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He H, Chen Y, Liao Y, Hu L, Qin H, Yang R. Association between body shape index and coronary heart disease in individuals over 20 years old with obese. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:123. [PMID: 39152519 PMCID: PMC11330033 DOI: 10.1186/s41043-024-00614-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 08/01/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND While body mass index (BMI) defines obesity as a well-established risk factor for cardiovascular disease, the paradoxical theory of BMI suggests that obesity may indeed have a favorable impact on the prognosis of cardiovascular disease. Therefore, this study aims to assess the correlation between body shape index (ABSI), which is a novel measure of obesity, and coronary heart disease (CHD) among obese individuals in the United States. METHODS The data from the National Health and Nutrition Examination Survey (NHANES) were evaluated by us for 5046 patients. We assessed the exposure variable ABSI, which includes waist circumference (WC), height, and BMI. The outcome variable was CHD. RESULTS The cross-sectional study included a total of 5046 obese adults aged over 20 years, with an average age (standard deviation: SD) of 49.86 (16.24) years and a male proportion of 44.57%.The odds ratio (OR) values for CHD in Model 1, Model 2, 3 were found to be 2.45 (95%CI: 2.12, 2.83), 1.53 (95%CI:1.30, 1.81) and 1.31 (95%CI:1.09, 1.56) per SD increase in ABSI, respectively. In the fully adjusted model, we designated participants in the T1 group as the reference group. Our findings indicate a significant increase in the prevalence of CHD (OR:1.82, 95%CI: 1.07-3.10) only within the T3 group. Although there is an increased prevalence of CHD (OR:1.32, 95%CI: 0.77-2.29) in the T2 group, no statistically significant difference was observed. CONCLUSIONS The increase in ABSI is strongly associated with the rise in CHD prevalence among obese individuals in the United States.
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Affiliation(s)
- Huabin He
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Department of Cardiovascular Medicine, Jiu jiang NO.1 People's Hospital, Jiujiang, 332000, China
| | - Yang Chen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Yanhui Liao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Longlong Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Hao Qin
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Renqiang Yang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
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Lei Y, Qiu X, Zhou R. Construction and evaluation of neonatal respiratory failure risk prediction model for neonatal respiratory distress syndrome. BMC Pulm Med 2024; 24:8. [PMID: 38166798 PMCID: PMC10759760 DOI: 10.1186/s12890-023-02819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Neonatal respiratory distress syndrome (NRDS) is a common respiratory disease in preterm infants, often accompanied by respiratory failure. The aim of this study was to establish and validate a nomogram model for predicting the probability of respiratory failure in NRDS patients. METHODS Patients diagnosed with NRDS were extracted from the MIMIC-iv database. The patients were randomly assigned to a training and a validation cohort. Univariate and stepwise Cox regression analyses were used to determine the prognostic factors of NRDS. A nomogram containing these factors was established to predict the incidence of respiratory failure in NRDS patients. The area under the receiver operating characteristic curve (AUC), receiver operating characteristic curve (ROC), calibration curves and decision curve analysis were used to determine the effectiveness of this model. RESULTS The study included 2,705 patients with NRDS. Univariate and multivariate stepwise Cox regression analysis showed that the independent risk factors for respiratory failure in NRDS patients were gestational age, pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), hemoglobin, blood culture, infection, neonatal intracranial hemorrhage, Pulmonary surfactant (PS), parenteral nutrition and respiratory support. Then, the nomogram was constructed and verified. CONCLUSIONS This study identified the independent risk factors of respiratory failure in NRDS patients and used them to construct and evaluate respiratory failure risk prediction model for NRDS. The present findings provide clinicians with the judgment of patients with respiratory failure in NRDS and help clinicians to identify and intervene in the early stage.
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Affiliation(s)
- Yupeng Lei
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, China
| | - Xia Qiu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, China
| | - Ruixi Zhou
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, 610041, China.
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Li X, Zhang D, Zhao Y, Kuang L, Huang H, Chen W, Fu X, Wu Y, Li T, Zhang J, Yuan L, Hu H, Liu Y, Hu F, Zhang M, Sun X, Hu D. Correlation of heavy metals' exposure with the prevalence of coronary heart disease among US adults: findings of the US NHANES from 2003 to 2018. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:6745-6759. [PMID: 37378736 DOI: 10.1007/s10653-023-01670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
We sought to explore the association between heavy metal exposure and coronary heart disease (CHD) based on data from the US National Health and Nutrition Examination Survey (NHANES, 2003-2018). In the analyses, participants were all aged > 20 and had participated in heavy metal sub-tests with valid CHD status. The Mann-Kendall test was employed to assess the trends in heavy metals' exposure and the trends in CHD prevalence over 16 years. Spearman's rank correlation coefficient and a logistics regression (LR) model were used to estimate the association between heavy metals and CHD prevalence. 42,749 participants were included in our analyses, 1802 of whom had a CHD diagnosis. Total arsenic, dimethylarsonic acid, monomethylarsonic acid, barium, cadmium, lead, and antimony in urine, and cadmium, lead, and total mercury in blood all showed a substantial decreasing exposure level tendency over the 16 years (all Pfor trend < 0.05). CHD prevalence varied from 3.53 to 5.23% between 2003 and 2018. The correlation between 15 heavy metals and CHD ranges from - 0.238 to 0.910. There was also a significant positive correlation between total arsenic, monomethylarsonic acid, and thallium in urine and CHD by data release cycles (all P < 0.05). The cesium in urine showed a negative correlation with CHD (P < 0.05). We found that exposure trends of total arsenic, dimethylarsonic acid, monomethylarsonic acid, barium, cadmium, lead, and antimony in urine and blood decreased. CHD prevalence fluctuated, however. Moreover, total arsenic, monomethylarsonic acid, and thallium in urine all showed positive relationships with CHD, while cesium in urine showed a negative relationship with CHD.
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Affiliation(s)
- Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Lei Kuang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Hao Huang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, People's Republic of China
| | - Weiling Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xueru Fu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Jinli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
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Faqar-Uz-Zaman SF, Sliwinski S, Detemble C, Filmann N, Zmuc D, Mohr L, Dreilich J, Bechstein WO, Fleckenstein J, Schnitzbauer AA. Study protocol for a pilot trial analysing the usability, validity and safety of an interventional health app programme for the structured prehabilitation of patients before major surgical interventions: the PROTEGO MAXIMA trial. BMJ Open 2023; 13:e069394. [PMID: 37019492 PMCID: PMC10439343 DOI: 10.1136/bmjopen-2022-069394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/14/2023] [Indexed: 04/07/2023] Open
Abstract
INTRODUCTION Major surgery is associated with a high risk for postoperative complications, leading to an increase in mortality and morbidity, particularly in frail patients with a reduced cardiopulmonary reserve. Prehabilitation, including aerobic exercise training, aims to improve patients' physical fitness before major surgery and reduce postoperative complications, length of hospital stay and costs. The purpose of the study is to assess the usability, validity and safety of an app-based endurance exercise software in accordance with the Medical Device Regulation using wrist-worn wearables to measure heart rate (HR) and distance. METHODS AND ANALYSIS The PROTEGO MAXIMA trial is a prospective, interventional study with patients undergoing major elective surgery, comprising three tasks. Tasks I and II aim to assess the usability of the app, using evaluation questionnaires and usability scenarios. In Task IIIa, patients will undergo a structured risk assessment by the Patronus App, which will be correlated with the occurrence of postoperative complications after 90 days (non-interventional). In Task IIIb, healthy students and patients will perform a supervised 6 min walking test and a 37 min interval training on a treadmill based on HR reserve, wearing standard ECG limb leads and two smartwatches, which will be driven by the test software. The aim of this task is to assess the accuracy of HR measurement by the wearables and the safety, using specific alarm settings of the devices and lab testing of the participants (interventional). ETHICS AND DISSEMINATION Ethical approval was granted by the Institutional Review Board of the University Hospital of Frankfurt and by the Federal Institute for Pharmaceuticals and Medical Products (BfArM, reference number 94.1.04-5660-13655) on 7 February 2022. The results from this study will be submitted to peer-reviewed journals and reported at suitable national and international meetings. TRIAL REGISTRATION NUMBERS European Database on Medical Devices (CIV-21-07-037311) and German Clinical Trial Registry (DRKS00026985).
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Affiliation(s)
- Sara Fatima Faqar-Uz-Zaman
- Department for General, Visceral, Transplant and Thoracic Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
| | - Svenja Sliwinski
- Department for General, Visceral, Transplant and Thoracic Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
| | - Charlotte Detemble
- Department for General, Visceral, Transplant and Thoracic Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Dora Zmuc
- MCL Medical Center Ljubljana, Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Lisa Mohr
- Department of Sports Medicine and Exercise Physiology, Institute for Sports Science, Goethe University Frankfurt, Frankfurt, Germany
| | - Julia Dreilich
- Department of Sports Medicine and Exercise Physiology, Institute for Sports Science, Goethe University Frankfurt, Frankfurt, Germany
| | - Wolf O Bechstein
- Department for General, Visceral, Transplant and Thoracic Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
| | - Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Institute for Sports Science, Goethe University Frankfurt, Frankfurt, Germany
- Pain Centre, Klinikum Landsberg am Lech, Landsberg am Lech, Germany
| | - Andreas A Schnitzbauer
- Department for General, Visceral, Transplant and Thoracic Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
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Is the Tradeoff between Folic Acid or/and Multivitamin Supplementation against Birth Defects in Early Pregnancy Reconsidered? Evidence Based on a Chinese Birth Cohort Study. Nutrients 2023; 15:nu15020279. [PMID: 36678149 PMCID: PMC9865336 DOI: 10.3390/nu15020279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Several studies have reported conflicting results on the association between maternal exposure to folic acid (FA) and/or multivitamin (MV) supplements and the risk of birth defects (BDs), especially for different subtypes of BDs. The present study aimed to identify the association between maternal exposure to FA or/and MV and BDs in offspring. METHODS In the Chinese Birth Cohort Study initiated from 20 November 2017, 120,652 pregnant women completed follow-up until 20 August 2021. The participants were classified into four groups: without exposure to FA and MV, exposure to only FA, exposure to only MV, and exposure to FA and MV. Birth defects were coded by the International Classification of Diseases (ICD)-10. In order to explore the structural relationship between maternal FA or MV supplements and BDs, directed acyclic graphs were drawn. Then, an inverse probability treatment weighting was utilized to reduce the systematic differences in the baseline characteristics among the different groups. Lastly, a two-level mixed-effect log binomial regression analysis was used to estimate the relative risk (RR) value of the different subtypes of BDs under different exposures to FA and/or MV. RESULTS Compared with the maternal group without exposure to FA and MV, the RR values of nervous system defects, face, ear, and neck defects, limb defects, and CHDs in the maternal group with only FA supplementation were less than 1.0, but they were not statistically significant. The RR values of genitourinary defects, abnormal chromosomes, and oral clefts were more than 1.0, and they were also not statistically significant. However, the risk of genitourinary defects (RR: 3.22, 95% CI: 1.42-7.29) and chromosomal abnormalities (RR: 2.57, 95% CI: 1.16-5.73) in the maternal group with only MV supplementation increased more than those in the maternal group without exposure to FA and MV. In addition, the RR values of all subtypes of BDs in the maternal group with exposure to FA and MV were closer to 1.0 than those in maternal group with exposure to only MV, but they were not statistically significant. CONCLUSIONS It was indicated that the simultaneous supplementation of FA and MV in early pregnancy may have an interaction for the prevention of BDs and may have inconsistent effects for different subtypes of BDs. At the same time, excessive FA supplementation in pregnant women may increase the risk of BDs in their offspring. Although the mechanism is not clear, this evidence reminded us that more trade-offs are necessary for formulating strategies for the prevention of BDs with FA and/or MV supplementation in early pregnancy.
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Sheikh Rezaei S, Litschauer B, Anderle K, Maurer S, Beyers PJ, Reichardt B, Wolzt M. Antibiotic prescription after tooth extraction in adults: a retrospective cohort study in Austria. BMC Oral Health 2022; 22:519. [PMID: 36404324 PMCID: PMC9677908 DOI: 10.1186/s12903-022-02556-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Broad spectrum antibiotics are often used for the prophylaxis of infectious endocarditis and treatment of odontogenic infections, but there are limited data related to antibiotic use and adherence to prescription guidelines. METHODS: Data from patients with tooth extraction between 2014 and 2018 were selected from a database of a regional health insurance fund. We created three data sets, one based on all tooth extractions, one on multiple teeth extractions, and one including only single tooth extraction. After data collection, descriptive analysis was carried out. The differences in prescription pattern of antibiotic medicine were tested by χ2 test, Student´s t-test or ANOVA. RESULTS From 43,863 patients with tooth extraction, 53% were female, and 3,983 patients (9.1%) filled a prescription for antibiotic medicine. From 43,863 patients, 157 patients (0.4%) had endocarditis risk, but only 8 patients of these (5.1%) filled an antibiotic prescription. In total, 9,234 patients had multiple and 34,437 patients had only one tooth extraction. Patients with more than one tooth extraction received more often antibiotic treatment (10.7%) compared to those with single tooth extractions (χ2 = 36; p < 0,001). Patients with more than one tooth extraction were older, however, younger patients received antibiotics more frequently (t = 28,774, p = 0.001). There was no relationship with endocarditis risk status. Clindamycin and amoxicillin/clavulanic acid were the most frequently prescribed antibiotic medicines. CONCLUSIONS In this retrospective cohort study, dentists did not discriminate prophylactic antibiotic prescription with regard to endocarditis risk status. A factor influencing prescribing behaviour of antibiotic medicines was the number of extracted teeth.
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Affiliation(s)
- Safoura Sheikh Rezaei
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria
| | - Brigitte Litschauer
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria
| | - Karolina Anderle
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria
| | - Stephanie Maurer
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria
| | - Patrick Jan Beyers
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria
| | - Berthold Reichardt
- Austrian Social Health Insurance Fund, Österreichische Gesundheitskasse, 7000, Eisenstadt, Austria
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 13, 1090, Vienna, Austria.
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Bonmatí LM, Miguel A, Suárez A, Aznar M, Beregi JP, Fournier L, Neri E, Laghi A, França M, Sardanelli F, Penzkofer T, Lambin P, Blanquer I, Menzel M, Seymour K, Figueiras S, Krischak K, Martínez R, Mirsky Y, Yang G, Alberich-Bayarri Á. CHAIMELEON Project: Creation of a Pan-European Repository of Health Imaging Data for the Development of AI-Powered Cancer Management Tools. Front Oncol 2022; 12:742701. [PMID: 35280732 PMCID: PMC8913333 DOI: 10.3389/fonc.2022.742701] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/28/2022] [Indexed: 12/13/2022] Open
Abstract
The CHAIMELEON project aims to set up a pan-European repository of health imaging data, tools and methodologies, with the ambition to set a standard and provide resources for future AI experimentation for cancer management. The project is a 4 year long, EU-funded project tackling some of the most ambitious research in the fields of biomedical imaging, artificial intelligence and cancer treatment, addressing the four types of cancer that currently have the highest prevalence worldwide: lung, breast, prostate and colorectal. To allow this, clinical partners and external collaborators will populate the repository with multimodality (MR, CT, PET/CT) imaging and related clinical data. Subsequently, AI developers will enable a multimodal analytical data engine facilitating the interpretation, extraction and exploitation of the information stored at the repository. The development and implementation of AI-powered pipelines will enable advancement towards automating data deidentification, curation, annotation, integrity securing and image harmonization. By the end of the project, the usability and performance of the repository as a tool fostering AI experimentation will be technically validated, including a validation subphase by world-class European AI developers, participating in Open Challenges to the AI Community. Upon successful validation of the repository, a set of selected AI tools will undergo early in-silico validation in observational clinical studies coordinated by leading experts in the partner hospitals. Tool performance will be assessed, including external independent validation on hallmark clinical decisions in response to some of the currently most important clinical end points in cancer. The project brings together a consortium of 18 European partners including hospitals, universities, R&D centers and private research companies, constituting an ecosystem of infrastructures, biobanks, AI/in-silico experimentation and cloud computing technologies in oncology.
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Affiliation(s)
- Luis Martí Bonmatí
- Medical Imaging Department, La Fe University and Polytechnic Hospital & Biomedical Imaging Research Group Grupo de Investigación Biomédica en Imagen (GIBI2) at La Fe University and Polytechnic Hospital and Health Research Institute, Valencia, Spain,*Correspondence: Luis Martí Bonmatí,
| | - Ana Miguel
- Medical Imaging Department, La Fe University and Polytechnic Hospital & Biomedical Imaging Research Group Grupo de Investigación Biomédica en Imagen (GIBI2) at La Fe University and Polytechnic Hospital and Health Research Institute, Valencia, Spain
| | | | | | | | - Laure Fournier
- Collège des enseignants en radiologie de France, Paris, France
| | - Emanuele Neri
- Diagnostic Radiology 3, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Andrea Laghi
- Medicina Traslazionale e Oncologia, Sant Andrea Sapienza Rome, Rome, Italy
| | - Manuela França
- Department of Radiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Francesco Sardanelli
- Servizio di Diagnostica per Immagini, “Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato, Milanese, Italy
| | - Tobias Penzkofer
- Department of Radiology, CHARITÉ-Universitätsmedizin Berlin, Berlin, Germany
| | - Phillipe Lambin
- Department of Precision Medicine, Maastricht University, Maastricht, Netherlands
| | - Ignacio Blanquer
- Computing Science Department, Universitat Politècnica de València, València, Spain
| | - Marion I. Menzel
- GE Healthcare, München, Germany,Department of Physics, Technical University of Munich, Garching, Germany
| | | | | | - Katharina Krischak
- European Institute for Biomedical Imaging Research, EIBIR gemeinnützige GmbH, Vienna, Austria
| | - Ricard Martínez
- Departamento de Derecho Constitucional, Ciencia Política y Administración, Universitat de València, València, Spain
| | - Yisroel Mirsky
- Software and Information Systems Engineering, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Guang Yang
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Li L, Jing Q, Yan S, Liu X, Sun Y, Zhu D, Wang D, Hao C, Xue D. Amadis: A Comprehensive Database for Association Between Microbiota and Disease. Front Physiol 2021; 12:697059. [PMID: 34335304 PMCID: PMC8317061 DOI: 10.3389/fphys.2021.697059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
The human gastrointestinal tract represents a symbiotic bioreactor that can mediate the interaction of the human host. The deployment and integration of multi-omics technologies have depicted a more complete image of the functions performed by microbial organisms. In addition, a large amount of data has been generated in a short time. However, researchers struggling to keep track of these mountains of information need a way to conveniently gain a comprehensive understanding of the relationship between microbiota and human diseases. To tackle this issue, we developed Amadis (http://gift2disease.net/GIFTED), a manually curated database that provides experimentally supported microbiota-disease associations and a dynamic network construction method. The current version of the Amadis database documents 20167 associations between 221 human diseases and 774 gut microbes across 17 species, curated from more than 1000 articles. By using the curated data, users can freely select and combine modules to obtain a specific microbe-based human disease network. Additionally, Amadis provides a user-friendly interface for browsing, searching and downloading. We hope it can serve as a useful and valuable resource for researchers exploring the associations between gastrointestinal microbiota and human diseases.
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Affiliation(s)
- Long Li
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qingxu Jing
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Sen Yan
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuxu Liu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuanyuan Sun
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Defu Zhu
- Family Medicine General Practice Clinic, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Dawei Wang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chenjun Hao
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dongbo Xue
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Faqar-Uz-Zaman SF, Filmann N, Mahkovic D, von Wagner M, Detemble C, Kippke U, Marschall U, Anantharajah L, Baumartz P, Sobotta P, Bechstein WO, Schnitzbauer AA. Study protocol for a prospective, double-blinded, observational study investigating the diagnostic accuracy of an app-based diagnostic health care application in an emergency room setting: the eRadaR trial. BMJ Open 2021; 11:e041396. [PMID: 33419909 PMCID: PMC7798704 DOI: 10.1136/bmjopen-2020-041396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Occurrence of inaccurate or delayed diagnoses is a significant concern in patient care, particularly in emergency medicine, where decision making is often constrained by high throughput and inaccurate admission diagnoses. Artificial intelligence-based diagnostic decision support system have been developed to enhance clinical performance by suggesting differential diagnoses to a given case, based on an integrated medical knowledge base and machine learning techniques. The purpose of the study is to evaluate the diagnostic accuracy of Ada, an app-based diagnostic tool and the impact on patient outcome. METHODS AND ANALYSIS The eRadaR trial is a prospective, double-blinded study with patients presenting to the emergency room (ER) with abdominal pain. At initial contact in the ER, a structured interview will be performed using the Ada-App and both, patients and attending physicians, will be blinded to the proposed diagnosis lists until trial completion. Throughout the study, clinical data relating to diagnostic findings and types of therapy will be obtained and the follow-up until day 90 will comprise occurrence of complications and overall survival of patients. The primary efficacy of the trial is defined by the percentage of correct diagnoses suggested by Ada compared with the final discharge diagnosis. Further, accuracy and timing of diagnosis will be compared with decision making of classical doctor-patient interaction. Secondary objectives are complications, length of hospital stay and overall survival. ETHICS AND DISSEMINATION Ethical approval was received by the independent ethics committee (IEC) of the Goethe-University Frankfurt on 9 April 2020 including the patient information material and informed consent form. All protocol amendments must be reported to and adapted by the IEC. The results from this study will be submitted to peer-reviewed journals and reported at suitable national and international meetings. TRIAL REGISTRATION NUMBER DRKS00019098.
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Affiliation(s)
- S Fatima Faqar-Uz-Zaman
- Department for General, Visceral and Transplant Surgery, Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Frankfurt, Germany
| | - Dora Mahkovic
- Ljubljana Central Medical School, Ljubljana, Slovenia
| | | | - Charlotte Detemble
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | - Ulf Kippke
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | | | - Luxia Anantharajah
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | - Philipp Baumartz
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | - Paula Sobotta
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | - Wolf O Bechstein
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
| | - Andreas A Schnitzbauer
- Hospital of the Goethe University Frankfurt Surgery Centre, Frankfurt am Main, Hessen, Germany
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Mattei TA. The classic "Carrot-and-stick approach": Addressing underutilization of ICD-10 increased data granularity. NORTH AMERICAN SPINE SOCIETY JOURNAL 2020; 4:100032. [PMID: 35141601 PMCID: PMC8820015 DOI: 10.1016/j.xnsj.2020.100032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/29/2020] [Indexed: 06/14/2023]
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Chen MM, Hirsch JA, Lee RK, Hughes DR, Nicola GN, Rosenkrantz AB. Determining the Patient Complexity of Head CT Examinations: Implications for Proper Valuation of a Critical Imaging Service. Curr Probl Diagn Radiol 2019; 49:177-181. [PMID: 31160096 DOI: 10.1067/j.cpradiol.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/05/2019] [Accepted: 05/07/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE The head-computed tomography (CT) exam code was recently identified by policy makers as having a potentially overvalued resource value units (RVU). A critical aspect in determining RVUs is the complexity of patients undergoing the service. This study evaluated the complexity of patients undergoing head-CT. METHODS The 2017 Medicare PSPS Master File was used to identify the most common site for performing head-CT examinations. Given the most common location, the 5% Research Identifiable File, was then used to evaluate complexity of patients undergoing head CT on the same day as an emergency department (ED) visit based on the Evaluation & Management (E&M) "level" of these visits (1-least complex to 5-most complex patient) and the ICD-10 diagnosis coding associated with the billed head CT claims. RESULTS 56.1% of head CT examinations were performed in the ED. Seventy percent of noncontrast exams performed in the ED were ordered in the most complex patient encounters (level 5 E&M visits). The most common ICD-10 code for head-CT without intravenous contrast billed with a level 5 E&M visit was "dizziness and giddiness," and for head-CT without and with intravenous contrast was "headache." CONCLUSION Head-CT is not only most frequently ordered in the ED, but also during the most complex ED visits, suggesting that the ICD-10 codes associated with such exams do not appropriately reflects patient complexity. The valuation process should also consider the complexity of associated billed patient encounters, as indicated by E&M visit levels.
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Affiliation(s)
| | | | - Ryan K Lee
- Thomas Jefferson University, Philadelphia, PA
| | - Danny R Hughes
- Georgia Institute of Technology, Atlanta, GA.; Harvey L. Neiman Health Policy Institute, Reston, VA
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Hirsch JA, Nicola G, McGinty G, Liu RW, Barr RM, Chittle MD, Manchikanti L. ICD-10: History and Context. AJNR Am J Neuroradiol 2016; 37:596-9. [PMID: 26822730 DOI: 10.3174/ajnr.a4696] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 11/07/2022]
Abstract
In recent months, organized medicine has been consumed by the anticipated transition to the 10th iteration of the International Classification of Disease system. Implementation has come and gone without the disruptive effects predicted by many. Despite the fundamental role the International Classification of Disease system plays in health care delivery and payment policy, few neuroradiologists are familiar with the history of its implementation and implications beyond coding for diseases.
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Affiliation(s)
- J A Hirsch
- From the Department of Radiology (J.A.H., R.W.L., M.D.C.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - G Nicola
- Department of Radiology (G.N.), Hackensack Radiology Group, University Medical Center, River Edge, New Jersey
| | - G McGinty
- Department of Radiology (G.M.), Weill Cornell Medical College, New York, New York
| | - R W Liu
- From the Department of Radiology (J.A.H., R.W.L., M.D.C.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - R M Barr
- Mecklenburg Radiology Associates (R.M.B.), Charlotte, North Carolina
| | - M D Chittle
- From the Department of Radiology (J.A.H., R.W.L., M.D.C.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - L Manchikanti
- Department of Anesthesiology and Perioperative Medicine (L.M.), Pain Management Center of Paducah, University of Louisville, Paducah, Kentucky
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Rai AT, Evans K, Riggs JE, Hobbs GR. Intravenous thrombolysis of large vessel occlusions is associated with higher hospital costs than small vessel strokes: a rationale for developing stroke severity-based financial models. J Neurointerv Surg 2015; 8:423-8. [PMID: 25665984 DOI: 10.1136/neurintsurg-2014-011632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/22/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Owing to their severity, large vessel occlusion (LVO) strokes may be associated with higher costs that are not reflected in current coding systems. This study aimed to determine whether intravenous thrombolysis costs are related to the presence or absence of LVO. METHODS Patients who had undergone intravenous thrombolysis over a 9-year period were divided into LVO and no LVO (nLVO) groups based on admission CT angiography. The primary outcome was hospital cost per admission. Secondary outcomes included admission duration, 90-day clinical outcome, and discharge destination. RESULTS 119 patients (53%) had LVO and 104 (47%) had nLVO. Total mean±SD cost per LVO patient was $18,815±14,262 compared with $15,174±11,769 per nLVO patient (p=0.04). Hospital payments per admission were $17,338±13,947 and $15,594±16,437 for LVO and nLVO patients, respectively (p=0.4). A good outcome was seen in 33 LVO patients (27.7%) and in 69 nLVO patients (66.4%) (OR 0.2, 95% CI 0.1 to 0.3, p<0.0001). Hospital mortality occurred in 31 LVO patients (26.1%) and in 7 nLVO patients (6.7%) (OR 0.2, 95% CI 0.08 to 0.5, p<0.0001). 31 LVO patients (32.6%) were discharged to home versus 64 nLVO patients (61.5%) (OR 4.5, 95% CI 2.6 to 8, p<0.0001). Admission duration was 7.5±6.9 days in LVO patients versus 4.9±4.2 days in nLVO patients (p=0.0009). Multivariate regression analysis after controlling for comorbidities showed the presence of LVO to be an independent predictor of higher total hospital costs. CONCLUSIONS The presence or absence of LVO is associated with significant differences in hospital costs, outcomes, admission duration, and home discharge. These differences can be important when developing systems of care models for acute ischemic stroke.
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Affiliation(s)
- Ansaar T Rai
- Department of Neuroradiology, Neurosurgery and Neurology West Virginia University Healthcare Room 2278, Morgantown, West Virginia, USA
| | - Kim Evans
- Decision Support, West Virginia University Healthcare, Morgantown, West Virginia, USA
| | - Jack E Riggs
- Department of Neurology, Morgantown, West Virginia, USA
| | - Gerald R Hobbs
- Department of Statistics, HSCS, Morgantown, West Virginia, USA
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