TASK DEFINITION: Given a passage, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
PROBLEM: Thyroid-stimulating hormone (TSH) levels within populations do not follow Gaussian distribution, and normal limits are derived after mathematical normalization. The clinical relevance of these limits is unknown. The objective of this study was to compare upper and lower TSH limits by four data normalization methods with non-normalized data and assess their clinical relevance.', 'Results of blood samples taken by community physicians and stored in a computerized database were analysed after removing samples from patients with evidence of thyroid illness. TSH values were normalized by the Hoffmann and Tukey methods and each method with natural log transformation. Non-normalized data for TSH in the uppermost and lowermost percentile were also calculated. Clinical relevance was determined by alterations in thyroid hormone levels at, below and above the limits for each method.', 'The maximal reduction from non-normalized data for the upper normal limit (UNL) was by the Hoffman method 43% = 3·1 mIU/l). The maximal increase for the lower normal limit (LNL) was also by the Hoffman method (708% = 0·81 mIU/l). There was very limited difference in average FT3 and FT4 between patients with TSH within, below or above the normal range for all methods.

SOLUTION: Do normal limits for serum thyrotropin vary greatly depending on method?

PROBLEM: Gastrin and pepsinogens reflect the functional state of the gastric mucosa.', 'To evaluate whether serum gastrin and pepsinogens correlate with the different grades of severity of gastro-oesophageal reflux disease (GERD).', "In all, 388 patients with heartburn not taking any form of acid suppressive therapy were matched-controlled for age and gender and sub-classified into four groups: group 1 non-erosive reflux disease (NERD); group 2, erosive reflux disease (ERD) Los Angeles (LA) A and B, group 3, ERD LA C and D; group 4 Barrett's oesophagus (BO). Fasting serum was analysed for gastrin 17, pepsinogen I, pepsinogen II und Helicobacter pylori using specific EIA tests (GastroPanel; Biohit, Plc).", 'Kruskal-Wallis test and analysis of variance.', 'There was a significant difference among the four groups with respect for pepsinogen I, but not for pepsinogen II, the pepsinogen I pepsinogen II ratio, H. pylori serology and gastrin levels. Pepsinogen I was the lowest in NERD and the highest in BO (median 91.6, mean +/- standard deviation 106.2 +/- 51.6 vs. median 114.7, mean +/- standard deviation 130.4 +/- 70.6; P = 0.046). Pepsinogen I levels were higher in H. pylori positive subjects. After adjusting for H. pylori status, the differences in pepsinogen I across patient groups were no longer statistically significant (P = 0.298).

SOLUTION: Do serum gastrin and pepsinogens correlate with the different grades of severity of gastro-oesophageal reflux disease : a matched case-control study?

PROBLEM: Recently, a considerable amount of evidence suggested that anxiety, depression and other psychosocial variables might influence the outcomes of cardiac surgery. This study investigated the relationship between length of stay at the intensive care unit (ICU) and hospital after surgery and different psychosocial variables (e.g. depression, anxiety, self rated health, happiness, satisfaction).', 'We enrolled prospective patients who were waiting for elective cardiac surgery (N\u2009=\u2009267) and consented to take part in the study. We collected data of sociodemographic, medical and perioperative factors as well as psychosocial questionnaires completed 1.56\xa0days (standard deviation [SD]\u2009=\u20090.7) before surgery. The primary clinical endpoint was an ICU stay of at least 3\xa0days and the secondary was hospital stay of at least 10\xa0days.', 'Two hundred sixty-seven patients participated in this study. Four patients (1.5%) died in the hospital and 38 patients (14.5%) spent more than 3\xa0days in the ICU and 62 patients (23.2%) spent more than 10\xa0days in the hospital. After controlling for medical and sociodemographic factors, lower self rated health (Adjusted Odds Ratio [AOR]: 0.51, 95% confidence interval [CI]: 0.28-0.95; p\u2009=\u20090.03), lower rate of happiness (AOR: 0.76, 95% CI: 0.59-0.97, p\u2009=\u20090.03), postoperative cardiac failure (AOR: 7.09, 95% CI:1.21-41.54; p\u2009=\u20090.03) and postoperative complications (AOR: 9.52, 95% CI: 3.76-24.11; p\u2009<\u20090.001) were associated with longer ICU stay. More than 10\xa0days of hospital stay was associated with higher occurrence of COPD (AOR 4.56, CI: 1.95-10.67, p\u2009<\u20090.001), NYHA stage (AOR 6.76, CI: 2.57-17.79, p\u2009<\u20090.001), operation time (AOR 1.45, CI: 1.19-1.76, p\u2009<\u20090.001), female gender (AOR 2.16, CI: 1.06-4.40, p\u2009=\u20090.034) and lower self-rated health (AOR 0.63, CI: 0.41-0.99, p\u2009=\u20090.044).

SOLUTION:
Is self-rated health associated with the length of stay at the intensive care unit and hospital following cardiac surgery?