Meta-análisis: Intervalos de confianza e Intervalos de predicción / Meta-analysis: Confidence intervals and Prediction intervals

En los informes meta-analíticos se suelen reportar varios tipos de intervalos, hecho que ha generado cierta confusión a la hora de interpretarlos. Los intervalos de confianza reflejan la incertidumbre relacionada con un número, el tamaño del efecto medio paramétrico. Los intervalos de predicción reflejan el tamaño paramétrico probable en cualquier estudio de la misma clase que los incluidos en un meta-análisis. Su interpretación y aplicaciones son diferentes. En este artículo explicamos su diferente naturaleza y cómo se pueden utilizar para responder preguntas específicas. Se incluyen ejemplos numéricos, así como su cálculo con el paquete metafor en R.(AU)

Several types of intervals are usually employed in meta-analysis, a fact that has generated some confusion when interpreting them. Confidence intervals reflect the uncertainty related to a single number, the parametric mean effect size. Prediction intervals reflect the probable parametric effect size in any study of the same class as those included in a meta-analysis. Its interpretation and applications are different. In this article we explain in de-tail their different nature and how they can be used to answer specific ques-tions. Numerical examples are included, as well as their computation with the metafor Rpackage.(AU)

Predictors of transition to schizophrenia and other long-lasting non-affective psychoses in first-episode patients with acute and transient psychotic disorders: A validation study

Background and objectives Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population. Methods We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge. Results Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses. Conclusion Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions. (AU)

Factors associated with neurofeedback and mindfulness-based combination therapy for patients with substance use disorder: A multicenter study

Background and objectives Substance use disorder (SUD) has become a major concern in public health globally, and there is an urgent need to develop an integrated psychosocial intervention. The aims of the current study are to test the efficacy of the integrated treatment with neurofeedback and mindfulness-based therapy for SUD and identify the predictors of the efficacy. Methods This study included 110 participants with SUD into the analysis. Outcome of measures includes demographic characteristics, severity of dependence, quality of life, symptoms of depression, and anxiety. Independent t test is used to estimate the change of scores at baseline and three months follow-up. Generalized estimating equations are applied to analyze the effect of predictors on the scores of dependence severity over time by controlling for the effects of demographic characteristics. Results A total of 22 (20 %) participants were comorbid with major mental disorder (MMD). The decrement of the severity in dependence, anxiety, and depression after treatment are identified. Improved scores of qualities of life in generic, psychological, social, and environmental domains are also noticed. After controlling for the effects of demographic characteristics, the predictors of poorer outcome are comorbid with MMD, lower quality of life, and higher level of depression and anxiety. Conclusion The present study implicates the efficacy of integrated therapy. Early identification of predictors is beneficial for healthcare workers to improve the treatment efficacy. (AU)

Analysis of learning curves in predictive modeling using exponential curve fitting with an asymptotic approach.

The existence of large volumes of data has considerably alleviated concerns regarding the availability of sufficient data instances for machine learning experiments. Nevertheless, in certain contexts, addressing limited data availability may demand distinct strategies and efforts. Analyzing COVID-19 predictions at pandemic beginning emerged a question: how much data is needed to make reliable predictions? When does the volume of data provide a better understanding of the disease's evolution and, in turn, offer reliable forecasts? Given these questions, the objective of this study is to analyze learning curves obtained from predicting the incidence of COVID-19 in Brazilian States using ARIMA models with limited available data. To fulfill the objective, a retrospective exploration of COVID-19 incidence across the Brazilian States was performed. After the data acquisition and modeling, the model errors were assessed by employing a learning curve analysis. The asymptotic exponential curve fitting enabled the evaluation of the errors in different points, reflecting the increased available data over time. For a comprehensive understanding of the results at distinct stages of the time evolution, the average derivative of the curves and the equilibrium points were calculated, aimed to identify the convergence of the ARIMA models to a stable pattern. We observed differences in average derivatives and equilibrium values among the multiple samples. While both metrics ultimately confirmed the convergence to stability, the equilibrium points were more sensitive to changes in the models' accuracy and provided a better indication of the learning progress. The proposed method for constructing learning curves enabled consistent monitoring of prediction results, providing evidence-based understandings required for informed decision-making.

Brain activity of professional investors signals future stock performance.

A major aspiration of investors is to better forecast stock performance. Interestingly, emerging "neuroforecasting" research suggests that brain activity associated with anticipatory reward relates to market behavior and population-wide preferences, including stock price dynamics. In this study, we extend these findings to professional investors processing comprehensive real-world information on stock investment options while making predictions of long-term stock performance. Using functional MRI, we sampled investors' neural responses to investment cases and assessed whether these responses relate to future performance on the stock market. We found that our sample of investors could not successfully predict future market performance of the investment cases, confirming that stated preferences do not predict the market. Stock metrics of the investment cases were not predictive of future stock performance either. However, as investors processed case information, nucleus accumbens (NAcc) activity was higher for investment cases that ended up overperforming in the market. These findings remained robust, even when controlling for stock metrics and investors' predictions made in the scanner. Cross-validated prediction analysis indicated that NAcc activity could significantly predict future stock performance out-of-sample above chance. Our findings resonate with recent neuroforecasting studies and suggest that brain activity of professional investors may help in forecasting future stock performance.

The future burden of type 2 diabetes in Belgium: a microsimulation model.

OBJECTIVE: To forecast the annual burden of type 2 diabetes and related socio-demographic disparities in Belgium until 2030. METHODS: This study utilized a discrete-event transition microsimulation model. A synthetic population was created using 2018 national register data of the Belgian population aged 0-80 years, along with the national representative prevalence of diabetes risk factors obtained from the latest (2018) Belgian Health Interview and Examination Surveys using Multiple Imputation by Chained Equations (MICE) as inputs to the Simulation of Synthetic Complex Data (simPop) model. Mortality information was obtained from the Belgian vital statistics and used to calculate annual death probabilities. From 2018 to 2030, synthetic individuals transitioned annually from health to death, with or without developing type 2 diabetes, as predicted by the Finnish Diabetes Risk Score, and risk factors were updated via strata-specific transition probabilities. RESULTS: A total of 6722 [95% UI 3421, 11,583] new cases of type 2 diabetes per 100,000 inhabitants are expected between 2018 and 2030 in Belgium, representing a 32.8% and 19.3% increase in T2D prevalence rate and DALYs rate, respectively. While T2D burden remained highest for lower-education subgroups across all three Belgian regions, the highest increases in incidence and prevalence rates by 2030 are observed for women in general, and particularly among Flemish women reporting higher-education levels with a 114.5% and 44.6% increase in prevalence and DALYs rates, respectively. Existing age- and education-related inequalities will remain apparent in 2030 across all three regions. CONCLUSIONS: The projected increase in the burden of T2D in Belgium highlights the urgent need for primary and secondary preventive strategies. While emphasis should be placed on the lower-education groups, it is also crucial to reinforce strategies for people of higher socioeconomic status as the burden of T2D is expected to increase significantly in this population segment.

Demand forecasting for platelet usage: From univariate time series to multivariable models.

Platelet products are both expensive and have very short shelf lives. As usage rates for platelets are highly variable, the effective management of platelet demand and supply is very important yet challenging. The primary goal of this paper is to present an efficient forecasting model for platelet demand at Canadian Blood Services (CBS). To accomplish this goal, five different demand forecasting methods, ARIMA (Auto Regressive Integrated Moving Average), Prophet, lasso regression (least absolute shrinkage and selection operator), random forest, and LSTM (Long Short-Term Memory) networks are utilized and evaluated via a rolling window method. We use a large clinical dataset for a centralized blood distribution centre for four hospitals in Hamilton, Ontario, spanning from 2010 to 2018 and consisting of daily platelet transfusions along with information such as the product specifications, the recipients' characteristics, and the recipients' laboratory test results. This study is the first to utilize different methods from statistical time series models to data-driven regression and machine learning techniques for platelet transfusion using clinical predictors and with different amounts of data. We find that the multivariable approaches have the highest accuracy in general, however, if sufficient data are available, a simpler time series approach appears to be sufficient. We also comment on the approach to choose predictors for the multivariable models.

Oncology Nursing for the Future: Multisector Planning Is Needed.

Assessing the landscape for oncology nursing of the future, the biggest problem that faces the specialty is that of workforce shortages. On the practice side, nursing turnover, resignations, and early retirements have contrib.

Next Directions in the Neuroscience of Cancers Arising outside the CNS.

SUMMARY: The field of cancer neuroscience has begun to define the contributions of nerves to cancer initiation and progression; here, we highlight the future directions of basic and translational cancer neuroscience for malignancies arising outside of the central nervous system.

The multi-strategy hybrid forecasting base on SSA-VMD-WST for complex system.

In view of the strong randomness and non-stationarity of complex system, this study suggests a hybrid multi-strategy prediction technique based on optimized hybrid denoising and deep learning. Firstly, the Sparrow search algorithm (SSA) is used to optimize Variational mode decomposition (VMD) which can decompose the original signal into several Intrinsic mode functions (IMF). Secondly, calculating the Pearson correlation coefficient (PCC) between each IMF component and the original signal, the subsequences with low correlation are eliminated, and the remaining subsequence are denoised by Wavelet soft threshold (WST) method to obtain effective signals. Thirdly, on the basis of the above data noise reduction and reconstruction, our proposal combines Convolutional neural network (CNN) and Bidirectional short-term memory (BiLSTM) model, which is used to analyze the evolution trend of real time sequence data. Finally, we applied the CNN-BiLSTM-SSA-VMD-WST to predict the real time sequence data together with the other methods in order to prove it's effectiveness. The results show that SNR and CC of the SSA-VMD-WST are the largest (the values are 20.2383 and 0.9342). The performance of the CNN-BiLSTM-SSA-VMD-WST are the best, MAE and RMSE are the smallest (which are 0.150 and 0.188), the goodness of fit R2 is the highest(its value is 0.9364). In contrast with other methods, CNN-BiLSTM-SSA-VMD-WST method is more suitable for denoising and prediction of real time series data than the traditional and singular deep learning methods. The proposed method may provide a reliable way for related prediction in various industries.

Blood donation projections using hierarchical time series forecasting: the case of Zimbabwe's national blood bank.

BACKGROUND: The discrepancy between blood supply and demand requires accurate forecasts of the blood supply at any blood bank. Accurate blood donation forecasting gives blood managers empirical evidence in blood inventory management. The study aims to model and predict blood donations in Zimbabwe using hierarchical time series. The modelling technique allows one to identify, say, a declining donor category, and in that way, the method offers feasible and targeted solutions for blood managers to work on. METHODS: The monthly blood donation data covering the period 2007 to 2018, collected from the National Blood Service Zimbabwe (NBSZ) was used. The data was disaggregated by gender and blood groups types within each gender category. The model validation involved utilising actual blood donation data from 2019 and 2020. The model's performance was evaluated through the Mean Absolute Percentage Error (MAPE), uncovering expected and notable discrepancies during the Covid-19 pandemic period only. RESULTS: Blood group O had the highest monthly yield mean of 1507.85 and 1230.03 blood units for male and female donors, respectively. The top-down forecasting proportions (TDFP) under ARIMA, with a MAPE value of 11.30, was selected as the best approach and the model was then used to forecast future blood donations. The blood donation predictions for 2019 had a MAPE value of 14.80, suggesting alignment with previous years' donations. However, starting in April 2020, the Covid-19 pandemic disrupted blood collection, leading to a significant decrease in blood donation and hence a decrease in model accuracy. CONCLUSIONS: The gradual decrease in future blood donations exhibited by the predictions calls for blood authorities in Zimbabwe to develop interventions that encourage blood donor retention and regular donations. The impact of the Covid-19 pandemic distorted the blood donation patterns such that the developed model did not capture the significant drop in blood donations during the pandemic period. Other shocks such as, a surge in global pandemics and other disasters, will inevitably affect the blood donation system. Thus, forecasting future blood collections with a high degree of accuracy requires robust mathematical models which factor in, the impact of various shocks to the system, on short notice.

CLPREM: A real-time traffic prediction method for 5G mobile network.

Network traffic prediction is an important network monitoring method, which is widely used in network resource optimization and anomaly detection. However, with the increasing scale of networks and the rapid development of 5-th generation mobile networks (5G), traditional traffic forecasting methods are no longer applicable. To solve this problem, this paper applies Long Short-Term Memory (LSTM) network, data augmentation, clustering algorithm, model compression, and other technologies, and proposes a Cluster-based Lightweight PREdiction Model (CLPREM), a method for real-time traffic prediction of 5G mobile networks. We have designed unique data processing and classification methods to make CLPREM more robust than traditional neural network models. To demonstrate the effectiveness of the method, we designed and conducted experiments in a variety of settings. Experimental results confirm that CLPREM can obtain higher accuracy than traditional prediction schemes with less time cost. To address the occasional anomaly prediction issue in CLPREM, we propose a preprocessing method that minimally impacts time overhead. This approach not only enhances the accuracy of CLPREM but also effectively resolves the real-time traffic prediction challenge in 5G mobile networks.