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https://www.readbyqxmd.com/read/27920019/personalized-diabetes-management-using-electronic-medical-records
#1
Dimitris Bertsimas, Nathan Kallus, Alexander M Weinstein, Ying Daisy Zhuo
OBJECTIVE: Current clinical guidelines for managing type 2 diabetes do not differentiate based on patient-specific factors. We present a data-driven algorithm for personalized diabetes management that improves health outcomes relative to the standard of care. RESEARCH DESIGN AND METHODS: We modeled outcomes under 13 pharmacological therapies based on electronic medical records from 1999 to 2014 for 10,806 patients with type 2 diabetes from Boston Medical Center...
December 5, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27919371/a-machine-learning-based-framework-to-identify-type-2-diabetes-through-electronic-health-records
#2
Tao Zheng, Wei Xie, Liling Xu, Xiaoying He, Ya Zhang, Mingrong You, Gong Yang, You Chen
OBJECTIVE: To discover diverse genotype-phenotype associations affiliated with Type 2 Diabetes Mellitus (T2DM) via genome-wide association study (GWAS) and phenome-wide association study (PheWAS), more cases (T2DM subjects) and controls (subjects without T2DM) are required to be identified (e.g., via Electronic Health Records (EHR)). However, existing expert based identification algorithms often suffer in a low recall rate and could miss a large number of valuable samples under conservative filtering standards...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919350/identification-and-characterization-of-severe-familial-hypercholesterolemia-in-patients-presenting-for-cardiac-catheterization
#3
Barak Zafrir, Chen Shapira, Gil Lavie, David A Halon, Moshe Y Flugelman
BACKGROUND: Patients with severe familial hypercholesterolemia (FH) are often unrecognized despite typical presentation. The introduction of PCSK9 inhibitors opens new therapeutic options and emphasizes the need for identification of severe FH patients. OBJECTIVES: The objective was identification, characterization, and management of severe FH patients by screening of cardiac catheterization (CC) database. METHODS: Retrospective analysis of CC database from 2002 to mid-2015 was performed for low-density lipoprotein cholesterol (LDL-C) ≥130 mg/dL (n = 2383)...
November 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27909038/decision-tree-based-modelling-for-identification-of-potential-interactions-between-type-2-diabetes-risk-factors-a-decade-follow-up-in-a-middle-east-prospective-cohort-study
#4
Azra Ramezankhani, Esmaeil Hadavandi, Omid Pournik, Jamal Shahrabi, Fereidoun Azizi, Farzad Hadaegh
OBJECTIVE: The current study was undertaken for use of the decision tree (DT) method for development of different prediction models for incidence of type 2 diabetes (T2D) and for exploring interactions between predictor variables in those models. DESIGN: Prospective cohort study. SETTING: Tehran Lipid and Glucose Study (TLGS). METHODS: A total of 6647 participants (43.4% men) aged >20 years, without T2D at baselines ((1999-2001) and (2002-2005)), were followed until 2012...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27899816/bariatric-surgery-for-obesity-and-metabolic-disorders-state-of-the-art
#5
REVIEW
Ninh T Nguyen, J Esteban Varela
Obesity is one of the most important public health conditions worldwide. Bariatric surgery for severe obesity is an effective treatment that results in the improvement and remission of many obesity-related comorbidities, as well as providing sustained weight loss and improvement in quality of life. Contemporary bariatric operations include Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric band and the duodenal switch. The vast majority of these procedures are now performed using laparoscopic technique, the main advantages of which include rapid recovery, the reduction of postoperative pain and the reduction of wound-related complications, compared with open surgery...
November 30, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27898976/development-and-validation-of-a-deep-learning-algorithm-for-detection-of-diabetic-retinopathy-in-retinal-fundus-photographs
#6
Varun Gulshan, Lily Peng, Marc Coram, Martin C Stumpe, Derek Wu, Arunachalam Narayanaswamy, Subhashini Venugopalan, Kasumi Widner, Tom Madams, Jorge Cuadros, Ramasamy Kim, Rajiv Raman, Philip C Nelson, Jessica L Mega, Dale R Webster
Importance: Deep learning is a family of computational methods that allow an algorithm to program itself by learning from a large set of examples that demonstrate the desired behavior, removing the need to specify rules explicitly. Application of these methods to medical imaging requires further assessment and validation. Objective: To apply deep learning to create an algorithm for automated detection of diabetic retinopathy and diabetic macular edema in retinal fundus photographs...
November 29, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27897004/identifying-genetic-associations-with-variability-in-metabolic-health-and-blood-count-laboratory-values-diving-into-the-quantitative-traits-by-leveraging-longitudinal-data-from-an-ehr
#7
Shefali S Verma, Anastasia M Lucas, Daniel R Lavage, Joseph B Leader, Raghu Metpally, Sarathbabu Krishnamurthy, Frederick Dewey, Ingrid Borecki, Alexander Lopez, John Overton, John Penn, Jeffrey Reid, Sarah A Pendergrass, Gerda Breitwieser, Marylyn D Ritchie
A wide range of patient health data is recorded in Electronic Health Records (EHR). This data includes diagnosis, surgical procedures, clinical laboratory measurements, and medication information. Together this information reflects the patient's medical history. Many studies have efficiently used this data from the EHR to find associations that are clinically relevant, either by utilizing International Classification of Diseases, version 9 (ICD-9) codes or laboratory measurements, or by designing phenotype algorithms to extract case and control status with accuracy from the EHR...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27887743/quantification-of-diabetic-macular-ischemia-using-optical-coherence-tomography-angiography-and-its-relationship-with-visual%C3%A2-acuity
#8
Wasim A Samara, Abtin Shahlaee, Murtaza K Adam, M Ali Khan, Allen Chiang, Joseph I Maguire, Jason Hsu, Allen C Ho
PURPOSE: To quantify foveal avascular zone (FAZ) area and macular vascular density objectively using optical coherence tomography angiography (OCTA) and to examine correlations with visual acuity in eyes with diabetic retinopathy (DR) in the absence of diabetic macular edema. DESIGN: Retrospective observational case series. PARTICIPANTS: Eighty-four eyes from 55 patients with DR and 34 control eyes from 27 age-matched healthy participants...
November 22, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27884846/real-world-evidence-studies-into-treatment-adherence-thresholds-for-intervention-and-disparities-in-treatment-in-people-with-type-2-diabetes-in-the-uk
#9
Andrew McGovern, William Hinton, Ana Correa, Neil Munro, Martin Whyte, Simon de Lusignan
PURPOSE: The University of Surrey-Lilly Real World Evidence (RWE) diabetes cohort has been established to provide insights into the management of type 2 diabetes mellitus (T2DM). There are 3 areas of study due to be conducted to provide insights into T2DM management: exploration of medication adherence, thresholds for changing diabetes therapies, and ethnicity-related or socioeconomic-related disparities in management. This paper describes the identification of a cohort of people with T2DM which will be used for these analyses, through a case finding algorithm, and describes the characteristics of the identified cohort...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27867702/evaluation-of-artifact-reduction-in-optical-coherence-tomography-angiography-with-real-time-tracking-and-motion-correction-technology
#10
Acner Camino, Miao Zhang, Simon S Gao, Thomas S Hwang, Utkarsh Sharma, David J Wilson, David Huang, Yali Jia
Artifacts introduced by eye motion in optical coherence tomography angiography (OCTA) affect the interpretation of images and the quantification of parameters with clinical value. Eradication of such artifacts in OCTA remains a technical challenge. We developed an algorithm that recognizes five different types of motion artifacts and used it to evaluate the performance of three motion removal technologies. On en face maximum projection of flow images, the summed flow signal in each row and column and the correlation between neighboring rows and columns were calculated...
October 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27864960/the-interplay-between-diabetes-and-pancreatitis-two-case-reports-of-sudden-natural-deaths-and-a-review-of-the-literature
#11
Daniel C Butler, Anthony J Emanuel, Sally E Self, Nicholas I Batalis
Diabetes mellitus (DM) is a common disease involving insulin resistance or deficit that, when left unchecked, may cause severe hyperglycemia and subsequent end-organ damage. Acute pancreatitis (AP) is inflammation of the pancreas that can lead to significant morbidity and mortality. AP and DM both account for a significant amount of sudden deaths, and rarely both disease processes may be present in the same decedent, causing some difficulty in wording the cause of death statement. Although much research has been directed at studying the causes and risk factors for AP and DM, there is a complex interplay between these diseases that is not fully understood...
November 16, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27864877/the-role-of-retinopathy-distribution-and-other-lesion-types-for-the-definition-of-examination-intervals-during-screening-for-diabetic-retinopathy
#12
Giovanni Ometto, Mogens Erlandsen, Andrew Hunter, Toke Bek
PURPOSE: It has previously been shown that the intervals between screening examinations for diabetic retinopathy can be optimized by including individual risk factors for the development of the disease in the risk assessment. However, in some cases, the risk model calculating the screening interval may recommend a different interval than an experienced clinician. The purpose of this study was to evaluate the influence of factors unrelated to diabetic retinopathy and the distribution of lesions for discrepancies between decisions made by the clinician and the risk model...
November 19, 2016: Acta Ophthalmologica
https://www.readbyqxmd.com/read/27861829/stratifying-patients-with-diabetes-into-clinically-relevant-groups-by-combination-of-chronic-conditions-to-identify-gaps-in-quality-of-care
#13
Elizabeth M Magnan, Daniel M Bolt, Robert T Greenlee, Jennifer Fink, Maureen A Smith
OBJECTIVE: To find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics. DATA SOURCES/STUDY SETTING: Twenty-nine thousand five hundred and sixty-two adult patients with diabetes seen at eight Midwestern U.S. health systems during 2010-2011. STUDY DESIGN: We retrospectively evaluated the relationship between six diabetes quality metrics and patients' combinations of chronic conditions...
November 13, 2016: Health Services Research
https://www.readbyqxmd.com/read/27859462/analysis-of-proportional-mean-residual-life-model-with-latent-variables
#14
Haijin He, Jingheng Cai, Xinyuan Song, Liuquan Sun
End-stage renal disease (ESRD) is one of the most serious diabetes complications. Numerous studies have been devoted to revealing the risk factors of the onset time of ESRD. In this article, we propose a proportional mean residual life (MRL) model with latent variables to assess the effects of observed and latent risk factors on the MRL function of ESRD in a cohort of Chinese type 2 diabetic patients. The proposed model generalizes the conventional proportional MRL model to accommodate the latent risk factor that cannot be measured by a single observed variable...
November 18, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27854055/fixed-dose-combination-of-canagliflozin-and-metformin-for-the-treatment-of-type-2-diabetes-an-overview
#15
REVIEW
Jaime A Davidson, Lance Sloan
: Metformin is recommended as a first-line therapy for patients with type 2 diabetes mellitus (T2DM). However, many patients do not achieve glycemic goals with metformin monotherapy and require subsequent combination therapy with other antihyperglycemic agents (AHAs). For newly diagnosed patients with high blood glucose, initial combination therapy may be required to achieve glycemic control. The American Association for Clinical Endocrinologists algorithm for the treatment of T2DM recommends metformin plus a sodium glucose co-transporter 2 (SGLT2) inhibitor as the first oral combination in patients who present with HbA1c ≥7...
November 16, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27852582/association-between-oct-based-microangiography-perfusion-indices-and-diabetic-retinopathy-severity
#16
Alexander D Lin, Aaron Y Lee, Qinqin Zhang, Kasra A Rezaei, James Kinyoun, Ruikang K Wang, Cecilia S Lee
AIM: To evaluate the association between retinal capillary non-perfusion and diabetic retinopathy (DR) severity using optical coherence tomography-based microangiography (OMAG). METHODS: 33 patients (51 eyes) with a history of diabetes underwent imaging with a 68 kHz Cirrus-5000 spectral domain OMAG prototype. Demographic and clinical characteristics were collected. The perfusion index (PI) was defined as per cent coverage of area by retinal vessels with flow, measured within a minimum of 6...
November 15, 2016: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27849311/choroidal-thickness-and-choroidal-vessel-density-in-nonexudative-age-related-macular-degeneration-using-swept-source-optical-coherence-tomography-imaging
#17
Fang Zheng, Giovanni Gregori, Karen B Schaal, Andrew D Legarreta, Andrew R Miller, Luiz Roisman, William J Feuer, Philip J Rosenfeld
Purpose: To analyze the relationship between choroidal thickness and the distribution of choroidal blood vessels in eyes with nonexudative AMD. Methods: Eyes with a diagnosis of nonexudative AMD were imaged using a prototype 100-kHz swept-source (SS) optical coherence tomography (OCT) instrument (Carl Zeiss Meditec, Dublin, CA, USA) with a central wavelength of 1050 nm. We used an OCT cube scan pattern consisting of 512 × 512 A-scans over a 12 × 12 mm retinal area...
November 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27847643/novel-perspectives-on-swept-source-optical-coherence-tomography
#18
REVIEW
Fabio Lavinsky, Daniel Lavinsky
Technologies for multimodal digital imaging of vitreoretinal diseases have improved the accuracy of diagnosis and the depth of the knowledge of the mechanisms of disease and their response to treatments. Optic coherence tomography (OCT) has become a mandatory tool for the management and for the follow-up of retinal pathologies. OCT technology evolved in the last two decades from time-domain to spectral domain and recently to the swept-source OCTs (SS-OCT). SS-OCT improved the depth of imaging and the scan speed, thus adding novel algorithms and features such as for vitreous and vitreoretinal interface evaluation, choroid segmentation and mapping, OCT angiography and En-face OCT...
2016: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/27842497/impact-of-carotid-atherosclerosis-detection-on-physician-and-patient-behavior-in-the-management-of-type-2-diabetes-mellitus-a-prospective-observational-multicenter-study
#19
In-Kyung Jeong, Sin-Gon Kim, Dong Hyeok Cho, Chong Hwa Kim, Chul Sik Kim, Won-Young Lee, Kyu-Chang Won, Doo-Man Kim
BACKGROUND: This study compared carotid ultrasound (CUS) and traditional risk calculations in determining cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (DM) and investigated whether awareness of CVD affects patient and/or physician behavior. METHODS: In this prospective, observational, multicenter study, 797 participants with type 2 diabetes were assessed using CUS, the United Kingdom Prospective Diabetes Study Risk Engine (UKPDSRE) calculator, and the Framingham Risk Score (FRS) algorithm...
November 14, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27836816/web-based-real-time-case-finding-for-the-population-health-management-of-patients-with-diabetes-mellitus-a-prospective-validation-of-the-natural-language-processing-based-algorithm-with-statewide-electronic-medical-records
#20
Le Zheng, Yue Wang, Shiying Hao, Andrew Y Shin, Bo Jin, Anh D Ngo, Medina S Jackson-Browne, Daniel J Feller, Tianyun Fu, Karena Zhang, Xin Zhou, Chunqing Zhu, Dorothy Dai, Yunxian Yu, Gang Zheng, Yu-Ming Li, Doff B McElhinney, Devore S Culver, Shaun T Alfreds, Frank Stearns, Karl G Sylvester, Eric Widen, Xuefeng Bruce Ling
BACKGROUND: Diabetes case finding based on structured medical records does not fully identify diabetic patients whose medical histories related to diabetes are available in the form of free text. Manual chart reviews have been used but involve high labor costs and long latency. OBJECTIVE: This study developed and tested a Web-based diabetes case finding algorithm using both structured and unstructured electronic medical records (EMRs). METHODS: This study was based on the health information exchange (HIE) EMR database that covers almost all health facilities in the state of Maine, United States...
November 11, 2016: JMIR Medical Informatics
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