prescriptive analytics

Ramzi Shawahna
BACKGROUND: Electronic health records (EHRs) with embedded clinical decision support systems (CDSSs) have the potential to improve healthcare delivery. This study was conducted to explore merits, features, and desiderata to be considered when planning for, designing, developing, implementing, piloting, evaluating, maintaining, upgrading, and/or using EHRs with CDSSs. METHODS: A mixed-method combining the Delphi technique and Analytic Hierarchy Process was used. Potentially important items were collected after a thorough search of the literature and from interviews with key contact experts (n = 19)...
November 8, 2019: BMC Medical Informatics and Decision Making
Suliana Teoh, Francesca Fiorini, Ben George, Katherine A Vallis, Frank Van den Heuvel
OBJECTIVE: To identify a subgroup of lung cancer plans where the analytical dose calculation (ADC) algorithm may be clinically acceptable compared to Monte Carlo (MC) dose calculation in intensity modulated proton therapy (IMPT). METHODS: Robust-optimised IMPT plans were generated for twenty patients to a dose of 70 Gy (relative biological effectiveness) in 35 fractions in Raystation. For each case, four plans were generated: three with ADC optimisation using the pencil beam algorithm (PB) followed by a final dose calculation with the following algorithms: PB (PB-PB), MC (PB-MC) and MC normalised to prescription dose (PB-MC scaled)...
November 7, 2019: British Journal of Radiology
Jaakko Taipale
This study examines two different approaches in empirical analysis of judges' evaluation of expertise in court: first, an analyst-based approach that employs predefined normative criteria to measure judges' performance, and second, an actor-based approach that emphasizes interpretative flexibility in judges' evaluation practice. I demonstrate how these different approaches to investigating judges' adjudication lead to differing understandings about judges' abilities to evaluate scientific evidence and testimonial...
November 2019: Public Understanding of Science
You Zhang, Tsuicheng Chiu, Jeffrey Dubas, Zhen Tian, Pam Lee, Xuejun Gu, Yulong Yan, David Sher, Robert Timmerman, Bo Zhao
INTRODUCTION: Stereotactic body radiation therapy (SBRT) was found effective in treating laryngeal cancer with only five treatment fractions by a recent clinical trial (NCT01984502, Nevertheless, this trial used the Cyberknife system, which is not widely accessible enough to benefit all patients affected by laryngeal cancer. Our study investigates the feasibility of larynx SBRT treatment planning on a conventional gantry-based LINAC and compares its plan quality with that from the Cyberknife...
November 4, 2019: Radiation Oncology
Brindusa Truta, Ira L Leeds, Joseph K Canner, Jonathan E Efron, Sandy H Fang, Azah Althumari, Bashar Safar
OBJECTIVES: Early discontinuation of infliximab (IFX) in pregnant women with inflammatory bowel disease (IBD) decreases the intrauterine fetal exposure to the drug but may increase the risk of disease flaring leading to poor pregnancy outcomes. In this study, we assessed the impact of early IFX discontinuation on mother's disease activity and on their at-risk babies. METHODS: In a retrospective study of the Truven Health Analytics MarketScan database from 2011 to 2015, we compared IBD patients who discontinued IFX more than 90 days ("early IFX") with those who discontinue IFX 90 days or less ("late IFX) before delivery...
October 31, 2019: Inflammatory Bowel Diseases
Cristina Canova, Lorenzo Simonato, Claudio Barbiellini Amidei, Ileana Baldi, Teresa Dalla Zuanna, Dario Gregori, Silvia Danieli, Alessandra Buja, Giulia Lorenzoni, Gisella Pitter, Giuseppe Costa, Roberto Gnavi, Giovanni Corrao, Federico Rea, Rosa Gini, Giulia Hyeraci, Giuseppe Roberto, Andrea Spini, Ersilia Lucenteforte, Nera Agabiti, Marina Davoli, Riccardo Di Domenicantonio, Giovanna Cappai
BACKGROUND: there has been a long-standing, consistent use worldwide of Healthcare Administrative Databases (HADs) for epidemiological purposes, especially to identify acute and chronic health conditions. These databases are able to reflect health-related conditions at a population level through disease-specific case-identification algorithms that combine information coded in multiple HADs. In Italy, in the past 10 years, HAD-based case-identification algorithms have experienced a constant increase, with a significant extension of the spectrum of identifiable diseases...
July 2019: Epidemiologia e Prevenzione
Jayme L Dahlin, Michael J Palte, John LaMacchia, Athena K Petrides
BACKGROUND: Monitoring of medication compliance and drug abuse is used by clinicians to increase patient prescription drug compliance and reduce illicit drug abuse and diversion. Despite available immunoassays, chromatography-mass spectrometry-based methods are considered the gold standard for urine drug monitoring owing to higher sensitivities and specificities. Herein, we report a fast, convenient ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay to detect or quantify 37 clinically relevant prescription drugs, drugs of abuse, and related glucuronides and other metabolites in human urine by single diluted sample injection...
May 2019: Journal of Applied Laboratory Medicine
Lucy Webster, Sergi Costafreda Gonzalez, Aisling Stringer, Amy Lineham, Jessica Budgett, Simon Kyle, Julie Barber, Gill Livingston
STUDY OBJECTIVES: Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness, and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia...
October 21, 2019: Sleep
T Schönfeld, A Heinemann, M Schulz, G Gradl, H Andresen-Streichert, A Müller, S Iwersen-Bergmann
Our aim was to investigate the reason for relatively low detection rates for opioids and fentanyl in particular in post-mortem cases in the State of Hamburg. We re-analysed 822 blood samples from two different time periods, 2011/12 and 2016. These samples had been previously analysed in accordance with post-mortem routine by a case selected strategy. All samples were re-analysed with an LC-MS/MS method specific for prescription opioids. The main point in the evaluation was to determine whether the previous analysis strategy had led to underreporting of drug-related deaths (DRD), especially with regard to fentanyl...
October 9, 2019: Forensic Science International
Anja Gilis
Quality research data are essential for quality decision-making and thus for unlocking true innovation potential to ultimately help address unmet medical needs.The factors influencing quality are diverse. They depend on institution type and experiment type and can be of both technical and cultural nature. A well-thought-out governance mechanism will help understand, monitor, and control research data quality in a research institution.In this chapter we provide practical guidance for simple, effective, and sustainable quality governance, tailored to the needs of an organization performing nonregulated preclinical research and owned by all stakeholders...
October 19, 2019: Handbook of Experimental Pharmacology
Qingqing Song, Jun Li, Yan Cao, Wenjing Liu, Huixia Huo, Jian-Bo Wan, Yuelin Song, Pengfei Tu
The principle of chromatographic fingerprint is that certain diagnostic metabolites should be always distributed in a given plant and currently, it has been widely accepted as a promising means for medicinal plant authentication. Moreover, the chemical profile is the only evidence to clarify the ingredients of those consumable plant products, e.g. traditional Chinese medicine (TCM) prescriptions. Herein, efforts were made to describe the diagnostic metabolome of medicinal plant or TCM prescription using a binary code sequence...
December 11, 2019: Analytica Chimica Acta
Vladislava S Batyrgareieva, Andriy M Babenko, Sandra Kaija
OBJECTIVE: Introduction: All social life spheres in Ukraine are influenced by corruption. Ukrainian citizens were inquired in order to determine corruption rate in various social spheres. It was conditioned by reforming criminal justice and administrative management, which is directed, particularly, for liquidation of corruption in the state. Special emphasize is stressed on corruption rate in the medical sphere. The aim of the article is to determine: 1) population's attitude towards to corruption, in particular, in the medical sphere; 2) the most corruptive social spheres; 3) efficiency of anti-corruption measures; 4) readiness of population to participate into struggle with corruption...
2019: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Nirmish Shah, Menaka Bhor, Lin Xie, Rashid Halloway, Steve Arcona, Jincy Paulose, Huseyin Yuce
BACKGROUND: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data. METHODS: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods...
October 16, 2019: Health and Quality of Life Outcomes
Reed F Beall, Lorian Hardcastle, Fiona Clement, Aidan Hollis
Canada recently entered into two multinational trade agreements (i.e., the Canada, United States, and Mexico Trade Agreement; and the Comprehensive Economic and Trade Agreement with the European Union). The resulting federal policy changes will prolong periods of market protection afforded to eligible brand-name prescription drugs by extending competition-blocking patent and data exclusivity terms. While previous studies have analysed these two policy changes in isolation, it remains unknown what the total combined impact will be in a typical year...
September 20, 2019: Health Policy
Pasitpon Vatcharavongvan, Viwat Puttawanchai
Objective: The primary objective was to examine potentially inappropriate medications (or PIMs) in the elderly using three different criteria: Beers 2015, STOPP version 2, and Winit-Watjana (for Thai elderly patients). The secondary objective was to examine PIM-related factors. Methods: This is a retrospective cross-sectional study. Eligible patients were aged ≥65 years in a primary care unit. Demographic data, medical prescriptions in the past year, clinical data and diagnoses were collected from electronic medical records...
July 2019: Pharmacy Practice
Zidane Qriouet, Zineb Qmichou, Nadia Bouchoutrouch, Hassan Mahi, Yahia Cherrah, Hassan Sefrioui
The prescription of psychotropic drugs, especially benzodiazepines (BZDs), occupies a preponderant place in the management of mental illnesses. Indeed, the BZDs have been used in different therapeutic areas including insomnia, anxiety, seizure disorders, or general anesthesia. Unfortunately, these drugs are present in the illegal street market, leading to a lot of drug abuse amongst some addicted users, road insecurity, and suicide. Hence, it has become essential to analyze the BZDs drugs in human biological specimens for drug abuse in forensic sciences...
2019: Journal of Analytical Methods in Chemistry
Pedro Augusto Simões, Luiz Miguel Santiago, Katia Maurício, José Augusto Simões
Background: In potentially inappropriate medications harm potentially outweighs benefits. Even appropriately prescribed medications may become inappropriate. They can lead to a high risk of adverse drug reactions, morbidity and mortality. The aim of this study was to determine the prevalence of potentially inappropriate medication in the older adult population attending primary care in Portugal and to identify associated sociodemographic and clinical factors. Methods: We conducted a cross-sectional, analytical study in primary care centres from the five Portuguese healthcare administrative regions and the two autonomous regions...
2019: Patient Preference and Adherence
Ryan C Pickens, Lacey King, Misty Barrier, Kendra Tezber, Jesse K Sulzer, Allyson Cochran, William B Lyman, Garth McClune, David A Iannitti, John B Martinie, Erin H Baker, Lee M Ocuin, Matthew Hanley, Dionisios Vrochides
Postoperative laboratory testing is an underrecognized but substantial contributor to health-care costs. We aimed to develop and validate a clinically meaningful laboratory (CML) protocol with individual risk stratification using generalizable and institution-specific predictive analytics to reduce laboratory testing and maximize cost savings for low-risk patients. An institutionally based risk model was developed for pancreaticoduodenectomy and hepatectomy, and an ACS-NSQIP®-based model was developed for distal pancreatectomy...
August 1, 2019: American Surgeon
Harriet Affran Bonful, Adolf Kofi Awua, Martin Adjuik, Doris Tsekpetse, Richard Mawuko Kofi Adanu, Pricillia Awo Nortey, Augustine Ankomah, Kwadwo Ansah Koram
BACKGROUND: Febrile children seen in malaria hypo-endemic settings, such as the Greater Accra region (GAR) of Ghana are more likely to be suffering from a non-malarial febrile illness compared to those seen in hyper-endemic settings. The need for prescribers to rely on malaria test results to guide treatment practices in the GAR is even greater. This study was designed to investigate the factors associated with inappropriate artemisinin-based combination therapy (ACT) prescription. METHODS: A survey was conducted in six health facilities in the region in 2015...
September 27, 2019: Malaria Journal
Mohammad B Nusair, M Ken Cor, Mary Roduta Roberts, Lisa M Guirguis
Background There are two fundamental approaches to clinical reasoning, intuitive and analytical. These approaches have yet to be well explored to describe how pharmacists make decisions to determine medication appropriateness. Objective (1) to identify the cognitive actions (i.e., operators) that pharmacists employ when they move from one cue (i.e., concept) to another, and (2) to describe the overall clinical reasoning approach taken by pharmacists when checking for medication appropriateness. Setting Pharmacists from a chain pharmacy in Canada were invited to participate in this study...
September 20, 2019: International Journal of Clinical Pharmacy
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