In this update, we review a framework for identifying and mitigating information bias in electronic health records and administrative claims data, highlighting practical recommendations for study design, variable definition, and statistical analysis. We also discuss a perspective on emerging privacy-preserving technologies - synthetic data and federated networks - that enable secure cross-border data access while maintaining patient privacy.

The hallucination issues in generative artificial intelligence (GAI), stemming from training data bias and algorithmic misjudgment, constitute a significant source for information security problems. The resultant novel security threats, particularly the dissemination of false and biased information, pose a bottleneck constraining the development of GAI. Existing supervision mechanisms mostly focus on the binary game between the government and enterprises, neglecting the supervision value of users as direct risk-bearers. Based on the evolutionary game theory, this paper constructs a tripartite dynamic game model among enterprises, government and users, and analyzes the synergistic evolution mechanisms of responsible innovation in enterprises, user participation in supervision and the reward and punishment policy by government. Through the tripartite strategy matrix and replicator dynamics equation, we analyze the evolutionarily stable strategies and their influencing factors of each player, exploring the collaborative supervision mechanisms of GAI by numerical simulation. We find that: (1) There is an equilibrium point in the system, which is the evolutionarily stable strategies of responsible innovation in enterprises, user participation in supervision, and strict supervision by government. (2) The implementation of reward and punishment mechanisms by government for enterprises accelerates the realization of the evolutionarily stable strategies of the system. When the sum of government rewards obtained by enterprises and reputation premium brought by user feedback exceeds their additional costs, incentive measures such as subsidies or rewards adopted by the government are more effective in promoting enterprises to choose responsible innovation strategies, compared with simply intensifying punitive measures. (3) Designing an effective user evaluation feedback mechanism and increasing the rewards for user participation in supervision enhance the supervision willingness of users and accelerate the realization of evolutionarily stable states of collaborative supervision.

Resources for observational comparative research have expanded enormously in recent years to include very large sources of granular, routinely collected health care data and modern statistical, epidemiologic, and econometric techniques. This scientific statement provides an overview of best practices and analytic considerations in observational comparative studies from the perspective of investigators, sponsors, publishers, and consumers of observational research. Observational comparative research is a component of the research landscape that fulfills a role distinct from that of interventional studies in the evaluation of drugs, surgical procedures, medical devices, and health policies. Sources of systematic error (ie, bias) in observational comparative studies include selection bias, information bias, and confounding. Principles from statistical science and econometrics can potentially be used to make causal conclusions from observational data. Target trial emulation is a useful framework to guide the rational design and illuminate the limitations of observational studies. As with interventional research, a formal study protocol should be prepared before every observational study to enhance rigor, reduce data manipulation, and promote transparency of study reporting. Selection of the study data source is a key decision early in the design stage of a study, and should be chosen on the basis of concordance between the needs of the specific study question and the properties of the data set. We recommend the use of causal directed acyclic graphs to clearly specify the study exposure, end points, confounders, colliders, moderators, and mediators. Taken together, these recommendations promote rational design choices and cautious interpretation of the results of observational comparative studies.

To investigate the factors associated with variant histology (VH) and prognostic significance of VH in urothelial carcinoma (UC) among patients undergoing radical cystectomy (RC) with ileal conduit urinary diversion. A retrospective analysis was conducted on 317 patients who underwent RC with ileal conduit diversion between 2019 and 2025. Patients were categorized based on the presence of VH in the final pathology. Demographic, clinical, perioperative, and pathological data were compared. Logistic regression was performed to identify factors associated with VH, while Kaplan-Meier and uni-multivariable Cox regression analyses evaluated overall survival (OS) and cancer-specific survival (CSS). VH was detected in 139 patients (43.8%), with squamous differentiation being the most prevalent variant, observed in 80 patients of the 317 patients who underwent RC with ileal conduit urinary diversion. Presence of hydronephrosis, clinical lymph node positivity and WBC > 7695g/dl were defined as factors associated with VH in multivariate logistic regression analysis. Kaplan-Meier survival analysis illustrated a statistically significant reduction in OS and CSS among patients harboring VH compared to those with pure UC following RC and ileal conduit urinary diversion (53.8 vs. 36.8 months for OS and 68 vs. 53 months for CSS, log-rank test, p < 0.001). Multivariable Cox regression analysis revealed that presence of variant histology was associated with reduced OS (HR = 1.624; 95% CI = 1.094-2.411; p = 0.016) and CSS (HR = 1.945; 95% CI = 1.043-3.626; p = 0.036). VH in UC is associated with advanced disease and poorer survival outcomes following RC. Certain preoperative factors-hydronephrosis, clinical lymphadenopathy, and elevated WBC-may be associated with the presence of VH. Early recognition of these features could guide individualized treatment strategies and improve prognostic assessment. However, the retrospective and single-center nature of this study may introduce selection and information bias, and the findings should be interpreted with caution until validated by prospective multicenter trials.

Electronic health records (EHRs) are valuable sources of data but are susceptible to biases from missing data and sample selection, often due to clinically informative visiting processes and non-probability sampling. This research explores whether genetic data, typically measured on nearly all participants in EHR-linked biobanks, can be used to mitigate these biases. Simulations were performed under conditions of missing completely at random (MCAR), missing at random (MAR), and missing not at random (MNAR) within random and biased sampling frameworks. We evaluated PRS-informed imputation, PRS-uninformed imputation, and complete case analysis across these scenarios in terms of bias, coverage, and root mean square error (RMSE) of the regression coefficient estimates. A real-world example using data from the Michigan Genomics Initiative (MGI, n = 68,063) compared the effectiveness of these methods against national benchmark estimates. PRS-informed imputation generally reduced bias and RMSE and improved coverage, particularly under MAR conditions in random samples. In analyses of biased samples of n = 10,000 with MAR exposure-only missingness, weighted, PRS-informed imputation analyses showed substantially lower percent bias (0.6%) and closer to nominal coverage (89.1%) compared to weighted, complete case analyses (9.4%; 74.3%). The MGI estimates showed that PRS-informed approaches aligned more closely with national benchmarks than unweighted complete case analysis. Leveraging genetic data with sample weighting can help reduce bias in outcome-exposure association estimates derived from biobank data. When available, researchers should consider including PRS for imputation and survey methods for sample weighting when estimating outcome-exposure association coefficients in a target population of interest, recognizing that benefits may vary by outcome and data structure.

In this study, using the data set obtained from the statistical tables for the years 2001-2023 published by the Turkish Statistical Institute (TUIK), 9 different models (McNally, Gompertz, Gamma, Bertalanffy, Orskov, Brody, Wood, Quadratic, Wilmink) for beef meat (tonnes) production and 8 different models (Logistic, McNally, Gamma, Bertalanffy, Brody, Wood, Quadratic, Wilmink) for beef milk (tonnes) production were compared statistically. The suitability of the models was evaluated using the mean square error, corrected coefficient of determination, accuracy and bias factors and information criteria (Akaike information criterion, corrected Akaike information criterion, Bayesian information criterion). As a result of the study, it was determined that the most suitable model for both data sets was the Brody model for beef meat (tonnes) production and the Logistic model for beef milk (tonnes) production. These models have been reported to have the lowest mean square error and information criteria (Akaike information criterion, corrected Akaike information criterion, Bayesian information criterion) values compared to other models. The research has revealed that the correct model selection can be made more soundly by evaluating different statistical criteria together, rather than relying solely on error terms. In future studies, it is recommended that Brody and Logistic models be analyzed on different data sets..

ABSTRACT There are notable individual differences in how people manage the lead up to, and aftermath of, stressful events. Trait anxiety has consistently been identified as a key factor contributing to these differences. There is growing consensus that trait anxiety is multidimensional, comprising two distinct dimensions, anxiety reactivity and anxiety perseveration. Yet the cognitive mechanisms driving individual differences in these dimensions remain unclear. The present study investigated the potential role of attentional bias towards information differing in content (situational vs. implicational) and valence (negative vs. positive) in driving these individual differences. Undergraduate university students (N = 93) completed a dual-probe assessment task which presented video clips varying in content and valence. State anxiety was assessed at crucial junctures throughout the experimental session to index anxiety reactivity and perseveration. Results revealed attentional bias for negative implicational information played a significant role in predicting anxiety perseveration. Conversely, attention bias for negative situational information was not a significant predictor of anxiety reactivity. Findings are discussed with reference to limitations and future extensions that could build on these findings to address causality and develop interventions capable of modifying cognitive biases.

Pediatric chronic kidney disease (CKD) is a serious public health problem and represents a considerable burden on health systems, particularly in low- and middle-income countries (LMICs). Despite well-documented global disparities in CKD management, the extent of these differences across continents remains insufficiently explored, particularly in pediatric populations. To explore the body of recent evidence on clinical complications and anthropometric indicators of CKD in childhood and to identify gaps in knowledge that can guide the development of future studies of CKD in childhood, in the global context. Studies were searched in following electronic databases: PubMed/Medline, Embase, Web of Science, and Google Scholar. Inclusion criteria consisted of observational quantitative articles (cohort, cross-sectional, case-control studies) in English that evaluated CKD in children. We excluded studies without reported data findings, case studies with fewer than 50 individuals and conducted with the same cohort. Children and adolescents aged 0 to 18years old with CKD. This research did not aim to evaluate the quality of individual studies, since the main objective of a scoping review is to map the evidence and identify strengths and weaknesses. We conducted a scoping review structured using the methodology developed by Arksey and O'Malley expanded by Levac et al. to map the existing literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension were adopted to increase methodological rigor. Two coders reviewed articles for descriptive information to create summary tables comparing variables of interest. Fifteen studies met inclusion criteria for this scoping review. Baseline clinical characteristics of individuals were analysed, with 889 from LMICs and 2564 from high-income countries (HICs). Inequality in access to treatment for pediatric patients with CKD between HICs and LMICs was evident. Scoping reviews typically have limitations due to their broad research focus and lack of in-depth analysis of a specific problem; therefore, a meta-analysis is not possible. We limited the included studies to those published in English to avoid translation/interpretation errors. Finally, information biases may be present since the data were mostly extracted from observational studies based on secondary information sources. Future studies should:1) Focus on standardizing variable definitions and measurement to reduce heterogeneity in the presentation of results; 2) Explore barriers and facilitators to access to treatment among of children with CKD from LMICs; 3) Promote the development of large multicenter collaborative cohorts of pediatric CKD in LMICs, enabling more representative data, longitudinal follow-up, and evidence-based strategies to improve outcomes. Open Science Framework protocol https://doi.org/10.17605/OSF.IO/Q4HN8.

Evidence-based practice relies on accurate measurement of healthcare conditions. However, measurement of phantom limb pain after amputation can be challenging due to the varying intensity, duration, and quality of pain episodes. Standard measurement of phantom limb pain involves patient recall during clinic appointments and therefore may provide biased information. The purpose of this study was to compare recalled average and maximum ratings of phantom limb pain intensity with real-time ratings. Participants (n = 17, 59% male, age 32-76) with lower limb amputation completed momentary ratings of phantom limb pain intensity on a 0-10 scale via ecological momentary assessment surveys on their mobile devices three times per day for 40 days. Momentary average and maximum ratings were compared to participants' recalled ratings on a 0-10 scale using standard clinical questions. Average recalled phantom limb pain intensity ratings were significantly higher than average momentary ratings when including zeros in the momentary average calculation (6.53 vs. 1.99; p < 0.001) and when including only nonzero momentary ratings (6.53 vs. 5.08; p = 0.001). Additionally, maximum recalled phantom limb pain intensity ratings were significantly higher than maximum momentary ratings (9.06 vs. 7.59; p = 0.001). These results suggest that momentary ratings of phantom limb pain intensity may yield more accurate information than standard recalled ratings. Assessment of phantom limb pain in a clinical setting could benefit from more frequent, real-time measurement to better track changes in pain and evaluate treatment effects.

Potential biases in observational infectious disease studies: examples using directed acyclic graphs.

To evaluate the clinical significance of late-onset cervical shortening diagnosed between 24.0 and 34.0 weeks of gestation following normal midtrimester screening, and to assess its association with spontaneous preterm birth (sPTB) and adverse neonatal outcomes. We also examined whether obstetric history modifies this risk. Retrospective cohort study. Participants/Materials: A total of 500 singleton pregnancies with normal midtrimester cervical length (CL) who were subsequently diagnosed with cervical shortening (<25 mm) between 24.0 and 34.0 weeks of gestation. Tertiary, university-affiliated medical center (Galilee Medical Center, Israel), March 2020 to May 2025. Patients with asymptomatic late cervical shortening were categorized into three groups: <10 mm, 11-15 mm, and 16-25 mm. CL measurements were further stratified by gestational age at diagnosis (24.0-27.6, 28.0-31.6, and 32.0-34.0 weeks). The primary outcome was sPTB <37 weeks. Secondary outcomes included sPTB <34 and <32 weeks and neonatal morbidity. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs). Receiver operating characteristic (ROC) curve analysis was performed to determine gestational age-specific CL thresholds for predicting sPTB. Results: A total of 500 patients were included: 24/500 (4.8%) with CL <10 mm, 80/500 (16.0%) with CL 11-15 mm, and 396/500 (79.2%) with CL 16-25 mm. Baseline characteristics were comparable across groups. Rates of sPTB <37 weeks were 18/24 (75.0%) in patients with CL <10 mm, 42/80 (52.5%) in those with CL 11-15 mm, and 99/396 (25.0%) in those with CL 16-25 mm (p<0.001). Similarly, sPTB <34 weeks occurred in 14/24 (58.3%), 20/80 (25.0%), and 33/396 (8.3%), and sPTB <32 weeks in 11/24 (45.8%), 12/80 (15.0%), and 20/396 (5.1%) (all p<0.001). When stratified by cervical length groups, sPTB rates did not differ according to obstetric history among patients with CL <10 mm and 11-15 mm. In contrast, among patients with CL 21-25 mm, sPTB occurred in 7/26 (26.9%) of those with a prior sPTB, 17/78 (21.8%) of nulliparas, and 10/78 (12.8%) of those with a prior term birth (p=0.041). ROC analysis identified gestational age-specific thresholds for predicting sPTB <37 weeks: 22 mm at 24.0-27.6 weeks (AUC 0.69, p<0.001), 20 mm at 28.0-31.6 weeks (AUC 0.62, p=0.002), and 18 mm at 32.0-34.0 weeks (AUC 0.72, p<0.001). Correspondingly, sPTB rates were higher below these cutoffs: 49.1% vs. 18.2% (p<0.001), 49.1% vs. 23.2% (p<0.001), and 43.9% vs. 18.8% (p<0.001), respectively. The retrospective design may introduce selection and information bias. Measurements were performed by multiple clinicians, potentially leading to inter-observer variability. Residual confounding cannot be excluded. Late-onset cervical shortening after normal midtrimester screening is strongly associated with spontaneous preterm birth and adverse neonatal outcomes. The degree of shortening and obstetric history significantly influence risk, particularly in patients with moderate late shortening. Gestational age-specific cervical length thresholds may enhance late pregnancy risk stratification and support individualized surveillance and management strategies.

Contemporary high-sensitivity cardiac troponin (hs-cTn) assays can detect very low levels of myocardial injury, leading many emergency department (ED) chest pain patients to exceed the 99th-percentile upper reference limit, despite low risk for myocardial infarction. This systematic review aimed to synthesize evidence quantifying the risk of MACE among ED patients with a single troponin concentration measurement above the 99th percentile reference limit but below diagnostic cutoffs for myocardial infarction. Electronic searches of MEDLINE, Cochrane Reviews, CINAHL and EMBASE (2002-2025) were conducted. Studies were included if outcomes for patients with indeterminate single hs-Tn measurements were reported or extractable. Patients with ECG findings suggestive of ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) were excluded. Two reviewers independently screened abstracts and extracted data. MACE was defined as acute myocardial infarction (MI), stroke, and cardiovascular mortality 30days after index ED visit. The search strategy yielded 709 potentially relevant citations. Eight studies were included: one randomized controlled trial, three prospective cohort, and four retrospective cohort studies. The incidence of MACE ranged from 0.3 to 14.8%. 46,066 of 129,060 eligible patients (40%) had a second test after an indeterminate result. Risk of bias was high for most observational studies, primarily due to information and incorporation bias, and randomized controlled trials had some concern for bias in the selection of the reported results, randomization process, and intended intervention. It remains unknown whether patients with an indeterminate hs-Tn result and no serial testing are at increased risk for MACE. More than half of such patients did not receive serial testing. The study demonstrates inconsistent approaches for managing indeterminate troponin results, underscoring the need for physicians to interpret indeterminate values cautiously and consider clinical assessment in low-risk chest pain patients.

Anchoring bias occurs when physicians fail to revise an incorrect diagnosis triggered by salient distracting features (SDFs) despite contradictory evidence. The cognitive mechanisms underlying anchoring bias are unclear. We examined differences in processing of biasing (SDFs) and critical diagnostic information (discriminating features, DFs), when physicians give an SDF-related-diagnosis or an accurate diagnosis. Randomized, crossover experiment with medical residents in Brazil. Each participant diagnosed six clinical vignettes while eye movements were tracked and subsequently recalled each vignette's clinical findings. Each vignette had three versions: without SDFs, with SDFs at the beginning, with SDFs at the end. Each participant diagnosed two vignettes in each version in counterbalanced manner. Fixations on DFs did not significantly differ between SDF-related-diagnoses and accurate diagnoses nor with the position of SDFs. Fixations on SDFs did not significantly differ with diagnostic accuracy. However, SDFs at the end of the vignette received fewer fixations than when at the beginning. Regardless of the SDFs position, physicians recalled more DFs and fewer SDFs when they gave an accurate diagnosis than an SDF-related-diagnosis (respectively, DFs: 0.47; 95 % CI, 0.40-0.53 vs. 0.20; 95 % CI, 0.06-0.33; SDFs: 0.16; 95 % CI, 0.08-0.24 vs. 0.37; 95 % CI, 0.24-0.50). DFs and SDFs attracted physicians' attention similarly extensively, but the recall suggests different cognitive processes were taking place. Overcoming anchoring bias apparently required engaging in inhibiting the SDFs while corroborating the diagnostic value of DFs. Clinical teaching should strengthen knowledge of DFs. Digital diagnostic support could possibly be optimized by directing physicians' attention to DFs during diagnosis.

Dasatinib, a second-generation tyrosine kinase inhibitor widely used for chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL), has been reported in association with rare cases of chylothorax. To systematically summarize published case reports and complement these findings with pharmacovigilance data in order to characterize the clinical presentation, management, and outcomes of dasatinib-associated chylothorax. A scoping review was conducted in accordance with PRISMA 2020 recommendations. PubMed/MEDLINE and an institutional discovery platform were searched for case reports and case series published up to February 13, 2026. Eligible reports included patients developing chylothorax during dasatinib therapy. In parallel, data from the FDA Adverse Event Reporting System (FAERS) were analyzed through September 30, 2024. Descriptive analyses were performed. FAERS data were interpreted as hypothesis-generating only. Forty-two publications describing 44 patients met the inclusion criteria. Patients ranged from 5 to 90years of age, with a slight male predominance. Time from dasatinib initiation to chylothorax onset varied from 2months to 10years. Management most commonly involved drug discontinuation and thoracentesis, frequently followed by clinical resolution. FAERS analysis identified 104 unique reports of chylothorax associated with dasatinib, all classified as serious adverse events; severe outcomes were uncommon. Reporting trends increased over time, particularly between 2017 and 2023. Evidence derives from case reports and spontaneous reporting data, which do not allow estimation of incidence or causal inference and are subject to reporting bias and incomplete information. Dasatinib-associated chylothorax is an uncommon but clinically relevant event that may occur even after prolonged therapy. Long-term monitoring and prompt recognition are essential. Findings from pharmacovigilance data should be interpreted cautiously and considered hypothesis-generating. Further studies using large retrospective administrative databases are warranted to formally evaluate this potential association.

This study aims to analyze the use of artificial intelligence in Islamic Religious Education learning in the hyper-digital era in Islamic High School. The study focuses on the forms of AI utilization, the opportunities it offers, the challenges it presents, and its implications for pedagogical practices in Islamic education. This research employed a qualitative approach with a field research design and descriptive-analytical method. Data were collected through observation, semi-structured interviews, and documentation, and were analyzed using an interactive model consisting of data collection, data condensation, data display, and conclusion drawing. The findings reveal that the use of AI in Islamic Religious Education learning in Islamic High School remains at an early stage and has not yet been systematically integrated into lesson planning, implementation, or evaluation. Nevertheless, AI has the potential to support learning that is more interactive, adaptive, and relevant to students’ characteristics in the digital era. On the other hand, this study also identifies several challenges, including the lack of clear pedagogical integration, the risk of educational dehumanization, the potential bias and inaccuracy of religious information, issues of scholarly authority, and the possible misuse of technology. Therefore, the use of AI in Islamic Religious Education learning should be positioned as a supporting tool that is managed selectively, critically, and value-based in order to remain aligned with the goals of Islamic education.

Safety of acetaminophen use in pregnancy: review of existing evidence.

Information Bias Learning Module: Ranker et al. (2025), Context matters: Sexual orientation identity and attraction changes among youth: prospective versus retrospective measurement.

In the digital era, students increasingly depend on online platforms to evaluate colleges based on reviews, placements, and facilities. However, existing systems often allow unverified users to submit feedback, resulting in fake, biased, and misleading information. To address these challenges, this paper proposes College Lens, a web-based platform that ensures authenticity and transparency through verified student reviews and intelligent admission prediction. The system utilizes Optical Character Recognition (OCR) to validate user authenticity by extracting and verifying information from academic documents such as mark sheets and fee receipts. Only verified students are permitted to post reviews, ensuring reliability. Additionally, a machine learning model built using Scikit-learn predicts suitable colleges based on student academic performance, including CET scores and 12th-grade percentages. The platform is developed using React for the frontend, Django for backend processing, and MySQL for efficient data management. By integrating verification mechanisms with predictive analytics, the proposed system provides a trustworthy and data-driven environment that assists students in making informed academic decisions.

ABSTRACT The close network among shareholders has become a critical channel for the spread of market risk, where strategy adjustments based on intra-network information can trigger large-scale sell-offs and contribute to the formation of stock price crash risk. Based on the perspective of the common shareholder network of funds, this paper examines its intrinsic link with the risk of stock price crash, as well as the mechanisms of risk contagion using a sample of funds listed among the top ten shareholders of A-share stocks from 2008 to 2023. Studies find that the higher a listed firm’s centrality in the common shareholder network of funds, the greater its stock price crash risk. Mechanism analyses indicate that network centrality attracts more analyst coverage, which in turn leads to information bias and also exacerbates firms’ selective information disclosure while reducing information transparency, thereby increasing crash risk. Moderating effect tests show that this positive relationship is more pronounced during economic downturns. Heterogeneity analyses further reveal that the effect is stronger for firms with lower media attention and for those located in eastern regions. This study provides new insights for preventing systemic financial risks and enhancing the stability of capital markets.

Systematic reviews and meta-analyses serve as the cornerstone of clinical guidelines, yet their validity hinges on the currency of the included evidence. The publication lag measured as the interval from the last search date to online publication remains unclear in top-tier general medical journals and the Cochrane Database of Systematic Reviews (CDSR). Existing data are largely outdated and lack exploration of associated factors. Our study aims to fill this gap by quantifying the current publication lag in top-tier general medical journals and the CDSR and identifying its independent predictors. This meta-epidemiological study will analyze interventional, RCT-based meta-analyses published in top-tier general medical journals and the CDSR between 2023 and 2025. We will calculate the publication lag, assess compliance with AMSTAR 2 timeliness standards, and compare the performance between top-tier general medical journals and the CDSR. Multivariable regression analysis will be employed to determine independent factors which associated with the extent of publication delay. Our study will systematically quantify the current status and determinants of publication lag in top-tier general medical journals and the CDSR. While our reliance on publicly available dates precludes a granular distinction between author-related revisions and editorial processing durations, this limitation may introduce information bias. Specifically, if certain journals attract more complex reviews requiring extensive author revisions, the observed lag may overstate editorial inefficiency. Conversely, high-performance editorial workflows might mask prolonged author delays. By acknowledging these potential directions of bias, our findings will provide a more nuanced, actionable framework for assessing evidence currency. https://osf.io/cjtk.