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Healthcare predictive modeling

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https://www.readbyqxmd.com/read/29331740/development-and-validation-of-a-new-population-based-simulation-model-of-osteoarthritis-in-new-zealand
#1
Ross Wilson, J Haxby Abbott
OBJECTIVE: To describe the construction and preliminary validation of a new population-based microsimulation model developed to analyse the health and economic burden and cost-effectiveness of treatments for knee osteoarthritis (OA) in New Zealand (NZ). METHOD: We developed the New Zealand Management of Osteoarthritis (NZ-MOA) model, a discrete-time state-transition microsimulation model of the natural history of radiographic knee OA. In this article, we report on the model structure, derivation of input data, validation of baseline model parameters against external data sources, and validation of model outputs by comparison of the predicted population health loss with previous estimates...
January 10, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29331253/evaluation-of-three-machine-learning-models-for-self-referral-decision-support-on-low-back-pain-in-primary-care
#2
Wendy Oude Nijeweme-d'Hollosy, Lex van Velsen, Mannes Poel, Catharina G M Groothuis-Oudshoorn, Remko Soer, Hermie Hermens
BACKGROUND: Most people experience low back pain (LBP) at least once in their life and for some patients this evolves into a chronic condition. One way to prevent acute LBP from transiting into chronic LBP, is to ensure that patients receive the right interventions at the right moment. We started research in the design of a clinical decision support system (CDSS) to support patients with LBP in their self-referral to primary care. For this, we explored the possibilities of using supervised machine learning...
February 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29325630/towards-precision-medicine
#3
Tanya Bardakjian, Pedro Gonzalez-Alegre
The concept of precision medicine, also referred to as individualized or personalized medicine, has recently gained traction in scientific, medical, and public spheres, and is frequently mentioned as the next model of healthcare delivery. Its goal is to integrate unique information obtained from a given patient to customize the care provided to achieve the best possible outcome. Although precision medicine is not fully implemented yet, its application is slowly infiltrating clinical practice, and the dream of individualizing healthcare to each patient is now closer to being fulfilled...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29324741/facilitating-healthcare-decisions-by-assessing-the-certainty-in-the-evidence-from-preclinical-animal-studies
#4
Carlijn R Hooijmans, Rob B M de Vries, Merel Ritskes-Hoitinga, Maroeska M Rovers, Mariska M Leeflang, Joanna IntHout, Kimberley E Wever, Lotty Hooft, Hans de Beer, Ton Kuijpers, Malcolm R Macleod, Emily S Sena, Gerben Ter Riet, Rebecca L Morgan, Kristina A Thayer, Andrew A Rooney, Gordon H Guyatt, Holger J Schünemann, Miranda W Langendam
Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.g., toxicology), studies in experimental animals may provide the only relevant or controlled data and directly inform clinical management decisions...
2018: PloS One
https://www.readbyqxmd.com/read/29322928/constraint-based-perturbation-analysis-with-cluster-newton-method-a-case-study-of-personalized-parameter-estimations-with-irinotecan-whole-body-physiologically-based-pharmacokinetic-model
#5
Shun Asami, Daisuke Kiga, Akihiko Konagaya
BACKGROUND: Drug development considering individual varieties among patients becomes crucial to improve clinical development success rates and save healthcare costs. As a useful tool to predict individual phenomena and correlations among drug characteristics and individual varieties, recently, whole-body physiologically based pharmacokinetic (WB- PBPK) models are getting more attention. WB-PBPK models generally have a lot of drug-related parameters that need to be estimated, and the estimations are difficult because the observed data are limited...
December 21, 2017: BMC Systems Biology
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#6
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29315323/developing-a-theoretical-model-and-questionnaire-survey-instrument-to-measure-the-success-of-electronic-health-records-in-residential-aged-care
#7
Ping Yu, Siyu Qian
Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes...
2018: PloS One
https://www.readbyqxmd.com/read/29315206/factors-associated-with-peer-victimization-among-adolescents-in-taiwan
#8
Hui-Wen Huang, Jyu-Lin Chen, Ruey-Hsia Wang
BACKGROUND: Adolescents who have experienced peer victimization face a higher risk of negative health outcomes. However, little is known about the factors that are associated with peer victimization among adolescents in Taiwan. PURPOSE: The aim of this study was to examine the factors related to peer victimization among Taiwanese adolescents. METHODS: A cross-sectional design was employed. Three hundred seventy-seven adolescents aged 13-16 years from seven middle schools in southern Taiwan were recruited as participants...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29306457/cost-effectiveness-of-pcsk9-inhibition-in-addition-to-standard-lipid-lowering-therapy-in-patients-at-high-risk-for-vascular-disease
#9
Manon C Stam-Slob, Yolanda van der Graaf, Anthonius de Boer, Jacoba P Greving, Frank L J Visseren
BACKGROUND: As proprotein convertase subtilisin-kexin type 9 (PCSK9) monoclonal antibodies are entering the market, we assessed the cost-effectiveness of PCSK9 inhibition added to standard lipid-lowering therapy in patient groups at high risk for major adverse cardiovascular events (MACE). METHODS: A lifetime Markov Model was designed to estimate healthcare costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) for PCSK9 inhibition added to standard therapy in patients with Familial Hypercholesterolemia (FH), patients with vascular disease at high MACE recurrence risk, and patients with vascular disease with diabetes mellitus...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29301576/predicting-7-day-30-day-and-60-day-all-cause-unplanned-readmission-a-case-study-of-a-sydney-hospital
#10
Yashar Maali, Oscar Perez-Concha, Enrico Coiera, David Roffe, Richard O Day, Blanca Gallego
BACKGROUND: The identification of patients at high risk of unplanned readmission is an important component of discharge planning strategies aimed at preventing unwanted returns to hospital. The aim of this study was to investigate the factors associated with unplanned readmission in a Sydney hospital. We developed and compared validated readmission risk scores using routinely collected hospital data to predict 7-day, 30-day and 60-day all-cause unplanned readmission. METHODS: A combination of gradient boosted tree algorithms for variable selection and logistic regression models was used to build and validate readmission risk scores using medical records from 62,235 live discharges from a metropolitan hospital in Sydney, Australia...
January 4, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29288881/a-novel-screening-method-to-identify-late-stage-dementia-patients-for-palliative-care-research-and-practice
#11
Natalie C Ernecoff, Kathryn L Wessell, Stacey Gabriel, Timothy S Carey, Laura C Hanson
CONTEXT: Investigators need novel methods for timely identification of patients with serious illness to test or implement new palliative care models. OBJECTIVE: The study aim was to develop an electronic health record (EHR) phenotype to identify patients with late-stage dementia for a clinical trial of palliative care consultation. METHODS: We developed a computerized method to identify patients with dementia on hospital admission. Within a data warehouse derived from the hospital's EHR, we used search terms of age, admission date, and ICD-9 and ICD-10 diagnosis codes to create a EHR dementia phenotype, followed by brief medical record review to confirm late-stage dementia...
December 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29287972/the-patient-perspective-on-radiogenomics-testing-for-breast-radiation-toxicity
#12
T Rattay, R P Symonds, S Shokuhi, C J Talbot, J B Schnur
AIMS: In the field of radiogenomics, several potential predictive genetic markers have been identified that are associated with individual susceptibility to radiation toxicity. Predictive models of radiation toxicity incorporating radiogenomics and other biomarkers are being developed as part of the ongoing multicentre REQUITE trial. The purpose of this study was to explore patient attitudes towards future predictive radiogenomics testing for breast radiation toxicity. PATIENTS AND METHODS: Twenty-one semi-structured interviews were conducted with breast cancer patients taking part in the REQUITE study at one centre...
December 26, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29283670/home-based-physical-activity-coaching-physical-activity-and-healthcare-utilization-in-copd-copd-smart-secondary-outcomes
#13
David B Coultas, Bradford E Jackson, Rennie Russo, Jennifer Peoples, Karan P Singh, John Sloan, Minyong Uhm, Jamile A Ashmore, Steven N Blair, Sejong Bae
RATIONALE: Physical inactivity among patients with chronic obstructive pulmonary disease (COPD) is associated with exacerbations requiring high-cost healthcare utilization including urgent, emergent, and hospital care. OBJECTIVE: To examine the effectiveness of a behavioral lifestyle physical activity intervention combined with COPD self-management education to prevent high-cost healthcare utilization. METHODS: This was an analysis of secondary outcomes of the Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial, a two-arm randomized trial of stable adult outpatients with COPD recruited from primary care and pulmonary clinics...
December 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29282274/developing-and-validating-a-novel-multisource-comorbidity-score-from-administrative-data-a-large-population-based-cohort-study-from-italy
#14
Giovanni Corrao, Federico Rea, Mirko Di Martino, Rossana De Palma, Salvatore Scondotto, Danilo Fusco, Adele Lallo, Laura Maria Beatrice Belotti, Mauro Ferrante, Sebastiano Pollina Addario, Luca Merlino, Giuseppe Mancia, Flavia Carle
OBJECTIVE: To develop and validate a novel comorbidity score (multisource comorbidity score (MCS)) predictive of mortality, hospital admissions and healthcare costs using multiple source information from the administrative Italian National Health System (NHS) databases. METHODS: An index of 34 variables (measured from inpatient diagnoses and outpatient drug prescriptions within 2 years before baseline) independently predicting 1-year mortality in a sample of 500 000 individuals aged 50 years or older randomly selected from the NHS beneficiaries of the Italian region of Lombardy (training set) was developed...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29282261/abc-index-quantifying-experienced-burden-of-copd-in-a-discrete-choice-experiment-and-predicting-costs
#15
Lucas Ma Goossens, Maureen Pmh Rutten-van Mölken, Melinde Rs Boland, Bas Donkers, Marcel F Jonker, Annerika Hm Slok, Philippe L Salomé, Onno Cp van Schayck, Johannes Ccm In 't Veen, Elly A Stolk
OBJECTIVE: The Assessment of Burden of COPD (ABC) tool supports shared decision making between patient and caregiver. It includes a coloured balloon diagram to visualise patients' scores on burden indicators. We aim to determine the importance of each indicator from a patient perspective, in order to calculate a weighted index score and investigate whether that score is predictive of costs. DESIGN: Discrete choice experiment. SETTING AND PARTICIPANTS: Primary care and secondary care in the Netherlands...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29281041/patterns-of-multi-morbidity-and-prediction-of-hospitalisation-and-all-cause-mortality-in-advanced-age
#16
Ruth O Teh, Oliver H Menzies, Martin J Connolly, Rob N Doughty, Tim J Wilkinson, Avinesh Pillai, Thomas Lumley, Cristin Ryan, Anna Rolleston, Joanna B Broad, Ngaire Kerse
Background: multi-morbidity is associated with poor outcomes and increased healthcare utilisation. We aim to identify multi-morbidity patterns and associations with potentially inappropriate prescribing (PIP), subsequent hospitalisation and mortality in octogenarians. Methods: life and Living in Advanced Age; a Cohort Study in New Zealand (LiLACS NZ) examined health outcomes of 421 Māori (indigenous to New Zealand), aged 80-90 and 516 non-Māori, aged 85 years in 2010...
December 21, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29278608/pneumonia-risk-stratification-scores-for-children-in-low-resource-settings-a-systematic-literature-review
#17
Katrina V Deardorff, Eric D McCollum, Amy Sarah Ginsburg
BACKGROUND: Pneumonia is the leading infectious cause of death among children less than five years of age. Predictive tools, commonly referred to as risk scores, can be employed to identify high-risk children early for targeted management to prevent adverse outcomes. This systematic review was conducted to identify pediatric pneumonia risk scores developed, validated, and implemented in low-resource settings. METHODS: We searched CAB Direct, Cochrane Reviews, Embase, PubMed, Scopus, and Web of Science for studies that developed formal risk scores to predict treatment failure or mortality among children less than five years of age diagnosed with a respiratory infection or pneumonia in low-resource settings...
December 22, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29278580/retroperitoneal-versus-transperitoneal-robotic-assisted-laparoscopic-partial-nephrectomy-a-matched-pair-bicenter-analysis-with-cost-comparison-using-time-driven-activity-based-costing
#18
Aaron A Laviana, Hung-Jui Tan, Jim C Hu, Alon Z Weizer, Sam S Chang, Daniel A Barocas
PURPOSE OF REVIEW: To perform a bicenter, retrospective study of perioperative outcomes of retroperitoneal versus transperitoneal robotic-assisted laparoscopic partial nephrectomy (RALPN) and assess costs using time-driven activity-based costing (TDABC). We identified 355 consecutive patients who underwent RALPN at University of California Los Angeles and the University of Michigan during 2009-2016. We matched according to RENAL nephrometry score, date, and institution for 78 retroperitoneal versus 78 transperitoneal RALPN...
December 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/29250812/a-multiple-model-generalisation-of-updating-clinical-prediction-models
#19
Glen P Martin, Mamas A Mamas, Niels Peek, Iain Buchan, Matthew Sperrin
There is growing interest in developing clinical prediction models (CPMs) to aid local healthcare decision-making. Frequently, these CPMs are developed in isolation across different populations, with repetitive de novo derivation a common modelling strategy. However, this fails to utilise all available information and does not respond to changes in health processes through time and space. Alternatively, model updating techniques have previously been proposed that adjust an existing CPM to suit the new population, but these techniques are restricted to a single model...
December 18, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29249645/healthcare-experience-among-older-cancer-survivors-analysis-of-the-seer-cahps-dataset
#20
Michael T Halpern, Matthew P Urato, Lisa M Lines, Julia B Cohen, Neeraj K Arora, Erin E Kent
OBJECTIVE: Little is known about factors affecting medical care experiences of cancer survivors. This study examined experience of care among cancer survivors and assessed associations of survivors' characteristics with their experience. MATERIALS AND METHODS: We used a newly-developed, unique data resource, SEER-CAHPS (NCI's Surveillance Epidemiology and End Results [SEER] data linked to Medicare Consumer Assessment of Healthcare Providers and Systems [CAHPS] survey responses), to examine experiences of care among breast, colorectal, lung, and prostate cancer survivors age >66years who completed CAHPS >1year after cancer diagnosis and survived ≥1year after survey completion...
December 14, 2017: Journal of Geriatric Oncology
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