Usage of Latent Class Analysis in Diagnostic Microbiology in the Absence of Gold Standard Test

The evaluation of performance of various tests diagnostic tests in the absence of gold standard is an important problem. Latent class analysis (LCA) is a statistical analysis method known for many years, especially in the absence of a gold standard for evaluation of diagnostic tests so that LCA has found its wide application area. During the last decade, LCA method has widely used in for determining sensivity and specifity of different microbiological tests. It has investigated in the diagnosis of mycobacterium tuberculosis, mycobacterium bovis, human papilloma virus, bordetella pertussis, influenza viruses, hepatitis E virus (HEV), hepatitis C virus (HCV) and other various viral infections. Researchers have compared several diagnostic tests for the diagnosis of different pathogens with LCA. We aimed to evaluate performance of latent class analysis method used microbiological diagnosis in various diseases in several researches. When we took into account all of these tests' results, we suppose that LCA is a good statistical analysis method to assess different test performances in the absence of gold standard. [Archives Medical Review Journal 2016; 25(4.000): 467-488

Comparative analysis of models in confirmatory factor analysis: Exploring clinical applications and interpretation

To demonstrate the explainability of the scales with fewer dimensions instead of the number of existing dimensions by ensuring that the scale structures created by explanatory factor analysis (EFA) are verified with confirmatory factor analysis (CFA). Data from the Nutritional Behavior Scale in Children, answered by the parents of 204 children with autism spectrum disorder (ASD) were used. EFA was performed with the data obtained from the scale. In the next step, the explained variance percentages and dimensions were determined and the model goodness of fit indexes were calculated with CFA. The dimensions with the lowest explained variance percentages were removed from the model, respectively, and three different scale models were tested. The variance explanation percentage of the first eight-dimensional model created with EFA was calculated as 72.68%. The food fussiness sub-dimension was removed and CFA was applied to the model again and new indices were calculated. Finally, the emotional under-eating sub-dimension was excluded from the model, resulting in a six-dimensional Child Eating Behavior Scale (CEBS). Goodness-of-fit indices of the CFA model established with six dimensions were χ2 / df; 1.545, AIC; 715,433 and RMSEA; 0.052 was found. It has been shown that the eight, seven, and six-dimensional scale models constructed according to the percentages of variance explained for CEBS are sufficient to explain the sample and that the six-dimensional scale model can be used for CEBS. Our study is the first to use competing models in confirmatory factor analysis in reducing scale dimensions. [Med-Science 2023; 12(2.000): 562-8

The importance of ICD-10 applications on daily practice

This study assessed the adequacy of patient data entry in the context of International Statistical Classification of Diseases and Related Health Problems (ICD-10) in the Hospital Information Administration System. It was also aimed to study the adequacy and functionality of the ICD-10 coding in the current Turkish Otorhinolaryngology (ORL) practice in detail. The medical records of 1216 patients who presented to the ORL outpatient clinic between 2012 and 2013 were reviewed. Eight diagnostic codes used by the ORL department were selected from the patient diagnoses report to form patient lists. The accessibility of the ICD-10 codes was analyzed. The data was transferred into the MEdCalc 12.0 software package in a digital medium. The study data was analyzed using frequency tables, Chi-square test, and the two sided likelihood ratio test. Among the ICD-10 codes included in the study, the larynx malignant neoplasm diagnosis (C32.9) was recorded at a rate of 60% and had the greatest ratio of recorded medical history, followed by malignant disorders (C32.3) of the laryngeal cartilage, vertigo (R42) (12.4%) whereas facial asymmetry (Q67.0) (10.5%) had the lowest recorded medical history ratios. There was a significant difference between the recorded and unrecorded patient groups (p [Med-Science 2018; 7(4.000): 873-7

Trends in heart failure between 2016 and 2022 in Türkiye (TRends-HF): a nationwide retrospective cohort study of 85 million individuals across entire population of all ages

Background: Data on the burden of heart failure (HF) outside western countries are limited, but available data suggest it may present differently in other countries. The aim of this study was to examine the incidence, prevalence, and survival rates of HF in Türkiye, with a specific focus on how these rates vary according to age, sex, comorbidities, and socioeconomic status (SES). Methods: We harnessed the extensive National Electronic Database of the Turkish Ministry of Health, covering Turkey's entire population from January 1, 2016, to December 31, 2022, to identify 2,722,151 cases of HF and their associated comorbidities using ICD-10 codes. Analyzing the primary endpoint of all-cause mortality, our study utilized anonymized data to examine patient demographics, comorbidities, socioeconomic status, and survival patterns, employing statistical techniques to delve into relationships and trends. The data were segmented by gender, socioeconomic status, and age, involving cross-tabulations and statistical metrics to explore connections, odds ratios, and survival rates. Findings: The estimated prevalence of HF was 2.114% in Türkiye at the end of 2022, with an annual incidence ranging between 3.00 and 6.06 per 1000 person years. Females were older than males (69.8 ± 13.9 years vs. 66.8 ± 13.9 years, respectively). The most common comorbidities were congenital heart diseases and anemia under the age of 20, and hypertension and atherosclerotic cardiovascular disease in the adult population. Only 23.6% (643,159/2,722,151) of patients were treated with any triple guideline-directed medical therapy (GDMT) and 3.6% (96,751/2,722,151) of patients were on quadruple GDMT. The survival rates for patients with HF at 1, 5, and 7 years were 83.3% (95% CI: 83.2–83.3), 61.5% (95% CI: 61.4–61.6), and 57.7% (95% CI: 57.6–57.8) among females, and 82.1% (95% CI: 82.0–82.2), 58.2% (95% CI: 58.1–58.3), and 54.2% (95% CI: 54.0–54.3) among males. Despite a tendency for an increase from the highest to the lowest SES, the prevalence of HF and mortality were paradoxically lowest in the lowest SES region. Interpretation: The prevalence, incidence, and survival rates of HF in Türkiye were comparable to western countries, despite the notable difference of HF onset occurring 8–10 years earlier in the Turkish population. Drug usage statistics indicate there is a need for effective strategies to improve treatment with GDMT. Funding: None