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Exact Test P (exact + test_p)

Distribution by Scientific Domains
Medical Sciences80%

Kinds of Exact Test P

  • fisher exact test p
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    Selected Abstracts

    Randomized controlled trial comparing the effectiveness of 308-nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in the treatment of vitiligo of the face and neck

    BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2008
    F. Sassi
    Summary Background, Vitiligo is a pigmentary disorder which may have disfiguring consequences. Its treatment remains a challenge. Objectives, We designed a parallel-group randomized controlled trial to compare the effectiveness of 308-nm excimer laser alone or in combination with topical hydrocortisone 17-butyrate cream in patients with vitiligo unresponsive to previous treatment with topical steroids or narrow-band ultraviolet (UV) B phototherapy. Methods, Consecutive patients aged 18,75 years with nonsegmental vitiligo localized on the face and/or neck lacking response to previous conventional treatment were eligible. In total, 84 patients (44 women and 40 men, mean age 44 years) were randomized to 308-nm excimer laser phototherapy twice weekly alone or in combination with topical hydrocortisone 17-butyrate cream twice daily for three periods of 3 weeks followed by a 1-week steroid-free interval. The primary outcome was a reduction of at least 75% of the overall lesional areas as judged by automatic image analysis on reflected UV photographs, conducted blind to treatment assignment, at 12 weeks compared with baseline. Secondary outcomes were clearance, and improvements on Physician's Global Assessment (PGA) and Skindex-29 scores. Results, A total of 76 (90%) patients completed the study. In an intention-to-treat analysis, seven [16·6%; 95% confidence interval (CI) 5·3,27·8%] patients in the excimer monotherapy arm and 18 (42·8%; 95% CI 27·8,57·8%) in the combination arm showed , 75% reduction of vitiligo lesions at 12 weeks (,2 test 6·89, P = 0·0087). Clearance was observed in two (4·7%; 95% CI 1·6,11·2%) and nine (21·4%; 95% CI 9·0,33·8%) patients, respectively (Fisher's exact test P = 0·04). A significant difference also emerged for PGA scores, while no difference was documented for Skindex-29. Conclusions, Recalcitrant vitiligo of the face and neck may benefit from the combination of excimer laser phototherapy with topical hydrocortisone 17-butyrate cream. [source]

    Photocoagulation for diabetic retinopathy: determinants of patient satisfaction and the patient,provider relationship

    ACTA OPHTHALMOLOGICA, Issue 3 2005
    Maneli Mozaffarieh
    Abstract. Purpose:,To assess satisfaction with photocoagulation treatment in diabetes patients and to investigate how it relates to patient-related characteristics and patients' visual ability. Further, to observe the interaction between physician and patient and suggest ways to improve the patient,provider relationship and, thereby, treatment satisfaction. Methods:,This open longitudinal study included 123 diabetes patients undergoing first photocoagulation treatment for diabetic maculopathy or proliferative retinopathy. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was completed by all patients. Communication, scheduling and adherence scores were defined for each physician,patient pair. Outcome measures were: the patient's overall satisfaction with laser treatment; the patient's degree of satisfaction in relation to visual results; communication, scheduling and adherence scores, and visual acuity results. Results:,The level of satisfaction after initial photocoagulation treatment was high; 46.4% of patients with proliferative retinopathy and 53.1% with maculopathy scored 31 or higher. Although 69.5% of all patients reported that their expectations of treatment corresponded to their final 9-month visual results, only 8.7% of these patients reported an improvement in visual acuity after 9 months. The number of unwanted actions performed by the patients during treatment were significantly related to the number of unclear instructions given by the physician (Fisher's exact test P < 0.01). Conclusions:,A high level of satisfaction was observed, despite the minimal improvements in visual acuity. Attempts to further improve patient satisfaction might focus on improved education of patients on the possible benefits of laser treatment, greater care in communicating information during treatment, additional nursing support, and additional clerical time to communicate with patients before each appointment. [source]

    Analysis of the human APC mutation spectrum in a saccharomyces cerevisiae strain with a mismatch repair defect

    INTERNATIONAL JOURNAL OF CANCER, Issue 5 2003
    Kazunori Otsuka
    Abstract Somatic APC mutations in colorectal tumors with an RER phenotype reflect excessive frameshift mutations, especially in simple repetition tracts within the coding sequence. Because this type of mutation is characteristic of cells with a deficient DNA MMR system, the APC mutation signature of RER tumors may be attributable to a defect in the MMR system. However, there is little experimental evidence to prove that the spectrum of mutations and the APC gene distribution are directly influenced by MMR system defects. We therefore examined the mutation spectrum of the MCR of the APC gene after transfection into both MMR-proficient and MMR-deficient yeast strains and compared it with a previously reported human APC mutation database. Small insertions or deletions in mono- or dinucleotide repeats were more common in the MMR-deficient than in the MMR-proficient strain (91.2% vs. 38.1%, Fisher's exact test p < 0.0001). Furthermore, the 2 mutation hot spots, 4385,4394(AG)5 and 4661,4666(A)6, found in the yeast system corresponded with those in human tumors. Combining our data with those from human tumors, there appears to be hypermutable mutations in specific simple repetitive sequences within the MCR, which are more prevalent in MMR-deficient cells and RER tumors than in MMR-proficient cells and non-RER tumors. We therefore consider that the differences in the spectra of RER and non-RER tumors are attributable at least in part to the MMR system of the host cells. © 2002 Wiley-Liss, Inc. [source]

    Homocysteine metabolism in families from southern Italy with neural tube defects: role of genetic and nutritional determinants

    PRENATAL DIAGNOSIS, Issue 1 2006
    Elvira Grandone
    Abstract Objective To evaluate the role of different polymorphic gene variants involved in homocysteine metabolism and plasma levels of homocysteine, folate and vitamin B12 in families from southern Italy with neural tube defects (NTDs). Methods Eighteen fathers, 15 NTD children and 60 women who had conceived NTD foetuses were investigated. A group of 100 adults and 43 apparently healthy children was used as control. At the time of blood draw, none were taking vitamin pills or nutritional supplements. Results Among controls, 79 (55.2%) were heterozygous for C677T MTHFR variant and 26 (18.2%) were TT homozygous. Among the cases, 35 (61.4%) out of 57 mothers and 7 (38.9%) out of 18 fathers carried the T allele; 12 (21.1%) mothers and 2 (11.1%) fathers had the TT genotype. Four (26.7%) out of 15 probands were TT homozygous and 11 (73.3%) were heterozygous (Fisher exact test p = 0.025). No significant difference between groups was observed for the 1298C MTHFR variant and CBS haplotypes. Median homocysteine in NTD children was significantly higher (10.0 µmol/L) than that of controls (median 4.5 µmol/L, Mann,Whitney p < 0.05). Folate and B12 were not different among groups. Conclusions The T677 MTHFR allele is significantly associated with the occurrence of NTDs; no significant association has been observed with other genetic determinants analysed. Homocysteine levels in children with NTDs are significantly higher than those of the paediatric population from the same geographical area. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    Emergency Medicine Subinternship: Does a Standard Clinical Experience Improve Performance Outcomes?

    ACADEMIC EMERGENCY MEDICINE, Issue 1 2008
    Christopher J. Lampe MD
    Abstract Background:, The emergency medicine (EM) subinternship provides a varied experience for senior medical students depending on gender, specialty choice, and interest. A didactic curriculum can be standardized, but the clinical component is difficult to control. Students can be directed to see patients with specific chief complaints. Objectives:, To assess whether a clinical requirement of 10 predetermined cases improves general knowledge as measured on an objective exam. Methods:, This was a prospective, nonrandomized, case-controlled study at a public teaching hospital. Students were assigned to the control group (CG) or test group (TG) by alternating block rotations over 6 months. The CG saw emergency department (ED) patients according to interest and faculty direction. The TG was also required to identify ten specific chief complaints. Patient encounters were recorded in computerized logs. A 10-question pretest assessed preexisting knowledge of each chief complaint, and a 40-question final exam tested general EM knowledge. Descriptive statistics measured demographic data. Groups were compared by Fisher's exact test. Difference in means testing was performed to see if pre- to posttest differences varied by group. Multivariate analysis controlled for gender and specialty choice. Results:, Eighteen CG students saw a mean of 57 patients, and 24 TG students saw a mean of 54 patients; 1 CG student (6%) and 7 TG students (31.8%) saw all 10 required cases (Fisher's exact test p = 0.044). Difference in means testing demonstrated a greater relative change in performance (13.4% points) by the TG relative to the CG on a general knowledge exam, compared with their performance on a brief pretest (p = 0.014). The authors performed multivariate regression controlling for pretest score, gender, and EM specialty choice, and neither gender nor intended EM specialty choice was a contributing factor to the improved performance. A greater relative change in performance (7% points) in the TG exam score was found when compared to the CG (p = 0.020). Conclusions:, Students who participated in the usual didactic curriculum and were required to see ED patients with representative chief complaints performed better on a general EM exam than those who employed common methods of choosing patients. [source]