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Zhang ZY, Huang L, Gao M, Zhang TQ, Zhang FY, Yi J, Liu ZL. Parallel-Forms Reliability and Minimal Detectable Change of the Four Telerehabilitation Version Mobility-Related Function Scales in Stroke Survivors. Arch Phys Med Rehabil 2024; 105:1124-1132. [PMID: 38307318 DOI: 10.1016/j.apmr.2024.01.016] [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] [Revised: 11/25/2023] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To investigate the parallel-forms reliability, minimal detectable change with 95% confidence interval (MDC95), and feasibility of the 4 telerehabilitation version mobility-related function scales: Fugl-Meyer Assessment-lower extremity subscale (Tele-FMA-LE), Berg Balance Scale (Tele-BBS), Tinetti Performance Oriented Mobility Assessment-Gait subscale (Tele-POMA-G), and Rivermead Mobility Index (Tele-RMI). DESIGN Reliability and agreement study and cross-sectional study. SETTING Medical center. PARTICIPANTS Stroke survivors' ability to independently walk 3 meters with assistive devices, age of ≥18 years for participants and their partners, stable physical condition, and absence of cognitive impairment (N=60). INTERVENTIONS Not applicable. MAIN OUTCOMES MEASURES Parallel-forms reliability and MDC95 of Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI. RESULTS No significant differences (P>.05) were observed among the mean scores of the telerehabilitation version and face-to-face version mobility-related function scales. Intraclass correlation coefficients (ICCs) indicated good reliability for most scales, with Tele-FMA-LE, Tele-BBS, and Tele-RMI scores achieving values of 0.81, 0.78, and 0.84. Tele-POMA-G scores demonstrated moderate reliability (ICC=0.72). Weighted kappa (κw) showed good-to-excellent reliability for most individual items (κw>0.60). The MDCs of the Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI were 5.84, 8.10, 2.74, and 1.31, respectively. Bland-Altman analysis showed adequate agreement between tele-assessment and face-to-face assessment for all scales. The 5 dimensions affirm the robust feasibility of tele-assessment: assessment time, subjective fatigue perception, overall preference, participant satisfaction, and system usability. CONCLUSIONS The study demonstrates good parallel-forms reliability, MDC, and promising feasibility of the 4 telerehabilitation version mobility-related function scales (Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI) in survivors of stroke.
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Affiliation(s)
- Zhi-Yuan Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Lu Huang
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Min Gao
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Tian-Qi Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Feng-Yue Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Jiang Yi
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China
| | - Zhong-Liang Liu
- Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China.
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Beckett RD, Brattain Y, Truong J, Engle G. Tertiary drug information sources for treatment and prevention of COVID-19. J Med Libr Assoc 2023; 111:783-791. [PMID: 37928123 PMCID: PMC10621729 DOI: 10.5195/jmla.2023.1662] [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] [Indexed: 11/07/2023] Open
Abstract
Objective To evaluate tertiary drug information databases in terms of scope, consistency of content, and completeness of COVID-19 drug information. Methods Five electronic drug information databases: Clinical Pharmacology, Lexi-Drugs, AHFS DI (American Hospital Formulary Service Drug Information), eFacts and Comparisons, and Micromedex In-Depth Answers, were evaluated in this cross-sectional evaluation study, with data gathered from October 2021 through February 2022. Two study investigators independently extracted data (parallel extraction) from each resource. Descriptive statistics were primarily used to evaluate scope (i.e., whether the resource addresses use of the medication for treatment or prevention of COVID-19) and completeness of content (i.e., whether full information is provided related to the use of the medication for treatment or prevention of COVID-19) based on a 10-point scale. To analyze consistency among resources for scope, the Fleiss multi-rater kappa was used. To analyze consistency among resources for type of recommendation (i.e., in favor, insufficient evidence, against), a two-way mixed effects intraclass coefficient was calculated. Results A total of 46 drug monographs, including 3 vaccination monographs, were evaluated. Use of the agents for treatment of COVID-19 was most frequently addressed in Lexi-Drugs (73.9%), followed by eFacts and Comparisons (71.7%), and Micromedex (54.3%). The highest overall median completeness score was held by AHFS DI followed by Micromedex, and Clinical Pharmacology. There was moderate consistency in terms of scope (kappa 0.490, 95% CI 0.399-0.581, p<0.001) and recommendations (intraclass correlation coefficient 0.518, 95% CI 0.385-0.651, p<0.001). Conclusion Scope and completeness results varied by resource, with moderate consistency of content among resources.
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Affiliation(s)
- Robert D Beckett
- , Clinical Standard Coordinator, Parkview Health, Fort Wayne, IN
| | - Yashawna Brattain
- , Manchester University College of Health Sciences and Pharmacy, Fort Wayne, IN
| | - Judy Truong
- , Drug Information Resident, Creighton University School of Pharmacy and Health Professions, Omaha, NE
| | - Genevieve Engle
- , Director of the Drug Information Center and Associate Professor, Belmont University College of Pharmacy, Nashville, TN
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Ferdowsi S, Knafou J, Borissov N, Vicente Alvarez D, Mishra R, Amini P, Teodoro D. Deep learning-based risk prediction for interventional clinical trials based on protocol design: A retrospective study. PATTERNS (NEW YORK, N.Y.) 2023; 4:100689. [PMID: 36960445 PMCID: PMC10028430 DOI: 10.1016/j.patter.2023.100689] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/07/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023]
Abstract
Success rate of clinical trials (CTs) is low, with the protocol design itself being considered a major risk factor. We aimed to investigate the use of deep learning methods to predict the risk of CTs based on their protocols. Considering protocol changes and their final status, a retrospective risk assignment method was proposed to label CTs according to low, medium, and high risk levels. Then, transformer and graph neural networks were designed and combined in an ensemble model to learn to infer the ternary risk categories. The ensemble model achieved robust performance (area under the receiving operator characteristic curve [AUROC] of 0.8453 [95% confidence interval: 0.8409-0.8495]), similar to the individual architectures but significantly outperforming a baseline based on bag-of-words features (0.7548 [0.7493-0.7603] AUROC). We demonstrate the potential of deep learning in predicting the risk of CTs from their protocols, paving the way for customized risk mitigation strategies during protocol design.
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Affiliation(s)
- Sohrab Ferdowsi
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Geneva School of Business Administration, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Julien Knafou
- Geneva School of Business Administration, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Nikolay Borissov
- Clinical Trials Unit, University of Bern, Bern, Switzerland
- Risklick AG, Bern, Switzerland
| | - David Vicente Alvarez
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Geneva School of Business Administration, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Rahul Mishra
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Poorya Amini
- Clinical Trials Unit, University of Bern, Bern, Switzerland
- Risklick AG, Bern, Switzerland
| | - Douglas Teodoro
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Geneva School of Business Administration, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Corresponding author
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Elkin ME, Zhu X. A machine learning study of COVID-19 serology and molecular tests and predictions. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 26:100331. [PMID: 36281350 PMCID: PMC9583626 DOI: 10.1016/j.smhl.2022.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
Serology and molecular tests are the two most commonly used methods for rapid COVID-19 infection testing. The two types of tests have different mechanisms to detect infection, by measuring the presence of viral SARS-CoV-2 RNA (molecular test) or detecting the presence of antibodies triggered by the SARS-CoV-2 virus (serology test). A handful of studies have shown that symptoms, combined with demographic and/or diagnosis features, can be helpful for the prediction of COVID-19 test outcomes. However, due to nature of the test, serology and molecular tests vary significantly. There is no existing study on the correlation between serology and molecular tests, and what type of symptoms are the key factors indicating the COVID-19 positive tests. In this study, we propose a machine learning based approach to study serology and molecular tests, and use features to predict test outcomes. A total of 2,467 donors, each tested using one or multiple types of COVID-19 tests, are collected as our testbed. By cross checking test types and results, we study correlation between serology and molecular tests. For test outcome prediction, we label 2,467 donors as positive or negative, by using their serology or molecular test results, and create symptom features to represent each donor for learning. Because COVID-19 produces a wide range of symptoms and the data collection process is essentially error prone, we group similar symptoms into bins. This decreases the feature space and sparsity. Using binned symptoms, combined with demographic features, we train five classification algorithms to predict COVID-19 test results. Experiments show that XGBoost achieves the best performance with 76.85% accuracy and 81.4% AUC scores, demonstrating that symptoms are indeed helpful for predicting COVID-19 test outcomes. Our study investigates the relationship between serology and molecular tests, identifies meaningful symptom features associated with COVID-19 infection, and also provides a way for rapid screening and cost effective detection of COVID-19 infection.
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Affiliation(s)
- Magdalyn E Elkin
- Department of Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Xingquan Zhu
- Department of Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL 33431, USA
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Sayyid RK, Hiffa A, Woodruff P, Oberle MD, Lambert JH, Terris MK, Wallis CJD, Klaassen Z. Suspension of Oncology Randomized Clinical Trials during the COVID-19 Pandemic: A Cross-Sectional Evaluation of COVID-Related Suspensions. Cancer Invest 2022; 40:743-749. [PMID: 35852930 DOI: 10.1080/07357907.2022.2104305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We conducted a cross-sectional analysis of ClinicalTrials.gov-registered oncology randomized controlled trials between September 2019 and December 2021 to identify predictors of trial suspensions. The dataset included 1,183 oncology trials, of which 384 (32.5%) were suspended. COVID-19 accounted for 47 (12.2%) suspensions. Trials that were single center- or US-based had higher odds of COVID-19 (ORs: 3.85 and 2.48, 95% CIs: 1.60-11.50 and 1.28-4.93, respectively) or any-reason suspensions (ORs: 2.33 and 2.04, 95% CIs: 1.46-3.45 and 1.40-2.76, respectively). Phase two (OR 1.27), three (OR 6.45) and four trials (OR 11.5) had increased odds of COVID-19 suspensions, compared to phase one trials.
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Affiliation(s)
- Rashid K Sayyid
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA
| | - Anthony Hiffa
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA
| | - Phillip Woodruff
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA
| | - Michael D Oberle
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA
| | - Joshua H Lambert
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA
| | - Martha K Terris
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA.,Georgia Cancer Center, Augusta University, Augusta, GA, USA
| | | | - Zachary Klaassen
- Section of Urology, Department of Surgery, Augusta University, Augusta, GA, USA.,Georgia Cancer Center, Augusta University, Augusta, GA, USA
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On Graph Construction for Classification of Clinical Trials Protocols Using Graph Neural Networks. Artif Intell Med 2022. [DOI: 10.1007/978-3-031-09342-5_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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