Formula In Patients Research Articles

Comparison of GFR estimation in patients with diabetes mellitus using the EKFC and CKD-EPI equations.

The estimation of glomerular filtration rate (eGFR) is essential in the early detection of diabetic nephropathy. We herein compare the performance of common eGFR formulas against a gold standard measurement of GFR in patients with diabetes mellitus. GFR was measured in 93 patients with diabetes mellitus using iohexol clearance as the reference standard. The performance of the creatinine- and cystatin C-based EKFC formulas (2021, 2023) and the CKD-EPI formulas (2009, 2012) was compared against measured GFR. Sixty patients with type 2 diabetes mellitus and 33 patients with type 1 diabetes mellitus were included. The creatinine-based EKFC formula showed lower bias and higher accuracy than the CKD-EPI formula. No significant difference was observed between the cystatin C-based formulas. The combined creatinine- and cystatin C-based formulas had the highest accuracy and lowest bias. Body fat or diabetes type did not significantly influence the accuracy of the cystatin C-based formulas. Our study demonstrated a slight advantage of the creatinine-based EKFC formula over the CKD-EPI formula in patients with diabetes. However, both for the CKD-EPI and the EKFC formula, the best performance was achieved by the combined creatinine- and cystatin C-based formulas.

Improving the Accuracy of Lens Formulas for in-the-bag Intraocular Lens Implantation in Marfan Syndrome Patients with Ectopia Lentis.

To improve the accuracy of intraocular lens (IOL) power calculation formulas by modifying the effective lens position (ELP) equations for patients with Marfan Syndrome (MFS) and ectopia lentis (EL) undergoing in-the-bag IOL implantation. Eye and ENT Hospital of Fudan University. Retrospective cohort study. The formula-specific ELP was obtained from the SRK/T, T2, Holladay I, and HofferQ formulas. The back-calculated ELP was obtained based on the vergence formula using preoperative biometry, postoperative refraction, and the IOL power. The Generalized Linear Models or Gradient Boosting Machines were used to predict ELP or ELP error. A total of 255 patients (255 eyes) were assigned randomly into a training set and a validation set (7:3 ratio). Linear correlation identified axial length(AL), corneal height, and white-to-white as predictors for ELP and ELP error for patients with shorter AL (AL ≤ 24 mm). For those with longer AL (AL > 24 mm), AL and the central corneal radius were identified as the primary predictors. Incorporating these predictors into the modified ELP formula significantly improved the accuracy in the validation set, including SRK/T, T2, Haigis, Holladay I, and HofferQ formulas. The improvement was more pronounced in patients with shorter AL. Additionally, the GLM-modified formulas outperformed both the Barrett Universal II and Kane formulas. The accuracy across different ocular dimensions was comparable among the modified formulas, based on which an online calculator was developed. Using the more accurately predicted ELP can significantly improve the accuracy of existing formulas in patients with MFS.

Effect of an Enteral Formula Enriched With ω-3 Fatty Acids, Carnitine, and Vitamin D on Body Weight, Heart Weight, and Blood Biochemical Parameters in a Dahl Rat Heart Failure Model.

Malnutrition is known to worsen the prognosis of chronic heart failure (HF). To gain information that may be helpful in establishing appropriate nutritional interventions for chronic HF, this study was performed to investigate the efficacy of nutritional management with 2 enteral formulas, EH, with a standard nutritional composition, and ER, fortified with omega-3 fatty acids, vitamin D, and carnitine. Experiments were performed in a Dahl rat HF model. After being fed a standard rodent feed (MF) containing 8% NaCl (high salt-MF [HS-MF]) from 6 to 11 weeks of age, rats were assigned to freeze-dried EH or ER diets with an NaCl concentration of 8% (HS-ER or HS-EH) until 18 weeks of age. Serum albumin was significantly higher at 14 and 17 weeks of age in rats fed the HS-ER and HS-EH diets compared with those remaining on the HS-MF diet. Body weight was also significantly higher at 14 and 17 weeks of age in animals fed the HS-ER diet, showing that nutritional deterioration was prevented. In addition, heart weight was significantly lower at 18 weeks of age in the HS-ER group than that in the HS-MF group, suggesting that cardiac hypertrophy was prevented. This study demonstrated improved nutritional status in a HF model in Dahl rats presumably owing to differences in nutritional composition in the diets. Future studies are needed to explore optimal nutritional management with enteral formulas in patients with chronic HF.

Refractive Outcome, Lens Power Calculation, and Surgically Induced Astigmatism After Four-Flanged Intrascleral Intraocular Lens Fixation.

To evaluate the refractive prediction error of common intraocular lens (IOL) power calculation formulas in patients who underwent intrascleral IOL fixation using the four-flanged technique. This prospective, longitudinal, single-site, single-surgeon study's setting was the Department for Ophthalmology and Optometry, Medical University of Vienna, Austria. Patients who received IOL implantation via the four-flanged technique were followed up to 3 months after the operation. Refraction was measured using the Early Treatment of Diabetic Retinopathy Study visual acuity test at 4 m. Lens decentration, tilt, and aqueous anterior chamber depth were evaluated using anterior segment optical coherence tomography. The SRKT, Holladay 1, and Hoffer-Q formulas were used to assess prediction error (PE) and absolute error (AE). Correlations between axial length, keratometry, and white-to-white distance were subsequently evaluated. A total of 28 eyes of 28 patients were examined in this study. The application of all formulas resulted in a hyperopic PE (SRKT: 0.35 ± 0.86 diopters [D], Holladay 1: 0.36 ± 0.78 D and Hoffer-Q: 0.37 ± 0.73 D). There was no variation between the PE of different formulas discovered (P > .05). The AE was within 0.50 D in 54% to 61% and within 1.00 D in 79% of eyes, depending on the formula used. Furthermore, Cochrane's Q test detected no significant distinctions between formulas (P > .05). The PE of each formula demonstrated a significant correlation to the axial length of the eyes (P < .05). The correlation estimates ranged from -0.25 D/mm to -0.39 D/mm, subject to the applied formula. This study demonstrates that the four-flanged technique for scleral IOL fixation yields reliable outcomes. PE was closest to zero using the Hoffer-Q formula, although there was no statistically significant difference compared to the other formulas. Axial length emerged as the most pertinent factor for PE. Short eyes resulted in a more hyperopic outcome, whereas longer eyes resulted in a more myopic outcome than intended. This myopic and hyperopic shift was due to the standardized surgical technique with an externalization of the haptics 2.5 mm behind the limbus resulting in a consistent aqueous anterior chamber depth across all eye lengths, coupled with a reduction or increase in the distance from the IOL to the macula, which is dependent on the length of the eye. [J Refract Surg. 2024;40(12):e985-e993.].

Agreement Between Resting Energy Expenditure Predictive Formulas and Indirect Calorimetry in Non-Dialysis Dependent Chronic Kidney Disease.

The gold standard method for measuring resting energy expenditure (REE) is indirect calorimetry (IC) using an expensive device that requires specialized training. To overcome the limitations of IC, REE prediction formulas are used in patients with chronic kidney disease (CKD). However, it is still controversial which of these formulas has greater accuracy compared to IC. We aimed to determine the accuracies of REE measured by IC and estimated by formulas in patients with CKD. Fifty-three patients with stage 4-5 CKD underwent IC and five current REE prediction formulas. Accuracy was measured by Lin's correlation coefficient. Bland-Altman repeated measures analysis was used to assess the agreement of the formulas' results with those of IC. Precision was measured by the predicted IC ± 10% and 20%. Systematic bias was assessed by the Student's t-test, and linear regression was used to assess proportionality bias. Patients had a mean estimated glomerular filtration rate (eGFR) of 12 ± 4 mL/min/1.73 m2, a mean age of 65 years, and 62% were male. The mean REE measured by IC was 1341 ± 37 Kcal/day, and the formula with the lowest mean bias (0.1509 [-653.5121; 398.9056]), best correlation (r = 0.789; p = 0.000), and best accuracy (85%) was the formula developed by Fernandes and Cols (REE (kcal/day) = 854 + (7.4 × body weight) + (179 × sex) - (3.3 × age) + (2.1 × eGFR) + 26 (if diabetes)). The Fernandes and Cols equation had good accuracy and was valuable for estimating energy requirements in the population studied.

Anthropometric and Demographic Features Affect the Interpretation of Cerebrospinal Fluid Biomarkers in Patients with Different Dementia Syndromes and Cognitively Healthy Adults.

Clinical distinction between dementia with Lewy bodies (DLB) and late-onset Alzheimer's disease (AD) is difficult, while several features might affect the analyses of biomarkers. This study aimed to verify associations of anthropometric and demographic features with cerebrospinal fluid biomarkers, their ratios, and restructured traditional regression formulas in patients with DLB and AD, as well as in cognitively healthy controls. Consecutive outpatients with DLB were paired with outpatients with AD according to sex, dementia stage, and cognitive status, and with controls according to sex and age to investigate associations of sex, age, dementia duration, total sleep time, body mass index, alcohol use, smoking, sanitation, and APOE-ε4 alleles on the measurement of cerebrospinal fluid α-synuclein, biomarker ratios, and restructured traditional regression formulas involving amyloid-β (Aβ42,Aβ40,Aβ38), tau, and phospho-tau Thr181. Overall, 81 participants were included with DLB (n = 27;11 APOE-ε4 +) or AD (n = 27;12 APOE-ε4 +), and controls (n = 27;4 APOE-ε4 +); two thirds were women. Cerebrospinal fluid evidence of amyloidosis and tauopathy was more prevalent among women with AD, while Aβ42/Aβ38 could also discriminate men with DLB from men with AD. Restructured traditional regression formulas had higher diagnostic accuracy for women with AD. Aging, higher body mass index, and APOE-ε4 alleles were associated with amyloidosis in DLB, while only in AD were higher body mass index associated with lower tau pathology load, and more alcohol use associated with higher phospho-tau Thr181/Aβ42. These findings confirm the effects of anthropometric and demographic features on cerebrospinal fluid biomarkers, and also differences in aberrant amyloidosis and tauopathy between DLB and AD.

A-117 Discordance of CKD stage assignment by different Western and Asian estimated GFR formulae in patients of Eastern India

Abstract Background Chronic Kidney Disease (CKD) Stage based on estimated GFR governs the decision between treatment choices eg dialysis, transplant etc. There is no customized eGFR formula for Indians, and hardly any data is available regarding concordance between CKD staging by various formulae on Indian population. The CKD-EPI-Pakistan formula, developed through a collaboration involving original authors of MDRD/CKD-EPI, is the Asian formula ethno-geographically closest to India. However it has not been tested on Indians. Methods We compared 4 eGFR formulae: MDRD(4-factor), CKD-EPI-2009, and CKD-EPI-2021-Creatinine and CKD-EPI-Pakistan for 126 patients undergoing kidney function testing in a tertiary care center in Eastern India. Input for race was non-black in all. Results Thirty six of 126 (29%) were discordant by 1 stage between 1 or more formula-pairs, and Kendall's W was 0.034366339 suggesting weak concordance. Among the MDRD CKD3b and CKD4 cases, CKD-EPI Pakistan re-classified 12% by one stage higher. In the same cases, CKD-EPI-2009 and 2021 both assigned 1 stage lower than MDRD in about 18% and 35% respectively. For MDRD-CKD3a cases too CKD-Epi-Pakistan predicted one stage higher in 50%, whereas both CKD-EPI-2009 and 2021 gave one stage lower in 25%. CKD5 staging were mutually concordant, except Pak formula giving 66% more CKD5. Conclusions There is a significant under-staging of CKD stages of Indian patients using western CKD-EPI equations compared to MDRD, whereas CKD-EPI-Pakistan over-stages them especially in the severe stages. If Asian CKD-EPI-Pakistan is considered biologically appropriate for Indians, about 20-30% of treatment-needing patients might currently be under-classified and denied life-saving treatment modalities e.g. Dialysis/CRRT/Transplant, and it might become worse if CKD-EPI 2009 or 2021 is adapted instead of MDRD, especially for higher CKD Grades. The mutual discordance highlights urgent need of having formulae customized for Indian population validated over a large number of patients locally using measured GFR.

Effects of soluble fiber-enriched enteral formula in patients after gastrointestinal surgery: a prospective randomized and controlled trial

Effects of soluble fiber-enriched enteral formula in patients after gastrointestinal surgery: a prospective randomized and controlled trial

Clinical Efficacy of Dienogest Combined with Wenjing Tang in Adenomyosis

Objective: To investigate the clinical efficacy of Dienogest (DNG) combined with Wenjing Tang Formula in patients with uterine adenomyosis. Methods: 60 patients with adenomyosis were randomly divided into Group A and Group B. Group A patients received continuous oral treatment with DNG 2 mg/d for 3 months, while Group B patients were given Wenjing Tang Formula based on Group A treatment. The treatment effect, size of adenomyoma and incidence of adverse reactions were compared between the two groups. Results: The total effective rate of treatment in Group B was 96.67%, which was significantly higher than 73.33% in Group A (P &lt; 0.05); the size of uterine adenomyoma in Group B was significantly smaller than that in Group A, with a significant difference (P &lt; 0.05). In terms of the incidence of adverse reactions, group B was 6.67%, which was significantly lower than 26.67% in group A (P &lt; 0.05). Conclusion: The treatment of adenomyosis of the uterus via dienogest combined with the addition and subtraction of Wenjing Tang showed higher therapeutic efficacy and significant tumor shrinkage, and at the same time, it could reduce the incidence of adverse reactions, which has a good prospect of clinical application, and it is recommended to be promoted for use in clinical practice.

Relationship between strain energy and alveolar overdistension in patients with acute respiratory distress syndrome: The research protocol

Background: Energy produced during mechanical ventilation has been es¬tablished as a contributor to mortality in acute respiratory distress syndrome (ARDS) patients, elucidated through ventilator-induced lung injury (VILI). How¬ever, the potential association between strain energy, an engineering-based concept, and the risk of VILI remains unexplored. Objectives: This study aims to investigate the correlation between strain en¬ergy and alveolar overdistension and the relationship between strain energy and single-breath mechanical power (MP) calculated by a simplified formula in patients with ARDS. Methods: A prospective observational study will be conducted on moderate to severe ARDS patients under sedation and paralysis. We will gradually reduce positive end-expiratory pressure (PEEP) by two cmH2O every two minutes from 20 to 8 cmH2O in pressure-controlled ventilation mode. During decremental PEEP titration, patients would be monitored simultaneously for esophageal pressure and electrical impedance tomography (EIT). Data gathered from the mechanical ventilator and EIT during the decrementing PEEP titration were fo¬cused on seven PEEP levels: 20, 18, 16, 14, 12, 10, and 8 cmH2O, providing a dataset of 7 events per patient for analysis. Strain energy and single-breath MP were calculated from ventilator parameters, while EIT provided data on alveolar overdistension. Hypothesis: We hypothesized that strain energy and single-breath mechanical MP correlate with alveolar overdistension in ARDS patients. Conclusions: This study aims to assess the correlation between strain energy and alveolar overdistension, as well as the correlation between strain energy and single-breath MP in ARDS patients. Ethics and dissemination: The study protocol has been approved by the fac¬ulty of medicine ethics committee, Ramathibodi Hospital, Mahidol University (COA MURA2023/718). Trial registration: TCTR20240320001

Accuracy of intraocular lens power formulas in patients with average keratometry greater than 46 diopters

ObjectiveTo compare the accuracy of Kane, Barrett Universal II, Haigis, and SRK-T formulas in eyes with average keratometry greater than 46 diopters (D). MethodsA retrospective analysis was conducted on 101 eyes of 101 patients with average keratometry greater than 46 D. The absolute prediction error (EA) was obtained for each patient one month after surgery. The mean absolute prediction error (MEA), median absolute prediction error (MedEA) and the percentage of patients with absolute refractive error less than 0.25 D, 0.50 D, and 1.00 D were calculated for each formula analyzed. ResultsThe Kane formula achieved the lowest MEA (0.53 ± 0.43) and the lowest MedEA (0.41), followed by Barrett Universal II (MEA: 0.56 ± 0.42, MedEA: 0.49), SRK-T (MEA: 0.59 ± 0.44, MedEA: 0.54), and Haigis (MEA: 0.77 ± 0.47, MedEA: 0.69), showing a significant difference in the results. It was also observed that the Kane formula was the most accurate, with the highest percentage of patients, with EA less than 0.25 D, 0.50 D, and 1.00 D (30.7%, 54.4%, and 86.1%, respectively), while the Haigis formula was the least accurate (12.9%, 33.7%, and 69.3%, respectively). ConclusionIn eyes with corneas having average keratometry greater than 46 D, the Kane formula proves to be a useful tool in intraocular lens (IOL) power calculation and demonstrates higher precision compared to the Barrett Universal II, SRK-T, and Haigis formulas.

Accuracy of intra ocular lens calculation formulae in patients with pseudoexfoliation syndrome

BackgroundThe purpose of this study was to investigate the visual and refractive outcomes in patients with pseudoexfoliation (PXF) undergoing routine cataract surgery and to compare the accuracy of intraocular lens (IOL) power calculation formulae.MethodsRetrospective case-series study from Shamir medical center, a public hospital, Israel. Medical records of patients who underwent routine cataract surgery between January 2019 and August 2021 were investigated. Postoperative visual acuity and manifest refraction were examined. The error in predicted refraction and IOL power calculation accuracy within a range of ± 0.50 to ± 1.00 diopters were compared between different IOL calculating formulae.Results151 eyes of 151 patients ages 73.9 ± 7.1 years were included in this study- 58 eyes in the PXF group and 93 eyes in the control group. The mean absolute error (MAE) for the BUII formula was 0.63D ± 0.87 for the PXF group and 0.36D ± 0.48 for the control group (p < 0.05). The MAE for the Hill-RBF 3.0 formula was 0.61D ± 0.84 for the PXF group and 0.42D ± 0.55 for the control group (p = 0.05). There were significant differences in MAE and MedAE between PXF group and control group measures (p < 0.05). In the PXF group there were no significant differences between the different formulae.ConclusionsThere were significant differences in accuracy of IOL power calculations in all formulae between PXF group and control group measures. PXF patients show hyperopic shift from predicted refraction. Barret universal II formula had the highest proportion of eyes with absolute error in prediction below or equal to 0.50 D in both PXF and control groups.

Comparison of Different Intraocular Lens Power Calculation Formulas in Eyes With Primary Angle Closure.

Prospective case series. This prospective study determines which formulas can best predict the refractive outcome in patients with primary angle closure disease (PACD) after cataract surgery. To compare the accuracy of 6 intraocular lens power calculation formulas, Barrett Universal II (BU II), Haigis, Hoffer Q, Holladay I, Kane and SRK/T, in eyes with PACD. Patients diagnosed with PACD and cataracts and who met the indication for cataract surgery were enrolled in the study. Six intraocular lens power calculation formulas were used to calculate the refractive diopter. The percentage of eyes with prediction error (PE) within ±0.50 D and the median absolute PE were compared to determine the accuracy of different formulas in patients with PACD. Subgroup analysis was performed according to axial length (AL). The accuracy of BU II was compared between patients with PACD and patients with age-related cataracts. One hundred five patients (105 eyes) with PACD and 35 patients (35 eyes) with age-related cataracts were enrolled in the study. Haigis, Kane, and BU II formula achieved a comparable outcome and outperformed over the other 3 formulas in patients with PACD. Subgroup analysis showed that the group with long AL has lower values of median absolute PE. PE was significantly positively correlated with AL and negatively correlated with relative lens position when calculated using BU II and Kane. Haigis, Kane, and BU II formula achieved a comparable outcome and outperformed over the other 3 formulas in patients with PACD.

The association between enteral nutrition with survival of critical patients with COVID-19.

Coronavirus disease 2019 (COVID-19) results in several complications and mortality in intensive care unit (ICU) patients. Limited studies have investigated the effect of enteral nutrition (EN) on the survival of COVID-19 patients in the ICU. The aim of this study was to investigate the association of EN with biochemical and pathological indices associated with mortality in ICU patients with COVID-19. This case-control study was conducted on 240 patients with COVID-19 hospitalized in the ICU including 120 eventual nonsurvived as the cases and 120 survived patients as the controls. All of the patients received EN as a high protein high volume or standard formula. Data on general information, anthropometric measurements, and the results of lab tests were collected. The recovered patients received significantly more high protein (60.8% vs. 39.6%, p = .004) and high volume (61.6% vs. 42.3%, p = .005) formula compared to the nonsurvived group. Mortality was inversely associated with high volume (odds ratio [OR]: 0.45 confidence interval [CI]95%, p = .008) and high protein (OR: 0.42 CI95%, p = .003) formula. The results remained significant after adjusting for age and sex. Further adjustment for underlying diseases, smoking, body mass index, and the acute physiology and chronic health evaluation II (APACHE II) score did not change the results. The findings of the study showed that there was a significant inverse association between mortality and high volume and high protein formula in patients with COVID-19. Further investigation is warranted.

Improving Accuracy of In-The-Bag Intraocular Lens Power Calculation in Adult Eyes with Unilateral Subluxated Lenses by Using the Anterior Chamber Depth of the Unaffected Eye

Introduction: This study aimed to determine the interchangeability of bilateral anterior chamber depth (ACD) in intraocular lens (IOL) power calculations for cataractous eyes and refractive outcomes using the unaffected fellow eye’s ACD in subluxated crystalline lenses. Methods: The predicted postoperative spherical equivalent (SE) calculated using the Kane formula with and without fellow eye’s ACD in 202 cataract patients was compared. Refractive outcomes of the newer formulas (the Kane, Barrett Universal II [BUII], and Pearl-DGS formulas) with affected eye’s ACD and with unaffected fellow eye’s ACD were compared in 33 eyes with lens subluxation (the affected eye) undergoing in-the-bag IOL implantation. The SD of the prediction error (PE) was assessed using the heteroscedastic method. Results: In 202 paired cataractous eyes, no marked ACD difference was found bilaterally; the predicted SE obtained without the fellow eye’s ACD was comparable with that calculated with the fellow eye one (p = 0.90), with a mean absolute difference of 0.03 ± 0.03 D. With the affected eye AL, keratometry, and ACD, the median absolute error (MedAE) was 0.38–0.64 D, and the percentage of PE within ±0.50 D was 30.30–57.58%. The unaffected eye’s ACD improved the results (MedAE, 0.35–0.49 D; the percentage of PE within ±0.50 D, 54.55–63.64%). The SDs of the BUII (0.82 D) and Pearl-DGS formulas (0.87 D) with the affected eye’s ACD were significantly larger than those of the Kane and Pearl-DGS formulas (both 0.69 D) with the unaffected eye’s ACD. Conclusion: Bilateral ACD was interchangeable in IOL power calculation for cataractous eyes when using the Kane formula. Unaffected eye’s ACD in lieu of affected eye’s ACD can enhance the accuracy of newer formulas in patients with unilateral subluxated lenses undergoing in-the-bag IOL implantation.

Comparison of estimated GFR using cystatin C versus creatinine in pediatric kidney transplant recipients

BackgroundAn accurate, rapid estimate of glomerular filtration rate (GFR) in kidney transplant patients affords early detection of transplant deterioration and timely intervention. This study compared the performance of serum creatinine (Cr) and cystatin C (CysC)-based GFR equations to measured GFR (mGFR) using iohexol among pediatric kidney transplant recipients.MethodsCysC, Cr, and mGFR were obtained from 45 kidney transplant patients, 1–18 years old. Cr- and CysC-estimated GFR (eGFR) was compared against mGFR using the Cr-based (Bedside Schwartz, U25-Cr), CysC-based (Gentian CysC, CAPA, U25-CysC), and Cr-CysC combination (CKiD Cr-CysC, U25 Cr-CysC) equations in terms of bias, precision, and accuracy. Bland–Altman plots assessed the agreement between eGFR and mGFR. Secondary analyses evaluated the formulas in patients with biopsy-proven histological changes, and K/DOQI CKD staging.ResultsBias was small with Gentian CysC (0.1 ml/min/1.73 m2); 88.9% and 37.8% of U25-CysC estimations were within 30% and 10% of mGFR, respectively. In subjects with histological changes on biopsy, Gentian CysC had a small bias and U25-CysC were more accurate—both with 83.3% of and 41.7% of estimates within 30% and 10% mGFR, respectively. Precision was better with U25-CysC, CKiD Cr-CysC, and U25 Cr-CysC. Bland–Altman plots showed the Bedside Schwartz, Gentian CysC, CAPA, and U25-CysC tend to overestimate GFR when > 100 ml/min/1.72 m2. CAPA misclassified CKD stage the least (whole cohort 24.4%, histological changes on biopsy 33.3%).ConclusionsIn this small cohort, CysC-based equations with or without Cr may have better bias, precision, and accuracy in predicting GFR.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

The reporting quality of randomized controlled trials in Chinese herbal medicine (CHM) formulas for diabetes based on the consort statement and its extension for CHM formulas.

Background: This study aimed to assess the overall reporting quality of randomized controlled trials (RCTs) in Chinese herbal medicine (CHM) formulas for patients with diabetes, and to identify factors associated with better reporting quality. Methods: Four databases including PubMed, Embase, Cochrane Library and Web of Science were systematically searched from their inception to December 2022. The reporting quality was assessed based on the Consolidated Standards of Reporting Trials (CONSORT) statement and its CHM formula extension. The overall CONSORT and its CHM formula extension scores were calculated and expressed as proportions separately. We also analyzed the pre-specified study characteristics and performed exploratory regressions to determine their associations with the reporting quality. Results: Seventy-two RCTs were included. Overall reporting quality (mean adherence) were 53.56% and 45.71% on the CONSORT statement and its CHM formula extension, respectively. The strongest associations with reporting quality based on the CONSORT statement were multiple centers and larger author numbers. Compliance with the CHM formula extension, particularly regarding the disclosure of the targeted traditional Chinese medicine (TCM) pattern (s), was generally insufficient. Conclusion: The reporting quality of RCTs in CHM formulas for diabetes remains unsatisfactory, and the adherence to the CHM formula extension is even poorer. In order to ensure transparent and standardized reporting of RCTs, it is essential to advocate for or even mandate adherence of the CONSORT statement and its CHM formula extension when reporting trials in CHM formulas for diabetes by both authors and editors.

Anterior Segment Changes and Refractive Outcomes after Cataract Surgery Combined with Gonioscopy-Assisted Transluminal Trabeculotomy in Open-Angle Glaucoma

To compare the accuracy of intraocular lens (IOL) calculation formulas in patients undergoing phacoemulsification combined with gonioscopy-assisted transluminal trabeculotomy (phaco-GATT) and to determine the predictive factors for refractive errors. Fifty-three eyes of 53 patients undergoing phaco-GATT were retrospectively reviewed. The preoperative and postoperative 3-month anterior segment (AS) parameters were measured by Scheimpflug camera. The mean prediction error (PE), mean absolute error (MAE) in the Sanders-Retzlaff-Kraft/theoretical (SRK/T), Barrett- Universal II, Hill-radial basis function (Hill-RBF) and Kane formulas were compared. The influence of biometric parameters on PE were analyzed by correlation analysis. Postoperatively, there was a statistically significant decrease in axial length (AL) and significant enlargement in anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (p<0.001). The mean PE using SRK/T (-0.08 diopters [D]) was more myopic than in the Barret (0.01 D) and Hill-RBF (0.01 D). The PE closest to zero was in the Kane formula (0.001 D). The Kane formula provided a lower MAE (0.30±0.28 D) than the SRK/T (0.38±0.32 D) and Barrett (0.36±0.30 D) (p<0.001). The MAE in Hill-RBF (0.32±0.28) was comparable with that in Kane (p=0.02). Preoperative AL was significantly associated with PE in all formulas except Kane. Barrett was the only formula that did not have a significant correlation between PE and postoperative ACD and ACA. The Kane formula may provide higher predictability of the IOL power calculation than the SRK/T and Barrett-Universal II formulas in phaco-GATT surgery, which can cause significant changes in the AS and AL.

Influence of Ocular Biometry Parameters on the Predictive Accuracy of IOL Power Formulas in Patients with High Myopia.

The aim of this study was to investigate the influence of ocular biometry parameters on the predictive accuracy of 10 intraocular lens (IOL) power formulas in patients with high myopia (HM). We analyzed 202 eyes of 202 patients. The ocular biometry was determined preoperatively using an IOLMaster700. The associations between the biometry parameters and the prediction error (PE) 1month postoperatively were assessed. HM was defined as an axial length exceeding 26.50mm. In patients with HM (n = 108), the K6, Emmetropia Verifying Optical (EVO), Olsen, and Barrett UniversalII (BUII) formulas had the lowest absolute PEs among the 10 formulas. The ocular biometry parameters were not associated with the PE of K6, EVO, Olsen, or BUII. A longer axial length in HM eyes was associated with myopic outcomes by Kane, Hoffer QST, and VRF and hyperopic outcomes by Holladay2 and T2. Steeper keratometry, a deeper anterior chamber, and a thicker lens were associated with a hyperopic shift in HM eyes when using VRF, Kane, and Hoffer QST, respectively. In patients without HM (n = 94), there was no difference between the formulas in absolute PE. The significant associations between the biometry parameters and PE in patients with HM were not present in patients without HM. K6, EVO, Olsen, and BUII displayed high accuracy in HM eyes and were not influenced by preoperative biometry parameters. For the remaining formulas, the preoperative keratometry, anterior chamber depth, lens thickness, and axial length were possible error sources underlying an inaccurate IOL power prediction in patients with HM.

Comparison of intraocular lens power calculation formulas in patients with a history of acute primary angle-closure attack

BackgroundTo compare the accuracy of nine intraocular lens (IOL) power calculation formulas, including three traditional formulas (SRK/T, Haigis, and Hoffer Q) and six new-generation formulas (Barrett Universal II [BUII], Hill-Radial Basis Function [RBF] 3.0, Kane, Emmetropia verifying optical [EVO], Ladas Super, and Pearl-DGS) in patients who underwent cataract surgery after acute primary angle closure (APAC).MethodsIn this retrospective cross-sectional study, 44 eyes of 44 patients (APAC) and 60 eyes of 60 patients (control) were included. We compared the mean absolute error, median absolute error (MedAE), and prediction error after surgery. Subgroup analyses were performed on whether axial length (AL) or preoperative laser peripheral iridotomy affected the postoperative refractive outcomes.ResultsIn the APAC group, all formulas showed higher MedAE and more myopic shift than the control group (all P < 0.05). In APAC eyes with AL ≥ 22 mm, there were no differences in MedAEs according to the IOL formulas; however, in APAC eyes with AL < 22 mm, Haigis (0.49 D) showed lower MedAE than SRK/T (0.82 D) (P = 0.036) and Hill-RBF 3.0 (0.54 D) showed lower MedAE than SRK/T (0.82 D), Hoffer Q (0.75 D) or Kane (0.83 D) (P = 0.045, 0.036 and 0.027, respectively). Pearl-DGS (0.63 D) showed lower MedAE than Hoffer Q (0.75 D) and Kane (0.83 D) (P = 0.045 and 0.036, respectively). Haigis and Hill-RBF 3.0 showed the highest percentage (46.7%) of eyes with PE within ± 0.5 D in APAC eyes with AL < 22 mm. Iridectomized eyes did not show superior precision than the non-iridotomized eyes in the APAC group.ConclusionsRefractive errors in the APAC group were more myopic than those in the control group. Haigis and Hill-RBF 3.0 showed high precision in the eyes with AL < 22 mm in the APAC group.