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Healthcare predictive modeling

Nadia Schott, Maike Tietjens
Mobility restriction as a consequence of a fall is a major issue in assisted living facilities. Although many factors are related to falling, little is known about the relationship between falls, social support, falls efficacy, and physical activity. We examined the relationship between falls and the Social-Support-Questionnaire, the Activities-specific Balance Confidence scale, and physical activity simultaneously in 81 older adults (66-94 years) using structural equation modeling (SEM). The SEM model revealed that being older was associated with lower falls efficacy and a higher number of falls...
March 15, 2018: Journal of Aging and Physical Activity
Victoria Omranifard, Ebrahim Haghighizadeh, Shahla Akouchekian
Background: The most common neurodegenerative disease is dementia. Family of dementia patients says that their lives have been changed extensively after happening of dementia to their patients. One of the problems of family and caregivers is depression of the caregiver. In this study, we aimed to find the prevalence of depression and factors can affect depression in the dementia caregivers. Materials and Methods: This study was cross-sectional study with convenient sampling method...
2018: Advanced Biomedical Research
Xu Cong Ruan, Lian Leng Low, Yu Heng Kwan
INTRODUCTION The risk of rhabdomyolysis in the general population is elevated by the increased prevalence of statin use. As the presentation of rhabdomyolysis is varied, there is a risk of delayed diagnosis leading to patient complications and increased healthcare costs. Creatine kinase (CK) alone is not sufficiently predictive for risk stratification. Beyond serum CK, other biomarkers such as transaminases may be used as surrogates to evaluate rhabdomyolysis severity and predict complication risks. AIM To assess if other biomarkers are associated with peak CK and severity of rhabdomyolysis to aid in clinical diagnosis of rhabdomyolysis...
December 2017: Journal of Primary Health Care
Jinsong Zhang, Anastasia Miller, Yongxia Li, Qinqin Lan, Ning Zhang, Yanling Chai, Bing Hai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations...
March 7, 2018: Tuberculosis and Respiratory Diseases
Anna K Paschall, S Mojdeh Mirmomen, Rolf Symons, Amir Pourmorteza, Rabindra Gautam, Amil Sahai, Andrew J Dwyer, Maria J Merino, Adam R Metwalli, W Marston Linehan, Ashkan A Malayeri
PURPOSE: To determine whether objective volumetric whole-lesion apparent diffusion coefficient (ADC) distribution analysis improves upon the capabilities of conventional subjective small region-of-interest (ROI) ADC measurements for prediction of renal cell carcinoma (RCC) subtype. METHODS: This IRB-approved study retrospectively enrolled 55 patients (152 tumors). Diffusion-weighted imaging DWI was acquired at b values of 0, 250, and 800 s/mm2 on a 1.5T system (Aera, Siemens Healthcare)...
March 8, 2018: Abdominal Radiology
Sara Viotti, Lynnette Essenmacher, Lydia E Hamblin, Judith E Arnetz
In spite of the considerable number of studies on co-worker incivility, knowledge on this topic needs to be further enhanced. In particular, no studies have focused on the reciprocal nature of the relationship of incivility with other important aspects of working life, i.e. employee well-being and the quality of the working process. The aim of the present study was to examine the cross-lagged associations among co-worker incivility, work-related exhaustion, and organisational efficiency in a sample of healthcare workers...
2018: Work and Stress
Anamika Pandey, Lynda Clarke, Lalit Dandona, George B Ploubidis
OBJECTIVE: We report inequity in out-of-pocket payments (OOPP) for hospitalisation in India between 1995 and 2014 contrasting older population (60 years or more) with a population under 60 years (younger population). METHODS: We used data from nationwide healthcare surveys conducted in India by the National Sample Survey Organisation in 1995-96, 2004 and 2014 with the sample sizes ranging from 333,104 to 629,888. We used generalised linear and fractional response models to study the determinants of OOPP and their burden (share of OOPP in household consumption expenditure) at a constant price...
February 6, 2018: Social Science & Medicine
Maria Chiara Corti, Francesco Avossa, Elena Schievano, Pietro Gallina, Eliana Ferroni, Natalia Alba, Matilde Dotto, Cristina Basso, Silvia Tiozzo Netti, Ugo Fedeli, Domenico Mantoan
BACKGROUND: The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local Health Trusts (LHTs) is based on a capitation system adjusted only for age, gender and area of residence. We applied a risk-adjustment system (Johns Hopkins Adjusted Clinical Groups System, ACG® System) in order to explain health care costs using routinely collected administrative data in the Veneto Region (North-eastern Italy)...
March 4, 2018: European Journal of Internal Medicine
Elizabeth C Lee, Ali Arab, Sandra M Goldlust, Cécile Viboud, Bryan T Grenfell, Shweta Bansal
The surveillance of influenza activity is critical to early detection of epidemics and pandemics and the design of disease control strategies. Case reporting through a voluntary network of sentinel physicians is a commonly used method of passive surveillance for monitoring rates of influenza-like illness (ILI) worldwide. Despite its ubiquity, little attention has been given to the processes underlying the observation, collection, and spatial aggregation of sentinel surveillance data, and its subsequent effects on epidemiological understanding...
March 7, 2018: PLoS Computational Biology
Emili Vela, Ákos Tényi, Isaac Cano, David Monterde, Montserrat Cleries, Anna Garcia-Altes, Carme Hernandez, Joan Escarrabill, Josep Roca
BACKGROUND: Clinical management of patients with chronic obstructive pulmonary disease (COPD) shows potential for improvement provided that patients' heterogeneities are better understood. The study addresses the impact of comorbidities and its role in health risk assessment. OBJECTIVE: To explore the potential of health registry information to enhance clinical risk assessment and stratification. DESIGN: Fixed cohort study including all registered patients with COPD in Catalonia (Spain) (7...
March 6, 2018: BMJ Open
Garrett S Bowen, Michelle S Diop, Lan Jiang, Wen-Chih Wu, James L Rudolph
OBJECTIVES: To derive and validate a 30-day mortality clinical prediction rule for heart failure based on admission data and prior healthcare usage. A secondary objective was to determine the discriminatory function for mortality at 1 and 2 years. DESIGN: Observational cohort. SETTING: Veterans Affairs inpatient medical centers (n=124). PARTICIPANTS: The derivation (2010-12; n=36,021) and validation (2013-15; n=30,364) cohorts included randomly selected veterans admitted for HF exacerbation (mean age 71±11; 98% male)...
March 6, 2018: Journal of the American Geriatrics Society
Theodora S Brisimi, Ruidi Chen, Theofanie Mela, Alex Olshevsky, Ioannis Ch Paschalidis, Wei Shi
BACKGROUND: In an era of "big data," computationally efficient and privacy-aware solutions for large-scale machine learning problems become crucial, especially in the healthcare domain, where large amounts of data are stored in different locations and owned by different entities. Past research has been focused on centralized algorithms, which assume the existence of a central data repository (database) which stores and can process the data from all participants. Such an architecture, however, can be impractical when data are not centrally located, it does not scale well to very large datasets, and introduces single-point of failure risks which could compromise the integrity and privacy of the data...
April 2018: International Journal of Medical Informatics
Felipe Maia de Toledo Piza, Leo Anthony Celi, Rodrigo Octavio Deliberato, Lucas Bulgarelli, Fabricio Rodrigues Torres de Carvalho, Roberto Rabello Filho, Miguel Angel Armengol de La Hoz, Jennifer Cohn Kesselheim
BACKGROUND: Datathons are increasingly organized in the healthcare field. The goal is to assemble people with different backgrounds to work together as a team and engage in clinically relevant research or develop algorithms using health-related datasets. Criteria to assess the return of investment on such events have traditionally included publications produced, patents for prediction, classification, image recognition and other types of software, and start-up companies around the application of machine learning in healthcare...
April 2018: International Journal of Medical Informatics
Fangying Xie, Juliana C N Chan, Ronald C W Ma
Diabetes has become a major burden of healthcare expenditure. Diabetes management following a uniform treatment algorithm is often associated with progressive treatment failure and development of diabetic complications. Recent advances in our understanding in the genomic architecture of diabetes and its complications have provided the framework for development of precision medicine to personalize diabetes prevention and management. In this review, we summarized recent advances in the understanding of the genetic basis of diabetes and its complications...
March 2, 2018: Journal of Diabetes Investigation
John F Steiner, Sandra H Stenmark, Andrew T Sterrett, Andrea R Paolino, Matthew Stiefel, Wendolyn S Gozansky, Chan Zeng
OBJECTIVES: To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. DESIGN: Retrospective cohort study. SETTING: Kaiser Permanente Colorado. PARTICIPANTS: Adult members who completed a pre-Medicare Annual Wellness Visit survey. MEASUREMENTS: Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self-reported characteristics from the survey were used to develop the prediction model...
March 1, 2018: Journal of the American Geriatrics Society
Darko Vucicevic, Lily Honoris, Federica Raia, Mario Deng
Heart failure (HF) is a complex clinical syndrome that results from structural or functional cardiovascular disorders causing a mismatch between demand and supply of oxygenated blood and consecutive failure of the body's organs. For those patients with stage D HF, advanced therapies, such as mechanical circulatory support (MCS) or heart transplantation (HTx), are potentially life-saving options. The role of risk stratification of patients with stage D HF in a value-based healthcare framework is to predict which subset might benefit from advanced HF (AdHF) therapies, to improve outcomes related to the individual patient including mortality, morbidity and patient experience as well as to optimize health care delivery system outcomes such as cost-effectiveness...
January 2018: Annals of Cardiothoracic Surgery
Lei Yang, Kaarina Korhonen, Heta Moustgaard, Karri Silventoinen, Pekka Martikainen
BACKGROUND: Previous studies have found depression to be negatively associated with the prognosis of both cardiovascular disease (CVD) and cancer, but this may partly reflect reverse causality. We limited the possibility of reverse causality by measuring depression before the first diagnosis of CVD or cancer. METHODS: We used an 11% longitudinal random sample of the Finnish population aged 25 years or older who are residents of Finland for at least 1 year between 1987 and 2007, with an 80% oversample of those who died during this period...
February 26, 2018: Journal of Epidemiology and Community Health
Amanda J Hessels, Jianfang Liu, Bevin Cohen, Jingjing Shang, Elaine L Larson
INTRODUCTION: Severity of illness (SOI) measures are commonly used in adults for comparison of treatment and outcomes in similar populations. Less is known about the psychometric properties of measures available to providers and healthcare systems caring for pediatric patients. The purpose of this study was to (1) identify SOI measures used for pediatric patients admitted to acute care hospitals and (2) compare the ability of two SOI measures to predict mortality and length of stay (LOS)...
February 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Scott R Beach, Richard Schulz, Esther M Friedman, Juleen Rodakowski, Grant Martsolf, Alton Everette James
Objectives: We explore adverse consequences of unmet needs for care among high-need/high-cost (HNHC) older adults. Method: Interviews with 4,024 community-dwelling older adults with ADL/IADL/mobility disabilities from the 2011 National Health and Aging Trends Study (NHATS). Reports of socio-demographics, disability compensatory strategies, and adverse consequences of unmet needs in the past month were obtained from older adults with multiple chronic conditions (MCC), probable dementia (DEM), and/or near end-of-life (EOL) and compared older adults not meeting these criteria...
February 17, 2018: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
Jorge G Ruiz, Zubair Rahaman, Stuti Dang, Ramanakumar Anam, Willy M Valencia, Michael J Mintzer
BACKGROUND: Frailty is a state of vulnerability to stressors which results in higher morbidity, mortality and healthcare utilization. The FRAIL scale is used as a validated screening for frailty. The Care Assessment Need (CAN) score is automatically generated from electronic health record data using a statistical model that includes data elements similar to the deficit accumulation model for frailty and predicts risk for hospitalization and/or mortality. AIM: To determine the correlation of the CAN score with the FRAIL scale...
February 21, 2018: Aging Clinical and Experimental Research
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