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Hierarchical Condition Category

Cecilia Bartholdson, Bert Molewijk, Kim Lützén, Klas Blomgren, Pernilla Pergert
BACKGROUND: In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions...
March 2018: Nursing Ethics
Matthew E Lancaster, Donald Homa
The present study explored feature-to-feature and label-to-feature inference in a category task for different category structures. In the correlated condition, each of the 4 dimensions comprising the category was positively correlated to each other and to the category label. In the uncorrelated condition, no correlation existed between the 4 dimensions comprising the category, although the dimension to category label correlation matched that of the correlated condition. After learning, participants made inference judgments of a missing feature, given 1, 2, or 3 feature cues; on half the trials, the category label was also included as a cue...
April 2017: American Journal of Psychology
Yan-Qin Yang, Hong-Xu Yin, Hai-Bo Yuan, Yong-Wen Jiang, Chun-Wang Dong, Yu-Liang Deng
In the present work, a novel infrared-assisted extraction coupled to headspace solid-phase microextraction (IRAE-HS-SPME) followed by gas chromatography-mass spectrometry (GC-MS) was developed for rapid determination of the volatile components in green tea. The extraction parameters such as fiber type, sample amount, infrared power, extraction time, and infrared lamp distance were optimized by orthogonal experimental design. Under optimum conditions, a total of 82 volatile compounds in 21 green tea samples from different geographical origins were identified...
2018: PloS One
Ann L Horgas, Urszula Snigurska, Michelle Z Farland, Michael Marsiske
Objectives: Analyzing medication data for research purposes is complex, and methods are rarely described in the literature. Our objective was to describe methods of quantifying opioid and nonopioid analgesics and to compare the utility of five different analgesic coding methods when analyzing relationships between pain, analgesic use, and clinical outcomes. In this study, we used physical function as the outcome variable for its clinical relevance and its relationship to pain in older adults...
February 2, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Akritee Shrestha, Savannah Bergquist, Ellen Montz, Sherri Rose
OBJECTIVE: To propose nonparametric ensemble machine learning for mental health and substance use disorders (MHSUD) spending risk adjustment formulas, including considering Clinical Classification Software (CCS) categories as diagnostic covariates over the commonly used Hierarchical Condition Category (HCC) system. DATA SOURCES: 2012-2013 Truven MarketScan database. STUDY DESIGN: We implement 21 algorithms to predict MHSUD spending, as well as a weighted combination of these algorithms called super learning...
December 15, 2017: Health Services Research
Mark A Green, Danny Dorling, Richard Mitchell
To honour the 175th anniversary of Edwin Chadwick's seminal 'Report on the Sanitary Conditions of the Labouring Poor', we update Chadwick's famous analysis of geographical differences in occupational based inequalities. Much of the field of Health Geography owes both its direction of development and its initial impetus to his 1842 report. The report presented evidence for the importance of local context to health, with individuals of the lowest occupations in Rutland living longer than individuals of the highest occupations in Liverpool...
January 2018: Social Science & Medicine
Winfried März, Franz-Werner Dippel, Karlheinz Theobald, Katherine Gorcyca, Şerban R Iorga, David Ansell
BACKGROUND AND AIMS: Elevated low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for cardiovascular (CV) events. European guidelines recommend reducing LDL-C as the primary lipid target to reduce CV risk, using lifestyle modifications and lipid-lowering therapy (LLT). Many European patients do not achieve guideline-recommended LDL-C levels. The present database analysis aimed to assess LLT treatment patterns and LDL-C threshold attainment in Germany in a large, real-world cohort of patients...
January 2018: Atherosclerosis
Eric T Roberts, Alan M Zaslavsky, J Michael McWilliams
Background: When risk adjustment is inadequate and incentives are weak, pay-for-performance programs, such as the Value-Based Payment Modifier (Value Modifier [VM]) implemented by the Centers for Medicare & Medicaid Services, may contribute to health care disparities without improving performance on average. Objective: To estimate the association between VM exposure and performance on quality and spending measures and to assess the effects of adjusting for additional patient characteristics on performance differences between practices serving higher-risk and those serving lower-risk patients...
February 20, 2018: Annals of Internal Medicine
Andrew B Rosenkrantz, Wenyi Wang, Arvind Vijayasarathi, Richard Duszak
RATIONALE AND OBJECTIVES: Meaningfully measuring physician outcomes and resource utilization requires appropriate patient risk adjustment. We aimed to assess Medicare patient complexity by physician specialty and to further identify radiologist characteristics associated with higher patient complexity. MATERIALS AND METHODS: The average beneficiary Hierarchical Condition Category (HCC) risk scores (Medicare's preferred measure of clinical complexity) were identified for all physicians using 2014 Medicare claims data...
November 3, 2017: Academic Radiology
Roberto Baiocco, Paola Castelli Gattinara, Giorgia Cioccetti, Salvatore Ioverno
BACKGROUND: Duchenne muscular dystrophy (DMD) is the most frequent inherited form of muscular dystrophy during childhood. DMD is a severe and progressive disease. Children initially have no symptoms, but the diagnosis is often delayed until the child is about 5 years old. PURPOSE: Although few studies have addressed parent reactions to DMD, parental reactions to other serious childhood conditions have been documented. This study aims to understand the resolution styles that parents use in the context of their children with DMD...
December 2017: Journal of Nursing Research: JNR
Michael Mehring, Ewan Donnachie, Antonius Schneider, Martin Tauscher, Roman Gerlach, Constanze Storr, Klaus Linde, Andreas Mielck, Werner Maier
OBJECTIVES: A considerable proportion of regional variation in healthcare use and health expenditures is to date still unexplained. The aim was to investigate regional differences in the gatekeeping role of general practitioners and to identify relevant explanatory variables at patient and district level in Bavaria, Germany. DESIGN: Retrospective routine data analysis using claims data held by the Bavarian Association of Statutory Health Insurance Physicians. PARTICIPANTS: All patients who consulted a specialist in ambulatory practice within the first quarter of 2011 (n=3 616 510)...
October 22, 2017: BMJ Open
George F Chamoun, Linyan Li, Nassib G Chamoun, Vikas Saini, Daniel I Sessler
BACKGROUND: The Risk Stratification Index and the Hierarchical Condition Categories model baseline risk using comorbidities and procedures. The Hierarchical Condition categories are rederived yearly, whereas the Risk Stratification Index has not been rederived since 2010. The two models have yet to be directly compared. The authors thus rederived the Risk Stratification Index using recent data and compared their results to contemporaneous Hierarchical Condition Categories. METHODS: The authors reimplemented procedures used to derive the original Risk Stratification Index derivation using the 2007 to 2011 Medicare Analysis and Provider review file...
January 2018: Anesthesiology
Joseph Kwon, Sung Wook Kim, Wendy J Ungar, Kate Tsiplova, Jason Madan, Stavros Petrou
BACKGROUND: A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by several methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors, and to determine the effects of methodological factors on childhood utilities...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
C Annette DuBard, Carlos T Jackson
Care management of high-cost/high-needs patients is an increasingly common strategy to reduce health care costs. A variety of targeting methodologies have emerged to identify patients with high historical or predicted health care utilization, but the more pertinent question for program planners is how to identify those who are most likely to benefit from care management intervention. This paper describes the evolution of complex care management targeting strategies in Community Care of North Carolina's (CCNC) work with the statewide non-dual Medicaid population, culminating in the development of an "Impactability Score" that uses administrative data to predict achievable savings...
October 2, 2017: Population Health Management
Fanyu Meng, Pengpeng Xu, S C Wong, Helai Huang, Y C Li
This study aimed to identify the factors affecting the crash-related severity level of injuries in taxis and quantify the associations between these factors and taxi occupant injury severity. Casualties resulting from taxi crashes from 2004 to 2013 in Hong Kong were divided into four categories: taxi drivers, taxi passengers, private car drivers and private car passengers. To avoid any biased interpretation caused by unobserved spatial and temporal effects, a Bayesian hierarchical logistic modeling approach with conditional autoregressive priors was applied, and four different model forms were tested...
November 2017: Accident; Analysis and Prevention
Eun Jong Kong, Hyunjung Lee
Previous research has shown differential degrees of attention in processing hierarchical linguistic information where higher order cues require greater attention in speech processing. The current study investigated the influence of attentional resources on acoustic cue weightings in speech perception by examining Korean listeners' identifications of the three-way laryngeal stops (tense vs. lax vs. aspirated). Using a dual-task paradigm, we presented 28 adult Korean listeners with identification tasks blocked by no-distractor versus distractor conditions where arithmetic calculations distracted the listeners' speech processing...
September 1, 2017: Language and Speech
Yi Lei, Xiuling Liang, Chongde Lin
Although a number of studies have explored the time course of category-based induction, little is known about how the hierarchical levels (superordinate, basic, subordinate) of premises affect category-based induction. The EEG data were recorded when nineteen healthy human participants were performing a simplified category-based induction task. The ERP results showed that: in the subordinate conclusion condition, the basic premise elicited a larger N400, versus the superordinate promise; in the basic conclusion condition, the superordinate promise elicited a larger P300 relative to both the basic premise and subordinate premise; in the superordinate conclusion condition, however, no difference was found between different promise...
September 18, 2017: Scientific Reports
Bongsong Kim
Hierarchical association coefficient algorithm calculates the degree of association between observations and categories into a value named hierarchical association coefficient (HA-coefficient) between 0 for the lower limit and 1 for the upper limit. The HA-coefficient algorithm can be operated with stratified ascending categories based on the average of observations in each category. The upper limit refers to a condition where observations are increasingly ordered into the stratified ascending categories, whereas the lower limit refers to a condition where observations are decreasingly ordered into the stratified ascending categories...
2017: Evolutionary Bioinformatics Online
Carina Salt, Penelope J Morris, Alexander J German, Derek Wilson, Elizabeth M Lund, Tim J Cole, Richard F Butterwick
Limited information is available on what constitutes optimal growth in dogs. The primary aim of this study was to develop evidence-based growth standards for dogs, using retrospective analysis of bodyweight and age data from >6 million young dogs attending a large corporate network of primary care veterinary hospitals across the USA. Electronic medical records were used to generate bodyweight data from immature client-owned dogs, that were healthy and had remained in ideal body condition throughout the first 3 years of life...
2017: PloS One
Roberto Baiocco, Paola Castelli Gattinara, Giorgia Cioccetti, Salvatore Ioverno
BACKGROUND: Duchenne muscular dystrophy (DMD) is the most frequent inherited form of muscular dystrophy during childhood. DMD is a severe and progressive disease. Children initially have no symptoms, but the diagnosis is often delayed until the child is about 5 years old. PURPOSE: Although few studies have addressed parent reactions to DMD, parental reactions to other serious childhood conditions have been documented. This study aims to understand the resolution styles that parents use in the context of their children with DMD...
August 12, 2017: Journal of Nursing Research: JNR
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