Prevalence Rates Range Research Articles

Prevalence and Characteristics of Adults with Difficult-to-Treat Rheumatoid Arthritis in a Large Patient Registry.

An estimated 5-20% of patients with rheumatoid arthritis (RA) fail multiple treatments and are considered "difficult-to-treat" (D2T), posing a substantial clinical challenge for rheumatologists. A European Alliance of Associations for Rheumatology (EULAR) task force proposed a definition of D2T-RA in 2021. We applied EULAR's D2T definition in a cohort of patients with established RA to assess prevalence and we compared clinical characteristics of participants with D2T-RA with matched comparisons. Data from the longitudinal Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) registry was used. Participants were classified as D2T if they met EULAR's definition. A comparison group of non-D2T RA patients were matched 2:1 to every D2T patient, and differences in characteristics were evaluated in descriptive analyses. Prevalence rates of D2T were estimated using Poisson regression. We estimated the prevalence of D2T-RA to be 14.4 (95% CI: 12.8-16.3 per 100 persons) among 1,581 participants with RA, and 22.3 (95% CI: 19.9-25.0 per 100 persons) among 1,021 who were biologic/targeted synthetic DMARD experienced. We observed several differences in demographics, comorbidities, and RA disease activity between D2T-RA and non-D2T RA comparisons. Varying EULAR sub-criteria among all participants in BRASS resulted in a range of D2T-RA prevalence rates, from 0.6-17.5 per 100 persons. EULAR's proposed definition of D2T-RA identifies patients with RA who have not achieved treatment targets. Future research should explore heterogeneity in these patients and evaluate outcomes to inform the design of future studies aimed at developing more effective RA management protocols.

Prenatal opioid exposure by likelihood of exposure and risk to prenatal development: Medicaid-covered births in Wisconsin, 2010-2019.

Prenatal opioid exposure is an established public health problem, in particular among Medicaid-covered births. Yet, existing prevalence rates are plausibly underestimated. We leverage extensive linked longitudinal administrative data for all Medicaid-covered live births in Wisconsin from 2010 to 2019 to estimate a range of prevalence rates using an innovative strategy that jointly accounts for both likelihood of exposure and potential risk to prenatal development. We find that 20.8% of infants may have been prenatally exposed to opioids, with 1.7% diagnosed with neonatal abstinence syndrome and an additional 1.2% having a high combined likelihood of exposure and potential risk to prenatal development, 2.6% a moderate combined likelihood and risk, and 15.3% a low or uncertain combined likelihood and risk. We assess improvements in prevalence estimates based on our nuanced classification relative to those of prior studies. Our strategy could be broadly used to quantify the scope of the opioid crisis for pregnant populations, target interventions, and promote child health and development.

Microbiological Characteristics of Kidney Stones in Patients With Urolithiasis

Microbiological Characteristics of Kidney Stones in Patients With Urolithiasis

545 - Prevalence of moderate and severe atopic dermatitis in Ireland: a cross-sectional, real-world study of a secondary care population.

Abstract Introduction/Background Atopic dermatitis (AD) is a common chronic inflammatory skin disease with significant unmet needs globally.1 European prevalence rates range from up to 8% and 20% of adults and children respectively.2 In the E.U., a 12-month prevalence of AD has been reported at 4.4%.4 Self-reported moderate-to-severe AD affects between 46-66% of E.U. adult AD patients.4 However, global prevalence estimates vary widely. In Ireland, the epidemiology of AD is not fully understood. Objectives The aim of this study was to estimate the prevalence of patients aged 12 years or older presenting to secondary care dermatology clinics in Ireland with moderate-to-severe AD. The primary objective was to estimate the prevalence of patients aged 12 years and over with moderate or severe AD within secondary care clinics in Ireland. Secondary objectives included estimating the prevalence and incidence of moderate-to-severe AD patients aged 12–17 and ≥ 18 years respectively within secondary care clinics in Ireland. Methods Three secondary care sites located in the south of Ireland collated the number of AD patients ≥ 12 years old (one visit per patient only) with moderate or severe AD presenting between August 2021 and March 2022. The aggregated six-month data from each site was expected to include all patients with AD being actively treated within secondary care in the Munster region. As this epidemiological study was exploratory in nature, no limit was placed on the volume of aggregated patient data collected. Prevalence of AD was standardised to the regional population by dividing the total number of patients with a clinic visit, by the regional population covered by the sites using the 2016 census data. Incidence of AD was standardised similarly by dividing the total number of new patients attending clinic by the regional population covered by the sites using the 2016 census data. The regional prevalence and incidence estimates were stratified by age group and gender and then multiplied by the total Irish population (per the 2016 county level census data) to estimate the national number of cases of moderate and severe AD in secondary care over a six-month period. Results The outcome of the analysis estimates an overall prevalence rate for moderate-to-severe AD in secondary care in Ireland of 2.893 patients per 10,000 people in the Irish population. The total estimated number of moderate-to-severe AD cases in secondary care was 1,141. The prevalence rate (95% CI) was 1.456 (1.236, 1.704) and 1.437 (1.218, 1.683) per 10,000 for patients with moderate AD and severe AD respectively. The highest overall prevalence rate of 6.03 patients per 10,000 of the Irish population was observed for patients aged 12–17 years with moderate-to-severe AD in secondary care. Amongst adults, similar prevalence rates were reported for moderate and severe AD patients (1.204 and 1.359 patients per 10,000 respectively) with the highest prevalence rates for 18–24 year olds (2.680 and 2.776 patients per 10,000 for moderate and severe AD respectively). An overall incidence rate of 0.385 patients per 10,000 (in 6-months) was observed for patients aged 12 years and older with moderate-to-severe AD in secondary care, with an estimated 152 new AD patients entering secondary care in Ireland in 6 months. Twenty percent of all current AD patients had attended their first secondary care AD clinic visit during the study period. Conclusions Considering E.U. prevalence estimates of AD4, the findings of this study suggest that a very small proportion of patients with moderate-to-severe AD are being seen in secondary care clinics in Ireland.

Thyroid Hemiagenesis: An Incidental Discovery during Treatment for Papillary Thyroid Carcinoma

Abstract Thyroid hemiagenesis (THA) is a rare congenital abnormality in which one of the thyroid lobes fails to develop normally. The prevalence rates range from 0.02% to 0.25%, with no gender preponderance and most commonly involve the left lobe. We report a case of left THA in a 37-year-old female that was found incidentally during total thyroidectomy for right papillary thyroid carcinoma. Most patients with THA are asymptomatic, however, may have subclinically raised thyroid-stimulating hormone levels or be predisposed to developing thyroid disorders such as nodular goiter, hyperthyroidism, Grave’s disease, Hashimoto’s thyroiditis, hyperparathyroidism, or malignancy. Usual imaging techniques such as ultrasonography, computed tomography, and magnetic resonance imaging allow the confirmation of diagnosis and provide clearer glandular and regional visualization. Additional modalities such as thyroid scintigraphy enable the functional assessment and identification of any suspicious nodules and aid in decision-making. THA is a very uncommon condition and the diagnosis is primarily made through imaging. Clinicians should be aware that this condition exists along with documented associations of concomitant thyroid disorders and malignancy.

Birth Outcomes of Twin’s Pregnancy and Associated Factors in Selected Public Hospitals of Addis Ababa, Ethiopia, 2022

Background: Twin birth is a type of multiple births when the mother gives birth to two offspring from the same pregnancy. The prevalence rates range from less than 8 twin pregnancies per 1,000 births in the East and Southern Asia, India, and Oceania to 17 or more per 1,000 births in Africa. There are factors to increase the negative birth outcome of twin delivery; from these, some of them are associated with increased maternal age, prim parity, low birth weight, chronic disease, low ANC follow-up, and PROM. Adverse birth outcome for twin delivery is a critical health issue in developing countries such as Ethiopia. It resulted in many bad consequences, neonatal and infant morbidity and mortality. Objective: The objective of this study was to assess birth out come and associated factors of twin’s pregnancy in selected public Hospitals, Addis Ababa, Ethiopia. Methods: Facility based cross sectional study was conducted on 246 maternal records of twin delivery in selected public hospitals of Addis Ababa to assess birth out come and associated factors of twin’s pregnancy from December, 2020-June, 2021.A pretested questionnaire which will be analyzed by SPSS and result will be reported in tables, bivariate and multivariate regression will be done to show correlations by Crude and adjusted odds ratio. A confidence limit of 95% and p- value less than 0.05 will be used as cut of point to see presence of statistical significance. Result: The prevalence of adverse birth outcome (Both maternal and fetal) among twin delivery in the three selected public hospitals of Addis Ababa is 234 (95%). majority, 156(63.4%) were in the age group 18-28 years, with the mean age of 29.78 and Standard deviation of±6.53.Most of the mothers 227(92%) were married. Mothers who had Pregnancy induced hypertension (AOR= 10.465, 95% CI (2.922-37.474)), Mothers who had ruptured membrane before the onset of Labor (AOR= 3.577, 95% CI (1.198-10.682)) and Mothers who labor for more than 12 hours were (AOR= 3.324, 95% CI (1.101-10.034)) were significantly associated with adverse maternal birth outcome. While mothers who had ANC follow up at private clinic (AOR= 0.252, 95% CI (0.098-0.649)) and Mothers who live outside Addis Ababa were unlikely to have adverse fetal outcome (AOR= 0.343, 95% CI (0.143-0.826)). Conclusion: Adverse birth outcome of Twins pregnancy is relatively higher when compared to similar studies conducted in Ethiopia. The Health facilities should have effective risk assessment in Antenatal care unit and labor ward. It is also recommended to have guidelines and protocols for the management of twin’s pregnancy. Since the Prevalence of Adverse twin’s Birth outcome is higher greater attention should be given on both Antepartum and Intrapartum care.

Dual strategy involving hospital-based study and community-based screening to eliminate hepatitis C in remote areas

Background/Purpose: To achieve the World Health Organization goal of eliminating viral hepatitis by 2030, a key strategy in resource-limited areas is to identify the areas with high prevalence and to prioritize screening and treatment intervention. We hypothesized that a hospital-based laboratory database could be used to estimate the township- and village-specific anti-hepatitis C virus (HCV) prevalence. MethodsYunlin County Public Health Bureau has been collecting anti-HCV test data from eight major hospitals. Township- and village-specific screening testing rates and anti-HCV prevalence were calculated for residents 40 years or older. A township with a wide range of anti-HCV prevalence rates was selected for outreach universal screening and for validating the village-specific prevalence of anti-HCV in the analysis of the data from the hospitals. ResultsThe overall anti-HCV screening testing rate in Yunlin County was 30.4 %, whereas the anti-HCV prevalence rate for persons 40 years or older was 15.4 %. The village-specific anti-HCV prevalence rates ranged from 3.8 % to 85.8 %. Community-based screening was conducted in Kouhu Township. The village-specific anti-HCV prevalence rates ranged from 0 % to 18.8 %. Three of the four villages had the highest village-specific anti-HCV prevalence in the community-based study and the hospital-based study. Additionally, 95.8 % of the new HCV cases detected by universal screening received anti-HCV therapy. ConclusionThe hospital-based database provided a framework for identifying the villages with high anti-HCV prevalence. Additionally, community-based universal screening should be prioritized for villages with high prevalence in hospital-based databases.

CO2 laser deroofing technique: A robust and effective treatment for hidradenitis suppurativa regardless of comorbidities (a retrospective study of 334 lesions in 130 treated patients)

AbstractBackgroundHidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the terminal hair follicles in areas rich in apocrine glands. The condition most commonly manifests in the axillae, inframammary areas and genitofemoral region. Prevalence rates range between 1% and 4%. The management of HS encompasses both medical and surgical treatments, with surgical options including wide excision and carbon dioxide (CO2) laser‐assisted deroofing.ObjectivesThe aim of this study is to characterize patients with HS and to evaluate the efficacy of CO2 laser‐assisted deroofing technique in the treatment of chronic HS lesions with a particular focus on recurrence rates.MethodsThis retrospective study included a cohort of 130 Danish patients treated at the Department of Dermatology, Aarhus University Hospital, Denmark, over a 4‐year period. All participants met the established criteria for HS and were treated using the deroofing technique. Data were manually extracted from the electronic patient record and subjected to statistical analysis using Microsoft Excel 2016 and STATA version 15. Kaplan−Meier survival curves were generated, and comparisons were made using the Log‐rank test.ResultsA total of 334 lesions were treated using the deroofing technique; 15.4% had Hurley stage I, 56.9% had Hurley stage II and 27.7% Hurley stage III. Recurrence was seen in 59 of 334 lesions (17.7%), affecting a total of 47 patients. Risk of recurrence was highest during the first 20 months.ConclusionsThis study confirms that CO2 laser deroofing is an effective treatment for chronic HS elements, demonstrating a low recurrence rate. Results showed that factors such as age, sex, diabetes, smoking habits, location of the treated area and lesion size did not significantly influence the risk of recurrence. However, patients with a body mass index greater than 25 showed a borderline significant increased risk of recurrence. The deroofing technique is robust and serves as an important tool in the surgeon's armamentarium.

The Effect of Digital Gaming Duration on Musculoskeletal System Symptoms: A Systematic Study

The aim of this study is to review the existing literature on the musculoskeletal system symptoms associated with digital gaming. Literature related to the subject was searched in Web of Knowledge, PubMed, Medline, PsycINFO, Proquest, Google Scholar, and Sport Discuss databases. Articles published from 2010 to 2022 were scanned using keywords describing digital gaming-related postural disturbances, and musculoskeletal system exposure (pain, muscle activity). The articles were independently scanned by three authors, the relevant data were extracted, and the methodological quality of the included studies was evaluated. A total of 1252 articles were scanned for eligibility. Eleven articles are included in the study. Systematic reviews and meta-analysis studies were not included in our study. A wide range of prevalence rates of musculoskeletal complaints in different body regions has been reported, with the highest prevalence commonly found in neck complaints. This review has only found some evidence showing that a neck flexion posture as well as the frequency of digital gaming are associated with musculoskeletal disorders and pain, postural disorders among users of digital devices. The findings were presented and discussed in relation to the effects of digital games on posture and the musculoskeletal system. There is limited evidence that digital gaming and its various aspects (occupancy and properties) are associated with musculoskeletal system symptoms and exposures. Therefore, it is considered that evidence-based guidelines should be presented by experts for the wise use of digital games.

3. Pain originating from the lumbar facet joints.

Pain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well-designed studies, the prevalence is generally between 10% and 20%, increasing with age. The literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized. There are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni- or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non-dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After "red flags" are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation. Well-selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.

Determining a Worldwide Prevalence of Oculocutaneous Albinism: A Systematic Review.

The aim of this systematic review was to investigate the available data on the epidemiology of oculocutaneous albinism (OCA) around the world, and to determine whether a generalizable, worldwide prevalence figure could be proposed. Extensive literature search strategies were conducted, interrogating PubMed, Scopus, and Web of Science, to locate relevant literature. Ultimately 34 studies reporting original data were included for analysis. Findings showed that most data were outdated, and only 6 of 34 articles (18%) were published after 2010. There were few good studies with sound methodology and large, clearly defined population samples. Only a small proportion of countries worldwide (26/193 [13%]) have produced prevalence figures for OCA. By continent, African studies were disproportionately represented (15/34 [44%]). The highest prevalence rates (range, 1 in 22 to 1 in 1300; mean, 1 in 464) were reported in population isolates. The mean prevalence from four African countries was 1 in 4264 (range, 1 in 1755 to 1 in 7900). Prevalence for three countries in Europe (mean, 1 in 12,000; range, 1 in 10,000 to 1 in 15,000) may be underestimated, as the phenotype, in fair-skinned populations, may be missed or misdiagnosed as ocular albinism or isolated visual impairment. Population rates may vary depending on local cultural factors (e.g., consanguineous matings) and may change over time. The prevalence of OCA varies widely between continents and population groups, and it is often influenced by local factors. It was not possible, therefore, to determine a single, generalizable worldwide prevalence rate for OCA, although continental rates for Africa and Europe are useful.

Pleural effusion in critically ill patients and intensive care setting.

Pleural effusion usually causes a diagnostic dilemma with a long list of differential diagnoses. Many studies found a high prevalence of pleural effusions in critically ill and mechanically ventilated patients, with a wide range of variable prevalence rates of up to 50%-60% in some studies. This review emphasizes the importance of pleural effusion diagnosis and management in patients admitted to the intensive care unit (ICU). The original disease that caused pleural effusion can be the exact cause of ICU admission. There is an impairment in the pleural fluid turnover and cycling in critically ill and mechanically ventilated patients. There are also many difficulties in diagnosing pleural effusion in the ICU, including clinical, radiological, and even laboratory difficulties. These difficulties are due to unusual presentation, inability to undergo some diagnostic procedures, and heterogenous results of some of the performed tests. Pleural effusion can affect the patient's outcome and prognosis due to the hemodynamics and lung mechanics changes in these patients, who usually have frequent comorbidities. Similarly, pleural effusion drainage can modify the ICU-admitted patient's outcome. Finally, pleural effusion analysis can change the original diagnosis in some cases and redirect the management toward a different way.

National Estimates of Narcolepsy in Korea

Epidemiological data on narcolepsy are rare in South Korea. We aimed to provide an overview of the burden of narcolepsy and its temporal trend in South Korea. Patients with narcolepsy were identified by their registration in the Rare and Intractable Disease (RID) register and the Health Insurance Review and Assessment database. Individuals registered in the RID program with the code V234 were considered as having 'definite narcolepsy', while those who claimed health insurance with G47.4 as the primary diagnostic code were considered as having 'probable narcolepsy'. We estimated the annual prevalence, incidence, and medical costs of narcolepsy between 2010 and 2019. The prevalence of definite narcolepsy was 8.4/100,000 in 2019, peaking at 32.0/100,000 in those aged 15-19 years. The prevalence was higher in males, with a relative risk of 1.72. The prevalence has increased over the past 6 years, with an average annual growth rate (AAGR) of 12.2%. The prevalence of probable narcolepsy was 10.7/100,000 in 2019. The incidence of definite narcolepsy increased up to 1.3/100,000 in 2019 with an AAGR of 7.1%. Annual medical expenditure for definite narcolepsy gradually increased up to 4.1 billion KRW in 2019, with a compound annual growth rate of 11.9%. This study has provided the first nationwide estimates for narcolepsy in South Korea. The prevalence of diagnosed narcolepsy in South Korea was at the low end of the range of narcolepsy prevalence rates reported for other countries. However, the prevalence and incidence have been steadily increasing over the past decade.

THE TOLL OF BINGE EATING ON AGING: THE PHYSICAL FUNCTIONING OF OLDER WOMEN WITH WEEKLY BINGE EATING

Abstract Binge eating (BE) is defined as eating an unusually large amount of food while feeling a loss of control; BE prevalence rates range from 12-26% in older adult women. BE is closely linked with obesity, depression, and poor micronutrient intake, as well as with cardiovascular issues and pain in younger populations. Among older adults, such morbidities can negatively affect quality of life and mobility. Yet, little is known about the toll of BE on the aging body in terms of physical function. Thus, the current investigation assessed the physical functioning of older women (60+ years) with clinical levels of BE (i.e., ≥weekly BE). Participants (N = 21) underwent several physical function tests including lower extremity functioning (Short Physical Performance Battery; SPPB), endurance (Six-Minute Walk Test), and grip strength. The majority of participants (76%) had a BE age of onset in midlife or later (age 42+). The average BMI was 35.08±8.64, and 90.48% met criteria for overweight or obesity. On the SPPB, 47.62% scored < 10, suggesting mobility limitations and predicting all-cause mortality. Most women (90.48%) scored >1SD below the age/gender matched norm on the Six-Minute Walk Test (M=355.96±67.04) while 61.9% scored >1SD below the norm for grip strength (M=24.91±6.40). Results indicate that older women struggling with BE also demonstrate diminished physical functioning, which confers risk for future health problems and poorer quality of life. Our findings suggest that intervention development for older populations struggling with BE may need to incorporate physical rehabilitation to promote healthy aging in this population.

MODERN METHODS OF ROSACEA TREATMENT

Rosacea is a chronic inflammatory dermatosis that mainly affects the cheeks, nose, chin and forehead. Rosacea usually begins between the ages of 30 and 50, but can occur at any age. Population prevalence rates range from < 1 to 22%, but these percentages are likely influenced by differences in study design, methodology, population, geographic location, and cultural and social differences. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia, and the eyes may be involved. Due to the fact that rosacea affects the face, patients with this pathology often have low self-esteem and are prone to anxiety and depression, because this disease has a cosmetic defect. In addition to general skin care, there are several approved treatment options available to address these issues, both topical and systemic. For some functions, intense pulsed light, laser, and surgery are valuable. Recent advances in basic science have highlighted the role of the innate and adaptive immune system, as well as neurovascular dysregulation, underlying the spectrum of clinical manifestations of rosacea. Endogenous and exogenous stimuli can initiate and exacerbate multiple pathways in patients with rosacea.
 With the updated diagnosis and classification of rosacea, treatment options for patients with rosacea have attracted the attention of dermatologists. Here, we summarize the latest advances in the treatment of rosacea, including skin care and cosmetic procedures, topical therapy, oral therapy, laser and light therapy, injection therapy, and combination therapy.

Prevalence of Cam-Type Femoroacetabular Impingement Morphology in Hip Joint of Asymptomatic Thai Population

Objective: To determine the prevalence of cam-type femoroacetabular impingement (FAI) in the hip joints of asymptomatic Thai individuals using increased alpha angle of more than 55° on computed tomography (CT) images. Materials and Methods: The prospective study was conducted between 2019 and 2021. CT images of the 226 hip joints with no history of hip pain within three months prior to CT, no history of congenital dysplasia, Perthes disease, slipped capital femoral epiphysis, hip fracture, hip surgery, and inflammatory arthropathy, negative anterior impingement test, and no CT findings of osteoarthritis were evaluated. Alpha angles were measured in the axial oblique and radial planes at 12 o’clock, 1 o’clock, 1:30 o’clock, 2 o’clock, and 3 o’clock. Alpha angles of more than 55° were considered cam-type FAI morphology. Results: The prevalence rates of cam-type FAI morphology using increased alpha angles of more than 55° measured on axial oblique and radial plane images at 12 o’clock, 1 o’clock, 1:30 o’clock, 2 o’clock, and 3 o’clock were 0.4%, 0%, 4.9%, 8.4%, 8.0%, and 1.8% respectively. Cam-type morphology was common in the anterosuperior aspect of the femoral head-neck junction. The prevalence of cam-type morphology was significantly higher in men than in women. Conclusion: The range of prevalence rates of cam-type FAI morphology are between 0 to 8.4%. The prevalence is different in each image plane and location of the femoral head-neck junction. The prevalence of cam-type morphology in the present study differed from those in the previous studies conducted in other countries, which may be caused from variations in race and ethnicity. Keywords: Prevalence; Cam-type Femoroacetabular Impingement (FAI); Alpha angle; Computed tomography (CT)

Estimating risk ratio from any standard epidemiological design by doubling the cases

BackgroundDespite the ease of interpretation and communication of a risk ratio (RR), and several other advantages in specific settings, the odds ratio (OR) is more commonly reported in epidemiological and clinical research. This is due to the familiarity of the logistic regression model for estimating adjusted ORs from data gathered in a cross-sectional, cohort or case-control design. The preservation of the OR (but not RR) in case-control samples has contributed to the perception that it is the only valid measure of relative risk from case-control samples. For cohort or cross-sectional data, a method known as ‘doubling-the-cases’ provides valid estimates of RR and an expression for a robust standard error has been derived, but is not available in statistical software packages.MethodsIn this paper, we first describe the doubling-of-cases approach in the cohort setting and then extend its application to case-control studies by incorporating sampling weights and deriving an expression for a robust standard error. The performance of the estimator is evaluated using simulated data, and its application illustrated in a study of neonatal jaundice. We provide an R package that implements the method for any standard design.ResultsOur work illustrates that the doubling-of-cases approach for estimating an adjusted RR from cross-sectional or cohort data can also yield valid RR estimates from case-control data. The approach is straightforward to apply, involving simple modification of the data followed by logistic regression analysis. The method performed well for case-control data from simulated cohorts with a range of prevalence rates. In the application to neonatal jaundice, the RR estimates were similar to those from relative risk regression, whereas the OR from naive logistic regression overestimated the RR despite the low prevalence of the outcome.ConclusionsBy providing an R package that estimates an adjusted RR from cohort, cross-sectional or case-control studies, we have enabled the method to be easily implemented with familiar software, so that investigators are not limited to reporting an OR and can examine the RR when it is of interest.

Investigating of the role of CT scan for cancer patients during the first wave of COVID-19 pandemic.

Amidst this current COVID-19 pandemic, we undertook this systematic review to determine the role of medical imaging, with a special emphasis on computed tomography (CT), on guiding the care and management of oncologic patients. Study selection focused on articles from 01/02/2020 to 04/23/2020. After removal of irrelevant articles, all systematic or non-systematic reviews, comments, correspondence, editorials, guidelines and meta-analysis and case reports with less than 5 patients were also excluded. Full-text articles of eligible publications were reviewed to select all imaging-based publications, and the existence or not of an oncologic population was reported for each publication. Two independent reviewers collected the following information: ( 1) General publication data; (2) Study design characteristics; (3) Demographic, clinical and pathological variables with percentage of cancer patients if available; (4) Imaging performances. The sensitivity and specificity of chest CT (C-CT) were pooled separately using a random-effects model. The positive predictive value (PPV) and negative predictive value (NPV) of C-CT as a test was estimated for a wide range of disease prevalence rates. A total of 106 publications were fully reviewed. Among them, 96 were identified to have extractable data for a two-by-two contingency table for CT performance. At the end, 53 studies (including 6 that used two different populations) were included in diagnosis accuracy analysis (N = 59). We identified 53 studies totaling 11,352 patients for whom the sensitivity (95CI) was 0.886 (0.880; 0.894), while specificity remained low: in 93% of cases (55/59), specificity was ≤ 0.5. Among all the 106 reviewed studies, only 7 studies included oncologic patients and were included in the final analysis for C-CT performances. The percentage of patients with cancer in these studies was 0.3% (34/11352 patients), lower than the global prevalence of cancer. Among all these studies, only 1 (0.9%, 1/106) reported performance specifically in a cohort of cancer patients, but it however only reported true positives. There is a concerning lack of COVID-19 studies involving oncologic patients, showing there is a real need for further investigation and evaluation of the performance of the different medical imaging modalities in this specific patient population.

Constructions and Comparisons of Pooling Matrices for Pooled Testing of COVID-19.

In comparison with individual testing, group testing is more efficient in reducing the number of tests and potentially leading to tremendous cost reduction. There are two key elements in a group testing technique: (i) the pooling matrix that directs samples to be pooled into groups, and (ii) the decoding algorithm that uses the group test results to reconstruct the status of each sample. In this paper, we propose a new family of pooling matrices from packing the pencil of lines (PPoL) in a finite projective plane. We compare their performance with various pooling matrices proposed in the literature, including 2D-pooling, P-BEST, and Tapestry, using the two-stage definite defectives (DD) decoding algorithm. By conducting extensive simulations for a range of prevalence rates up to 5%, our numerical results show that there is no pooling matrix with the lowest relative cost in the whole range of the prevalence rates. To optimize the performance, one should choose the right pooling matrix, depending on the prevalence rate. The family of PPoL matrices can dynamically adjust their construction parameters according to the prevalence rates and could be a better alternative than using a fixed pooling matrix.

Use of the Washington Group Questions in Non-Government Programming.

The Washington Group questions (WGQ) on functioning have been widely promoted as the go-to tool for disability data collection. Designed for use by government, the WGQ have been adopted by non-government organizations (NGOs) for use in programming. However, little is known about how the WGQs are being used by NGOs or how use may be contributing to disability inclusion. Method: This paper describes exploratory research on the use of the WGQ in NGO programming. An online survey provided an overview of adoption followed by semi-structured interviews from a purposive sample to explore data collection, analysis, and use. Results: Thematic analysis showed limited inclusion outcomes directly attributable to use of the WGQ, adoption driven by individual champions rather than systematically across organizations, and challenges in data collection resulting in a wide range of prevalence rates. What information the WGQ can realistically contribute to programs was also overestimated. However, the process of using the WGQ was raising awareness on disability inclusion within program teams and communities. Conclusion: Acknowledging differences in emerging use by NGOs beyond the WGQ’s intended purpose, alongside promoting a flexible and staged approach to adoption and use in programming, may improve utility and disability inclusion outcomes over time.