Background: Approximately 18 in every 100 000 people have experienced a ruptured Achilles tendon. Despite the prevalence of this condition, treatment options remain contested. Hypothesis/purpose: The objective of this study was to evaluate the use of spin—reporting practices that may exaggerate benefit or minimize harm—in abstracts of systematic reviews related to Achilles tendon repair. We also evaluated whether particular study characteristics were associated with spin. Study design: Cross-sectional. Methods: We developed a search strategy for Ovid MEDLINE and Ovid Embase for systematic reviews focused on Achilles tendon treatment. Following title and abstract screening of these search returns, these reviews were evaluated for spin (according to a previously developed classification scheme) and received AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews–2) appraisals by 2 investigators in a masked, duplicate manner. Study characteristics for each review were also extracted in duplicate. Results: Our systematic search returned 251 articles of which 43 systematic reviews and meta-analyses were eligible for data extraction. We found that 65.1% of included studies contained spin (28/43). Spin type 3 was the most common type, occurring in 53.5% (23/43) of abstracts. Spin types 5, 6, 1, and 4 occurred in 16.3% (7/43), 9.3% (4/43), 7% (3/43), and 5.3% (1/43), respectively. Spin types 2, 7, 8, and 9 did not occur. AMSTAR-2 appraised 32.6% (14/43) of the studies as “moderate” quality, 32.6% (14/43) as “low” quality, and 34.9% (15/43) as “critically low” quality. No systematic reviews were rated as “high” quality. There was no significant association between the presence of spin and the following study characteristics: intervention type, article discussing Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) adherence, journal recommending PRISMA adherence, funding sources, journal 5-year impact factor, year the review was received for publication, or AMSTAR-2 critical appraisals. Conclusion: Spin was present in abstracts of systematic reviews and meta-analyses—covering Achilles tendon tear treatment. Steps should be taken to improve the reporting quality of abstracts on Achilles tendon treatment as well as other common orthopedic conditions. Clinical relevance: In order to avoid negative patient outcomes, articles should be free of spin within the abstract.
A k‐plex is a clique relaxation introduced in social network analysis to model cohesive social subgroups that allows for a limited number of nonadjacent vertices (strangers) inside the cohesive subgroup. Several exact algorithms and heuristic approaches to find a maximum‐size k‐plex in the graph have been developed recently for this NP‐hard problem. This article develops a greedy randomized adaptive search procedure (GRASP) for the maximum k‐plex problem. We offer a key improvement in the design of the construction procedure that alleviates a drawback observed in multiple past studies. In existing construction heuristics, k‐plexes found for smaller values of parameter k are sometimes not found for larger k even though they are feasible; instead inferior solutions are found. We identify the reasons behind this behavior and address these in our new construction procedure. We then show that an existing exact algorithm for solving this problem on power‐law graphs can be considerably enhanced by using GRASP. The overall approach is able to solve the problem to optimality on massive social networks, including some with several million vertices and edges. These are orders of magnitude larger than the largest real‐life social networks on which this problem has been solved to optimality in the current literature. © 2017 Wiley Periodicals, Inc. NETWORKS, Vol. 69(4), 388–407 2017
Background: The purpose of this study was to evaluate known and yet unknown risk factors associated with readmission to the hospital within 30 days after hip fracture. Methods: In this study, we used the Cerner Health Facts Electronic Health Record database data from January to August 2015. The univariate association of each variable (discharge location, demographic details, and comorbidities) against the 30-day readmission status was evaluated using the Chi-square test or the Fisher exact test. The significant variables (P < 0.05) obtained by the univariate analysis were used to build the multivariate logistic regression model to evaluate the multivariate associations of the variables. Results: Thirty-four thousand seven hundred ninety index admissions of 33,740 unique patients were included in the study cohort. The overall 30-day readmission rate for patients with hip fractures was 10.7%. We demonstrated a new variable not discussed in previous articles on this topic: patients with previous inpatient/emergency visits within the past year were more likely to be readmitted within 30 days after the hip fracture surgery (P < 0.001). Conclusion: For patients with hip fractures, particular efforts should be taken to optimize outcomes in those with recent hospitalizations and/or discharge to a location other than home.
Diabetic retinopathy (DR) is a leading cause for blindness among working-aged adults. The growing prevalence of diabetes urges for cost-effective tools to improve the compliance of eye examinations for early detection of DR. The objective of this research is to identify essential predictors and develop predictive technologies for DR using electronic health records. We conducted a retrospective analysis on a derivation cohort with 3749 DR and 94,127 non-DR diabetic patients. In the analysis, an ensemble predictor selection method was employed to find essential predictors among 26 variables in demographics, duration of diabetes, complications and laboratory results. A predictive model and a risk index were built based on the selected, essential predictors, and then validated using another independent validation cohort with 869 DR and 6448 non-DR diabetic patients. Out of the 26 variables, 10 were identified to be essential for predicting DR. The predictive model achieved a 0.85 AUC on the derivation cohort and a 0.77 AUC on the validation cohort. For the risk index, the AUCs were 0.81 and 0.73 on the derivation and validation cohorts, respectively. The predictive technologies can provide an early warning sign that motivates patients to comply with eye examinations for early screening and potential treatments.
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