Historical Comparison Research Articles

A Historic and Aesthetic Comparison Analysis of Greek "Dark Age" Geometric Pottery and Chinese Ritual Bronzes

A Historic and Aesthetic Comparison Analysis of Greek "Dark Age" Geometric Pottery and Chinese Ritual Bronzes

Impact of incident rheumatoid arthritis on earnings: a nationwide sibling comparison study.

RA is known to impact work ability but much of this knowledge comes from historical comparisons vs the general population that neither reflects current RA management, nor distinguishes between effects of RA and pre-existing socio-economic conditions of patients. We therefore aimed to examine earnings of patients before and after RA diagnosis, using recent data and sibling comparisons. Swedish register data were used including demographic information and healthcare utilization. Participants were patients with RA (aged 30-60 years, diagnosed with RA 2006-2017) identified in the Swedish National Patient Register, and their same-sex siblings (n = 2433:2433; mean 48 y; 72% women). Earnings data for 2001-2019 were retrieved from Statistics Sweden and analysed from 5 years before to 5 years after RA diagnosis. No differences in average earnings were observed between siblings during the 5 years before diagnosis, but during the 5 years after diagnosis, patients with RA earned on average 5.4% less annually (-1430€[95%CI -2130, -720]) than same-sexed siblings. The change in earnings for the subgroup diagnosed 2006-2010 was -8.2% (-2020€[95%CI -2930, -1120]) but for patients diagnosed 2011-2017 there was no statistically significant change in earnings compared with siblings (-1.5%; -420€[95%CI -1490, 640]). Subgroup analyses demonstrated a more negative impact on earnings for older individuals and those with lower education level. RA diagnosis was associated with lower earnings in comparison with same-sex siblings, particularly for older individuals and those with lower education level. The negative impact of RA on earnings declined or disappeared over the study period.

Punctuation in Early Modern Texts: The English Translation of Rembert Dodoens’ Herbal in Handwriting and Printing

The present paper analyses the punctuation of a handwritten and a printed version of a distinguished herbal from the Early Modern period—that is—the English translation of Rembert Dodoens’ A Niewe Herball or Historie of Plants. The paper aims to contribute to the dissemination of knowledge on the use and distribution of punctuation in Early Modern English texts of a diverse typology, as well as to provide fresh observations as regards the historical linguistic comparison between scribes and printers’ writing practices. All this considered, it pursues the following objectives: to undertake (i) a quantitative survey of the various punctuation marks occurring in the texts; (ii) a qualitative examination of these at macro- and micro-textual levels; and (iii) an evaluation of the similarities and differences between the manuscript and the printed versions.

Innovative development indices for the national economies: on the way to the “ideal” assessment of innovation processes in the countries of the world

Purpose: is to develop recommendations for the construction of new indices of innovative development designed for cross-country comparisons.Methods: the conventional general scientific methods were used in the article, such as the ones of description, comparison, system analysis and historical comparison. The study was based on the documents describing calculation methods of the economic indices and scientific publications covering the history, specifics and problems of the practical application of those indices.Results: it is shown that since the 1930s, when the creation of economic indices drew attention of economic science, indices have evolved from the relatively simple statistical indicators to the complex tools with sophisticated calculation methods. Using several of the most famous or remarkable indices as an example, the principal methods currently used in assessing the level of innovative development are revealed. Basing on the conducted research, the major requirements for composing innovative development indices are stipulated.Conclusions and Relevance: it has been found out that in order to achieve the maximum objectivity in compiling indices of innovative development, the widest possible range of significant indicators should be used and a pool of experts should be engaged in their selection. It is also advisable to engage the pool in compiling the index formula, in particular the indicators weights. Data normalization should be used to ensure comparability of incommensurable indicators, and statistical outliers are advised to be neutralized through standardization techniques. It is also necessary to take into account the goals of the index compiled. At the same time, in the future it is necessary to take into account relationships between the actors of national innovation systems and between different innovation systems, effects of scale and, when possible, sectoral specialization of countries and other national specifics.

Long-term cause-specific mortality in adolescent and young adult Hodgkin lymphoma patients treated with contemporary regimens-A nationwide Danish cohort study.

The documented treatment-induced excess mortality in Hodgkin lymphoma (HL) has spurred important treatment changes over recent decades. This study aimed to examine mortality among young HL patients treated with contemporary strategies, including historical data comparison. This nationwide study included 1348 HL patients, diagnosed in 1995-2015 and aged 15-40 at diagnosis. Among the patients, 66.5% had Ann Arbor stage I-II and 33.5% had stage III-IV disease. With a median follow-up of 14.76 years, 139 deaths occurred, yielding a 5-year overall survival of 94.6%. Older age, advanced disease, earlier treatment periods and extensive regimens were associated with higher overall mortality risk. The cumulative risk of HL-related death showed an initial sharp rise, with a plateau at 5.3% 10-year post-diagnosis. Deaths due to cardiovascular or pulmonary diseases and second cancers initially had minimal risk, gradually reaching 1.2% and 2.0% at the 20-year mark respectively. HL cases had a 7.5-fold higher mortality hazard than the background population. This study suggests that contemporary HL treatment still poses excess mortality risk, but recent changes have notably reduced overall and cause-specific mortality compared to earlier eras. Balancing treatment efficacy and toxicity remains crucial, but our findings highlight improved outcomes with modern treatment approaches.

Small states’ diplomacies: changes in women’s descriptive representation in the Baltic states’ foreign services (1991–2021)

ABSTRACT By tracing gender inequality in the top leadership positions in the Baltic Ministries of Foreign Affairs and at ambassadorial levels over the past 30 years, this article provides the first historical and empirical comparison of women’s representation in the three Baltic foreign services, identifying where women have been and are presently positioned. Our examination also reveals patterns in how the Baltic diplomatic corps’ composition has changed over time, and where and why change is not visible. This empirical research draws on unique datasets collected by the authors of all Baltic ambassadorial appointments for the 1991–2021 period.

Graded exposure therapy for adults with persistent symptoms after mTBI: A historical comparison study

ABSTRACT Fear avoidance behaviour is associated with slow recovery from mild traumatic brain injury (mTBI). This study is a preliminary evaluation of graded exposure therapy (GET), which directly targets fear avoidance behaviour, for reducing post-concussion symptoms (PCS) and disability following mTBI. In a historical comparison design, we compared two groups from independent randomized trials. The GET + UC group (N = 34) received GET (delivered over 16 videoconference sessions) in addition to usual care (UC). The historical comparison group (N = 71) received UC only. PCS severity (Rivermead Post Concussion Symptoms Questionnaire; RPQ) and disability (World Health Organization Disability Assessment Schedule; WHODAS 2.0 12-item) were measured at clinic intake (M = 2.7, SD = 1.1 months after injury) and again at M = 4.9 (SD = 1.1) months after injury. Between-group differences were estimated using linear mixed effects regression, with a sensitivity analysis controlling for injury-to-assessment intervals. The estimated average change on the RPQ was −14.3 in the GET + UC group and −5.3 in the UC group. The estimated average change on the WHODAS was −5.3 in the GET + UC group and −3.2 in the UC group. Between-group differences post-treatment were −5.3 on the RPQ and −1.5 on the WHODAS. Treatment effects were larger in sensitivity analyses. Findings suggest that a randomized controlled trial is warranted.

On the Question of the Social Origins of Early Cossack Communities: Results, Methodology and Prospects of Research

Introduction. Addressing the complex and controversial problem of domestic Cossack studies – the determination of the stage affiliation of early Slavic Cossack communities – the author sets himself the task of summing up many years of discussions, identifying the most promising directions for further research, and identifying the associated methodological guidelines. Methods and materials. Many studies of the problem of the stage affiliation of early Cossack communities, carried out by pre-revolutionary, Soviet, and modern Russian Cossack researchers, as well as works on male unions and communities of the Slavic, Caucasian, and Turkic worlds, served as materials for the article. The analysis of sources and scientific publications was carried out using comparative historical and structural-functional methods, as well as methods of classification and typologization. Analysis. The available scientific papers on the problem were classified based on the social and political prototypes of early Cossack communities determined by scientists. Three groups of versions about the social nature of early Cossack communities have been identified, which correlate them: 1) with state structures; 2) with paramilitary communities that existed in the South Russian steppes and adjacent territories at the same time as the Cossacks; 3) with archaic structures (the so-called military democracy and male unions). Results. Defining the third direction as the most promising, the author of the article suggests expanding research on the cultural and historical comparison of Cossack organizations with archaic male unions and their later forms known in the Turkic, Caucasian, and Slavic worlds. We should start this case by adhering to a set of crucial methodological principles. These principles indicate that male unions were cultural universals, and their correlation with Cossack organizations may indicate not so much (and not only) genetic connections as typological ones. In contrast to the Caucasian and Central Asian unions, Cossack communities arose outside the metropolis, which, on the one hand, led to the need for them to build their own potestar structures and, on the other hand, determined the strong external impact on them from the Russian state. The development of Cossack communities did not follow the path of evolution but was first carried out in the form of a rollback to the archaic and then was associated with a series of sociocultural transformations.

Frequency of exposure incidents in hospital workers before and during the COVID-19 pandemic based on the hospital status and the use of personal protective equipment: a descriptive study with a historical comparison group

BackgroundAn occupational exposure, i.e. exposure incident (EI), is contact with potentially contaminated material that may contain bloodborne pathogens and that occurs during occupational activities inside or outside a health care facility, either during direct work with a patient or during contact with a patient’s body fluids and tissues. This study aimed to compare the frequency of EIs in a university hospital before and during the Coronavirus Disease 2019 (COVID-19) pandemic.MethodsThis was a descriptive study with a historical comparison group conducted at the Dubrava University Hospital (DUH) in Zagreb, Croatia. We compared the frequency of EIs among healthcare and non-healthcare workers before (from March 11, 2018, to March 10, 2020) and during (from March 11, 2020, to March 11, 2022) the COVID-19 pandemic, expressed as the number of EIs per number of hospitalized patients and the total number of hospital activities. We analyzed data based on the status of the hospital (a COVID-19 hospital or not) and the use of personal protective equipment (PPE) as recommended by the World Health Organization.ResultsDuring the total analyzed period, 241 EIs were reported in DUH. Before the pandemic, 128 EIs were reported, compared to 113 during the pandemic. Before the pandemic, 91% of EIs were recorded in healthcare workers, while during the pandemic, 96% of EIs were recorded in healthcare workers. Slightly more EIs were recorded during the period of mixed work form and de-escalation of PPE. The rate of EIs relative to the total number of hospital patients was significantly higher during the pandemic (3.9/1000) than in the pre-pandemic period (2.5/1000). The rate of EIs relative to the total number of hospital activities was significantly higher during the pandemic (0.4/1000) than in the pre-pandemic period (0.2/1000).ConclusionThe rate of EIs relative to the total number of hospitalized patients and the total number of hospital activities in DUH was significantly higher during the pandemic, and the rate of total EIs increased among healthcare workers during the COVID-19 pandemic. The results of this study show that it is necessary to constantly and effectively work on the prevention of EI.

Bell's palsy and COVID-19: A cohort study with historical rate comparison

IntroductionDuring the SARS-CoV-2 pandemic, immune-mediated neurological events have been described in patients vaccinated against the virus or who have overcome the disease. Among these events is Idiopathic peripheral facial palsy or Bell’s palsy. ObjectivesTo study the incidence of Bell's Palsy in the ENT emergency department of a tertiary hospital in Catalonia during the SARS-CoV-2 pandemic. MethodsRetrospective historical cohort comparison study of patients diagnosed with Bell's palsy between January 2018 and December 2021. Crude incidence rates were calculated as the total number of events divided by person time at risk per 100.000 person-years. Observed (2020, 2021) and historical (2018, 2019) rates were compared using standardized incidence rates with corresponding 95% confidence intervals. ResultsOf the total number of ENT emergency department visits from 2018 to 2021 (22.658), there were 247 cases of Bell's palsy. The incidence rate of Bell's palsy in the pre-pandemic group was 12,2 and 10,9 per 100.000 person-years for 2018 and 2019, respectively. The 2020 standardized incidence rate of Bell's palsy was 0,70 [95% CI 0,49–1,01] and 1,25 [95% CI 0,93–1,67] for 2021. No significant differences were evident between the two groups. ConclusionIn our cohort, no association was found between vaccination or COVID-19 infection and the development of Bell's Palsy.

Legal Framework of State Formation in Lithuania: A Historical Comparison Pre- and Post-EU Integration

The accession of new countries to the European Union (EU) in May 2004 marked a qualitatively new stage in the integration processes both in Europe and worldwide. Analysing the positive and negative phenomena accompanying the enlargement of the EU is significant for countries considering or potentially joining the EU in the future. This analysis is crucial when forming long-term economic policies and deciding their integration directions. The experience of the Republic of Lithuania in studying the impact of external political situations on the processes of integration into the European community is seen as illustrative for Ukraine due to shared initial characteristics and historical proximity between the states. The article analyses the features of Lithuania’s integration into the European community. A significant normative and systemic gap between the periods studied in the context of the legislative field is demonstrated. The study aims to analyse the dynamics of the normative-legal framework in developing European integration and state-building processes in Lithuania from 1990 to 2021. The research identifies which countries had the most significant influence on the state-building process in Lithuania after 1990 during the establishment and development of democratisation. Fundamental concepts of state-building in Lithuania during the studied period and the corresponding normative-legal framework of the process are highlighted. It is established that Lithuania’s accession, despite a solid societal push for integration into the Western political and economic culture, had several distinctive features related to constitutional institutions, significantly impacting the resolution of issues between the government and EU institutions.

Репрезентативность показателей и объективность оценок в компаративистике: экономика Российской империи второй половины XIX столетия в современных зарубежных исследованиях

The relevance of comparative studies of the level of industrial and economic development of the Russian Empire in the second half of the XIX century is determined by the fact that their results in some cases are used to substantiate theoretical ideas about the national characteristics of the Russian economy and society in comparison with the leading countries of Industrial Revolution. In economic literature, assertions about the “catastrophic” backwardness of Russia during this period are often encountered. Modern foreign historical-economic research allows for a more objective assessment of the gap between the level of industrial and economic development of the Russian Empire and the “advanced” states. However, the authors of these studies do not always succeed in consistently applying the principle of uniform criteria for comparing different economies. In particular, it is hardly justified: in some cases, to take into account, and in others, not to take into account the population and economic potential of territorial isolated peripheral regions of the respective economies. For example, the value of historical and economic comparisons is reduced by the confusion in research between the actual territory of the Russian Empire in the middle and second half of the XIX century, its territory within the conditional “borders of 1913” and the territory within “former USSR” borders. In this regard the article notes that conclusions drawn on the basis of fragmentary and arbitrarily interpreted information can’t be considered as fully correct. According to the author, in a comparative analysis of the economies-leaders of the Industrial Revolution, it is necessary to use assessment methods that take into account the population and indicators of economic development of peripheral territories were included in trade and financial exchanges with these economies, because this inclusion strongly spired the development of economies-leaders.

Grouping sounds into evolving units for the purpose of historical language comparison

Computer-assisted approaches to historical language comparison have made great progress during the past two decades. Scholars can now routinely use computational tools to annotate cognate sets, align words, and search for regularly recurring sound correspondences. However, computational approaches still suffer from a very rigid sequence model of the form part of the linguistic sign, in which words and morphemes are segmented into fixed sound units which cannot be modified. In order to bring the representation of sound sequences in computational historical linguistics closer to the research practice of scholars who apply the traditional comparative method, we introduce improved sound sequence representations in which individual sound segments can be grouped into evolving sound units in order to capture language-specific sound laws more efficiently. We illustrate the usefulness of this enhanced representation of sound sequences in concrete examples and complement it by providing a small software library that allows scholars to convert their data from forms segmented into sound units to forms segmented into evolving sound units and vice versa.

Arthropods to Eutherians: A Historical and Contemporary Comparison of Sparse Prenatal Microbial Communities Among Animalia Species.

Since the advent of next-generation sequencing, investigators worldwide have sought to discern whether a functional and biologically or clinically relevant prenatal microbiome exists. One line of research has led to the hypothesis that microbial DNA detected in utero/in ovo or prior to birth/hatching is a result of contamination and does not belong to viable and functional microbes. Many of these preliminary evaluations have been conducted in humans, mice, and nonhuman primates due to sample and specimen availability. However, a comprehensive review of the literature across animal species suggests organisms that maintain an obligate relationship with microbes may act as better models for interrogating the selective pressures placed on vertical microbial transfer over traditional laboratory species. To date, studies in humans and viviparous laboratory species have failed to illustrate the clear presence and transfer of functional microbes in utero. Until a ground truth regarding the status and relevance of prenatal microbes can be ascertained, it is salient to conduct parallel investigations into the prevalence of a functional prenatal microbiome across the developmental lifespan of multiple organisms in the kingdom Animalia. This comprehensive understanding is necessary not only to determine the role of vertically transmitted microbes and their products in early human health but also to understand their full One Health impact. This review is among the first to compile such comprehensive primary conclusions from the original investigator's conclusions, and hence collectively illustrates that prenatal microbial transfer is supported by experimental evidence arising from over a long and rigorous scientific history encompassing a breadth of species from kingdom Animalia.

Legal Aspects of Using Blockchain Technologies in the Field of E-Commerce on SDG'S

Objective: The objective of this study is legal aspects of blockchain. Theoretical Framework: Blockchain is one of the most prominent technologies and it has become a driving factor in business transformation. Method: Methods of historical and logical analysis and comparison, expert opinions, system analysis and forecasting were used. The research materials included legal aspects, in particular, in the development of blockchain technology. Results and Discussion: Blockchain, like any electronic technology, can have different forms of social implementation. Their openness is manifested in the fact that anyone can become a network node participating in the consensus procedure. Information in public blockchains is actually and legally publicly available. The listed qualities ensure a high level of security of public blockchains and a high level of users’ trust toward them. Research Implications: The legal regulation of digital technologies is becoming an important tool for ensuring a balance between public and private interests, benefits and risks of the digital age. Originality/Value: The global blockchain market will grow significantly in the coming years. The new vector of blockchain technology will be aimed at accelerating the pace of digitalization, financial inclusion and enhancing security. There is no doubt that blockchain is a disruptive technology and will continue to dominate the business world in the coming years.

A Journey Towards a Non‐Western International Relations Theory: Non‐Western Conceptualization of the English School

The purpose of this study is to examine non‐Western international relations theory (IRT) and explore, at the theoretical level, the potential for epistemological autonomy from the confines of Western‐centered epistemology prevalent in existing IRT. As a consequence, the non‐Western world, subjected to colonialist expansion and modernization and often regarded as merely the leaves, has been relegated to a passive role within the international system, becoming a disengaged object of little interest. However, what has existed cannot be entirely erased. While it is undeniable that international politics was predominantly developed based on a Western‐centric epistemology, other ancient civilizations had diverse international systems and orders that molded their identities as regional international societies. Consequently, the study provides a crucial backdrop for theoretical endeavors aimed at integrating the voices and experiences of the Global South into IRT, which has traditionally been dominated by Western perspectives. This study seeks to explore the potential for transcending Western intellectual hegemony by critiquing the limitations of a singular worldview and expanding and transforming the English School Theory (EST). It seeks to investigate the possibility of moving beyond Western‐centricity in international relations theory by conducting a historical comparison of civilizations across countries and the associated disciplines within civilizations as a field.

A case series of osseous metastases in patients with glioblastoma.

Extracranial metastases occur in <2% of cases of glioblastoma (GBM). When metastases do occur, bone is the most common destination. Herein, we review clinical characteristics of GBM patients with osseous metastases and evaluate both potential risk factors and prognostic significance. Using an institutional database, we identified and retrospectively analyzed 6 patients with both GBM and osseous metastases. We collected data on patient demographics, tumor genetics, clinical courses, and outcomes. Given the rarity of metastatic GBM, we conducted historical comparisons using previously published literature. Five patients with osseous metastases (83%) were male, with a median age of 46 years at GBM diagnosis (range: 20-84). All patients had IDH-wildtype, MGMT promoter unmethylated GBM and 5 (83%) had alterations in TP53. All patients underwent surgical resection for GBM followed by radiation with concurrent and adjuvant temozolomide. Four patients (67%) received bevacizumab prior to bone metastasis diagnosis. Bone metastases were discovered at a median of 12.2 months (range: 5.3-35.2) after GBM diagnosis and 4.8 months after starting bevacizumab (range: 3.5-13.2). Three patients (50%) received immunotherapy. After osseous metastasis diagnosis, the median survival was 25 days (range: 13-225). In our cohort, most patients were male and young at the time of GBM diagnosis. All patients had IDH-wildtype, MGMT promoter unmethylated GBM, and most had alterations in TP53, which may be important for osseous metastasis. Most patients received bevacizumab, which has been associated with earlier metastasis. Osseous metastases of GBM occur and portend a dismal prognosis in an already aggressive malignancy.

A Single Center Experience of Pulmonary Arterial Hypertension Management in Korea: A 25-Year Comparative Analysis Following the Introduction of Targeted Therapy.

The transformation of pulmonary arterial hypertension (PAH) treatment in Korea, ushered by targeted therapy's advent, prompted our analysis of baseline attributes, treatment trends, and survival shifts within our single-center registry. We examined 230 patients (72.6% female, mean age 40.6±17.4 years) diagnosed and/or treated between 1980 and 2021 in our PAH clinic. Given targeted therapy's introduction and active use since 2007, we compared diagnostic classification, demographics, and treatment patterns at that juncture. Survival analysis encompassed PAH types and the overall population. For historical survival comparison, 50 non-registry patients were retrospectively added, and age-sex matching enabled pooled analysis. Congenital heart disease-associated pulmonary arterial hypertension (CHD-PAH) constituted the largest subset (43.0%), trailed by connective tissue disease-associated PAH (CTD-PAH, 29.6%) and idiopathic PAH (IPAH, 19.1%). Post-2007, CTD-PAH proportions surged, notably with an elevated initiation rate of targeted therapy (95.4%). Overall survival rates at 1, 5, and 10 years stood at 91.3%, 77.4%, and 65.8%, respectively, with CHD-PAH exhibiting superior survival to idiopathic or CTD-PAH. Age-sex matching analysis indicated survival disparities between those starting immediate targeted therapy vs. conservative treatment upon diagnosis, especially driven by IPAH. In the post-introduction of the targeted therapy era, patients with PAH promptly started treatment right away, and higher survival rates of patients who started initial PAH-targeted therapy were demonstrated. The transition towards early treatment initiation might have likely contributed to the elevated survival rates observed in Korea's PAH patient cohort.

Mírové smlouvy v mezinárodních vztazích. (K problematice kritérií a systematizace)

The subject of this study is the issue of peace treaties, which are among the most important diplomatic acts and documents in international relations. Peace treaties represent one of the most important types of international treaties. They are an integral part of the couple relationship of peace and war. Their basic specificity is the fact that, on the one hand, they confirm the end of the war conflict and, on the other hand, establish measures and rules for the subsequent relations between the participants in the conflict. In contrast to the prevailing approach, which deals with this issue from the point of view of international law, the author approached the issue on the basis of historical analysis and comparison. His goal was to establish criteria and, based on this, systematize the most important peace treaties concluded in the course of the history of international relations. The author came to determine a total of six intertwining main models of peace treaties: 1. victory of one side over the other, 2. parties exhausted each other and none won, 3. only one of the stages of the war was ended, 4. participation in the conflict ended with a peace treaty only some parties, 5. number of parties involved, 6. content aspect of the treaty. Following this, the author also paid attention to other related problems. Specifically, these are the ratification and observance of peace treaties, accompanying and follow-up contractual arrangements, the extent and degree of punishment of the defeated party, and treaties intended to prevent conflict. The purpose of the study was to create a conceptual and systematically anchored framework for further research on this important part of international relations and diplomacy.

Prospective Evaluation of the Kaiser Permanente Prostate Cancer Risk Calculator in Biopsy-Naïve Men With Mild PSA Elevations.

Our goal was to assess the impact of providing prostate cancer risk estimates to patients and urologists among biopsy-naïve men with mild PSA elevations. This prospective intervention study was conducted in urology departments in Kaiser Permanente Northern California among biopsy-naïve men with mild PSA elevations (<10 ng/mL) between March 2021 and March 2023. The intervention was providing prostate cancer risk estimates for intermediate-/high-grade cancer (Grade Groups 2-5) and any cancer to patients and urologists using our previously validated risk calculator. Biopsy outcomes were compared to a historical comparison group biopsied between January 2016 and December 2019. Over 24 months, the risk calculator was used to estimate risk for 1962 men, of whom 1455 (74%) accepted the biopsy. The men who accepted the biopsy had higher predicted intermediate-/high-grade cancer risks (median 24%, interquartile range [IQR] 17%-31%, vs 20%, IQR 14%-29%; P < .0001) and higher predicted risks for any cancer (median 48%, IQR 40%-56%, vs 45%, IQR 37%-53%, respectively; P < .0001) than those who declined the biopsy. Compared to the historical group, use of the risk calculator resulted in a biopsy population enriched with intermediate-/high-grade cancer: 29% vs 25%; similar rates of low-grade cancer: 24% vs 24%; and fewer negative biopsies: 47% vs 51%, respectively; overall P = .013. In biopsy-naïve men with mild PSA elevations, use of this risk calculator resulted in a biopsy population that had more intermediate-/high-grade cancer and fewer negative biopsies compared to a historical group.