Displaying publications 1 - 20 of 235 in total

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  1. Arasan, Jayanthi
    MyJurnal
    This paper investigates several asymptotic confidence interval estimates, based on the Wald, likelihood ratio and the score statistics for the parameters of a parallel two-component system model, with dependent failure and a time varying covariate, when data is censored. This model is an extension of the bivariate exponential model. The procedures are investigated via a coverage probability study using the simulated data. The results clearly indicate that the interval estimates, based on the likelihood ratio method, work better than any of the other two methods when dealing with the censored data.
    Matched MeSH terms: Confidence Intervals
  2. Fauziah Maarof, Lim, Fong Peng, Noor Akma Ibrahim
    MyJurnal
    This paper investigates the confidence intervals of R2 MAD, the coefficient of determination based on
    median absolute deviation in the presence of outliers. Bootstrap bias-corrected accelerated (BCa)
    confidence intervals, known to have higher degree of correctness, are constructed for the mean and standard deviation of R2 MAD for samples generated from contaminated standard logistic distribution. The results indicate that by increasing the sample size and percentage of contaminants in the samples, and perturbing the location and scale of the distribution affect the lengths of the confidence intervals. The results obtained can also be used to verify the bound of R2 MAD.
    Matched MeSH terms: Confidence Intervals
  3. Tan, Yih Tyng, Abdul Rahman Othman, Lai, Choo Heng
    MyJurnal
    Setting a question paper for test, quiz, and examination is one of the teachers’ tasks. The factors that are usually taken into consideration in carrying out this particular task are the level of difficulty of the questions and the level of the students’ ability. In addition, teachers will also have to consider the number of questions that have impact on the examination. This research describes a model-based test theory to study the confidence intervals for the projected number of items of a test, given the reliability of the test, the difficulty of the question, and the students’ ability. Using the simulated data, the confidence intervals of the projected number of items were examined. The probability coverage and the length of the confidence interval were also used to evaluate the confidence intervals. The results showed that the data with a normal distribution, the ratio variance components of 4:1:5 and reliability equal to 0.80 gave the best confidence interval for the projected number of items.
    Matched MeSH terms: Confidence Intervals
  4. Samira Ehsani, Jayanthi Arasan, Noor Akma Ibrahim
    Sains Malaysiana, 2013;42:981-987.
    In this paper, we extended a repairable system model under general repair that is based on repair history, to incorporate covariates. We calculated the bias, standard error and RMSE of the parameter estimates of this model at different sample sizes using simulated data. We applied the model to a real demonstration data and tested for existence of time trend, repair and covariate effects. Following that we also conducted a coverage probability study on the Wald confidence interval estimates. Finally we conducted hypothesis testing for the parameters of the model.The results indicated that the estimation procedure is working well for the proposed model but the Wald interval should be applied with much caution.
    Matched MeSH terms: Confidence Intervals
  5. Kiani K, Arasan J, Habshah Midi
    Sains Malaysiana, 2012;41:471-480.
    There are numerous parametric models for analyzing survival data such as exponential, Weibull, log-normal and gamma. One of such models is the Gompertz model which is widely used in biology and demography. Most of these models are extended to new forms for accommodating different types of censoring mechanisms and different types of covariates. In this paper the performance of the Gompertz model with time-dependent covariate in the presence of right censored data was studied. Moreover, the performance of the model was compared at different censoring proportions (CP) and sample sizes. Also, the model was compared with fixed covariate model. In addition, the effect of fitting a fixed covariate model wrongly to a data with time-dependent covariate was studied. Finally, two confidence interval estimation techniques, Wald and jackknife, were applied to the parameters of this model and the performance of the methods was compared.
    Matched MeSH terms: Confidence Intervals
  6. Yii, Mei Wo, Zaharuddin Ahmad
    MyJurnal
    The studies of ¹³⁷Cs content in the seawater surrounding Peninsular Malaysia had been carried out as part of the Malaysia Marine Radioactivity Database Project. The results of the measurement will serve as the baseline data and reference level to Malaysia. A numbers of sampling locations, including coastal and offshore at the East Coast (South China Sea) and West Coast (Straits of Malacca) of Peninsular Malaysia had been selected for the study. From each location at the coastal area, water samples were collected from the surface of the seawater. Meanwhile, for the offshore area, water samples have been collected at three different depths. Due to usual low concentration of ¹³⁷Cs in the marine environment, large volumes of seawater were collected and the co precipitation technique was employed to concentrate the ¹³⁷Cs. The activity of ¹³⁷Cs was determined by measuring the peak area under photo peak of the gamma spectrum at 661 keV, which is equivalent to the gamma intensity corrected to the HpGe detection efficiency and percentage of gamma ray abundance of the ¹³⁴Cs. At each study location, there were no significant differences for ¹³⁷Cs activities at 95% confidence interval. The activities of ¹³⁷Cs found to be quite uniformly distributed in the range of 2.33 to 5.00 Bq/m3and 1.76 to 4.76 Bq/m3for the South China Sea and the Straits of Malacca, respectively.
    Matched MeSH terms: Confidence Intervals
  7. Piccini JP, Stromberg K, Jackson KP, Kowal RC, Duray GZ, El-Chami MF, et al.
    Europace, 2019 Nov 01;21(11):1686-1693.
    PMID: 31681964 DOI: 10.1093/europace/euz230
    AIMS: Patient selection is a key component of securing optimal patient outcomes with leadless pacing. We sought to describe and compare patient characteristics and outcomes of Micra patients with and without a primary pacing indication associated with atrial fibrillation (AF) in the Micra IDE trial.

    METHODS AND RESULTS: The primary outcome (risk of cardiac failure, pacemaker syndrome, or syncope related to the Micra system or procedure) was compared between successfully implanted patients from the Micra IDE trial with a primary pacing indication associated with AF or history of AF (AF group) and those without (non-AF group). Among 720 patients successfully implanted with Micra, 228 (31.7%) were in the non-AF group. Reasons for selecting VVI pacing in non-AF patients included an expectation for infrequent pacing (66.2%) and advanced age (27.2%). More patients in the non-AF group had a condition that precluded the use of a transvenous pacemaker (9.6% vs. 4.7%, P = 0.013). Atrial fibrillation patients programmed to VVI received significantly more ventricular pacing compared to non-AF patients (median 67.8% vs. 12.6%; P 

    Matched MeSH terms: Confidence Intervals
  8. Fatahi S, Kord-Varkaneh H, Talaei S, Mardali F, Rahmani J, Ghaedi E, et al.
    PMID: 31582198 DOI: 10.1016/j.numecd.2019.07.011
    BACKGROUND AND AIM: Although some earlier studies have indicated the effect of phytosterol (PS) supplementation on serum lipoprotein(a) (Lp(a)) and free fatty acid (FFA) concentration, findings are still conflicting. We aimed to assess the impact of PS supplementation on serum Lp(a) and FFA concentration through a systematic review and meta-analysis of available RCTs.

    METHODS AND RESULTS: We performed a systematic search of all available RCTs conducted up to 21 February 2019 in the following databases: PubMed, Scopus, and Cochrane. The choice of fixed- or random-effect model for analysis was determined according to the I2 statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Pooling of 12 effect sizes from seven articles revealed a significant reduction of Lp(a) levels following PS supplementation (MD: -0.025 mg/dl, 95% CI: -0.045, -0.004, p = 0.017) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.599). Also, PS supplementation significantly lowered FFA (MD: -0.138 mg/dl, 95% CI: -0.195, -0.081, p = 0.000) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.911). The results for meta-regression and sensitivity analysis were not significant.

    CONCLUSION: The meta-analysis suggests that oral PS supplementation could cause a significant reduction in serum Lp(a) and FFA.

    Matched MeSH terms: Confidence Intervals
  9. Wan Nor Arifin, Wan Arfah Nadiah, Muhammad Irfan, Chen, Xin Wee, Nani Draman, Nyi, Nyi Naing
    MyJurnal
    To ensure the reliability of manual blood pressure (BP) readings in a clinical trial, sources of error due to measurement must be reduced as much as possible. Apart from following standard procedure for BP measurement and ensuring good equipments, the measurement errors that come from the assessors themselves should be assessed. Objective: To demonstrate the use of two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) intraclass correlation coefficient (ICC) in the assessment of reliability of manual BP readings among assessors involved in a clinical trial using manual BP measurement, by using an interrater reliability study conducted by the authors as an example study. Methods: The steps involved in obtaining ICC in the study were discussed. Sample size given the number of assessors in the study was calculated. BP was measured using regularly maintained mercury sphygnomanometers, following recommendations by Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) for BP measurement in office setting. The outcomes were systolic and diastolic BP readings. A type of ICC, two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) ICC was chosen for the analysis and specifically discussed. Pre-requisite assumptions for ICC were meticulously checked and described. The interrater reliability for systolic and diastolic BP readings as expressed by ICC (single measure) were presented with confidence interval (CI). The ICCs obtained in the example study were discussed and concluded. The flaws of the study were also criticised. Results: The interrater reliability for systolic and diastolic BP measurements as expressed by ICC (single measure) were 0.87 (95% confidence interval [CI] 0.722, 0.956) and 0.77 (95% CI 0.560, 0.918) respectively. Conclusion: We demonstrated the steps required to obtain ICC. Since the use of manual BP measurement using mercury sphygmomanometer is still considered as gold standard of BP measurement, it is important that studies in which the BP outcome is measured using such method conduct interrater reliability studies properly.
    Matched MeSH terms: Confidence Intervals
  10. Iliassa II, Mohammad WM, Tan JJ, Ayob Y
    Asian J Transfus Sci, 2016 Jul-Dec;10(2):145-9.
    PMID: 27605853 DOI: 10.4103/0973-6247.187934
    BACKGROUND: Cryoprecipitate is generally used to treat bleeding patients with hypofibrinogenemia, and the transfusion decision is guided based on published guidelines.
    AIM: This study aimed to evaluate the practice appropriateness in accordance to cryoprecipitate transfusion guidelines in Hospital Kuala Lumpur.
    METHODOLOGY: This cross-sectional study of 117 cryoprecipitates transfused adult patients was conducted in Kuala Lumpur Hospital from January to June 2012. The compliance of the indication of cryoprecipitate was considered as appropriate if indicated for patients who have hypofibrinogenemia (<1.0 g/L) with bleeding, or otherwise inappropriate if pretransfusion fibrinogen level was more than 1.0 g/L, pretransfusion fibrinogen level was not examined and posttransfusion fibrinogen level more than 1.5 g/L.
    RESULTS: Most of the cryoprecipitate prescriptions were found to be inappropriate, which read 81.2% (95% confidence interval = 0.740, 0.880). Patients who underwent neurovascular surgery were the major recipient of cryoprecipitate, but majority of the prescription was found not appropriate. The decision to transfuse cryoprecipitate was found mostly appropriate when was guided by fibrinogen (52.2%), but the percentage dropped to 10.6% when pretransfusion fibrinogen test was not performed. Regrettably, only 19.7% of total cryoprecipitate were given based on pretransfusion fibrinogen level.
    KEYWORDS: Appropriateness; bleeding; cryoprecipitate transfusion; guideline
    Matched MeSH terms: Confidence Intervals
  11. Yong, W.Z., Haresh, K.K., Wong, W.C., 1 Pui, C.F., Son, R.
    MyJurnal
    The objectives highlighted in the present study were to determine the estimates of measurement uncertainty associated with PALCAM and CHROMagarTM Listeria media, to compare the efficacy between both media in relation to their measurement uncertainties. In addition, this study was carried out to assess the performance characteristics of spread and spiral plating procedures based on the comparison of Listeria monocytogenes enumeration between PALCAM and CHROMagarTM Listeria media. This work involved pure culture experiment, artificially contaminated samples experiment and naturally contaminated samples experiment. In pure culture experiment, PALCAM performance was relatively inferior to CHROMagarTM Listeria medium for both plating procedures. From the artificially contaminated samples, the results revealed that the values of repeatability, reproducibility, and measurement uncertainty at 95% confidence interval were comparable between both media under evaluation. However, at the level of naturally contaminated samples, the performance of CHROMagar
    TM Listeria medium was refutable as the presence of high number of competitive microorganisms reduced the clarity of the medium. The current emphasis in ensuring microbiological safety which requires use of accredited laboratories has led to measurable need for measurement uncertainty to ensure reliability of test results for global acceptance.
    Matched MeSH terms: Confidence Intervals
  12. Titik, B., Naiyana, C.
    MyJurnal
    The objectives of this study were predicting the transmission and survival of L. monocytogenes in cooked ham during supply chain. Cooked ham are frequently contaminated with L. monocytogenes during postprocessing steps through contact on surface of processing, handling, packaging equipment. Transfer rate of L. monocytogenes on static and dynamic condition in various surface type was investigated. The prevalence and level of L. monocytogenes in cooked ham at plant as well as the prevalence of unsatisfactory processing at retail were studied. A Monte Carlo simulation model was created by using @risk. The simulation predicted that the prevalence was 11.76 % with 90% confidence interval of 2% to 25% and estimated level was -4.02 log CFU/cm2. It was estimated to be occurred on slicing step at plant. Our results suggest that, the prevalence and level of L. monocytogenes can be reduced by Good Handling Process application and/or HACCP application.
    Matched MeSH terms: Confidence Intervals
  13. Springer SA, Di Paola A, Barbour R, Azar MM, Altice FL
    J. Acquir. Immune Defic. Syndr., 2018 09 01;79(1):92-100.
    PMID: 29781884 DOI: 10.1097/QAI.0000000000001759
    OBJECTIVE: To determine whether extended-release naltrexone (XR-NTX) would improve or maintain viral suppression (VS) among incarcerated individuals with HIV and alcohol use disorders (AUDs) transitioning to the community.

    DESIGN: A randomized, double-blind, placebo-controlled trial was conducted among incarcerated individuals with HIV and AUDs transitioning to the community from 2010 through 2016.

    METHODS: Eligible participants (N = 100) were randomized 2:1 to receive 6 monthly injections of XR-NTX (n = 67) or placebo (n = 33) starting at release and continued for 6 months. The primary and secondary outcomes were the proportion that maintained or improved VS at <200 and <50 copies per milliliter from baseline to 6 months, respectively, using an intention-to-treat analysis.

    RESULTS: Participants allocated to XR-NTX improved VS from baseline to 6 months for <200 copies per milliliter (48.0%-64.2%, P = 0.024) and for <50 copies per milliliter (31.0%-56.7%, P = 0.001), whereas the placebo group did not (<200 copies/mL: 64%-42.4%, P = 0.070; <50 copies/mL: 42.0%-30.3%, P = 0.292). XR-NTX participants were more likely to achieve VS than the placebo group at 6 months (<200 copies/mL: 64.2% vs. 42.4%; P = 0.041; <50 copies/mL: 56.7% vs. 30.3%; P = 0.015). XR-NTX independently predicted VS [<200 copies/mL: adjusted odds ratio (aOR) = 2.68, 95% confidence interval (CI) = 1.01 to 7.09, P = 0.047; <50 copies/mL: aOR = 4.54; 95% CI = 1.43 to 14.43, P = 0.009] as did receipt of ≥3 injections (<200 copies/mL: aOR = 3.26; 95% CI = 1.26 to 8.47, P = 0.010; <50 copies/mL: aOR = 6.34; 95% CI = 2.08 to 19.29, P = 0.001). Reductions in alcohol consumption (aOR = 1.43, 95% CI = 1.03 to 1.98, P = 0.033) and white race (aOR = 5.37, 95% CI = 1.08 to 27.72, P = 0.040) also predicted VS at <50 copies per milliliter.

    CONCLUSIONS: XR-NTX improves or maintains VS after release to the community for incarcerated people living with HIV and AUDs.

    Matched MeSH terms: Confidence Intervals
  14. Gallo V, Vineis P, Cancellieri M, Chiodini P, Barker RA, Brayne C, et al.
    Int J Epidemiol, 2019 Jun 01;48(3):912-925.
    PMID: 30462234 DOI: 10.1093/ije/dyy230
    BACKGROUND: The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait.

    METHODS: A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset.

    RESULTS: Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking <20 years were 0.84 [95% confidence interval (CI) 0.67-1.07], 20-29 years 0.73 (95% CI 0.56-0.96) and >30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding.

    CONCLUSIONS: These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.

    Matched MeSH terms: Confidence Intervals
  15. Rajah R, Hassali MAA, Murugiah MK
    Public Health, 2019 Feb;167:8-15.
    PMID: 30544041 DOI: 10.1016/j.puhe.2018.09.028
    OBJECTIVES: Health literacy is increasingly recognized as a public health concern. Most of the literature on health literacy concentrate in the Western countries. Therefore, this study aimed to systematically review and examine the available studies on health literacy in Southeast Asian countries and estimate its prevalence in this region.

    STUDY DESIGN: Systematic review.

    METHODS: A search for relevant articles was carried out using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE (via EBSCOhost), Scopus, Science Direct, PubMed and Google Scholar with multiple search terms. Inclusion criteria comprised articles published in English language and assessing general health literacy. Risk of bias reduced with the involvement of two independent reviewers in the screening of the literature and the quality assessment process.

    RESULTS: A total of 11 studies were included, which only consist of studies from five countries out of 11 making up the Southeast Asian region. The overall prevalence of limited health literacy varied considerably, 1.6%-99.5% with a mean of 55.3% (95% confidence interval [CI]: 35.1%-75.6%). A much higher prevalence was noted in studies conducted in healthcare settings, 67.5% (95% CI: 48.6%-86.3%). The most common factors associated with limited health literacy were education attainment, age, income and socio-economic background. Other factors identified were gender and health behaviours.

    CONCLUSIONS: In summary, despite the little evidence available and existences of high heterogeneity among studies, limited health literacy is still prevalent in Southeast Asian countries. Urgent strategies to improve and promote health literacy in the region are highly warranted. Besides, more studies on health literacy with better quality on the methodology aspect are needed.

    Matched MeSH terms: Confidence Intervals
  16. New, C.Y., Ubong, A., Nur Hasria, K., Nur Fatihah, A., Son, R.
    MyJurnal
    Vibrio parahaemolyticus is well known to be abundantly distributed in marine, coastal and
    estuarine environments. Since 1951, V. parahaemolyticus had been the source of numerous
    outbreaks related to contaminated or mishandled seafood. However, V. parahaemolyticus
    had been detected on other types of food. This issue has prompted this study to investigate
    on the prevalence of V. parahaemolyticus in various food samples and determine the risk
    associated with it. The results of the MPN-plating technique of the study indicated that V.
    parahaemolyticus was detected in seafood (33.3%, 95% Confidence Interval [CI] 31.9 – 34.8 ,
    94 – 290 MPN/g) and vegetables (10.0%, 95% CI 9.7 – 10.3 , 9.2 – 23 MPN/g) while negative
    V. parahaemolyticus was detected in fruits (0.0%, 95% CI 0 – 1,
    Matched MeSH terms: Confidence Intervals
  17. Dzulkarnain AAA, Sani MKA, Rahmat S, Jusoh M
    J Audiol Otol, 2019 Jul;23(3):121-128.
    PMID: 30857383 DOI: 10.7874/jao.2018.00381
    BACKGROUND AND OBJECTIVES: There is a scant evidence on the use of simulations in audiology (especially in Malaysia) for case-history taking, although this technique is widely used for training medical and nursing students. Feedback is one of the important components in simulations training; however, it is unknown if feedback by instructors could influence the simulated patient (SP) training outcome for case-history taking among audiology students. Aim of the present study is to determine whether the SP training with feedback in addition to the standard role-play and seminar training is an effective learning tool for audiology case-history taking.

    SUBJECTS AND METHODS: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals.

    RESULTS: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05).

    CONCLUSIONS: The SP training (with/ without feedback) is a beneficial learning tool for history taking to students in audiology major.

    Matched MeSH terms: Confidence Intervals
  18. Lall P, Saifi R, Baggio D, Schoenberger SF, Choo M, Gilbert L, et al.
    Asia Pac J Public Health, 2019 Apr;31(3):227-237.
    PMID: 30983376 DOI: 10.1177/1010539519841294
    Malaysia currently has an estimated hepatitis C virus (HCV) prevalence of 1.3% with an infected population of 384,000. Fishermen in Malaysia are at risk of HCV infection due to injection drug use and disproportionately high rates of incarceration. This study used quantitative data from Project WAVES, a large-scale mixed methods project charting environmental drivers of risk-taking behaviors among a respondent-driven sample of 406 fishermen in Malaysia. Over a quarter of participants (27.9%) reported injecting drugs in the past month; 49.8% of the sample tested positive for HCV. Respondents who had previously been arrested displayed increased odds of being HCV-positive (adjusted odds ratio = 4.79, confidence Interval = 2.46-9.35). Participants who reported being in lock-up displayed close to 6-fold odds of being HCV-infected (adjusted odds ratio = 5.49, confidence interval = 2.77-10.90, P < .001). These findings underscore the need for policies and structural interventions targeting the negative effects of aggressive incarceration contributing to the burden of HCV among high-risk communities.
    Matched MeSH terms: Confidence Intervals
  19. Low SK, Giannis D, Bahaie NS, Trong BLH, Moris D, Huy NT
    Am. J. Clin. Oncol., 2019 Aug;42(8):668-674.
    PMID: 31343423 DOI: 10.1097/COC.0000000000000575
    OBJECTIVES: Patients with neuroendocrine tumors (NETs) are at increased risk of mortality from competing causes in light of the improvement in overall survival over recent decades. The purpose of this study was to explore the competing causes of deaths and the risk factors associated with competing mortality.

    MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results database was used to identify patients diagnosed with NETs between 1973 and 2015. Risk of competing mortality was estimated by the standardized mortality ratios (SMRs) and by using the Fine and Gray multivariate regression model.

    RESULTS: Of the 29,981 NET patients, 42.5% of the deaths that occurred during follow-up were attributed to competing causes (83.9% from noncancer causes and 16.1% from second primary neoplasms). Overall SMR of competing mortality was 2.50 (95% confidence interval [CI]: 2.43-2.56). The SMR of noncancer causes was 2.65 (95% CI: 2.58-2.73), with the highest risk present within the first year of diagnosis. The SMR of second primary neoplasms was 1.91 (95% CI: 1.79-2.04), with the highest risk observed after 10-year postdiagnosis. A drastic rise in competing mortality was observed in the last decade between 2005 and 2015. Advanced age, black race, small intestinal and gastric NETs, and surgery were significantly associated with competing mortality. Female, pancreatic and recto-anal NETs, distant and regional spread, chemotherapy and radiotherapy were significantly associated with lower competing mortality.

    CONCLUSIONS: Competing mortality plays an increasingly significant role over the years and may hamper efforts made to improve survival outcomes in NET patients.

    Matched MeSH terms: Confidence Intervals
  20. He C, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al.
    Psychother Psychosom, 2019 Oct 08.
    PMID: 31593971 DOI: 10.1159/000502294
    BACKGROUND: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

    OBJECTIVE: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

    METHODS: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview.

    RESULTS: Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88).

    CONCLUSIONS: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.

    Matched MeSH terms: Confidence Intervals
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