Methods: We identified ARD patients through the Taiwan National Health Insurance Research Database from 2001 to 2012. From the general population, we randomly selected a comparison cohort that was frequency-matched by age (in 5-year increments), sex and index year. We analysed the risk of PD, stratified by sex, age and comorbidities, by using a Cox regression model.
Results: The risk of PD was 1.37 times greater in ARD patients than in controls after adjustment for age, sex, and comorbidities. ARD subgroups, such as the rheumatoid arthritis and Sjogren syndrome (SS) cohorts, were associated with a significantly higher risk of PD (adjusted hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.03–1.2 and adjusted HR, 1.56; 95% CI, 1.35–1.79, respectively). Furthermore, primary and secondary SS patients had significantly higher risks of PD (adjusted HR, 1.58; 95% CI, 1.32–1.88 and adjusted HR, 1.53, 95% CI, 1.23–1.90, respectively).
Conclusions: The risk of PD was significantly higher in the ARD patients. Prospective studies are needed to confirm whether ARDs indeed increase the risk of PD. 相似文献
Methods: Data were analyzed for 2671 men (≥40 years of age) who participated in the National Health and Nutrition Examination Survey (2005–2008). We define abdominal obesity as a waist circumference >102 cm. Men with Incontinence Severity Index ≥3 were defined as having UI. Logistic regression analyses were used to identify factors associated with stress and urge UI.
Results: Multivariate analysis found that in abdominal obese men, stress UI was associated with enlarged prostate (odds ratio [OR] = 2.20, 95% confidence interval [CI]: 1.16–4.16), chronic respiratory tract disease (OR = 2.78, 95% CI: 1.55–4.97), and major depression (OR = 4.79, 95% CI: 1.79–12.84). In non-obese men, arthritis was associated with stress UI (odds ratio = 3.37, 95% CI: 1.06–10.73). Urge UI in abdominally obese men was associated with age ≥65 years (OR = 1.67, 95% CI: 1.05–2.67), being non-Hispanic black (OR = 1.63, 95% CI: 1.06–2.52), and with enlarged prostate (OR = 2.30, 95% CI: 1.54–3.40), arthritis (OR = 1.39, 95% CI: 1.03–1.88), and major depression (OR = 2.96, 95% CI: 1.89–4.64). Urge UI in non-obese men was associated with current smoking (OR = 1.79, 95% CI: 1.01–3.17), major depression (OR = 2.60, 95% CI: 1.33–5.09) and vitamin D deficiency (OR = 1.61, 95% CI: 1.01–2.59).
Conclusion: Factors associated with urinary incontinence varied with abdominal obesity status and type of UI. The findings identify important contributors to urinary incontinence that clinicians should consider to help manage and effectively treat the condition. 相似文献
Design: Cross-sectional, self-administered survey.
Subjects: Three hundred and fifty two asthma patients (mean age 57.5 years) attending outpatient pulmonologist consultations in Riga, Latvia during September 2013 to December 2015. The sample size was calculated to detect a prevalence of poor asthma control of 50% with a margin of error of 5% and a power of 95%.
Main outcome measures: The validated Beliefs about Medication Questionnaire (BMQ) and the Brief Illness Perception Questionnaire (brief IPQ) were used. Good asthma control was assessed using the asthma control test (ACT), a validated five-item scale that reliably assesses asthma control over a recall period of four weeks. Logistic regression models were used to predict poor asthma control.
Results: Patients who had a good control of asthma medication (OR 0.70; 95% CI 0.61–0.79) or were confident that their asthma medication improves illness (OR 0.84; 95% CI 0.74–0.95) had a reduced risk of poor asthma control. The more symptoms (OR 1.63; 95% CI 1.44–1.84) the asthma patients perceived or the more their illness affects their life, the higher the probability of poor asthma control (OR 1.47; 95% CI 1.31–1.65). Some beliefs of necessity and concerns of asthma medication were also statistically significantly related to poor asthma control.
Conclusions: Beliefs of necessity of asthma medication, cognitive and emotional illness perception factors correlate well with poor asthma control in Latvian patients. 相似文献
Methods: A cohort of 1070 persons aged ≥60 with Geriatric Mental State (GMS) diagnoses of major and subthreshold depression, and data on health behaviour (smoking, alcohol, physical activity) and physical comorbidity (hypertension, diabetes, cardiovascular disease, stroke, chronic pulmonary disease, multi-comorbidity and activity of daily living disability) at baseline (15 Feb 2003 - 30 Mar 2004) were followed up on mortality from 1 Jan 2005 to 31 Dec 2012.
Results: Major and subthreshold depression was present in 5.1% and 9.9% of the participants at baseline. The all-cause mortality HR adjusted for age, sex, ethnicity and marital status was 1.73 (95% CI, 1.11-2.67) for major depression and 1.38 (95% CI, 0.96-1.97) for subthreshold depression. In hierarchical models, the addition of health behaviour and especially physical comorbidity substantially reduced the HR estimates for all-cause mortality associated with major depression (HR=1.39, 95% CI, 0.89-2.18) and subthreshold depression (HR=0.94, 95% CI, 0.64-1.37). Controlling for the effects of all variables, only major depression was significantly associated with increased cardiovascular disease and stroke mortality (HR=2.10, 95% CI, 1.07-4.11).
Conclusions: Both major and subthreshold depression were associated with increased mortality, largely due to hazardous behaviours and physical comorbidity. Only major depression per se was independently associated with excess cardiovascular disease and stroke mortality. 相似文献
Methods: From the National Health Insurance Research Database, we identified 300,649 patients who had asthma between 2000 and 2007 as an asthma cohort. We identified another matched non-asthma cohort. All subjects were followed until the end of 2008. A Cox model was used to estimate the association of asthma on the risk of HZ.
Results: Asthma cohort had significantly higher risk of developing HZ than the comparison cohort (HR=1.15; 95 % CI =1.06-1.26). However, compared to those without regular controller, asthma cohort with regular inhaled corticosteroid (ICS) treatment had slightly increased risk for HZ (HR=1.14; 95% CI=1.01-1.27) but decreased risk for HZ in those with regular combined ICS and Montelukast (HR=0.83; 95% CI=0.69-0.98). Uncontrolled asthma with more than 3-4 times ED visits and admissions per year had 3.72 (CI =1.86-7.47) and 20.5 (CI =10.2-41.2) greater risks for HZ than those without asthma, respectively.
Conclusions: Asthma poses an increased risk of zoster, therefore control of asthma is important to minimize risk of HZ. 相似文献
Methods: This cross-sectional study was conducted in rural areas of China, and 1,198 type 2 diabetic patients with complete data were recruited. Elevated ALT and AST levels were defined as >40 U/L. Prevalence of abnormal liver enzymes was analyzed and multivariable analysis was used to identify independent risk factors.
Results: 10.3% and 6.1% diabetic patients had elevated ALT and elevated AST, respectively. The prevalence of elevated liver enzymes was gender-related; it was 13.8% in men and 7.5% in women for elevated ALT, and 7.4% in men and 3.1% in women for elevated AST. High triglyceride was positively associated with both elevated ALT (OR 1.80, 95% CI 1.08–3.01, p = 0.024) and elevated AST (OR 2.24, 95%CI 1.08–4.65, p = 0.031), while taking anti-diabetes medicine was inversely related to both elevated ALT (OR 0.48, 95% CI 0.29–0.80, p = 0.005) and elevated AST (OR 0.37, 95% CI 0.17–0.82, p = 0.014). The risk of elevated ALT in diabetic patients increased with the presence of obesity (OR 2.54, 95% CI 1.07–6.01, p = 0.034), and was lower in women (OR 0.37, 95% CI 0.19–0.72, p = 0.003). Hypertension (OR 4.33, 95% CI 1.41–13.30, p = 0.011), current drinking status (OR 2.90, 95% CI 1.21–6.96, p = 0.017) and national minority (OR 3.26, 95%CI 1.31–8.12, p = 0.011) were risk factors for elevated AST.
Conclusion: A relatively high prevalence of abnormal serum liver enzymes in diabetic patients was demonstrated in China, especially in males. More attention should be paid to preventing liver injuries in diabetic patients. 相似文献
Methods: In this cross-sectional study, a total of 7135 adults (3320 men and 3815 women) aged 35 years or older were recruited from the rural Northeast China. Data on lifestyle factors, such as physical activities, sleep duration, current smoking and drinking status, dietary habits and familial factors were collected in interviews and laboratory examinations were performed by well-trained personnel.
Results: Plasma total homocysteine (tHcy) level was higher in men than in women, and greater in the elderly than in other age groups. Subjects with Hhcy were more likely to be current smokers (men: OR 1.328, 95% CI 1.143–1.543, p<0.001; women: OR 1.465, 95% CI 1.214–1.767, p<0.001). Separately, men with Hhcy were more likely to have an education of primary school or below (OR 1.251, 95% CI 1.068–1.465, p=0.006) and less likely to eat more vegetables (OR 0.927, 95% CI 0.863–0.996, p=0.037) than the normal-tHcy participants. In women, participants with Hhcy were more likely to have longer sleeping time (>9h/d) (OR 1.677, 95% CI 1.292–2.177, p<0.001), low physical activity (OR 1.721, 95% CI 1.197–2.475, p=0.044) and increased diet score (OR 1.126, 95% CI 1.007–1.259, p=0.037) and less likely to be current drinkers (OR 0.488, 95% CI 0.297–0.802, p=0.005) than the normal-tHcy participants.
Conclusion: Our study revealed that physical activity and current drinking status were not significantly associated with Hhcy in males, but inversely associated in females. In both genders, current smoking status and dietary habits were significantly associated with Hhcy. Our study supports existing recommendations for Chinese to maintain a physically active behaviors and healthy lifestyle habits. 相似文献
Method: Community-living diabetic and non-diabetic participants (N = 2696) aged 55 and above were assessed on CI (MMSE) and PF (CHS criteria) status. Among 486 diabetic persons, we estimated the odds ratio and 95% confidence intervals (OR, 95% CI) of association of CI and/or PF with prevalent IADL and ADL disability and mortality from 11 years of follow up.
Results: Diabetes was associated with significantly higher prevalence of CI and/or PF. Adjusted for sex, age, education, smoking, alcohol intake, physical activity, and BMI, diabetes was associated with higher prevalence of PF alone (OR = 2.24, 1.16–4.34) and PF with CI (OR = 2.01, 1.12–3.60), but not with CI alone (OR = 1.02, 0.73–1.44). In multivariable analyses of 486 diabetic older adults, compared to non-frail (NF) and cognitive normal (CN), CI alone was not significantly associated with IADL (OR = 1.06, 0.53–2.10), but PF alone was associated with considerably higher prevalence of IADL (OR = 6.72, 1.84–24.5). PF with CI was associated with the highest prevalence of IADL (OR = 17.8, 3.66–8.68) and ADL disability (OR = 93.8, 23.6–372.4). Whether singly or in combination, PF and/or CI were associated with worse hazard (HR) ratio for mortality outcomes: CI alone (HR = 2.72, 1.48–5.01), PF alone (HR = 4.30, 1.88–9.82) and CI with PF (HR = 8.41, 3.95–17.9).
Conclusion: Cognitive impairment and/or physical frailty are powerful prognostic factors identifying people with diabetes at high risk of mortality. 相似文献
Methods A systematic search was carried out in Pubmed, Web of Science, the Cochrane Library, Medline and Embase up to 19 April 2018. The pooled hazard ratio (HR) of overall survival (OS) and progression-free survival (PFS), the relative risk (RR) of objective response rate (ORR) were calculated.
Results Overall, a total of eight studies comprising 2979 patients were included. When generally comparing TP53 mutation group with TP53 wild-type group, we confirmed the prognostic value of poor OS of TP53 in EGFR mutant lung cancers (HR 1.73, 95% CI 1.22–2.44, P = 0.002). In subgroup analysis of OS, the prognostic value was maintained in patients treated with EGFR tyrosine kinase inhibitors (TKIs) but not in those treated with non-targeted therapy (HR 2.29, 95% CI 1.39–3.76, P = 0.001), and was also maintained in patients with advanced-stage lung cancers rather than those of all stages (HR 2.00, 95% CI 1.11–3.61, P = 0.021). For patients treated with EGFR TKIs, TP53 commutation was predictive of a poor PFS (HR 2.18, 95% CI 1.42–3.36, P < 0.001) but the prognostic value on ORR was not observed (RR 1.15, 95% CI 0.92–1.44, P = 0.212). Additional subgroup analysis based on TP53 mutation subtypes was not pooled due to limited data.
Conclusion Generally we confirmed the prognostic value of poor OS and PFS of TP53 commutation in EGFR mutant lung cancers, and it should be further investigated and validated regarding the prognostic role of TP53 mutation subtypes. 相似文献
Design: Prospective study.
Setting: MEDLINE (PubMed) and Google Scholar were searched for relevant publications from 1 January 2009 up until 31 August 2014.
Methods: Abstracts accepted for oral or poster presentation were identified from the original congress booklets from the Nordic Congresses of General Practice in 2009 and 2011. Based on PubMed and Google Scholar searches, we subsequently identified full journal publications within a 36-month follow-up from both congresses. In cases of doubt, the first author was contacted directly.
Main outcome measures: Full journal publication within 36 months after the congress.
Results: A total of 200 abstracts were analyzed. Of these, 85 (42.5%) were identified with a full publication within 36 months after the congress. More abstracts from the 2011 congress were published compared to the 2009 congress odds ratio (OR) 1.97, 95% confidence interval (CI) (1.10; 3.50). Abstracts accepted for oral presentation were more often published OR 1.94, 95% CI (1.08; 3.50) than accepted poster abstracts. In the multivariate analysis, a university affiliation for both first and last author increased the probability for publication OR 4.23, 95% CI (1.71; 10.42), as well as more than two authors. An optimal number, based on the highest OR, seems to be 3–4 authors with OR 2.43, 95% CI (1.07; 5.54). Qualitative studies were published at the same frequency as quantitative studies OR 1.36, 95% CI (0.57; 3.24).
Conclusion: Less than half of the abstracts accepted for oral or poster presentation at two consecutive Nordic Congresses of General Practice were published as full text articles within 36 months.
- Key points
Congress abstracts accepted for Nordic Congress of General Practice are not indexed in international search databases.
Less than half of the abstracts accepted for oral or poster presentation at two consecutive Nordic Congresses of General Practice were published as full text articles within 36 months.
Future congress committees could address this aspect in order to increase the visibility of and accessibility to research within the field of general practice.
Material and methods: 3033 subjects underwent a symptom-limited bicycle exercise test. Exercise capacity was defined as the mean of last four minutes of exercise workload.
Results: During an average follow-up of 19 years, 186 (11.6%) CVD and 370 (20.6%) all-cause deaths in men and 57 (5.0%) CVD and 155 (12.5%) all-cause deaths in women occurred. Among exercise test variables (workload, ECG, BP, HR), exercise capacity was the strongest predictor of mortality. Low exercise capacity (1st quartile) was associated with a hazard ratio of 4.2 (95% CI: 1.7, 10.8) for CVD and 4.0 (95% CI: 2.5, 6.4) for all-cause mortality compared with high exercise capacity (4th quartile) among men and in women with a 5.4-fold (95% CI: 1.2, 24.0) risk for CVD and 2.3-fold (95% CI: 1.2, 4.3) risk for all-cause mortality, respectively. The relationship between other exercise test variables and mortality was much weaker.
Conclusions: Among exercise test variables exercise capacity was the strongest predictor of CVD and all-cause mortality in both genders, and especially CVD deaths in women.
- Key Messages
Exercise capacity was the most powerful predictor of CVD and all-cause mortality in both men and women.
Low exercise capacity is a strong predictor of CVD death, especially among women.
Objectives: To determine the risk of recurrence after a first intentional overdose. Secondary objectives included characterization of the temporal course and potential predictors of repeat overdose, a strong risk factor for death from suicide.
Methods: Design: Population-based cohort study.
Setting: Ontario, Canada, from 1 April 2002 to 31 March 2013.
Participants: All Ontario residents presenting to an emergency department after a first intentional overdose.
Main outcome measures: The incidence and timing of recurrent overdose.
Results: We followed 81,675 patients discharged from hospital after a first intentional overdose. Overall, 13,903 (17.0%) returned with a repeat overdose after a median interval of 288 (inter-quartile range: 62 to 834) days. Of these, 4493 (5.5%) had multiple repeat episodes. Factors associated with repeat self-poisoning included psychiatric care in the preceding year (adjusted hazard ratio [aHR] 1.55; 95% confidence interval [CI] 1.50 to 1.61), alcohol dependence (aHR 1.41; 95% CI 1.35 to 1.46) and documented depression (aHR 1.39; 95% CI 1.34 to 1.44). Female sex, rural residence, lower socioeconomic status, ingestion of psychoactive drugs and younger age were also weakly associated with repeat overdose.
Discussion: Hospital presentation for repetition of intentional overdose is common, with recurrent episodes often far removed from the first. While several factors predict overdose repetition, none is particularly strong.
Conclusion: Secondary prevention initiatives should be implemented for all individuals who present to the emergency department and survive intentional overdose. 相似文献
Methods: We surveyed 500 PWID in Tehran concerning demographic characteristics, drug-related and sexual risk behaviors, and HIV testing. HIV-related stigma variables were assessed using a scale consisted of 22 agree/disagree statements in three subscales including shame/blame/isolation, perceived discrimination, and equity. We used multivariate logistic regression to identify factors associated with HIV testing.
Results: Participant ages ranged from 19 to 67 years. Multivariable model shows that factors independently associated with recent HIV testing included level of education (adjusted odds ratios [aOR] 1.12, 95% CI 1.44–4.42), living status (aOR 1.91, 95% confidence interval [CI] 1.35–2.71), income (aOR 1.64, 95% CI 1.18–2.29), length of injecting career (aOR 1.3, 95% CI 1.2–2.23), and perceived risk of HIV infection (aOR 0.51, 95% CI 1.18–0.88). There was a statistically significant relationship between lower level of HIV-related stigma and HIV testing among PWID (OR 2.78, 95% CI 1.15–5.2).
Conclusions: These findings suggested a need to strengthen current HIV testing programs by social support and reducing HIV-related stigma. It is also important to modify the attitude of the public toward people living with HIV/AIDS. 相似文献
Methods: Blood pressure (BP), fasting lipid profiles, and anthropometric parameters were recorded in a cross-sectional study of 11,400 participants (mean age, 54 years; 53% women) from China. Logistic regression models were used to assess associations of CMI, LAP, and BAI with prevalent hypertension.
BAI was evaluated according to hip (cm)/[height (m)1.5]-18; LAP was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; and CMI was defined by TG/HDL-C × waist-to-height ratio.
Results: CMI, LAP, and BAI were independently correlated with higher SBP and DBP, with nonstandardized (B) coefficients ranging from 1.827 to 4.590 mmHg and 1.475 to 2.210 mmHg (all P < 0.001). After adjustment for hypertension risk factors and potential confounders, CMI, LAP, and BAI, modeled as continuous measures, carried hypertension odds (95% CI) of 1.356 (1.259–1.459), 1.631 (1.501–1.771), and 1.555 (1.454–1.662) in women, respectively, per SD increment. In men, each SD increase in CMI, LAP, and BAI experienced a 31%, 65%, and 53% higher hypertension risk, respectively. Moreover, among women, the odds ratio (95% CI) for hypertension were 2.318 (1.956–2.745), 3.548 (2.985–4.217), and 3.004 (2.537–3.557) in the 4th quartile vs the first quartile of CMI, LAP, and BAI, respectively. For men, the corresponding figures were 2.200 (1.838–2.635), 3.892 (3.238–4.677), and 3.288 (2.754–3.927), respectively.
Conclusion: Measurements of CMI, LAP, and BAI provide a more complete understanding of hypertension risk related to variation in body fat distribution and pinpoint hypertensive participants in great risk of cardiovascular disease in the future. 相似文献
Methods: A literature search was performed to capture studies reporting data on the impact of asymptomatic AF burden on the risk of stroke. Data was then extracted from each included study including burden of AF, hazard ratio (HR) for stroke, and CHADS2 score. A random effects meta-analysis was carried out on the log-transformed HRs for different subgroups of AF burden. A meta-regression was performed on the two variables: burden of asymptomatic AF and CHADS2 score.
Results: The random-effect pooled analysis performed on a single subgroup of the six studies reporting data on HR, showed a HR of 2.150 (95% CI 1.523–3.003) for stroke during asymptomatic AF compared to sinus rhythm. At univariate meta-regression, no correlation was detected between burden of asymptomatic AF and HR for stroke (p-value 0,874). When CHADS2 score was included in the regression model as a covariate, no significant association was detected (p-value 0,939).
Conclusion: A direct correlation between burden of asymptomatic AF and HR for stroke cannot be detected in our pooled analysis. However, due to the limitations acknowledged in the analysis, our findings need to be confirmed in large cohort studies. 相似文献
Methods: Data from the 1999–2010 National Health and Nutrition Examination Survey were used, with participants followed up through 31 December 2011 to ascertain mortality status. The analyzed sample included 11,171 cardiovascular disease-free adults (40–79 years of age). The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined from the PCR equations.
Results: For the entire sample, 849,202 person-months occurred with an incidence rate of 0.29 (95% CI: 0.25–0.33) residual-specific deaths per 1,000 person-months. The unweighted median follow-up duration was 72 months. For all analyses, ASCVD risk score (via the PCR equations) was significantly associated with residual-specific mortality. In a fully adjusted model including moderate-to-vigorous physical activity (MVPA), obesity, age (yrs; continuous measure), gender (male/female) and race-ethnicity (Mexican American, non-Hispanic white, non-Hispanic black and other) as covariates, those with an ASCVD ≥ 20 (vs. < 20) had a 91% increased hazard of residual-specific death during the follow-up period (HR = 1.91; 95% CI: 1.10–3.31). Expressed as probability, there was a 66% chance that those with ASCVD ≥ 20 (vs. < 20) would have a residual specific-death during the follow-up period.
Conclusion: The 10-year predicted risk of a first ASCVD event via the PCR equations was directly associated with residual-specific mortality among those free of cardiovascular disease (CVD) at baseline, providing evidence of predictive validity of the PCR equations among this national sample of U.S. adults. 相似文献
Marso S, Daniels G, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311–322.
Mann J, Orsted D, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377: 839–848.
This comprehensive research project, LEADER, led to two reports, one focusing on the effect of liraglutide on cardiovascular events, and the second one reporting on the renal effects on the same study population. The study group included 9340 patients with type 2 diabetes. Patients were required to have type 2 diabetes and an age 50 with a previous cardiovascular problem or chronic heart failure, or an age of 60 with at least one cardiovascular risk factor. Patients were randomized to 1.8 mg (or the maximum tolerated dose) of liraglutide, or placebo. The median follow up was 3.8 years. The primary cardiovascular outcome, a combined endpoint of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke, was seen in 13% (608 of 4668 patients) treated with liraglutide versus 14.9 % (694 of 4672 patients) in the placebo patients (HR 0.87; 95% confidence interval [CI] 0.78 to 0.97; P = 0.01 for superiority). Death from cardiovascular disease and death from any cause were also lower in the liraglutide group. The rates for nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure were not significantly reduced. In the renal report, the renal outcome was reduced in the liraglutide versus the placebo group (268 of 4668 versus 337 out of 4672 in the placebo group; HR 0.78; CI 0.67 to 0.92; p = 0.003). This improvement was mainly driven by a lower rate of the new onset of persistent macroalbuminuria in the liraglutide patients (161 vs 215 patients; HR 0.74; 95% CI, 0.60 to 0.91; p = 0.004), while the rates of other renal adverse events were similar in both groups. When taken together these two reports are the first data to show that the glucagon-like peptide 1 (GLP-1) analogue liraglutide can reduce cardiovascular events and halt progression to macroalbuminuria in patients with Type 2 diabetes. 相似文献
Materials and methods: A total of 705 Chinese women aged 40–60 years were included in this cross-sectional investigation of a self-report questionnaire from the Physical Examination Center at Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. Depressive symptoms and sleep quality were evaluated using self-rating depressive symptom scale (SDS)and the Pittsburgh Sleep Quality Index (PSQI), respectively. After setting up a logistic regression model and computing the odds ratio value, we further calculated and predicted the risk score for depressive symptoms and then established a risk score system. Finally, we validated the risk score in two investigations (Validation 1 and Validation 2).
Results: The risk scoring system for predicting depressive symptoms included a history of cancer, subjective sleep quality, sleep disorder and daytime dysfunction, with total scores ranging from 0–35 points. The receiver operating characteristic (ROC) sample curve was 0.801 (95% CI 0.753–0.848). The Area Under the Curve (AUC) was 0.832 (95% CI 0.738–0.925) in Validation 1 and 0.799 (95%CI 0.667–0.930) in Validation 2. The best cutoff point for depressive symptoms in the sample population was ≥8 points, and the sensitivity and specificity were 0.698 and 0.824, respectively. The sensitivity was 0.775 and 0.667 in Validation 1 and Validation 2, respectively.
Conclusions: The risk score for predicting depressive symptoms in menopausal women based on sleep is convenient. Because there is no complex assessment of multiple scales requiredIt may be a preliminary screening tool for depressive symptoms in menopausal women. 相似文献
Design: Randomised survey study.
Setting: Denmark.
Subjects: A random sample of women from the birth cohorts 1993, 1994 and 1995 drawn from the general population.
Interventions: A web-based questionnaire and information intervention. We randomised potential respondents to one of the following four different information modules about benefits and harms of cervical screening: no information; non-numerical information; and two numerical information modules. Moreover, we provided HPV-vaccinated women in one of the arms with numerical information about benefits and harms in two steps: firstly, information without consideration of HPV vaccination and subsequently information conditional on HPV vaccination.
Main outcome measure: Self-reported intention to participate in cervical screening.
Results: A significantly lower proportion intended to participate in screening in the two groups of women receiving numerical information compared to controls with absolute differences of 10.5 (95% CI: 3.3–17.6) and 7.7 (95% CI: 0.4–14.9) percentage points, respectively. Among HPV-vaccinated women, we found a significantly lower intention to participate in screening after numerical information specific to vaccinated women (OR of 0.38).
Conclusions: Women are sensitive to numerical information about the benefits and harms of cervical screening. Specifically, our results suggest that HPV-vaccinated women are sensitive to information about the expected changes in benefits and harms of cervical screening after implementation of HPV vaccination.
- KEY POINTS
Women were less likely to participate in cervical screening when they received numerical information about benefits and harms compared to non-numerical or no information.
Specifically, numerical information about the potential impact of the reduced risk of cervical cancer among HPV-vaccinated women reduced the intention to participate among vaccinated women.