Comparison Of Outcomes Research Articles

Comparison of Obstetric Outcomes Among Various Weight Strata in a Teaching Hospital in Southwest, Nigeria

AIM:The aim of the study is to evaluate the trend in adverse obstetric outcomes of parturients across the spectrum of body mass index.METHODS:This is a cohort study of pregnant women who received obstetric care at the Obstetrics and Gynecology Department of the Ekiti State University Teaching Hospital, Ado-Ekiti, between January 2015 and December 2015. The data were prospectively collected into the Obstetric Data Registry of the department. Composite adverse maternal outcomes and composite adverse fetal outcomes were obtained for each group. Data were analyzed with SPSS version 24, and ap-value of less than .05 was considered statistically significant.RESULTS:Out of the 1,006 parturients, 334 (33.2%) were obese. Composite adverse maternal outcome increased from 35.1% for women with normal weight to 62.3% for obese women (p< .001). Composite adverse fetal outcome also increased from 25.9% for women with normal weight to 30% for obese women (p< .001). The odds of composite adverse maternal outcome were increased in overweight women (adjusted odds ratio [aOR] 1.52, 95% confidence interval [CI] [1.12, 3.49]) and obese women (aOR 1.65, 95% CI [1.21, 2.24]) compared with women with normal weight. Also, the odds of composite adverse fetal outcome were reduced in overweight (aOR 0.64, 95% CI [0.44, 0.93]) but increased in underweight (aOR 4.78, 95% CI [2.00, 11.44]) and obese (aOR 1.16, 95% CI [1.03, 12.39]) women.CONCLUSION:Composite adverse obstetric outcomes were increased in underweight, overweight, and obese women when compared with women with normal weight.

Oncologic and Perioperative Outcomes of Robot-Assisted Versus Conventional Laparoscopy for the Treatment of Clinically Uterine-Confined High-Grade Adenocarcinoma.

The aim of this study was to compare oncologic and perioperative outcomes of robot-assisted laparoscopy (RA) and conventional laparoscopy (LSC) in apparent clinically uterine-confined, high-grade adenocarcinoma. A retrospective review was conducted to identify patients with newly diagnosed high-grade uterine adenocarcinoma treated at our institution between 1 January 2009 and 30 June 2021. Exclusion criteria included bulky extrauterine disease, no lymph node assessment, or synchronous tumors. Clinicopathologic details were obtained from medical records. Postoperative complications were classified using the Memorial Sloan Kettering Cancer Center Surgical Secondary Events system, and statistical analysis was performed using appropriate tests. Of 901 patients identified, 748 (83%) underwent RA and 153 (17%) underwent LSC. Median age was 65 years (range 25-92) and median body mass index was 30 kg/m2 (range 15-60). Overall, 650 patients (72%) had 2009 International Federation of Obstetrics and Gynecology (FIGO) stage I disease. Forty-one patients (4.6%) converted to laparotomy-26 (3.5%) from RA versus 15 (9.8%) from LSC (p=0.02). Postoperative complications occurred in 81 patients (9.0%), with no significant differences in type or rate between groups. Median operative time was 192mins (range 88-936) for RA versus 168 mins (range 90-372) for LSC (p=0.002). Median follow-up was 52 months (range 1-163) for RA and 66 months (range 7-165) for LSC. Four-year progression-free survival (PFS) and disease-specific survival (DSS) were similar between groups. Multivariate analysis showed stage, histology, peritoneal cytology, and lymphovascular invasion predicated a decrease in PFS and DSS. RA demonstrated comparable oncologic outcomes to LSC in patients with high-grade endometrial carcinoma, with no significant difference in postoperative complications or long-term survival.

Comparison of early outcomes of primary total knee arthroplasties performed using subvastus and medial parapatellar approaches and evaluation of quadriceps muscle elastography

Comparison of early outcomes of primary total knee arthroplasties performed using subvastus and medial parapatellar approaches and evaluation of quadriceps muscle elastography

A comparison of data visualization tools: A case study in health-related research

Data visualization tools are important tools for making health decisions based on large amounts of data. However, very few comparisons of data visualization tools have been done in the context of health-related research. This paper compares commonly available visualization tools from the perspective of a dashboard developer in the context of scientific health research using real-world data and to provide general suggestions for dashboard developers’ future visualization efforts in health-related scientific discoveries. We evaluated four commonly available visualization tools (Tableau, Spotfire, PowerBI, and R Shiny). Each tool was evaluated on visualization outcomes (comparing the generated outputs of tables, scatterplots, correlation plots, treemaps, heatmaps, and geographic maps), usability, Cloud compatibility, analytic integration, and a few other factors. All tools generated comparable visualization outcomes in our tests and were equally usable with the exception of R Shiny which is not recommended for users with limited coding experience. Every tool except R Shiny supports connections to PostgreSQL, gSheets, and Athena without additional configurations. All tools support integration with R and Python; however, PowerBI requires some additional configuration. Every tool is capable of data pre-processing and supports data transformation, null detection and outlier detection. Each tool has its own unique advantages and limitations.

Procedural and clinical impact of intracoronary lithotripsy in heavily calcified aorto-ostial coronary lesions.

Percutaneous coronary intervention of calcified aorto-ostial lesions (AOL) pose unique challenges due to anatomical propensity for recoil, leading to poorer outcomes compared to non-AOL. Although intravascular lithotripsy (IVL) has shown excellent success and safety in heavily calcified plaques, evidence specific to AOL is limited. This study aims to evaluate the efficacy and safety of IVL in AOL versus non-AOL. Patients treated with IVL between 2019 and 2023 from an ongoing prospective multicenter registry were eligible for inclusion. Patients were therefore classified in AOL and non-AOL groups, based on anatomical location. The primary technical endpoint was device success, defined as the ability to deliver the IVL catheter and pulses at the target lesion, without angiographic complications. Secondary technical endpoint encompassed procedural success <30%, consisting of device success with residual stenosis <30%, final thrombolysis in myocardial infarction grade 3 flow, and no in-hospital major adverse cardiovascular events (MACE). The primary clinical endpoint was in-hospital MACE, including cardiac death, nonfatal myocardial infarction, or target lesion revascularization. A total of 321 patients underwent IVL, including 48 with AOL. Device success showed no significant difference between AOL and non-AOL groups (100% vs. 98.2%; p = 0.35). A nonsignificant trend toward worse procedural success with residual stenosis <30% was observed in the AOL arm (AOL 81.3% vs. non-AOL 90.5%, p = 0.06). In-hospital MACE was significantly higher in AOL (4.2% vs. 0.7%, p = 0.048), attributed entirely to cardiac deaths. At 6-month follow-up, the incidence of MACE (AOL 8.3% vs. non-AOL 4.0%, p = 0.19), and cardiac deaths (AOL 4.2% vs non-AOL1.1%, p = 0.11) were comparable between groups. IVL treatment for heavily calcified AOL demonstrates comparable procedural and 6-month clinical outcomes when compared to non-AOL, despite a higher incidence of in-hospital MACE.

Comparison between Different Visual Acuity Tests and Validation of a Digital Device.

To compare different visual acuity (VA) tests (printed and digital, symbols and letters) and to validate a new device for VA testing called DIVE (Devices for an Integral Visual Examination). VA was tested in a wide spectrum of adult people with printed tests (ETDRS and LEA Symbols) and with two implemented tests in DIVE (HOTV and DIVE Symbols). We measured agreement between the different VA tests using the intraclass correlation coefficient and Bland-Altman method. In addition, we measured the repeatability of all tests. Right eyes from 51 adult participants were included in the study. Correlation between tests was high (ICC from 0.95 to 0.97). Bland-Altman analysis showed good agreement among the different tests, with differences within reasonable clinical limits. However, slightly better VA values were obtained with DIVE HOTV and ETDRS, followed by LEA and DIVE Symbols. ETDRS had the best repeatability. The four evaluated VA tests provide comparable outcomes. In an adult sample, letter optotypes obtained better VA values than symbol optotypes. DIVE VA tests are reliable and well-correlated with printed VA tests.

Abstract C125: Improving access to genetic counseling and testing for underserved populations through telehealth

Abstract Introduction: A lack of access to genetic counseling for hereditary cancer risk in rural and underserved areas is well-documented and can exacerbate disparities in cancer risk reduction and early detection. Telehealth has the potential to bridge this gap, providing remote access to specialized care. The COVID-19 pandemic accelerated telehealth availability, allowing estimation of the causal effects of shifting to a model of virtual care delivery for genetic counseling services. Methods: The Stanford Cancer Genetic Counseling Clinic provided solely in-person care at two clinical sites (Palo Alto and San Jose, CA) until March 2020, and solely virtual care from April 2020 onward. We performed a regression discontinuity design, allowing outcomes comparison before and after the threshold of early 2020, to evaluate the impact of telehealth genetic counseling on access to care for patients living in areas of higher deprivation. The assignment variable (the exposure measured before versus after the threshold) was the three-month period during which the patients were seen, with the March-May 2020 quarter excluded because of disruption of care during the early COVID-19 pandemic. The primary endpoint was proportion of patients whose primary residence zip code had a state area deprivation index of at least 4. Secondary endpoints included driving distance to the primary clinic location in Palo Alto, CA, insurance type, race/ethnicity, and primary language. Results: The study included N=5,957 patients seen in the Stanford Cancer Genetics Program between January 2017 and February 2020, and N=9,469 patients seen between June 2020 and April 2024. The regression discontinuity analysis revealed a significant discontinuity at the threshold for telehealth in access for patients living in areas of higher deprivation, who accounted for 22% of patients seen just prior to telehealth implementation and 27% just after telehealth implementation, a proportional increase of 21% (p=0.006). Mean driving distance to Palo Alto, CA also increased, from 49 minutes just prior to the threshold to 56 minutes just after (p=0.003). There were no significant differences in insurance type, race/ethnicity, or primary language across the threshold. Conclusion: The implementation of telehealth services at the Stanford Cancer Genetic Counseling Clinic significantly improved access to genetic counseling for patients from areas with higher deprivation, as evidenced by a 21% increase in the proportion of such patients among those seen. These results quantify the effectiveness of telehealth in reducing geographical and socioeconomic barriers to specialized genetic counseling and testing services. Citation Format: Jennifer L. Caswell-Jin, Hao Tang, Mina Satoyoshi, Kerry Kingham, Allison W. Kurian. Improving access to genetic counseling and testing for underserved populations through telehealth [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C125.

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures

Comparison of Outcomes after Autologous Breast Reconstruction: Latissimus Dorsi with Immediate Fat Transfer versus Abdominally Based Free Flaps.

Autologous breast reconstruction confers favorable patient reports of satisfaction and quality of life compared with implant-based reconstruction over a lifetime. The latissimus dorsi with immediate fat transfer (LIFT) is an alternative approach to abdominally based free flaps (Ab-FF), which expands fully autologous reconstruction to nonmicrosurgeons. This study compared the 2 procedures concerning their clinical and patient-reported outcomes 1 year postoperatively. The authors conducted a retrospective review of LIFTs and Ab-FFs performed between March of 2017 and August of 2022. The primary outcomes were postoperative complications, reoperations, and longitudinal BREAST-Q scores. BREAST-Q modules included Satisfaction with Breasts, Satisfaction with Abdomen, Satisfaction with Back, Psychosocial Well-being, Physical Well-being: Chest, Physical Well-being: Abdomen, Physical Well-being: Back, and Sexual Well-being. Of the 281 included patients (408 breasts), 211 received Ab-FF and 70 received LIFT. One-year follow-up (median [interquartile range], 12 [12] months) demonstrated that Ab-FF independently predicted dehiscence, reoperation procedures, and revisional surgery. LIFT independently increased the odds of seroma. Obesity predicted dehiscence, and bilateral reconstructions predicted revisional fat grafting. BREAST-Q scores fluctuated over time but were similar across all measured domains by 1 year postoperatively. Although Ab-FF is the standard approach for fully autologous reconstruction, LIFT procedures may be associated with a less complicated postoperative course while eliciting similar patient-reported outcomes. LIFT may be preferred to limit postoperative complications, particularly in patients with obesity. LIFT can be used by plastic surgeons who are not trained in microsurgical procedures or do not have an environment that fosters Ab-FF. Therapeutic, III.

A Comparison of Brand-Related Outcomes Between Naming Rights and Jersey Sponsorships in Professional Sport

Naming rights and jersey sponsorship are highly visible, offering numerous benefits to both brands and properties but at a particularly high cost. The purpose of this study was to examine individuals’ attitudes and behaviors toward naming rights and jersey sponsors. The study drew on the Persuasion Knowledge (PK) Model as a lens for differentiating between consumers’ responses to each sponsor. A between-group design was employed; two versions of a questionnaire (one for each sponsorship condition) were distributed to a nationwide sample of Canadians, yielding 331 usable responses. Findings suggested participants had better awareness of the naming rights sponsor than the jersey sponsor, but no attitudinal differences were observed. However, attitudinal differences were observed on team identification. Furthermore, it appears that the triggering process for PK may differ in the sport sponsorship setting than what is observed with traditional advertising, likely due to a moderating effect of team identification.

A Comparison of Fetomaternal Outcomes of Spontaneous and Induced Labour amongNulliparous Women: A Cross-sectional Study in a Tertiary Care Hospital in Manipur, India

A Comparison of Fetomaternal Outcomes of Spontaneous and Induced Labour amongNulliparous Women: A Cross-sectional Study in a Tertiary Care Hospital in Manipur, India

Comparative outcomes of systemic diseases in people with type 2 diabetes, or obesity alone treated with and without GLP-1 receptor agonists: a retrospective cohort study from the Global Collaborative Network

Comparative outcomes of systemic diseases in people with type 2 diabetes, or obesity alone treated with and without GLP-1 receptor agonists: a retrospective cohort study from the Global Collaborative Network

Cardiac Arrest Mortality and Disposition Patterns in United States Emergency Departments.

Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED visits, with a particular focus on outcomes of mortality and transition of care. Methods: We conducted a retrospective cohort analysis using the National Emergency Department Sample (NEDS) database. The study population included patients aged 18 years or older who visited the ED between January 2016 and December 2020. Statistical analysis of patients and hospital characteristics included chi-squared tests for independence and multivariable logistic regression models to report the associations of factors with mortality in the ED and disposition from the ED. The primary outcome measured was mortality in the ED, and the secondary outcome included transition of care. Results: A total of 699,822,424 ED visits occurred between 2016 and 2020, with 1,414,060 (0.20%) CAs. The survival rate from CA ranged from 24.6% to 28.1%. In 2020, the rate of ED CA increased to 0.27%, with an inpatient mortality rate of 58.8%. There was no significant difference in mortality between sexes (p = 0.690). There was a trend for higher mortality in the ED among patients who were self-paid. Notably, the odds of transfer from the ED to other hospitals were significantly lower in minority groups. Conclusions: Our results showed significant disparities in ED mortality and patient disposition following cardiac arrest, highlighting the need for equitable healthcare resources and policies.

Outcome Comparison between Platelet Rich Plasma in Combination with Hyaluronic Acid Versus Steroid Alone in the Treatment of Primary Knee Osteoarthritis

Outcome Comparison between Platelet Rich Plasma in Combination with Hyaluronic Acid Versus Steroid Alone in the Treatment of Primary Knee Osteoarthritis

Testing a Consumer Wearables Program to Promote the Use of Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea: Protocol for a Pilot Randomized Controlled Trial.

Although positive airway pressure (PAP) therapy is considered first-line treatment for obstructive sleep apnea (OSA), nonadherence is common. Numerous factors influence PAP use, including a belief that the therapy is important and effective. In theory, providing information to patients about their blood oxygen levels during sleep (which may be low when PAP is not used), juxtaposed to information about their PAP use, may influence a patient's beliefs about therapy and increase PAP use. With the advent of consumer wearable smartwatches' blood oxygen saturation monitoring capability (and the existing routine availability of PAP use data transmitted via modem to clinical dashboards), there is an opportunity to provide this combination of information to patients. This study aims to test the feasibility, acceptability, and preliminary efficacy of the Chronic Care Management With Wearable Devices in Patients Prescribed Positive Airway Pressure Therapy (mPAP), a program that augments current PAP therapy data with consumer-grade wearable device to promote self-management of PAP therapy for OSA in a pilot randomized waitlist-controlled clinical trial. This is a single-blinded randomized controlled trial. We will randomize 50 individuals with a history of OSA, who receive care from a Department of Veterans Affairs medical center in the Los Angeles area and are nonadherent to prescribed PAP therapy, into either an immediate intervention group or a waitlist control group. During a 28-day intervention, the participants will wear a study-provided consumer wearable device and complete a weekly survey about their OSA symptoms. A report that summarizes consumer wearable-provided oxygen saturation values, PAP use derived from modem data, and patient-reported OSA symptoms will be prepared weekly and shared with the patient. The immediate intervention group will begin intervention immediately after randomization (T1). Assessments will occur at week 5 (T3; 1 week after treatment for the immediate intervention group and repeat baseline for the waitlist control group) and week 11 (T5; follow-up for the immediate intervention group and 1 week after treatment for the waitlist control group). The primary outcome will be the change in 7-day PAP adherence (average minutes per night) from T1 to T3. The primary analysis will be a comparison of the primary outcome between the immediate intervention and the waitlist control groups (intention-to-treat design), using a 2-sample, 2-sided t test on change scores (unadjusted). Recruitment began in October 2023. Data analysis is expected to begin in October 2024 when all follow-ups are complete, and a manuscript summarizing trial results will be submitted following completion of data analysis. Findings from the study may provide additional insights on how patients with OSA might use patient-generated health data collected by consumer wearables to inform self-management of OSA and possibly increase their use of PAP therapy. ClinicalTrials.gov NCT06039865; https://clinicaltrials.gov/study/NCT06039865. DERR1-10.2196/60769.

Beam‐Generated Sample Evolution to Emphasize Spatial Inhomogeneities: The Example of HPO42−‐Containing Amorphous Calcium Phosphate

ABSTRACTAmorphous calcium phosphates (ACPs) represent a family of bioactive compounds particularly relevant to bone regeneration. However, due to their intrinsic metastability, their processing into 3D‐shaped materials cannot be undergone by conventional sintering methods and requires cold sintering approaches. Also, their microstructure and local compositional changes still have to be explored in detail. To this aim, spectroscopy techniques are particularly appealing to probe local chemical environments at the microscale. Concerning ACPs, one question regards the distribution of (hydrogenated) phosphate species, as they may lead to various evolutionary trends. In this contribution, we purposely exploited the laser–beam interaction through Raman mapping to trigger the in situ HPO42−‐to‐P2O74− transformation. Analysis by a multivariate approach allowed us to spot P2O74− clusters resulting from HPO42−‐rich initial domains. Moreover, a blue shift of the ν1PO43− band was noticed in the close vicinity of these clusters, thus evidencing a local evolution of the chemical composition of the ACP. These results, corroborated by differential thermal analysis, demonstrate the relevance of using the laser–sample interaction through local heating to probe the spatial evolution induced, in our case, by an ultrafast compaction process. Comparison of outcomes obtained using two different laser/power strategies finally evidenced the need to adapt the Raman analytical conditions to the behavior of the metastable material to analyze.

Comparative outcomes of topical and laser treatment in newly diagnosed patients with primary glaucoma

Comparative outcomes of topical and laser treatment in newly diagnosed patients with primary glaucoma

The TLI system can help day-3 single cleavage embryo transfer to obtain comparative clinical outcomes to day-4 or day-5.

The aim was to explore whether the time-lapse imaging system can help day-3 single cleavage embryo transfer to obtain comparative clinical outcomes to day-4 or 5. The data of 1237 patients who underwent single embryo transfer from January 1, 2018, to September 30, 2020, in our reproductive medicine centre were retrospectively analysed. They were divided into the day-3 single cleavage-stage embryo transfer (SCT) group (n = 357), day-4 single morula transfer (SMT) group (n = 129) and day-5 single blastocyst transfer (SBT) group (n = 751) according to the different embryo transfer stage. The clinical and perinatal outcomes of the three groups were analysed and compared. The clinical pregnancy rates of the patients in the day-3 SCT group, day-4 SMT group and day-5 SBT group were 68.07, 70.54 and 72.04%, respectively. The live birth rates were 56.86, 61.24 and 60.99%, respectively. The monozygotic twin (MZT) rate in the day-3 SCT group was significantly lower than that in the day-5 SBT group (P = 0.049). Regarding perinatal outcomes, only the secondary sex ratio had a significant difference (P < 0.05). After age stratification, no improvement was found in the pregnancy outcomes of patients >35 years of age receiving blastocyst transfer. Our findings suggest that for patients with multiple high-quality embryos on day-3, prolonging the culture time can improve the pregnancy outcome to some extent, but it will bring risks. For centres that have established morphodynamic models, day-3 SCT can also achieve an ideal pregnancy outcome and reduce the rate of monozygotic twins and sex ratio.

Comparative Analysis of Refractive Outcomes Using Optical and Ultrasound Biometry in Phacoemulsification Cataract Surgery

Background: Accurate biometry is critical for optimal visual outcomes in cataract surgery. Both optical and ultrasound biometry are widely used, but their comparative effectiveness remains under evaluation.Objective: To compare the refractive outcomes of optical and ultrasound biometry in patients undergoing elective phacoemulsification cataract surgery.Methods: This prospective cohort study included 352 patients aged 30-60 years undergoing elective phacoemulsification with in-the-bag IOL implantation. Patients were randomly assigned to either optical biometry using the Zeiss IOL Master 700 or ultrasound biometry with Axis Nano contact A-mode echography. Visual acuity and spherical equivalent were measured at baseline and 4 weeks post-operatively. Data were analyzed using SPSS version 25, with independent t-tests comparing outcomes between groups.Results: The mean post-operative visual acuity was 0.83 ± 0.22, with a mean spherical equivalent of -0.88 ± 0.16. No significant difference was found between the ultrasound (-0.89 ± 0.17) and optical biometry (-0.87 ± 0.16) groups (p=0.152, 95% CI -0.06 to 0.01).Conclusion: Both optical and ultrasound biometry provide comparable refractive outcomes in cataract surgery, with no significant difference in post-operative spherical equivalent.

Comparative outcomes of endoscopic mucosal resection for laterally spreading lesions in inflammatory bowel disease.

The role of endoscopic mucosal resection (EMR) for laterally spreading lesions (LSLs) in inflammatory bowel disease (IBD) remains controversial despite its effectiveness in the general population. We aimed to characterize outcomes of EMR for IBD-associated LSLs compared with controls without IBD. We performed a retrospective observational cohort study of patients with IBD who underwent EMR and endoscopic follow-up for LSLs, compared with a control group without IBD. The primary outcome was histologic recurrence. Secondary outcomes included en bloc resection and adverse events. Factors associated with recurrence were identified using multivariate mixed effects logistic regression. 210 premalignant lesions in 155 patients were included. By histology, 91.0% were adenoma/low grade dysplasia or sessile serrated lesions. Median (IQR) lesion size was 25 (12-30) mm in the IBD group and 20 (12-30) mm in the control group. Recurrence was detected in 30.4% of IBD-associated lesions (7/23) compared with 20.9% of controls (39/187; odds ratio [OR] 2.51, 95%CI 0.59-10.71). En bloc resection was less common in the IBD group (2/23 [8.7%], 95%CI 1.1-28.0) versus controls (106/187 [56.7%], 95%CI 50.4-65.2). After adjusting for lesion size and histology, recurrence appeared more common in patients with IBD compared with controls (OR 3.08, 95%CI 1.04-9.13). Recurrence of LSLs after EMR appeared to be more frequent in patients with IBD. Given the added complexity, EMR in patients with IBD should be performed in expert centers with close endoscopic surveillance.