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Healthcare predictive modeling

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https://www.readbyqxmd.com/read/28092756/effects-of-assisted-outpatient-treatment-and-health-care-services-on-psychotic-symptoms
#1
Andres R Schneeberger, Christian G Huber, Undine E Lang, Kristina H Muenzenmaier, Dorothy Castille, Matthias Jaeger, Azizi Seixas, Julia Sowislo, Bruce G Link
RATIONALE: An ongoing debate concerns acceptability, benefits, and shortcomings of coercive treatment such as assisted outpatient treatment (AOT). The hypothesis that involuntary commitment to outpatient treatment may lead to a better clinical outcome for a subgroup of persons with severe mental illness (SMI) is controversial. Nonetheless, positive effects of AOT may be mediated by an increased availability of healthcare resources or increased service use. OBJECTIVE: The purpose of the present study is to evaluate the course of delusions, hallucinations, and negative symptoms among patients with SMI receiving AOT compared to patients receiving non-compulsory treatment (NCT)...
January 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28091336/who-are-the-patients-that-default-tuberculosis-treatment-space-matters
#2
C Nunes, R Duarte, A M Veiga, B Taylor
The goals of this article are: (i) to understand how individual characteristics affect the likelihood of patients defaulting their pulmonary tuberculosis (PTB) treatment regimens; (ii) to quantify the predictive capacity of these risk factors; and (iii) to quantify and map spatial variation in the risk of defaulting. We used logistic regression models and generalized additive models with a spatial component to determine the odds of default across continental Portugal. We focused on new PTB cases, diagnosed between 2000 and 2013, and included some individual information (sex, age, residence area, alcohol abuse, intravenous drug use, homelessness, HIV, imprisonment status)...
January 16, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28077893/the-prediction-of-the-risk-level-of-pulmonary-embolism-and-deep-vein-thrombosis-through-artificial-neural-network
#3
Laleh Agharezaei, Zhila Agharezaei, Ali Nemati, Kambiz Bahaadinbeigy, Farshid Keynia, Mohammad Reza Baneshi, Abedin Iranpour, Moslem Agharezaei
BACKGROUND: Venous thromboembolism is a common cause of mortality among hospitalized patients and yet it is preventable through detecting the precipitating factors and a prompt diagnosis by specialists. The present study has been carried out in order to assist specialists in the diagnosis and prediction of the risk level of pulmonary embolism in patients, by means of artificial neural network. METHOD: A number of 31 risk factors have been used in this study in order to evaluate the conditions of 294 patients hospitalized in 3 educational hospitals affiliated with Kerman University of Medical Sciences...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28077408/predicting-patient-cost-blooms-in-denmark-a-longitudinal-population-based-study
#4
Suzanne Tamang, Arnold Milstein, Henrik Toft Sørensen, Lars Pedersen, Lester Mackey, Jean-Raymond Betterton, Lucas Janson, Nigam Shah
OBJECTIVES: To compare the ability of standard versus enhanced models to predict future high-cost patients, especially those who move from a lower to the upper decile of per capita healthcare expenditures within 1 year-that is, 'cost bloomers'. DESIGN: We developed alternative models to predict being in the upper decile of healthcare expenditures in year 2 of a sample, based on data from year 1. Our 6 alternative models ranged from a standard cost-prediction model with 4 variables (ie, traditional model features), to our largest enhanced model with 1053 non-traditional model features...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28065773/using-the-electronic-medical-record-to-identify-patients-at-high-risk-for-frequent-ed-visits-and-high-system-costs
#5
David W Frost, Shankar Vembu, Jiayi Wang, Karen Tu, Quaid Morris, Howard B Abrams
BACKGROUND: A small proportion of patients accounts for a very high proportion of healthcare utilization. Accurate pre-emptive identification may facilitate tailored intervention. We sought to determine whether Machine Learning techniques using text from a family practice Electronic Medical Record (EMR) can be used to predict future high Emergency Department (ED) use and total costs by patients who are not yet high ED users or high cost to the healthcare system. METHODS: Text from fields of the Cumulative Patient Profile within an EMR (PS Suite) of 43,111 patients was indexed...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28065193/incidence-of-surgical-site-infections-cannot-be-derived-reliably-from-point-prevalence-survey-data-in-dutch-hospitals
#6
A P Meijs, J A Ferreira, S C DE Greeff, M C Vos, M B G Koek
Thorough studies on whether point prevalence surveys of healthcare-associated infections (HAIs) can be used to reliably estimate incidence of surgical site infections (SSIs) are scarce. We examined this topic using surveillance data of 58 hospitals that participated in two Dutch national surveillances; HAI prevalence and SSI incidence surveillance, respectively. First, we simulated daily prevalences of SSIs from incidence data. Subsequently, Rhame & Sudderth's formula was used to estimate SSI incidence from prevalence...
January 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28065185/predictors-of-immunodeficiency-related-death-in-a-cohort-of-low-income-people-living-with-hiv-a-competing-risks-survival-analysis
#7
M F P M Albuquerque, D N Alves, C C Bresani Salvi, J D L Batista, R A A Ximenes, D B Miranda-Filho, H R L Melo, M Maruza, U R Montarroyos
We conducted a survival analysis with competing risks to estimate the mortality rate and predictive factors for immunodeficiency-related death in people living with HIV/AIDS (PLWH) in northeast Brazil. A cohort with 2372 PLWH was enrolled between July 2007 and June 2010 and monitored until 31 December 2012 at two healthcare centres. The event of interest was immunodeficiency-related death, which was defined based on the Coding Causes of Death in HIV Protocol (CoDe). The predictor variables were: sociodemographic characteristics, illicit drugs, tobacco, alcohol, nutritional status, antiretroviral therapy, anaemia and CD4 cell count at baseline; and treatment or chemoprophylaxis for tuberculosis (TB) during follow-up...
January 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28065172/incorporating-environmental-outcomes-into-a-health-economic-model
#8
Kevin Marsh, Michael Ganz, Emil Nørtoft, Niels Lund, Joshua Graff-Zivin
OBJECTIVES: Traditional economic evaluations for most health technology assessments (HTAs) have previously not included environmental outcomes. With the growing interest in reducing the environmental impact of human activities, the need to consider how to include environmental outcomes into HTAs has increased. We present a simple method of doing so. METHODS: We adapted an existing clinical-economic model to include environmental outcomes (carbon dioxide [CO2] emissions) to predict the consequences of adding insulin to an oral antidiabetic (OAD) regimen for patients with type 2 diabetes mellitus (T2DM) over 30 years, from the United Kingdom payer perspective...
January 9, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28063706/associations-of-trust-and-healthcare-provider-advice-with-hpv-vaccine-acceptance-among-african-american-parents
#9
Linda Y Fu, Gregory D Zimet, Carl A Latkin, Jill G Joseph
OBJECTIVE: Healthcare providers (HCPs) are advised to give all parents a strong recommendation for HPV vaccination. However, it is possible that strong recommendations could be less effective at promoting vaccination among African Americans who on average have greater mistrust in the healthcare system. This study examines the associations of parental trust in HCPs and strength of HCP vaccination recommendation on HPV vaccine acceptance among African American parents. METHODS: Participants were recruited from an urban, academic medical center between July 2012 and July 2014...
January 4, 2017: Vaccine
https://www.readbyqxmd.com/read/28061831/acute-kidney-injury-as-an-independent-risk-factor-for-unplanned-90-day-hospital-readmissions
#10
Simon Sawhney, Angharad Marks, Nick Fluck, David J McLernon, Gordon J Prescott, Corri Black
BACKGROUND: Reducing readmissions is an international priority in healthcare. Acute kidney injury (AKI) is common, serious and also a global concern. This analysis evaluates AKI as a candidate risk factor for unplanned readmissions and determines the reasons for readmissions. METHODS: GLOMMS-II is a large population cohort from one health authority in Scotland, combining hospital episode data and complete serial biochemistry results through data-linkage. 16453 people (2623 with AKI and 13830 without AKI) from GLOMMS-II who survived an index hospital admission in 2003 were used to identify the causes of and predict readmissions...
January 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28061818/perspectives-preferences-and-needs-regarding-early-prediction-of-preeclampsia-in-dutch-pregnant-women-a-qualitative-study
#11
Neeltje M T H Crombag, Marije Lamain-de Ruiter, Anneke Kwee, Peter C J I Schielen, Jozien M Bensing, Gerard H A Visser, Arie Franx, Maria P H Koster
BACKGROUND: To improve early risk-identification in pregnancy, research on prediction models for common pregnancy complications is ongoing. Therefore, it was the aim of this study to explore pregnant women's perceptions, preferences and needs regarding prediction models for first trimester screening for common pregnancy complications, such as preeclampsia, to support future implementation. METHOD: Ten focus groups (of which five with primiparous and five with multiparous women) were conducted (n = 45)...
January 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28057799/prospective-study-of-oral-anticoagulants-and-risk-of-liver-injury-in-patients-with-atrial-fibrillation
#12
Alvaro Alonso, Richard F MacLehose, Lin Y Chen, Lindsay Gs Bengtson, Alanna M Chamberlain, Faye L Norby, Pamela L Lutsey
OBJECTIVE: To assess the risk of liver injury hospitalisation in patients with atrial fibrillation (AF) after initiation of direct oral anticoagulants (DOACs) or warfarin and to determine predictors of liver injury hospitalisation in this population. METHODS: We studied 113 717 patients (mean age 70, 39% women) with AF included in the MarketScan Commercial and Medicare Supplemental databases with a first prescription for oral anticoagulation after 4 November 2011, followed through 31 December 2014...
January 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28056835/clinical-prediction-in-defined-populations-a-simulation-study-investigating-when-and-how-to-aggregate-existing-models
#13
Glen P Martin, Mamas A Mamas, Niels Peek, Iain Buchan, Matthew Sperrin
BACKGROUND: Clinical prediction models (CPMs) are increasingly deployed to support healthcare decisions but they are derived inconsistently, in part due to limited data. An emerging alternative is to aggregate existing CPMs developed for similar settings and outcomes. This simulation study aimed to investigate the impact of between-population-heterogeneity and sample size on aggregating existing CPMs in a defined population, compared with developing a model de novo. METHODS: Simulations were designed to mimic a scenario in which multiple CPMs for a binary outcome had been derived in distinct, heterogeneous populations, with potentially different predictors available in each...
January 6, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28056524/venous-thromboembolism-requiring-extended-anticoagulation-among-hiv-infected-patients-in-a-rural-resource-constrained-setting-in-western-kenya
#14
John Kanyi, Rakhi Karwa, Sonak Dinesh Pastakia, Imran Manji, Simon Manyara, Collins Saina
BACKGROUND: HIV-infected patients are at an increased risk of developing venous thromboembolism (VTE), and minimal data are available to describe the need for extended treatment. OBJECTIVE: To evaluate the frequency of and determine predictive risk factors for extended anticoagulation of VTE in HIV-infected patients in rural, western Kenya. METHODS: A retrospective chart review was conducted at the Anticoagulation Monitoring Service affiliated with Moi Teaching and Referral Hospital and the Academic Model Providing Access to Healthcare...
December 1, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28047912/tu-h-207a-08-estimating-radiation-dose-from-low-dose-lung-cancer-screening-ct-exams-using-tube-current-modulation
#15
A Hardy, M Bostani, K McMillan, M Zankl, C Cagnon, M McNitt-Gray
PURPOSE: The purpose of this work is to estimate effective and lung doses from a low-dose lung cancer screening CT protocol using Tube Current Modulation (TCM) across patient models of different sizes. METHODS: Monte Carlo simulation methods were used to estimate effective and lung doses from a low-dose lung cancer screening protocol for a 64-slice CT (Sensation 64, Siemens Healthcare) that used TCM. Scanning parameters were from the AAPM protocols. Ten GSF voxelized patient models were used and had all radiosensitive organs identified to facilitate estimating both organ and effective doses...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047670/su-f-p-20-predicting-waiting-times-in-radiation-oncology-using-machine-learning
#16
A Joseph, D Herrera, T Hijal, L Hendren, A Leung, J Wainberg, M Sawaf, M Gorshkov, R Maglieri, M Keshavarz, J Kildea
PURPOSE: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047472/su-g-206-12-the-correlation-between-table-height-and-patient-size-in-ct-a-simple-way-to-properly-position-patients
#17
T Szczykutowicz, E Janssen-Saldivar, D Miller, A Malkus
PURPOSE: Proper patient positioning is essential in CT to ensure automatic exposure control functions properly, noise uniformity, and CT number uniformity. This work describes how table height can be used as a surrogate for proper patient positioning and motivates incorporating table height recommendations as a function of patient size into technologist training programs. METHODS: Scan data were acquired from 551 adult and pediatric patients under IRB approval. The table height, mean anterior-posterior patient dimension, and mean lateral patient dimension were calculated for each patient...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28035840/cost-effectiveness-of-switching-to-insulin-degludec-from-other-basal-insulins-evidence-from-swedish-real-world-data
#18
Lena Landstedt-Hallin, Jens Gundgaard, Åsa Ericsson, Susanne Ellfors-Zetterlund
OBJECTIVES: Health economic analysis from a health care and societal point of view was conducted to assess cost-effectiveness of insulin degludec (IDeg) after switching from other basal insulins in people with type 1 diabetes. MATERIAL AND METHODS: This was a prospective, open-label, single arm, observational follow-up from August 2013-October 2015 of 476 consecutive patients at Danderyd Hospital [Stockholm, Sweden] who switched to IDeg from other basal insulins (99% basal insulin analogs)...
December 30, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28032940/the-relationship-between-risk-factors-and-medication-adherence-among-breast-cancer-survivors-what-explanatory-role-might-depression-play
#19
Louis C Markovitz, Nicholas J Drysdale, B Ann Bettencourt
OBJECTIVE: Despite the efficacy of clinical treatments (e.g., adjuvant hormonal therapy) for breast cancer survivors (BCS), nonadherence rates remains high, increasing the risk of recurrence and mortality. The current study tested a theoretical model of medical nonadherence that proposes depression to be the most proximal predictor of medical nonadherence among BCS. METHODS: BCS were recruited from radiation clinics in Missouri. Survey data were collected 12 months after the end of primary treatment...
December 29, 2016: Psycho-oncology
https://www.readbyqxmd.com/read/28032828/a-review-of-discharge-prediction-processes-in-acute-care-hospitals
#20
Anna De Grood, Kenneth Blades, Sachin R Pendharkar
AIMS AND OBJECTIVES: Discharge prediction is designed to streamline inpatient flow and reduce hospital overcrowding without adding capacity. This study's objective was to describe the literature on discharge prediction and assess its usefulness in evaluating the implementation and outcomes of discharge prediction projects. METHODS: The authors reviewed the current peer-reviewed and grey literature on discharge prediction projects in acute care hospitals. Project descriptions were analyzed using Donabedian's structure-process-outcome model for evaluating complex healthcare innovations...
November 2016: Healthcare Policy, Politiques de Santé
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