Bias ; Coronavirus Infections ; epidemiology ; transmission ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology ; transmission ; Uncertainty

Arm ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Carboplatin ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Maintenance Chemotherapy ; Ovarian Neoplasms ; Prognosis ; Quality of Life ; Recombination, Genetic ; Sample Size

bias of 0.005 (95% CI −0.011 to 0.021) with 95% limits of agreement of −0.16 to 0.17 between vFFR and FFR. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.0%, 87.1%, 72.5%, 58.7%, and 92.6%, respectively, using the FFR cutoff of 0.80. They were 87.0%, 95.0%, 80.0%, 54.3%, and 98.5%, respectively, with the FFR cutoff of 0.75. The area under the receiver-operating characteristics curve of vFFR versus obstructive CTA stenosis was 0.88 versus 0.61 for the FFR cutoff of 0.80, respectively; it was 0.94 versus 0.62 for the FFR cutoff of 0.75.CONCLUSION: Our novel, fully automated, on-site vFFR technology showed excellent diagnostic performance for the detection of lesion-specific ischemia.]]>
Angiography ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Fractional Flow Reserve, Myocardial ; Humans ; Ischemia ; Patient-Specific Modeling ; Sensitivity and Specificity

bias. In addition, there were no significant differences in intensive care unit (ICU) mortality, in-hospital mortality, 28-day mortality, or ICU length of stay between the groups.CONCLUSION: Discontinuing NE prior to AVP was associated with a lower incidence of hypotension in patients recovering from septic shock. However, our results should be interpreted with caution, due to the considerable between-study heterogeneity.]]>
Arginine Vasopressin ; Arginine ; Bias (Epidemiology) ; Consensus ; Hospital Mortality ; Humans ; Hypotension ; Incidence ; Intensive Care Units ; Length of Stay ; Mortality ; Norepinephrine ; Odds Ratio ; Population Characteristics ; Sepsis ; Shock, Septic ; Treatment Outcome ; Vasoconstrictor Agents

Cardiovascular disease (CVD) is considered a primary driver of global mortality and is estimated to be responsible for approximately 17.9 million deaths annually. Consequently, a substantial body of research related to CVD has developed, with an emphasis on identifying strategies for the prevention and effective treatment of CVD. In this review, we critically examine the existing CVD literature, and specifically highlight the contribution of Mendelian randomization analyses in CVD research. Throughout this review, we assess the extent to which research findings agree across a range of studies of differing design within a triangulation framework. If differing study designs are subject to non-overlapping sources of bias, consistent findings limit the extent to which results are merely an artefact of study design. Consequently, broad agreement across differing studies can be viewed as providing more robust causal evidence in contrast to limiting the scope of the review to a single specific study design. Utilising the triangulation approach, we highlight emerging patterns in research findings, and explore the potential of identified risk factors as targets for precision medicine and novel interventions.
Artifacts ; Bias (Epidemiology) ; Cardiovascular Diseases ; Mendelian Randomization Analysis ; Mortality ; Precision Medicine ; Random Allocation ; Risk Factors

The accuracy and predictability of mixture models in NONMEM® may change depending on the relative size of inter-individual differences and the size of the differences in the parameters between subpopulations. This study explored the accuracy of mixture models when dealing with missing a categorical covariate under various situations that may occur in reality. We generated simulation data under various scenarios where genotypes representing extensive metabolizers (EM) and poor metabolizers (PM) of drug-metabolizing enzymes affect the clearance of a drug by different degrees, and the inter-individual variations in clearance are different for each scenario. From each simulated datum, a specific proportion of the covariate (genotype information) was randomly removed. Based on these simulation data, the proportion of each individual subpopulation and the clearance were estimated using a mixture model. Overall, the clearance estimate was more accurate when the difference in clearance between subpopulations was large, and the inter-individual variations were small. In some scenarios that showed higher ETA or epsilon shrinkage, the clearance estimates were significantly biased. The mixture model made better predictions for individuals in the EM subpopulation than for individuals in the PM subpopulation. However, the estimated values were not significantly affected by the tested ratio, if the sample size was secured to some extent. The current simulation study suggests that when the coefficient of variation of inter-individual variations of clearance exceeds 40%, the mixture model should be used carefully, and it should be taken into account that shrinkage can bias the results.
Bias (Epidemiology) ; Genotype ; Sample Size

bias factor of this study and further studies supplementing these factors are needed.]]>
Bias (Epidemiology) ; Cognition ; Humans ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pilot Projects ; Placebos ; Prefrontal Cortex ; Sample Size ; Transcranial Magnetic Stimulation ; Treatment Outcome

OBJECTIVE: To investigate feasibility of recruitment, tablet use in intervention delivery, and use of self-report outcome measures and to analyze the effect of Energy Conservation plus Problem-Solving Therapy versus Health Education interventions for individuals with heart failure-associated fatigue.METHODS: This feasibility study was a block-randomized controlled trial involving 23 adults, blinded to their group assignment, in a rural southern area in the United States. Individuals with heart failure and fatigue received the interventions for 6 weeks through videoconferencing or telephone. Participants were taught to solve their fatigue-related problems using energy conservation strategies and the process of Problem-Solving Therapy or educated about health-related topics.RESULTS: The recruitment rate was 23%. All participants completed the study participation according to their group assignment, except for one participant in the Energy Conservation plus Problem-Solving Therapy group. Participants primarily used the tablet (n=21) rather than the phone (n=2). Self-report errors were noted on Activity Card Sort (n=23). Reported fatigue was significantly lower for both the Energy Conservation plus Problem-Solving Therapy (p=0.03, r=0.49) and Health Education (p=0.004, r=0.64) groups. The Health Education group reported significantly lower fatigue impact (p=0.019, r=0.48). Participation was significantly different in low-physical demand leisure activities (p=0.008; r=0.55) favoring the Energy Conservation plus Problem-Solving Therapy group.CONCLUSION: The recruitment and delivery of the interventions were feasible. Activity Card Sort may not be appropriate for this study population due to recall bias. The interventions warrant future research to reduce fatigue and decrease participation in sedentary activities (Clinical Trial Registration number: NCT03820674).
Adult ; Bias (Epidemiology) ; Fatigue ; Feasibility Studies ; Health Education ; Heart Failure ; Heart ; Humans ; Leisure Activities ; Occupational Therapy ; Outcome Assessment (Health Care) ; Rehabilitation ; Telephone ; United States ; Videoconferencing

Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I² index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.
Bias (Epidemiology) ; Leishmania braziliensis ; Leishmaniasis ; Leishmaniasis, Cutaneous ; Methods ; Parasites ; Population Characteristics ; Publication Bias ; Skin ; Sudden Infant Death ; Ulcer ; World Health Organization

Over the last decade, genome-wide association studies (GWASs) have provided an unprecedented amount of genetic variations that are associated with various phenotypes. However, previous GWAS were mostly conducted in European populations, and these biased results for non-Europeans may result in a significant reduction in risk prediction for non-Europeans. An issue with the early GWAS was the winner's curse problem, which led to misleading results when constructing the polygenic risk scores (PRS). Therefore, more non-European population-based studies are needed to validate reported variants and improve genetic risk assessment across diverse populations. In this study, we validated 422 variants independently associated with glycemic indexes, liver enzymes, and type 2 diabetes in 125,872 samples from a Korean population, and further validated the results by assessing publicly available summary statistics from European GWAS (n = 898,130). Among the 422 independently associated variants, 284, 320, and 361 variants were replicated in Koreans, Europeans, and either one of the two populations. In addition, the effect sizes for Koreans and Europeans were moderately correlated (r = 0.33–0.68). However, 61 variants were not replicated in both Koreans and Europeans. Our findings provide valuable information on effect sizes and statistical significance, which is essential to improve the assessment of disease risk using PRS analysis.
Asian Continental Ancestry Group ; Bias (Epidemiology) ; Genetic Variation ; Genome-Wide Association Study ; Glycemic Index ; Humans ; Liver ; Phenotype ; Polymorphism, Single Nucleotide ; Risk Assessment