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Arch Iran Med. 27(8):465. doi: 10.34172/aim.27317

Commentary

Comments on "Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: a Guide for Selective Node Dissection"

Hadi Raeisi Shahraki 1, * ORCID logo

Author information:
1Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

*Corresponding Author: Hadi Raeisi Shahraki, Email: raeisi.shahraki_hadi@yahoo.com

Copyright and License Information

© 2024 The Author(s).
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article as: Raeisi Shahraki H. Comments on "effects of patient and tumor characteristics on central lymph node metastasis in papillary thyroid cancer: a guide for selective node dissection". Arch Iran Med. 2024;27(8):465. doi: 10.34172/aim.27317

Recently, Altiner et alpublished an article entitled above and showed that gender (OR = 1.22), tumor subtype (OR = 0.44) and lymphovascular invasion (OR = 2.59) significantly increase the odds of central lymph node metastasis (CLNM), while intra-thyroidal localization of the tumor is not significantly associated with CLNM based on the multiple logistic regression.1 However, these findings are doubtful due to the following reasons:

  • The estimated crude odds ratios are not true for women (correct OR = 0.51), lymphovascular invasion (correct OR = 138.19) and extracapsular invasion (correct OR = 8.87).

  • In Table 2, for not applicable ORs, 95% confidence intervals were reported!

  • The negative values in the confidence interval of odds ratios are definitely wrong because the odds ratio is always positive.

  • The adjusted OR for lymphovascular invasion is 2.59, but the 95% confidence intervals range from 4.47 to 7.9 which is impossible.

  • In the multiple logistic regression, just one OR was reported for each of the quantitative variables with more than two categories. Considering a category as the baseline, four ORs must be reported for intra-thyroidal localization and two ORs for tumor subtype. So, the current ORs are not valid.

  • The confidence interval of OR for gender ranges from 0.99 to 1.55 which contains one and cannot be significant; so, P value = 0.025 is not true and the correct P value is greater than 0.05, indicating gender is not statistically significant.

I hope this note shows some deleterious effects of inappropriate statistical analysis in medical research.


Competing Interests

Nothing to declare.

Ethical Approval

Not applicable.


References

  1. Altiner S, Kozan R, Emral AC, Taneri F, Karamercan A. Effects of Patient and Tumor Characteristics on Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Guide for Selective Node Dissection. Arch Iran Med. 2022:25(11):730-6. 10.34172/aim.2022.115.
Submitted: 23 Mar 2023
Accepted: 16 Mar 2024
First published online: 01 Aug 2024
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