Statistical Significance In Study Research Articles

The association of Metabolic Syndrome and its Components with the Incidence and Survival of Colorectal Cancer: A Systematic Review and Meta-analysis

Background: This meta-analysis was aimed to quantitatively assess the associations of metabolic syndrome (MetS) and its components with colorectal cancer (CRC).Methods: PubMed, EMBASE and Web of Science databases were systematically searched for eligible studies. A total of 18 studies for CRC incidence and 12 studies for CRC mortality were identified.Results: MetS was associated with an increased risk of CRC incidence and mortality in male (RR: 1.28, 95 % CI 1.16-1.39, and 1.24, 1.18-1.31, respectively) and correlated with an increased risk of CRC incidence in female (RR: 1.21, 1.13-1.30), but not with CRC mortality in female. MetS increased the risk of cancer-specific mortality (RR: 1.72, 1.03-2.42), but not overall mortality. The risk estimates of CRC incidence changed little depending on age, sex, cancer site, the type of studies, ethnicity, publication year, or definition of MetS. As for CRC mortality, further stratified analyses indicated statistical significance in studies with assessing cancer-specific survival outcome, in male, a cohort design, ethnicity of non-Chinese or with definition of MetS as ≥ 3 metabolic abnormalities. Obesity and hyperglycemia are risk factors of CRC incidence in both male and female. Only dysglycemia is the risk factor for CRC mortality.Conclusions: MetS is associated with an increased risk of CRC incidence and cancer-specific mortality, but not overall mortality. In addition, MetS may increase the CRC mortality in male rather than in female. However, since most of the studies on CRC mortality were conducted in Chinese, further studies are needed to clarify this connection.

Clinical Versus Statistical Significance in Studies of Thoracic Malignancies.

Clinical Versus Statistical Significance in Studies of Thoracic Malignancies.

Prevalencija i korelacija upotrebe kontracepcije kod žena reproduktivnog doba u Srbiji

Background/Aim. Analysis of prevalence and correlation of contraceptive use among women of reproductive age (15 to 49 years) in Serbia. Methods: Raper is based on data from a national health survey of the population of Serbia in 2013 (no data for Kosovo and Metohija). For the purposes of study, the data on households and population age 15 and over were used, so that the final sample for analysis entered 3.634 women of reproductive eage. χ2 test was applied to test the difference in frequency of categorical variables. Logistic regression analysis was applied to examine the correlates of female contraceptive use in Serbia. Results with probability that is equal to or les sthan 5% (p≤0.05) were considered statistically significant. Results: Overall contraceptive prevalence in women of reproductive age was 34.8%. Five variables had a significant connection with the use of contraceptives among women: age, education, marital status, residence region, index of wellbeing. Two variables had no statistical significance in study: employment status, type of settlement. Conclusions: Based on results, we can conclude that the prevalence of use of contraceptives among women in Serbia is relatively low and therefore reproductive health of women is endangered to agre at extent.

Comparative safety and effectiveness of coronary computed tomography: Systematic review and meta-analysis including 11 randomized controlled trials and 19,957 patients

Background/objectivesThe clinical approach to suspected or established coronary artery disease (CAD) has been revolutionized in the last few decades by coronary computed tomography (coroCT). Yet, uncertainty persists on its comparative diagnostic and clinical effectiveness. We conducted a systematic review on randomized controlled trials (RCTs) of coroCT. MethodsWe searched RCTs in PubMed and The Cochrane Library, extracting as outcomes of interest long-term rates of death, myocardial infarction, revascularization, and invasive coronary angiography. Effects were estimated with risk ratios (RR) and 95% confidence intervals. ResultsA total of 11 trials were included, with 19,957 patients followed for a median of 6months. One trial focused on screening, 3 on stable CAD, and 7 on acute CAD. Meta-analysis showed that coroCT was associated with a trend toward fewer deaths or myocardial infarctions (RR=0.84 [0.70–1.01]) whereas no significant difference was found for the risk of death (RR=0.91 [0.71–1.18]). Conversely, the risk of myocardial infarction tended to be lower with coroCT at the overall analysis (RR=0.77 [0.59–1.02]), and this effect reached statistical significance in studies focusing on subjects with stable CAD (RR=0.69 [0.49–0.99]). These potential benefits were offset (or mediated) by a significant albeit modest increase in the need for invasive angiography (RR=1.36 [1.08–1.72]), and ensuing coronary revascularization (RR=1.76 [1.29–2.40]). ConclusionsAccording to the current evidence base, coroCT is associated with an increased usage of invasive angiography and coronary revascularization when compared to standard of care, with possible benefits on nonfatal myocardial infarction, but without significant benefits on death or the composite of death or myocardial infarction.

The Impact of Hering's Law in Blepharoptosis: Literature Review.

The aim of this literature review is to examine Hering's law, a well-documented phenomenon in blepharoptosis patients, with 10% to 20% noted in cases of unilateral ptosis. Predominantly presenting as contralateral eyelid drop postoperatively, it poses a challenge for eyelid surgeons in the pursuit of symmetry and appropriate eyelid height. Proper preoperative evaluation is of utmost importance, consisting of one of either lifting test, covering test, or phenylephrine test. A deeper understanding of Hering's law further provides adequate information for optimal management of ptosis. In regard to ptosis etiology, congenital ptosis does not appear to have a distinct relation to positive Hering's law, commonly associated with a low incidence, when compared with acquired ptosis. Ptosis in the dominant eye seems to be related to a higher incidence of the phenomenon than ptosis in the nondominant eye, with statistical significance in studies ranging from P < 0.001 to P = 0.09. This can be explained as an innate response for increased innervation to regain the field of vision. Both ptosis severity and levator function appear to be of lesser importance than ptosis etiology, with minimal incidence of Hering's law in congenital ptosis regardless of these factors. It is, however, noted that ptosis severity has direct association with contralateral eyelid position in acquired ptosis, whereas there is a lack of studies for levator function. In the event of preoperative contralateral eyelid drop, surgeons should consider simultaneous surgery instead of delayed surgery for bilateral ptosis (P = 0.002). For unilateral ptosis, although reoperation is done per patient request, it may be more appropriate to first wait for roughly 2 weeks and reassess for self-regulation to a normal eyelid position.

Establishment of an index with increased sensitivity for assessing murine arthritis

The goals of our study were to establish quantitative outcomes for assessing murine knee arthritis and develop an Arthritis Index that incorporates multiple outcomes into a single calculation that provides enhanced sensitivity. Using an accepted model of meniscal/ligamentous injury (MLI)-induced osteoarthritis (OA), we assessed mouse knee arthritis using several approaches. Histology-based methods were performed to visualize joint tissues including articular cartilage and subchondral bone. Accepted histologic scoring methods and histomorphometry were performed to grade cartilage degeneration and determine articular cartilage area, respectively. MicroCT was used to visualize and quantify the bony structures of the joint including osteophytes and joint bone volume. A statistical algorithm was then developed that combined histologic scores and cartilage areas into a single Arthritis Index. MLI induced progressive, OA-like articular cartilage degeneration characterized by increasing (worsening) histologic score and decreasing cartilage area. MicroCT revealed osteophytes and increased joint bone volume between the femoral and tibial physes following MLI. Lastly, an Arthritis Index calculation was established, which incorporated histologic scoring and cartilage area. The Arthritis Index provided enhanced quantitative sensitivity in assessing the level of joint degeneration compared to either histologic scoring or cartilage area determination alone; when using the Index, between 29% and 43% fewer samples are needed to establish statistical significance in studies of murine arthritis. Arthritis in the mouse knee can be quantitatively assessed by histologic scoring, measuring cartilage area, and determining joint bone volume. Enhanced sensitivity can be achieved by performing the Arthritis Index calculation, a novel method for quantitatively assessing mouse knee arthritis.

Schizophrenia and Obsessive-Compulsive Disorder

Back to table of contents Previous article Next article Communications and UpdatesFull AccessSchizophrenia and Obsessive-Compulsive DisorderKavi Devulapalli, B.A, M.P.H., and Henry A. Nasrallah, M.D.Kavi DevulapalliSearch for more papers by this author, B.A, M.P.H., and Henry A. NasrallahSearch for more papers by this author, M.D.Published Online:1 Nov 2010https://doi.org/10.1176/appi.ajp.2010.10081111AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: In the July 2010 issue of the Journal, Carolyn I. Rodriguez, M.D., Ph.D., et al. (1) presented an interesting case illustrating the complexities of co-occurring psychotic and obsessive-compulsive disorders (OCD). The authors should be commended for their careful review of the differential diagnosis and treatments for a patient presenting with these intertwined symptoms.In the case study, the patient was found to have manifested obsessive compulsive symptoms prior to his first psychotic episode. Such a presentation is consistent with the results of a meta-analysis we conducted regarding the temporal relationship of OCD and schizophrenia in patients suffering from both disorders (2). Our analysis showed that in patients diagnosed with both disorders, OCD tends to precede schizophrenia by 1 year. While our study did not find this result to be statistically significant, it did nearly reach significance (p=0.066), suggesting the potential for statistical significance in studies with a larger sample size. Clearly, Dr. Rodriguez et al.'s suggestions for longitudinal studies of young people at risk for psychosis or OCD would provide for much needed insight into the epidemiology and clinical phenomenology of cooccurring obsessive compulsive and psychotic symptoms.In their discussion of the potential adverse drug-drug interactions between clozapine and fluvoxamine, the authors appropriately mentioned cytochrome 3A4. We would like to also mention that cytochrome 1A2 is even more significantly involved in the metabolism of clozapine (3). As a strong inhibitor of cyto-chrome 1A2, combining fluvoxamine with clozapine in patients suffering from both OCD and treatment-resistant schizophrenia may produce serious adverse effects. Further, nicotine in tobacco is an inducer of cytochrome 1A2 and may lead to attenuation of the efficacy of clozapine unless the dose is increased.Cleveland, OhioCincinnati, Ohioaccepted for publication in August 2010.Dr. Nasrallah has received research grant support from Forest, Janssen, Otsuka, and Shire; and he has served on the advisory board or speaker's bureau of AstraZeneca, Janssen, Merck, Novartis, Pfizer, and Sepracor. Dr. Devulapalli reports no financial relationships with commercial interests.

Predictive validity of the Family Attitude Scale in people with psychosis

Expressed Emotion (EE) strongly predicts relapse in mental disorders, but there remains a need to develop and refine brief, self-report measures. This article describes two studies testing the validity of a self-report measure of criticism or burden, the Family Attitude Scale (FAS), in relatives of patients with psychosis. Study 1 had 54 families of patients with psychosis and a substance use disorder, while Study 2 had 61 families of patients at an early psychotic episode. In Study 1, a consensus FAS was obtained; in Study 2 separate parental scores were used. The FAS was positively associated with EE, and with relationship negativity. Associations with negative caregiving experiences or stress were restricted to maternal or consensual FAS ratings. FAS scores predicted relapse in both studies, although prediction at the optimal cutoff (≥ 60) only reached statistical significance in Study 2, and time to relapse was only predicted by the FAS in Study 1. Prediction of relapse from the CFI was stronger, and the FAS did not add to that prediction. Results supported the utility of the FAS, but confirmed the pre-eminence of the CFI as a household-related predictor of relapse.

Cytosine Arabinoside Induces Programmed Endothelial Cell Death Through the Caspase-3 Pathway

The anti-cancer effects of cytosine arabinoside (ARA-C) are well known. However, effects on nonmalignant cells have not been elucidated and may be important to understanding treatment-related toxicity. The purpose of this study was to examine the effect of ARA-C on nondividing vascular endothelial cells. The objectives were to determine the effects of ARA-C on cell viability and to ascertain whether ARA-C caused apoptosis in cultured vascular endothelial cells and hydrocortisone blunted caspase-3-induced apoptosis. Endothelial cells were cultured until confluent and mitotically quiescent then exposed to ARA-C (10(-7)to 10(-3) M) for 1 to 4 days. Some experiments involved cotreatment with hydrocortisone (10(-11),10(-10),10(-4), and 10(-3) M). Light microscopy and the colorimetric MTS assay were used to measure viability. Fluorescent annexin-V and DNA fragmentation assays were used to measure apoptosis, and a fluorescence-based enzymatic assay was used to measure caspase-3 activity, which is one pathway involved in the apoptosis cascade. Two-way ANOVA or the appropriate nonparametric test was used to determine statistical significance in studies of viability and apoptosis. Oneway ANOVA was used to determine statistical significance for caspase-3 activity. Viability was decreased with higher concentrations of ARA-C and increased days of treatment. The percentage of apoptotic cells increased with higher concentrations of ARA-C and increased days of treatment. ARA-C-treated samples showed DNA fragmentation, indicative of apoptosis. Caspase-3 activity increased after ARA-C addition; hydrocortisone blunted this increase. ARA-C caused apoptosis in nondividing endothelial cells in culture. Hydrocortisone may protect against ARA-C-induced apoptosis by reducing caspase-3 activity.

Mature results from three large controlled studies with raltitrexed ('Tomudex').

Since the publication of the results of phase I dose-finding studies, an extensive phase II and III clinical study programme has been undertaken to study the clinical efficacy and tolerability of the quinazoline folate analogue raltitrexed ('Tomudex'), a novel direct and specific inhibitor of thymidylate synthase. Two international phase III trials, studies 3 and 12, have compared raltitrexed 3 mg m(-2) with 5-fluorouracil (5-FU) plus low-dose leucovorin (LV) (Mayo regimen) or high-dose LV (Machover regimen) respectively. A North American study (study 10) was originally set up to compare two raltitrexed dosage arms (3.0 and 4.0 mg m[-2]) with 5-FU and low-dose LV, but the 4.0 mg m(-2) arm was discontinued prematurely because of excessive toxicity. Minimum follow-up times for studies 3, 10 and 12 were 15.5, 12 and 9 months, respectively (for data other than survival), with corresponding survival follow-up times of 26, 12 and 17 months. Objective response rates were similar for raltitrexed and 5-FU + LV, and palliative improvements were seen to a similar extent with both treatments in all phase III studies. Survival was statistically similar for raltitrexed and 5-FU + LV in both studies 3 and 12. Raltitrexed was, however, associated with inferior survival to 5-FU + low-dose LV in study 10, but there appears to be evidence that this was linked to an unconscious effect on investigator behaviour of early toxicity problems in this trial, in that patients appeared to be withdrawn from raltitrexed treatment without progression or protocolled toxicity. Moreover, it appeared that 5-FU + LV patients were continued on treatment after disease progression. 5-FU-based therapy was associated with a higher incidence of mucositis than raltitrexed in all studies, with the attainment of statistical significance in studies 3 and 12. Elevations in hepatic transaminase levels were seen with raltitrexed, but these are thought to be of no clinical significance. Overall, much greater levels of toxicity were seen with 5-FU + LV than with raltitrexed in early treatment cycles. In addition, retrospective UK audit data have shown the monthly cost of raltitrexed therapy to be similar to that of Mayo and continuous infusion 5-FU regimens, and appreciably lower than that of the de Gramont regimen of 5-FU (bolus + 22-h infusion) + high-dose LV. Thus, raltitrexed is an effective alternative to 5-FU-based therapy in patients with advanced colorectal cancer, with an acceptable and, unlike 5-FU, predictable toxicity profile. In particular, patients receiving raltitrexed may benefit from the minimization or avoidance of mucositis, and both patients and healthcare providers may find the convenient administration schedule of the drug advantageous.

Choosing tests of statistical significance in studies of social interactive behaviour: A critical note on murray, hayes, and smith (1978)

Significant chi-square differences for boys and girls on variables of observational period and adult presence-absence, reported by Murray, Hayes, and Smith (1978), were found to be not significant when analysed by the Wilcoxon matched-pairs signed-rank test and t test. The discrepancy between the outcomes of the different analyses is seen to be related to the inappropriateness of chi-square as a test of significance using behavioural data which have been summed across individuals within the sample (Cochran, 1954; Lewis & Burke, 1949). Appropriate ways of using chi-square to analyse social interacuon and other methods of analysis, including analysis of variance, information analysis and transition probability, are reviewed.