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Healthcare predictive modeling

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https://www.readbyqxmd.com/read/28438733/use-and-customization-of-risk-scores-for-predicting-cardiovascular-events-using-electronic-health-record-data
#1
Julian Wolfson, David M Vock, Sunayan Bandyopadhyay, Thomas Kottke, Gabriela Vazquez-Benitez, Paul Johnson, Gediminas Adomavicius, Patrick J O'Connor
BACKGROUND: Clinicians who are using the Framingham Risk Score (FRS) or the American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) to estimate risk for their patients based on electronic health data (EHD) face 4 questions. (1) Do published risk scores applied to EHD yield accurate estimates of cardiovascular risk? (2) Are FRS risk estimates, which are based on data that are up to 45 years old, valid for a contemporary patient population seeking routine care? (3) Do the PCE make the FRS obsolete? (4) Does refitting the risk score using EHD improve the accuracy of risk estimates? METHODS AND RESULTS: Data were extracted from the EHD of 84 116 adults aged 40 to 79 years who received care at a large healthcare delivery and insurance organization between 2001 and 2011...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28437218/patient-physician-and-practice-characteristics-associated-with-cardiovascular-disease-preventive-care-for-women
#2
Caress A Dean, Lauren D Arnold, Paul J Hauptman, Jing Wang, Keith Elder
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death for American women. Although CVD preventive care has the potential to reduce a significant number of these deaths, the degree to which healthcare providers deliver such care is unknown. The purpose of this study was to identify patient, physician, and practice characteristics that significantly influence the provision of CVD preventive care during ambulatory care visits for female patients. METHODS: The National Ambulatory Medical Care Survey datasets from 2005 to 2010 were utilized...
February 27, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28429955/matrix-metalloproteinase-8-and-tissue-inhibitor-of-matrix-metalloproteinase-1-predict-incident-cardiovascular-disease-events-and-all-cause-mortality-in-a-population-based-cohort
#3
Immi Kormi, Mikko T Nieminen, Aki S Havulinna, Tanja Zeller, Stefan Blankenberg, Taina Tervahartiala, Timo Sorsa, Veikko Salomaa, Pirkko J Pussinen
Background Extracellular matrix degrading proteases and their regulators play an important role in atherogenesis and subsequent plaque rupture leading to acute cardiovascular manifestations. Design and methods In this prospective cohort study, we investigated the prognostic value of circulating matrix metalloproteinase-8, tissue inhibitor of matrix metalloproteinase-1 concentrations, the ratio of matrix metalloproteinase-8/ tissue inhibitor of matrix metalloproteinase-1 and, for comparison, myeloperoxidase and C-reactive protein concentrations for incident cardiovascular disease endpoints...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28427475/protocol-a-systematic-review-of-studies-developing-and-or-evaluating-search-strategies-to-identify-prognosis-studies
#4
Nadia Corp, Joanne L Jordan, Jill A Hayden, Emma Irvin, Robin Parker, Andrea Smith, Danielle A van der Windt
BACKGROUND: Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases...
April 20, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28427337/treatment-seeking-behaviour-in-low-and-middle-income-countries-estimated-using-a-bayesian-model
#5
Victor A Alegana, Jim Wright, Carla Pezzulo, Andrew J Tatem, Peter M Atkinson
BACKGROUND: Seeking treatment in formal healthcare for uncomplicated infections is vital to combating disease in low- and middle-income countries (LMICs). Healthcare treatment-seeking behaviour varies within and between communities and is modified by socio-economic, demographic, and physical factors. As a result, it remains a challenge to quantify healthcare treatment-seeking behaviour using a metric that is comparable across communities. Here, we present an application for transforming individual categorical responses (actions related to fever) to a continuous probabilistic estimate of fever treatment for one country in Sub-Saharan Africa (SSA)...
April 20, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28427011/biosensors-for-the-monitoring-of-harmful-algal-blooms
#6
REVIEW
Daniel A McPartlin, Jonathan H Loftus, Aoife S Crawley, Joe Silke, Caroline S Murphy, Richard J O'Kennedy
Harmful algal blooms (HABs) are a major global concern due to their propensity to cause environmental damage, healthcare issues and economic losses. In particular, the presence of toxic phytoplankton is a cause for concern. Current HAB monitoring programs often involve laborious laboratory-based analysis at a high cost and with long turnaround times. The latter also hampers the potential to develop accurate and reliable models that can predict HAB occurrence. However, a promising solution for this issue may be in the form of remotely deployed biosensors, which can rapidly and continuously measure algal and toxin levels at the point-of-need (PON), at a low cost...
April 17, 2017: Current Opinion in Biotechnology
https://www.readbyqxmd.com/read/28425405/cost-effectiveness-and-clinical-impact-of-antiviral-strategies-of-hbeag-positive-and-negative-chronic-hepatitis-b
#7
Itziar Oyagüez, María Buti, Max Brosa, Magdalena Rueda, Miguel A Casado
INTRODUCTION: Chronic hepatitis B (CHB) is associated with high burden and healthcare costs. Virologic response achieved with antivirals is associated with progression avoidance. This study aimed to estimate the efficiency and clinical impact of antiviral strategies in CHB patients. MATERIAL AND METHODS: A Markov model estimated lifetime complications and direct costs in both, HBeAg-positive and HBeAg-negative cohorts. Strategy 1 (71% of treated population) and strategy 2 (100%), both based on pegylated interferon (peg-IFN) followed by oral tenofovir or entecavir, were compared to no treatment...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28423786/prevalence-estimation-of-protected-health-information-in-swedish-clinical-text
#8
Aron Henriksson, Maria Kvist, Hercules Dalianis
Obscuring protected health information (PHI) in the clinical text of health records facilitates the secondary use of healthcare data in a privacy-preserving manner. Although automatic de-identification of clinical text using machine learning holds much promise, little is known about the relative prevalence of PHI in different types of clinical text and whether there is a need for domain adaptation when learning predictive models from one particular domain and applying it to another. In this study, we address these questions by training a predictive model and using it to estimate the prevalence of PHI in clinical text written (1) in different clinical specialties, (2) in different types of notes (i...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28413134/the-in-vitro-mimic%C3%A2-platform-reflects-age-associated-changes-in-immunological-responses-after-influenza-vaccination
#9
Allison Dauner, Pankaj Agrawal, Jose Salvatico, Tenekua Tapia, Vipra Dhir, S Farzana Shaik, Donald R Drake, Anthony M Byers
Increasing research and development costs coupled with growing concerns over healthcare expenditures necessitate the generation of pre-clinical testing models better able to predict the efficacy of vaccines, drugs and biologics. An ideal system for evaluating vaccine immunogenicity will not only be reliable but also physiologically relevant, able to be influenced by immunomodulatory characteristics such as age or previous exposure to pathogens. We have previously described a fully autologous human cell-based MIMIC® (Modular IMmune In vitro Construct) platform which enables the evaluation of innate and adaptive immunity in vitro, including naïve and recall responses...
April 13, 2017: Vaccine
https://www.readbyqxmd.com/read/28410981/predicting-healthcare-trajectories-from-medical-records-a-deep-learning-approach
#10
Trang Pham, Truyen Tran, Dinh Phung, Svetha Venkatesh
Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records...
April 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28409367/the-effect-of-health-system-factors-on-outcomes-and-costs-after-bariatric-surgery-in-a-universal-healthcare-system-a-national-cohort-study-of-bariatric-surgery-in-canada
#11
Aristithes G Doumouras, Fady Saleh, Sama Anvari, Scott Gmora, Mehran Anvari, Dennis Hong
INTRODUCTION: Previous data demonstrate that patients who receive bariatric surgery at a Center of Excellence are different than those who receive care at non-accredited centers. Canada provides a unique opportunity to naturally exclude confounders such as insurance status, hospital ownership, and lack of access on comparisons between hospitals and surgeons in bariatric surgery outcomes. The objective of this study was to determine the effect of hospital accreditation and other health system factors on all-cause morbidity after bariatric surgery in Canada...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28406271/the-relationship-between-higher-social-trust-and-lower-late-hiv-diagnosis-and-mortality-differs-by-race-ethnicity-results-from-a-state-level-analysis
#12
Yusuf Ransome, Ashley Batson, Sandro Galea, Ichiro Kawachi, Denis Nash, Kenneth H Mayer
INTRODUCTION: Black men who have sex with men (MSM) continue to suffer a disproportionate burden of new HIV diagnoses and mortality. To better understand some of the reasons for these profound disparities, we examined whether the association between social trust and late HIV diagnosis and mortality differed by race/ethnicity, and investigated potential indirect effects of any observed differences. METHODS: We performed generalized structural equation modelling to assess main and interaction associations between trust among one's neighbours in 2009 (i...
April 6, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28405748/translation-of-imaging-biomarkers-from-clinical-research-to-healthcare
#13
Ingo Kilimann, Jochen René Thyrian, Wolfgang Hoffmann, Stefan J Teipel
The use of biomarkers for diagnostics of Alzheimer's disease (AD) has increased over the last years in specialized care and experimental settings. With the possibly upcoming availability of disease-modifying therapeutic agents, the diagnostics and treatment of patients with cognitive impairment will change. Biomarkers will be used as theranostic markers for case finding. The development and evaluation of biomarkers can be framed in a phase model from preclinical studies through trials in expert center settings to the evaluation of biomarkers in primary care, up to testing the efficacy and the impact of biomarkers on the healthcare system...
April 12, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28402740/patients-at-high-risk-for-surgical-site-infection
#14
Krislynn M Mueck, Lillian S Kao
BACKGROUND: Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. METHODS: Review of the pertinent English-language literature. RESULTS: High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors...
April 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#15
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28397080/the-rituximab-biosimilar-ct-p10-in-rheumatology-and-cancer-a-budget-impact-analysis-in-28-european-countries
#16
László Gulácsi, Valentin Brodszky, Petra Baji, Fanni Rencz, Márta Péntek
INTRODUCTION: New biosimilars of monoclonal antibodies are anticipated to bring significant cost savings and increase access to treatment. The rituximab biosimilar CT-P10 has recently been approved in Europe in all indications held by reference rituximab (RTX), including rheumatoid arthritis, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. We analyzed the budgetary impact of the introduction of CT-P10 into the European Union (EU) for use in patients with rheumatoid arthritis and cancer diagnoses, using a budget impact analysis model...
April 10, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28395310/national-estimates-of-exposure-to-formaldehyde-in-italian-workplaces
#17
Alberto Scarselli, Marisa Corfiati, Davide Di Marzio, Sergio Iavicoli
Purpose: Formaldehyde is classified as human carcinogen and the association with nasopharyngeal cancer has been observed in many epidemiological studies. The aim of this study is to evaluate data about occupational exposure levels to formaldehyde in the Italian working force. Methods: Airborne concentrations of formaldehyde were extracted from the Italian database on occupational exposure to carcinogens and refer to the period 1996-2014. Descriptive statistics were calculated for exposure-related variables...
January 1, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/28393749/a-transdiagnostic-study-of-education-employment-and-training-outcomes-in-young-people-with-mental-illness
#18
R S C Lee, D F Hermens, J Scott, B O'Dea, N Glozier, E M Scott, I B Hickie
BACKGROUND: Optimizing functional recovery in young individuals with severe mental illness constitutes a major healthcare priority. The current study sought to quantify the cognitive and clinical factors underpinning academic and vocational engagement in a transdiagnostic and prospective youth mental health cohort. The primary outcome measure was 'not in education, employment or training' ('NEET') status. METHOD: A clinical sample of psychiatric out-patients aged 15-25 years (n = 163) was assessed at two time points, on average, 24 months apart...
April 10, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28392994/medical-big-data-promise-and-challenges
#19
Choong Ho Lee, Hyung-Jin Yoon
The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28392100/risk-prediction-for-ischemic-stroke-and-transient-ischemic-attack-in-patients-without-atrial-fibrillation-a-retrospective-cohort-study
#20
Zhong Yuan, Erica A Voss, Frank J DeFalco, Guohua Pan, Patrick B Ryan, Daniel Yannicelli, Christopher Nessel
BACKGROUND: Stroke mainly occurs in patients without atrial fibrillation (AF). This study explored risk prediction models for ischemic stroke and transient ischemic attack (TIA) in patients without AF. METHODS: Three US-based healthcare databases (Truven MarketScan Commercial Claims and Encounters [CCAE], Medicare Supplemental [MDCR], and Optum Clinformatics [Optum]) were used to establish patient cohorts without AF during the index period of 2008-2012. The performance of 2 existing models (CHADS2 and CHA2DS2-VASc) for predicting stroke and TIA was examined by fitting a logistic regression to a training dataset and evaluating predictive accuracy in a validation dataset (area under the curve, AUC) using patients with complete follow-up of 1 or 3 years, separately...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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