Beyond accuracy: a framework for evaluating algorithmic bias and performance, applied to automated sleep scoring.

Recent advancements in artificial intelligence (AI) have significantly improved sleep-scoring algorithms, bringing their performance close to the theoretical limit of approximately 80%, which aligns with inter-scorer agreement levels. While this suggests the problem is technically solved, clinical adoption remains challenging due to ethical and regulatory requirements for rigorous validation, fairness, and human oversight. Existing validation methods, such as Bland-Altman analysis, often rely on simple correlation metrics, overlooking potential non-linear influences of external factors (e.

Digital speech biomarkers can measure acute effects of levodopa in Parkinson's disease.

Speech abnormalities in Parkinson's disease (PD) are heterogeneous and often considered resistant to levodopa. However, human hearing may miss subtle treatment-related speech changes. Digital speech biomarkers offer a sensitive alternative to measure such changes objectively.

Predicting the impact of target volume contouring variations on the organ at risk dose: results of a qualitative survey.

Purpose: Integrating auto-contouring in radiotherapy workflows is shifting the role of radiation oncologists from manual delineation to reviewing and correcting automatically generated contours. However, we postulate that this process is hindered by significant inter-evaluator variability in assessing the dosimetric impact of contour variations. This study investigates how radiation oncologists and medical physicists evaluate the impact of glioblastoma target volume (TV) variations on the dose to organs at risk (OARs), focusing on understanding inter-evaluator variability and decision-making patterns.

The impact of smoking on lung cancer patients.

Although smoking prevalence has shown a decreasing trend, the total number of smokers remains high due to population growth. Smoking causes several diseases, including lung cancer, COPD, coronary heart disease, stroke and peripheral vascular disease. Most of the adverse effects of smoking are reversible and smoking cessation treatments are a cost-effective and high-impact intervention for reducing the risk of mortality and morbidity from smoking-related illness.

Steroid-eluting stents in challenging frontal sinus surgery: A critical real world experience.

Objectives: This study investigates the impact of placing steroid-eluting stents in the frontal sinus outflow tract on the need for postoperative interventions and postoperative changes in symptoms.

Methods: We performed a retrospective case-control study between January 2018 and December 2022 in 21 patients in each group with and without a steroid-eluting stent placed in the frontal sinus outflow tract. The outcome between the two groups was investigated regarding the need for revision surgery and changes in pre- and postoperative symptoms.

Unconsciousness reshapes the oscillatory topography of the subthalamic nucleus: A comparative study.

Background: Many centers perform Deep Brain Stimulation (DBS) surgery under general anesthesia (GA), known as asleep DBS. Local field potential (LFP) of the Subthalamic Nucleus (STN) recorded in awake Parkinson's disease (PD) patients revealed important insights into disease mechanism and DBS optimization-strategies. In contrast, the spectral characteristics of oscillations recorded in the GA-induced unconscious state remain only partially understood.

Effectiveness of Palatopharyngeal Surgery Modifications in Obstructive Sleep Apnea: A Meta-analysis.

Objective: The effectiveness of various palatopharyngeal surgeries is currently poorly understood. This study compares various palatopharyngeal surgery techniques without tonsillectomy for reducing the apnea-hypopnea index (AHI).

Data Sources: Embase, MEDLINE, Web of Science, ClinicalTrials, CINAHL, the Cochrane Library, and International Clinical Trials Registry Platform.

Designing digital health interventions with causal inference and multi-armed bandits: a review.

Recent statistics from the World Health Organization show that non-communicable diseases account for 74% of global fatalities, with lifestyle playing a pivotal role in their development. Promoting healthier behaviors and targeting modifiable risk factors can significantly improve both life expectancy and quality of life. The widespread adoption of smartphones and wearable devices enables continuous, in-the-wild monitoring of daily habits, opening new opportunities for personalized, data-driven health interventions.

Incidence of Diffusion-Weighted Imaging Lesions in Patients With Intracerebral Hemorrhage in the Acute and Subacute Time Periods.

Background And Objectives: Diffusion-weighted imaging (DWI) lesions in patients with intracerebral hemorrhage (ICH) are associated with poor outcomes. Knowledge about the underlying pathophysiology is scarce, and it is hypothesized that they are related to either the ICH itself, adverse effects of treatment, or the activity of the underlying small vessel disease (SVD) causing the ICH. We investigated their association with time point of MRI acquisition and underlying SVD type and burden.

REcovery from DEXmedetomidine-Induced Unresponsiveness (REDEX): A Study Protocol for a Single Center, Parallel Arm, Non-Randomized, Controlled Pilot Trial in Healthy Volunteers.

Purpose: Dexmedetomidine (DEX) is a well-tolerated sedative drug that induces a sleep-like state. DEX sedation offers a model to study transitions between different states of consciousness (indicated by, eg, behavior, the electroencephalogram (EEG), or transcranial magnetic stimulation (TMS) evoked EEG responses). However, the effects of repeated DEX exposure on recovery are poorly understood and will be investigated in this pilot study.

Sex differences in outcomes after endovascular therapy with prior antiplatelet use: A study from the EVA-TRISP registry.

Introduction: This study assessed sex differences in outcomes after mechanical thrombectomy (MT) with prior antiplatelet use using the EVA-TRISP multinational registry.

Patients And Methods: A cohort of consecutive patients (2015-2023) treated with MT was analysed by sex and prior antiplatelet use in multivariable logistic regression models. Primary outcomes were in-hospital symptomatic intracranial haemorrhage (sICH) and the 3-month modified Rankin Scale (mRS) score.

Application of a General Large Language Model-Based Classification System to Retrieve Information about Oncological Trials.

Introduction: The automated classification of clinical trials and key categories within the medical literature is increasingly relevant, particularly in oncology, as the volume of publications and trial reports continues to expand. Large language models (LLMs) may provide new opportunities for automating diverse classification tasks. They could be used for general-purpose text classification, retrieving information about oncological trials.

Blood biomarkers for predicting disability worsening in progressive multiple sclerosis: a multinational, individual participant-level analysis.

Background And Objectives: Biologically informative markers like glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) may help predict confirmed disability worsening (CDW) in multiple sclerosis (MS). However, data on the prognostic value of their blood concentrations in progressive MS (PMS) are limited, and there are substantial discrepancies in the published literature. This international collaboration uses individual participant data to define the prognostic value of serum GFAP and NfL in people with PMS (pwPMS).

Prehospital stroke care in low- and middle-income countries: A World Stroke Organization (WSO) scientific statement.

Evidence-based prehospital stroke care is effective in reducing stroke-related mortality and morbidity. The crucial period from symptom awareness to presentation at the hospital, the first step in the World Stroke Organization Road Map to Quality Care, is under-resourced in the majority of low- and middle-income countries (LMICs). Key challenges focus on a lack of stroke action awareness as well as human resources trained in stroke care.

Subthalamic beta power and gait in Parkinson's disease during unsupervised remote monitoring.

Background: Brain-sense enabled deep brain stimulation (DBS) in Parkinson's disease (PD) allows understanding the neurophysiological role of basal ganglia in gait dysfunction. Subthalamic nucleus (STN) local field potentials (LFPs) indicate pathological PD gait changes, but previous evidence is based on data obtained in controlled settings. This study aims to examine the relationship between STN oscillations and sensor-derived gait parameters in PD, in an unsupervised, real-life environment.

Antiplatelet Use Prior to Anticoagulant Initiation in Patients With Atrial Fibrillation-Related Ischemic Stroke: An ELAN Trial Analysis.

Background And Purpose: Antiplatelets are often used before direct oral anticoagulant (DOACs) initiation after an acute ischemic stroke related to atrial fibrillation (AF), but the evidence is weak. Here, we explored the risks and benefits of this approach.

Methods: A post-hoc analysis of ELAN (Early versus Late Initiation of Direct Oral Anticoagulants in Post-ischemic Stroke Patients with Atrial Fibrillation) trial data (NCT03148457) was conducted to compare the risk of recurrent ischemic stroke, systemic embolism, major bleeding (extracranial or intracranial hemorrhage [ICH]), and vascular death within 30 days (as a composite and as individual outcomes) in participants treated with and without antiplatelets before DOAC initiation after an AF-associated ischemic stroke.

Safety profiles of bone-conduction hearing implants revisited: A meta-analytic comparison adjusted for follow-up time.

Purpose: To estimate incidence rates of adverse events associated with bone-conduction hearing implants from primary literature and to compare rates among different technological designs.

Methods: A systematic literature review and meta-regression was conducted to estimate incidence rates of minor and major complications and their consequences (i.e.

Confirmed Worsening of Health-Related Quality of Life to Monitor Long-Term MS Disease Progression: A Longitudinal Analysis From the Swiss Multiple Sclerosis Registry.

Background: Monitoring multiple sclerosis (MS) progression traditionally relies on clinical measures, which may overlook symptoms affecting quality of life. Incorporating patient-reported outcomes could improve the understanding of disease worsening.

Objective: To evaluate an EQ-5D-based algorithm for detecting disease worsening and compare it with EDSS worsening.

Effect of metformin on hypoxia-associated gene expression in oral cavity squamous cell carcinoma in non-diabetic patients - a prospective window of opportunity study.

Purpose: Research suggests that metformin may reduce tumor hypoxia, rendering it a potential radiosensitizer. This study investigated metformin's effect on hypoxia-associated gene expression in oral cavity squamous cell carcinoma (OCSCC).

Methods: In this prospective trial, non-diabetic patients with OCSCC scheduled for curative surgery received preoperative metformin for 10 to 14 days.