Tag: nevin manimala

Drug Alcohol Rev. 2024 Aug 23. doi: 10.1111/dar.13933. Online ahead of print.

ABSTRACT

INTRODUCTION: More evidence for patterns of healthcare utilisation and associated costs among people receiving opioid agonist therapy (OAT) is needed. We investigated primary and secondary healthcare usage and costs among methadone and buprenorphine recipients in England.

METHODS: We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases of patients who were prescribed OAT between 1 January 2007 and 31 July 2019. The cohort was linked to Hospital Episode Statistics admitted patient care, outpatient and emergency department data, neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records. Negative binomial regression models were applied to estimate weighted rate ratios (wRR) of healthcare utilisation. Total and mean costs were calculated using Unit Costs of Health and Social Care and the National Healthcare Service Payment by Results National Tariffs.

RESULTS: Among 12,639 patients observed over 39,016 person-years, we found higher rate of hospital admissions (wRR 1.18; 1.08-1.28) among methadone compared with buprenorphine recipients. The commonest hospital discharge diagnoses among methadone patients were infectious diseases (19.2%), mental and behavioural disorders (17.0%) and drug-related poisoning (16.5%); the three commonest among buprenorphine patients were mental and behavioural diseases (21.5%), endocrine (13.8%) and genitourinary system diseases (13.1%). Methadone patients had similar mean costs compared with buprenorphine patients (cost difference: £539.01; 432.11-1006.69).

DISCUSSION AND CONCLUSIONS: Differences in healthcare utilisation frequency for methadone versus buprenorphine recipients were observed. The differences in associated costs were mainly driven by hospital admissions. These findings offer valuable insights for optimising care strategies and resource allocation for OAT recipients.

PMID:39176979 | DOI:10.1111/dar.13933

Stud Health Technol Inform. 2024 Aug 22;316:1069-1073. doi: 10.3233/SHTI240595.

ABSTRACT

This comparative study examines the transition from isolated registries to a consolidated data-centric approach at University Hospital Schleswig-Holstein, focusing on migrating the Atrioventricular Valve Intervention Registry (AVIR) from REDCap to a Medical Data Integration Center based openEHR registry. Through qualitative analysis, we identify key disparities and strategic decisions guiding this transition. While REDCap has historical utility, its limitations in automated data integration and traceability highlight the advantages of a data-centric approach, which include streamlined data (integration) management at a single-point-of-truth based on e.g., centralized consent management. Our findings lay the groundwork for the AVIR project and a proof-of-concept data-centric registry, reflecting a broader industry trend towards data-centric healthcare initiatives.

PMID:39176974 | DOI:10.3233/SHTI240595

Stud Health Technol Inform. 2024 Aug 22;316:1038-1042. doi: 10.3233/SHTI240588.

ABSTRACT

The effective management of human resources in nursing is fundamental to ensuring high-quality care. The necessary staffing levels can be derived from the nursing-related health status. Our approach is based on the use of artificial intelligence (AI) and machine learning (ML) to recognize key workload-driving predictors from routine data in the first step and derive recommendations for staffing levels in the second step. The precedent analysis was a multi-center study with data provided by three hospitals. The SPI (Self Care Index = sum score of 10 functional/cognitive items of the epaAC (epaAC = nursing assessment tool for AcuteCare (abbreviated from the German-language effiziente Pflege-Analyse AcuteCare))) was identified as a strong predictor of nursing workload. The SPI alone explains the variance in minutes with an adjusted R2 of 40% to 66%. With the addition of further predictors such as “fatigue” or “pain intensity”, the adjusted R2 can be increased by up to 17%. The resulting model can be used as a foundation for data-based personnel controlling using AI-based prediction models.

PMID:39176968 | DOI:10.3233/SHTI240588

Stud Health Technol Inform. 2024 Aug 22;316:993-997. doi: 10.3233/SHTI240577.

ABSTRACT

Healthcare processes are complex and involve uncertainties to influence the service quality and health of patients. Patient transportation takes place between the hospitals or between the departments within the hospital (i.e., Inter- or Intra-Hospital Transportation respectively). The focus of our paper is route planning for transporting patients within the hospital. The route planning task is complex due to multiple factors such as regulations, fairness considerations (i.e., balanced workload amongst transporters), and other dynamic factors (i.e., transport delays, wait times). Transporters perform the physical transportation of patients within the hospital. In principle, each job allocation respects the transition time between the subsequent jobs. The primary objective was to determine the feasible number of transporters, and then generate the route plan for all determined transporters by distributing all transport jobs (i.e., from retrospective data) within each shift. Secondary objectives are to minimize the sum of total travel time and sum of total idle time of all transporters and minimize the deviations in total travel time amongst transporters. Our method used multi-staged Local Search Metaheuristics to attain the primary objective. Metaheuristics incorporate Mixed Integer Linear Programming to allocate fairly the transport jobs by formulating optimization constraints with bounds for satisfying the secondary objectives. The obtained results using formulated optimization constraints represent better efficacy in multi-objective route planning of Intra-Hospital Transportation of patients.

PMID:39176958 | DOI:10.3233/SHTI240577

Stud Health Technol Inform. 2024 Aug 22;316:929-933. doi: 10.3233/SHTI240563.

ABSTRACT

Predictive modeling holds a large potential in clinical decision-making, yet its effectiveness can be hindered by inherent data imbalances in clinical datasets. This study investigates the utility of synthetic data for improving the performance of predictive modeling on realistic small imbalanced clinical datasets. We compared various synthetic data generation methods including Generative Adversarial Networks, Normalizing Flows, and Variational Autoencoders to the standard baselines for correcting for class underrepresentation on four clinical datasets. Although results show improvement in F1 scores in some cases, even over multiple repetitions, we do not obtain statistically significant evidence that synthetic data generation outperforms standard baselines for correcting for class imbalance. This study challenges common beliefs about the efficacy of synthetic data for data augmentation and highlights the importance of evaluating new complex methods against simple baselines.

PMID:39176944 | DOI:10.3233/SHTI240563

Stud Health Technol Inform. 2024 Aug 22;316:868-872. doi: 10.3233/SHTI240549.

ABSTRACT

This study investigates the forecasting of cardiovascular mortality trends in Greece’s elderly population. Utilizing mortality data from 2001 to 2020, we employ two forecasting models: the Autoregressive Integrated Moving Average (ARIMA) and Facebook’s Prophet model. Our study evaluates the efficacy of these models in predicting cardiovascular mortality trends over 2020-2030. The ARIMA model showcased predictive accuracy for the general and male population within the 65-79 age group, whereas the Prophet model provided better forecasts for females in the same age bracket. Our findings emphasize the need for adaptive forecasting tools that accommodate demographic-specific characteristics and highlight the role of advanced statistical methods in health policy planning.

PMID:39176930 | DOI:10.3233/SHTI240549

Stud Health Technol Inform. 2024 Aug 22;316:719-723. doi: 10.3233/SHTI240515.

ABSTRACT

Automatic deidentification of Electronic Health Records (EHR) is a crucial step in secondary usage for biomedical research. This study introduces evaluation of an intricate hybrid deidentification strategy to enhance patient privacy in secondary usage of EHR. Specifically, this study focuses on assessing automatic deidentification using OpenDeID pipeline across diverse corpora for safeguarding sensitive information within EHR datasets by incorporating diverse corpora. Three distinct corpora were utilized: the OpenDeID v2 corpus containing pathology reports from Australian hospitals, the 2014 i2b2/UTHealth deidentification corpus with clinical narratives from the USA, and the 2016 CEGS N-GRID identification corpus comprising psychiatric notes. The OpenDeID pipeline employs a hybrid approach based on deep learning and contextual rules. Pre-processing steps involved harmonizing and addressing encoding and format issues. Precision, Recall, F-measure metrics were used to assess the performance. The evaluation metrics demonstrated the superior performance of the Discharge Summary BioBERT model. Trained on three corpora with a total of 4,038 reports, the best performing model exhibited robust deidentification capabilities when applied to EHR. It achieved impressive micro-averaged F1-scores of 0.9248 and 0.9692 for strict and relaxed settings, respectively. These results offer valuable insights into the model’s efficacy and its potential role in safeguarding patient privacy in secondary usage of EHR.

PMID:39176896 | DOI:10.3233/SHTI240515

Stud Health Technol Inform. 2024 Aug 22;316:705-709. doi: 10.3233/SHTI240511.

ABSTRACT

To address privacy and ethical issues in using health data for machine learning, we evaluate the scalability of advanced synthetic data generation methods like GANs, VAEs, copulaGAN, and transformer models specifically for patient service utilization data. Our study examines five models on data from a Canadian health authority, focusing on training and generation efficiency, data resemblance, and practical utility. Our findings indicate that statistical models excel in efficiency, while most models produce synthetic data that closely mirrors real data, and is also useful for real-world applications.

PMID:39176892 | DOI:10.3233/SHTI240511

Stud Health Technol Inform. 2024 Aug 22;316:695-699. doi: 10.3233/SHTI240509.

ABSTRACT

Annotated language resources derived from clinical routine documentation form an intriguing asset for secondary use case scenarios. In this investigation, we report on how such a resource can be leveraged to identify additional term candidates for a chosen set of ICD-10 codes. We conducted a log-likelihood analysis, considering the co-occurrence of approximately 1.9 million de-identified ICD-10 codes alongside corresponding brief textual entries from problem lists in German. This analysis aimed to identify potential candidates with statistical significance set at p < 0.01, which were used as seed terms to harvest additional candidates by interfacing to a large language model in a second step. The proposed approach can identify additional term candidates at suitable performance values: hypernyms MAP@5=0.801, synonyms MAP@5 = 0.723 and hyponyms MAP@5 = 0.507. The re-use of existing annotated clinical datasets, in combination with large language models, presents an interesting strategy to bridge the lexical gap in standardized clinical terminologies and real-world jargon.

PMID:39176890 | DOI:10.3233/SHTI240509

Stud Health Technol Inform. 2024 Aug 22;316:1962-1966. doi: 10.3233/SHTI240818.

ABSTRACT

Submitted genomic data for respiratory viruses reflect the emergence and spread of new variants. Although delays in submission limit the utility of these data for prospective surveillance, they may be useful for evaluating other surveillance sources. However, few studies have investigated the use of these data for evaluating aberration detection in surveillance systems. Our study used a Bayesian online change point detection algorithm (BOCP) to detect increases in the number of submitted genome samples as a means of establishing ‘gold standard’ dates of outbreak onset in multiple countries. We compared models using different data transformations and parameter values. BOCP detected change points that were not sensitive to different parameter settings. We also found data transformations were essential prior to change point detection. Our study presents a framework for using global genomic submission data to develop ‘gold standard’ dates about the onset of outbreaks due to new viral variants.

PMID:39176877 | DOI:10.3233/SHTI240818