection status. With confirmatory PCR data, we estimated false positivity rates, sensitivity, specificity, and the rate of decline in detection probability subsequent to reporting a positive LFD for PCR tests by sociodemographic groups. We also estimated the daily incidence, allowing us to calculate the fraction of cases captured by the testing programme. From March, 2021 onwards, individuals in the most deprived regions reported approximately half as many LFD tests per capita as individuals in the least deprived areas (median ratio 0·50 [IQR 0·44-0·54]). During the period October, 2020, to June, 2021, PCR testing patterns showed the opposite trend, with individuals in the most deprived areas performing almost double the number of PCR tests per capita than those in the least deprived areas (1·8 [1·7-1·9]). Infection prevalences in Asian or Asian British individuals were considerably higher than those of other ethnic groups during the alpha (B.1.1.7) and omicron (B.1.1.529) BA.1 waves. Our estimates indicate that the England Pillar 2 COVID-19 testing programme detected 26-40% of all cases (including asymptomatic cases) over the study period with no consistent differences by deprivation levels or ethnic groups. Testing biases for PCR were generally higher than those for LFDs, in line with the general policy of symptomatic and asymptomatic use of these tests. Deprivation and age were associated with testing biases on average; however, the uncertainty intervals overlapped across deprivation levels, although the age-specific patterns were more distinct. We also found that ethnic minorities and older individuals were less likely to use confirmatory PCR tests through most of the pandemic and that delays in reporting a positive LFD test were possibly longer in populations self-reporting as "Black; African; Black British or Caribbean". Differences in testing behaviours across sociodemographic groups might be reflective of the higher costs of self-isolation to vulnerable populations, differences in test accessibility, differences in digital literacy, and differing perceptions about the utility of tests and risks posed by infection. This study shows how mass testing data can be used in conjunction with surveillance surveys to identify gaps in the uptake of public health interventions both at fine-scale levels and across sociodemographic groups. It provides a framework for monitoring local interventions and yields valuable lessons for policy makers in ensuring an equitable response to future pandemics. UK Health Security Agency.

Testing for sequential bias in school inspections

ABSTRACT Inspectors are tasked with judging the quality of provision based on visits to schools. They conduct these inspections sequentially, completing one before moving on to the next. However, empirical research in a range of settings outside education suggests that prior judgements in a sequence can influence subsequent judgements, despite being logically irrelevant. We investigate whether school inspectors in England display such sequential bias by testing whether they judge similar schools differently, depending on the judgements they reached in prior inspections. We find only limited evidence of sequential bias in primary school inspections. In particular, an inspector reaching an ‘Inadequate’ judgement in their previous inspection is associated with a 42 per cent reduction in the odds of reaching another ‘Inadequate’ judgement in their next inspection. Only around 5 per cent of inspection judgements result in an ‘Inadequate’ and we do not find consistent evidence of sequential bias at other grades, meaning this bias only affects a small minority of judgements. We also do not find the same results for secondary schools, albeit in a much smaller sample.