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Healthcare predictive modeling

Michael G Tecce, Marten N Basta, Valeriy Shubinets, Michael A Lanni, Michael N Mirzabeigi, Laura Cooney, Suneeta Senapati, Ashley F Haggerty, Jason M Weissler, J Andres Hernandez, John P Fischer
BACKGROUND: Incisional hernia (IH) is a complication following open abdominal hysterectomy. This study addresses the incidence and health care cost of IH repair after open hysterectomy, and identify perioperative risk factors to create predictive risk models. METHODS: We conduct a retrospective review of patients who underwent open hysterectomy between 2005 and 2013 at the University of Pennsylvania. The primary outcome was post-hysterectomy IH. Univariate/multivariate cox proportional hazard analyses identified perioperative risk factors...
October 11, 2016: American Journal of Surgery
L M M Lê, A Tfayli, J Zhou, P Prognon, A Baillet-Guffroy, E Caudron
Raman spectroscopy is a rapid, non-destructive and non-invasive method that is a promising tool for real-time analytical control of drug concentrations. This study evaluated a handheld Raman device to discriminate and quantify two isomeric drugs used to treat cancer. Doxorubicin (DOXO) and epirubicin (EPIR) samples were analyzed at therapeutic concentrations from 0.1 to 2mg/mL (n=90) and 0.08-2mg/mL (n=90) by non-invasive measurements using a portable Raman spectrometer. The discrimination of these two molecules was demonstrated for all concentrations (n=180) by qualitative analysis using partial least square discriminant analysis (PLS-DA) with 100% classification accuracy, sensitivity and specificity and 0% error rate...
December 1, 2016: Talanta
Erik David Storholm, Michael J Silverberg, Derek D Satre
Access to substance use disorder (SUD) treatment is a critical issue for women with HIV. This study examined differences in SUD diagnoses, comorbid psychiatric diagnoses, and predictors of SUD treatment initiation among a diverse sample of HIV-positive women (n = 228) and a demographically similar cohort of HIV-negative women (n = 693). Diagnoses and service utilization data were obtained from electronic health records of members of a large integrated healthcare system in Northern California. HIV-positive women were less likely to initiate SUD treatment...
October 21, 2016: Journal of Psychoactive Drugs
Antonio Miguel Cruz, Mayra R Guarín
To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions-Healthcare Technology Management database...
October 21, 2016: Journal of Medical Engineering & Technology
A Craig, N A Elbers, J Jagnoor, B Gopinath, A Kifley, M Dinh, I Pozzato, R Q Ivers, M Nicholas, I D Cameron
OBJECTIVE: To investigate the psychological impact of traffic injuries in bicyclists (cyclists) with comparisons to car occupants who also have sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated. METHODS: An inception cohort prospective design was used. Participants included cyclists who sustained a physical injury (n = 238) aged ≥17 years (mean age 41.7yrs), assessed within 28 days of the crash, following medical examination by a registered healthcare practitioner...
October 20, 2016: Traffic Injury Prevention
Sarah E Seaton, Lisa Barker, Elizabeth S Draper, Keith R Abrams, Neena Modi, Bradley N Manktelow
Modelling length of stay in neonatal care is vital to inform service planning and the counselling of parents. Preterm babies, at the highest risk of mortality, can have long stays in neonatal care and require high resource use. Previous work has incorporated babies that die into length of stay estimates, but this still overlooks the levels of care required during their stay. This work incorporates all babies, and the levels of care they require, into length of stay estimates. Data were obtained from the National Neonatal Research Database for singleton babies born at 24-31 weeks gestational age discharged from a neonatal unit in England from 2011 to 2014...
2016: PloS One
Amy Blakemore, Mark Hann, Kelly Howells, Maria Panagioti, Mark Sidaway, David Reeves, Peter Bower
BACKGROUND: Patient Activation is defined as the knowledge, skill, and confidence a patient has in managing their health. Higher levels of patient activation are associated with better self-management, better health outcomes, and lower healthcare costs. Understanding the drivers of patient activation can allow better tailoring of patient support and interventions. There are few data on patient activation in UK patients with long-term conditions. METHODS: A prospective cohort design was used...
October 18, 2016: BMC Health Services Research
Peter Rijnbeek
Massive numbers of electronic health records are currently being collected globally, including structured data in the form of diagnoses, medications, laboratory test results, and unstructured data contained in clinical narratives. This opens unprecedented possibilities for research and ultimately patient care. However, actual use of these databases in a multi-center study is severely hampered by a variety of challenges, e.g., each database has a different database structure and uses different terminology systems...
September 2016: Journal of Hypertension
Meghan K Mattos, Susan M Sereika, Jennifer G Naples, Steven M Albert
BACKGROUND: Older adults are especially susceptible to adverse consequences of potentially inappropriate medications (PIMs), such as benzodiazepine receptor agonists (BZDRAs), due to age-related pharmacokinetic and pharmacodynamic changes. Although some risk factors for BZDRA use in older adults have been identified, the role of rural versus urban residence is less clear. OBJECTIVE: To describe BZDRA use in rural versus urban older adults using pharmaceutical claims from Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) program...
September 2016: Drugs—Real World Outcomes
Marten N Basta, Liza C Wu, Suhail K Kanchwala, Joseph M Serletti, Julia C Tchou, Stephen J Kovach, Joshua Fosnot, John P Fischer
BACKGROUND: Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool. METHODS: An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome...
September 7, 2016: American Journal of Surgery
Paul McNamee, Elizabeth Murray, Michael P Kelly, Laura Bojke, Jim Chilcott, Alastair Fischer, Robert West, Lucy Yardley
This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions...
November 2016: American Journal of Preventive Medicine
M Yoshimura, K Moriwaki, S Noto, T Takiguchi
: Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. INTRODUCTION: The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture...
October 14, 2016: Osteoporosis International
Tiziana Frusca, Maria-Teresa Gervasi, Davide Paolini, Matteo Dionisi, Francesca Ferre, Irene Cetin
INTRODUCTION: Preeclampsia (PE) is a pregnancy disease which represents a leading cause of maternal and perinatal mortality and morbidity. Accurate prediction of PE risk could provide an increase in health benefits and better patient management. OBJECTIVE: To estimate the economic impact of introducing Elecsys sFlt-1/PlGF ratio test, in addition to standard practice, for the prediction of PE in women with suspected preeclampsia in the Italian NHS. METHODS: A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of clinical suspicion of PE in the 2nd and 3rd trimester until delivery...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
Daniel J Rubin, Elizabeth A Handorf, Sherita Hill Golden, Deborah B Nelson, Marie E McDonnell, Huaqing Zhao
OBJECTIVE: To develop and validate a tool to predict the risk of all-cause readmission within 30 days (30-d readmission) among hospitalized patients with diabetes. METHODS: A cohort of 44,203 discharges was retrospectively selected from the electronic records of adult patients with diabetes hospitalized at an urban academic medical center. Discharges of 60% of the patients (n = 26,402) were randomly selected as a training sample to develop the index. The remaining 40% (n = 17,801) were selected as a validation sample...
October 2016: Endocrine Practice
Marilyn L Moy, Michael K Gould, In-Lu Amy Liu, Janet S Lee, Huong Q Nguyen
The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD) hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011. All-cause mortality in the 12 months after discharge was the primary outcome. Physical activity, expressed as self-reported minutes of moderate to vigorous physical activity (MVPA), was routinely assessed at outpatient visits prior to hospitalisation...
January 2016: ERJ Open Research
Laura Petitta, Lixin Jiang, Charmine E J Härtel
The present study adds novel knowledge to the literature on emotional contagion (EC), discrete emotions, job burnout, and the management of healthcare professionals by simultaneously considering EC as both a job demand and a job resource with multiple social pathways. Integrating EC into the job demands-resource model, we develop and test a conceptual model wherein multiple stakeholder sources of emotional exchanges (i.e., leaders, colleagues, patients) play a differential role in predicting caregivers' absorption of positive (i...
October 10, 2016: Stress and Health: Journal of the International Society for the Investigation of Stress
Peng-Jun Lu, Alissa O'Halloran, Walter W Williams, Rafael Harpaz
INTRODUCTION: Shingles (herpes zoster) causes substantial morbidity, especially among older adults. The shingles vaccine has been recommended for people aged ≥60 years since 2006. This study assessed recent shingles vaccination at national and state levels among adults aged ≥60 years. METHODS: The 2014 Behavioral Risk Factor Surveillance System data were analyzed in 2015 to assess shingles vaccination coverage among adults aged ≥60 years at national and state levels...
October 5, 2016: American Journal of Preventive Medicine
Steve Goodison, Osamu Ogawa, Yoshiyuki Matsui, Takashi Kobayashi, Makito Miyake, Sayuri Ohnishi, Kiyohide Fujimoto, Yunfeng Dai, Yoshiko Shimizu, Kazue Tsukikawa, Hideki Furuya, Charles J Rosser
BACKGROUND: Bladder cancer (BCa) is among the most commonly diagnosed malignancies worldwide, and due the high rate of post-operative disease recurrence, it is one of the most prevalent in many countries. The development of non-invasive molecular assays that can accurately detect and monitor BCa would be a major advance, benefiting both patients and healthcare systems. We have previously identified a urinary protein biomarker panel that is being developed for application in at-risk patient cohorts...
October 7, 2016: Journal of Translational Medicine
Jonathan Lifshitz, Rachel K Rowe, Daniel R Griffiths, Megan N Evilsizor, Theresa C Thomas, P David Adelson, Tracy K McIntosh
BACKGROUND: After 30 years of characterisation and implementation, fluid percussion injury (FPI) is firmly recognised as one of the best-characterised reproducible and clinically relevant models of TBI, encompassing concussion through diffuse axonal injury (DAI). Depending on the specific injury parameters (e.g. injury site, mechanical force), FPI can model diffuse TBI with or without a focal component and may be designated as mild-to-severe according to the chosen mechanical forces and resulting acute neurological responses...
August 11, 2016: Brain Injury: [BI]
Virginia Ahalt, Nilay Tanık Argon, Serhan Ziya, Jeff Strickler, Abhi Mehrotra
According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power...
October 4, 2016: Health Care Management Science
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