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The most widespread method of computing confidence intervals (CIs) in complex surveys is to add and subtract the margin of error (MOE) from the point estimate, where the MOE is the estimated standard error multiplied by the suitable Gaussian quantile. This Wald-type interval is used by the American Community Survey (ACS), the largest US household sample survey. For inferences on small proportions with moderate sample sizes, this method often results in marked under-coverage and lower CI endpoint less than 0. We assess via simulation the coverage and width, in complex sample surveys, of seven alternatives to the Wald interval for a binomial proportion with sample size replaced by the 'effective sample size,' that is, the sample size divided by the design effect. Building on previous work by the present authors, our simulations address the impact of clustering, stratification, different stratum sampling fractions, and stratum-specific proportions. We show that all intervals undercover when there is clustering and design effects are computed from a simple design-based estimator of sampling variance. Coverage can be better calibrated for the alternatives to Wald by improving estimation of the effective sample size through superpopulation modeling. This approach is more effective in our simulations than previously proposed modifications of effective sample size. We recommend intervals of the Wilson or Bayes uniform prior form, with the Jeffreys prior interval not far behind.
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http://dx.doi.org/10.1093/jssam/smy019 | DOI Listing |
Eur J Clin Pharmacol
September 2025
Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China.
Background And Objective: While current clinical guidelines generally advocate for beta-blocker therapy following acute myocardial infarction (AMI), conflicting findings have surfaced through large-scale observational studies and meta-analyses. We conducted this systematic review and meta-analysis of published observational studies to quantify the long-term therapeutic impact of beta-blocker across heterogeneous AMI populations.
Methods: We conducted comprehensive searches of the PubMed, Embase, Cochrane, and Web of Science databases for articles published from 2000 to 2025 that examine the link between beta-blocker therapy and clinical outcomes (last search update: March 1, 2025).
AJNR Am J Neuroradiol
September 2025
From the Department of Department of Radiology, Massachusetts General Hospital, Boston, MA, United States.
Background And Purpose: Low-level light therapy (LLLT) has been shown to modulate recovery in patients with traumatic brain injury (TBI). However, the longitudinal impact of LLLT on brain metabolites has not been studied. The purpose of this study was to use magnetic resonance spectroscopic imaging (MRSI) to assess the metabolic response of LLLT in patients with moderate TBI at acute (within 1 week), subacute (2-3 weeks), and late-subacute (3 months) recovery phases.
View Article and Find Full Text PDFAm Surg
September 2025
Division of Gastroenterological & General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.
Incarcerated or threatened bowel obstruction with suspected intestinal ischemia requires prompt surgical intervention. This retrospective case series, involving 8 patients undergoing emergency laparotomy, evaluated the feasibility of combining indocyanine green (ICG) fluorescence and Doppler ultrasound for intraoperative bowel viability assessment. Indocyanine green was injected intravenously.
View Article and Find Full Text PDFJMIR Res Protoc
September 2025
Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
Background: In the United States, cancer is more prevalent in racial and ethnic minority groups and in rural-dwelling and low-income people. Compared with White people of non-Hispanic descent, Black and African American people have higher cancer mortality and Hispanic people are more likely to be diagnosed with infection-related cancers. In addition, people who live in persistent poverty areas are more vulnerable to cancer mortality.
View Article and Find Full Text PDFAten Primaria
September 2025
Gerencia de Atención Primaria de Gran Canaria, Las Palmas de Gran Canaria, España.
Aim: To describe the percentage of abdominal aortic aneurysm (AAA) cases in the Maspalomas Basic Health Zone among males aged 65 to 75 years who are current or former smokers. Our secondary objectives were to define the distribution of known risk factors for AAA development in our sample and to facilitate early referral to the appropriate vascular surgery service. We also aim to describe the percentage of subaneurysm cases, offering ultrasound follow-up at our center.
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